obstructive uropathy Flashcards
what happens
back-pressure in urrinary system
presentation: upper urinary tract obstruction
loin to groin pain
reduced/no UO
impaired renal function blood tests e.g. raised creatinine
presentation: lower urinary tract obstruction
difficult/unable pass urine: poor flow, hesitation
urinary retention
impaired renal function tests e.g. raised creatinine
causes: upper urinary tract obstruction
kidney stones tumour ureter strictures reteroperitoneal fibrosis bladder cancer uteterocele
causes: lower urinary tract obstruction
BPH bladder cancer prostate cancer urethral strictures neurogenic bladder
neurogenic bladder
abnormal function of nerves innvervating bladder and urethra
can result in over or under actiitvy of detrusor and sphincter muscles
neurogenic bladder causes
MS diabetes stroke parkinson's brain/spinal cord injury
neurogenic bladder problems
urge incontinence
increased bladder pressure
obstructive uropathy
obstructive uropathy management
remove or bypass obstruction
what can be used to bypass obstruction
nephrostomy
urethral or suprapubic catheter
complications of OU
pain AKI (post-renal) CKD infection hydronephrosis urinary retension overflow incontinence
hydronephrosis
swelling of renal pelvis and calyces in kidney
occurs due to urinary tract obstruction causing back pressure into kidneys
idiopathic hydronephrosis
narrowing at pelviureteric junction (PUJ)
Mx with pyeloplasty
hydronephrosis presentation
vague renal angle pain
mass in kidney area
hydronephrosis treatment
treat underlysing ccause
releive pressure
- percutaneous nephrostomy or
- antegrade ureteric stunt
