Bladder outlet obstruction

Question 1

What are the different causes of obstruction within the kidney?

Answer 1

Intrarenal obstruction include kidney stones, sequelae of current or prior infection, urothelial carcinoma, blood clots, TB (rare cause)

Question 2

What are the different causes of obstruction at or distal to the renal pelvis (at the level of the ureter)?

Answer 2

Stones, urothelial carcinoma, thrombi, tumors, or retroperitoneal fibrosis

Question 3

What are the different causes of obstruction distal to the ureters?

Answer 3

Bladder tumors, bladder outlet obstruction from prostate enlargement or posterior urethral valves, and neurogenic bladder

Question 4

What are s/s of patients with UTO?

Answer 4

Urinary urgency, HTN, hematuria, changes in urine output, or pain

Question 5

Diagnosis of UTO is usually made by imaging (US and CT), the hallmarks of UTO are

Answer 5

hydronephrosis and dilated bladder

Question 6

In a patient with a high clinical suspicion for urinary retention or bladder outlet obstruction; what should you do?

Answer 6

Bedside bladder scan and catheterization

Question 7

Clinical suspicion for UTO is high among patients who have AKI, newly discovered CKD, or

Answer 7

Prostatic hypertrophy or prostate cancer
Prior urologic surgery
Known or suspected abdominal or retroperitoneal malignancy
History of nephrolithiasis or presence of renal colic
Profuse gross hematuria
Prior pelvic or retroperitoneal surgery
New lower abdominal, pelvic, or flank pain or tenderness
Neurologic disorders affecting the bladder