FN: Urinary Tract Obstruction Flashcards Preview

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Flashcards in FN: Urinary Tract Obstruction Deck (11):
1

Causes

Luminal
Mural
Extramural

2

Luminal

Stones
Blood clots
Sloughed papilla

3

Mural

Congenital/acquired stricture
Tumour: renal, ureteric, bladder
Neuromuscular dysfunction

4

Extramural

Prostatic enlargemnt
Abdo/pelvis mass/ tumou
Retroperitoneal

5

Presentation acute

Upper Urinary tract - loin to groin pain
Lower tract: Frequency, hesitancy, poor stream, terminal dribbling, overflow incontinence
Distended, palpable bladder ± large prostate PR

6

Chronic presentation

Upper: Flank pain, renal failure
Lower:
- frequnecy, hesitancy, poor stream, terminal dribbling, overflow incontinence
- Distended, palpable bladder ± large prostate PR

7

Investigations

Bloods: FBC, U+E
Urine: dip, MC+S
Imaging:
-US: hydronephrosis or hydroureter
- Anterograde/retrpgrade ureterograms - allow therapeutic drainage
- Radionucleotide imaging: renal function
CT/MRI

8

Management upper tract

Nephrostomy
Ureteric stent

9

Mx ower

Urethral or supra pubic catheter - may be a large post-obstructive diuresis

10

Complications of Stents common

infection
Haematuria
Trigonal irritation
Encrustation

11

Rare complications of stents

Obstruction
Ureteric rupture
Stent migration

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