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Phase 2 - General Surgery Placement > Urology Surgical Presentations > Flashcards

Urology Surgical Presentations Flashcards

1
Q

what is a lower urinary tract symptom?

A

symptoms that affect the control and quality of micturition in the lower urinary tract

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2
Q

true or false: LUTS can only affect men

A

false.

they affect both men and women - but more common in older aged men

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3
Q

what are common causes for LUTS in males?

A
  • BPH
  • chronic prostatitis
  • urethral stricture
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4
Q

what are common causes for LUTS in females?

A
  • menopause

- urethral stricture

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5
Q

what are common causes for LUTS in both male and females?

A
  • UTI
  • urological malignancy
  • detrusor muscle weakness/ instability
  • external compression (pelvic tumour or faecal impaction)
  • neurological disease (MS, spinal injury)
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6
Q

true or false: UTIs are the most common cause of LUTS in males and females

A

false.

females: UTIs
males: BPH

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7
Q

what lifestyle factors can make LUTS worse?

A
  • excess alcohol intake

- excess caffeine intake

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8
Q

what are ‘storage’ symptoms of LUTS?

A 
happens when the bladder should be storing urine
common symptoms:
- urgency
- frequency
- nocturnal
- urgency incontinence
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9
Q

what are ‘voiding’ symptoms of LUTS?

A 
happens usually due to bladder outlet obstruction - making passing urine more difficult
common symptoms:
- hesitancy 
- intermittency
- straining
- terminal dribbling
- incomplete emptying
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10
Q

what are common associated symptoms with LUTS?

A
  • visible haematuria
  • suprapubic discomfort
  • colicky pain
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11
Q

what medications can cause/ exacerbate LUTS?

A
  • anticholinergics
  • antihistamines
  • bronchodilators
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12
Q

what initial investigations are important for someone with LUTS?

A
  • urinalysis
  • routine bloods
  • post-void bladder scanning and flow rate
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13
Q

what could you find on a urinalysis of someone with LUTS and what pathology would this indicate?

A
  • assess for signs of a UTI and send for urine culture
  • haematuria (indicates bladder stones)
  • glycosuria (diabetes)
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14
Q

what bloods would you do and what would they show in a person with LUTS?

A

FBC, U&Es, CRP - show a baseline as well as any signs of infection
PSA - check for prostate pathology

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15
Q

why would you do a post-void bladder scan and flow rate in someone with LUTS?

A

will be used to help distinguish between the causes of LUTS and the severity of the symptoms

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16
Q

what specialist investigations would you consider doing in a person with LUTS?

A
  • urodynamic studies

- upper urinary tract imaging

17
Q

when would a cystoscopy be indicated in a patient with LUTS?

A

history of recurrent infection or if the patient has haematuria

18
Q

what do urodynamic studies assess in a patient with LUTS?

A

assesses flow rate, detrusor pressure, storage capacity

used when a patient may have a neurogenic bladder dysfunction

19
Q

when would upper urinary tract imaging be used in a patient with LUTS?

A

ultrasound or CT scanning is useful if there is a history of chronic retention, recurrent infection, or if the patient has haematuria

20
Q

what is the initial conservative management of a patient with LUTS?

A
  • regulate fluid intake (timing and amount of drinks)
  • urethral milking techniques (if patient has trouble voiding)
  • pelvic floor exercises (in cases of stress incontinence)
  • bladder training technique (increase duration between urge to void and micturition - useful in an overactive bladder)
21
Q

what are the pharmacological interventions a patient with LUTS can have?

A
  • over active bladder: anticholinergics

- BPH: alpha-blockers

22
Q

how do anticholinergics help treat an overactive bladder?

A

helps relax the detrusor muscle by opposing the parasympathetic cholinergic control of contraction

23
Q

what are the names of some commonly used anticholinergics?

A

oxybutinin and tolterodine

24
Q

how do alpha blocker help relieve symptoms in BPH?

A

helps reduce prostate size by relaxing the prostatic muscle

25
Q

what are the names of some commonly used alpha blockers?

A

alfuzosin and tamsulosin

26
Q

what are the common complication of LUTS?

A
  • untreated LUTS increase risk of infection and stone formation due to stagnant urine
  • chronic obstruction can lead to bladder muscle hypertrophy leading to overflow incontinence
  • renal complications such as hydronephrosis and renal failure

Phase 2 - General Surgery Placement (14 decks)

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