13 - Common Urological Conditions

Question 1

What scoring system can be used to evaluate LTS in accordance with possible prostate problems?

Answer 1

I-PSS

(International Prostate Symptom Score)

Question 2

What are the symptoms of urinary tract obstruction?

Answer 2

Question 3

Why can you get cardiac arrythmias with renal failure?

Answer 3

Because K+ isn’t being excreted - therefore potassium levels rise.

Question 4

What is USS not good at showing in terms of the urinary tract?

Answer 4

Ureters

Question 5

Which is the best mode of imaging to see the ureters?

Answer 5

CT Urogram

Question 6

Is an absence of nitrites on dipstick a definite sign that no UTI is present?

What is the definitive test for a UTI?

Answer 6

No - not all bacteria produce nitrites.

Definitive test = MSU (midstream specimen urinalysis)

Question 7

What is CT contrast good for showing in terms of urology? What does it sometimes not show well?

Answer 7

CT contrast - good for showing renal parenchyma and tissue. However not always good for showing stones - sometimes better to do CT without contrast for stones, and then add contrast after initial CT and do another one.

Question 8

What does a triple phase CT show?

Answer 8

It will show contrast at different stages = so when it is initially going through the kidneys, then the ureters and then the bladder.

Question 9

Which investigation is best for showing the urinary tract?

Answer 9

CT Urogram

Question 10

What investigations should you carry out for haematuria?

Answer 10

Question 11

What can cause UTIs / LUTS?

Answer 11

Infection
Stones
Obstruction
Incomplete voiding

Question 12

What investigations should you carry out for UTIs / LUTS?

Answer 12

Question 13

What investigations should you carry out for incontinence?

Answer 13

Question 14

What investigations should you carry out for pain?

Answer 14

Question 15

What are the following types of incontinence called?
- Due to increased intrabdominal pressure (e.g. coughing)
- Associated with increased frequency and urgency
- Can be caused by obstructed labour or malignancy
- Can be caused by lack of awareness / dementia
- Can be as a result of chronic retention

Answer 15

• Stress incontience
• Urge incontinence
• Fistula incontinence
• Functional incontinence
• Overflow incontinence

Question 16

Which nerves provide parasympathetic innervation to the bladder? Which neurotransmitter do they use?

Answer 16

Pelvic nerves - S2-4
ACh = muscarinic receptors

Question 17

Which nerve provides sympathetic innervation to the bladder? Which neurotransmitter does it use?
Which receptors are found in the bladder for this NT?

Answer 17

Hypogastric nerve
Noradrenaline
Β receptors = body of bladder - inhibit contraction
Α receptors = found in neck of bladder - make the neck of the bladder contract.

Question 18

Which nerve provides somatic control for seeing? What receptor does it use?

Answer 18

Pudendal nerve (S2-4)
Uses nicotinic receptors (ACh)
Allows relaxation of the external urethral sphincter to wee

Question 19

Which drugs can be used for urge incontinence?

Answer 19

Anticholinergics = Oxybutynin & Solifenacin

Β 3 Agonist = Mirabegron

Neurotoxin for the detrusor muscle to stop contraction = botulinum