Lower Urinary Tract Symptoms and Urinary Retention Flashcards Preview

MD2 Surgery and Anaesthesia > Lower Urinary Tract Symptoms and Urinary Retention > Flashcards

Flashcards in Lower Urinary Tract Symptoms and Urinary Retention Deck (18):
1

What are the obstructive urinary symptoms?

Poor flow
Hesistancy
Intermittency
Terminal dribbling

2

What are the irritative urinary symptoms?

Frequency
Urgency
Nocturia
Incontinence

3

What are the causes of obstructive urinary symptoms?

Benign prostatic hypertrophy
Prostate cancer
Stricture

4

What are the causes of irritative urinary symptoms?

Secondary to obstruction
UTI
Bladder cancer
Stone
Diabetes
TB

5

What is the medical treatment for benign prostatic hypertrophy?

Alpha blockers
5-alpha reductase inhibitors
Combination of 2

6

What is the surgical treatment for benign prostatic hypertrophy?

Transurethral resection of prostate (TURP)
Bladder neck incision
Open prostatectomy

7

What is acute urinary retention?

Sudden and painful inability to pass urine

8

What is the most frequent urological emergency?

Acute urinary retention

9

What are the causes of urinary retention?

Benign prostatic hypertrophy
Prostate cancer
Stricture
Acute precipitants
- UTI
- Diuresis; eg: alcohol
- Constipation
- Drugs
- Postoperative
- Bleeding - clot retention
Neurological
- Beware spinal cord compression
- Diabetes
- Stroke
- Parkinson's disease
- Acute spinal cord injury

10

What is the pathophysiology of spontaneous urinary retention?

Usually history of progressive lower urinary tract symptoms
Risk factors
- Ageing
- Established lower urinary tract symptoms
- Low urinary flow rate
- Large prostate
- Raised PSA

11

What medications can cause urinary retention?

Anticholinergics

12

What postoperative things can cause urinary retention?

Pain
Anaesthetic
Analgesics
Loss of mobility

13

What are the causes of acute urinary retention in females?

Reflex acute urinary retention
- Urethritis
- UTI
Intrinsic compression
- Meatal stenosis/stricture
- Tumour
- Urethral diverticulum/stone
Extrinsic compression
- Severe prolapse
- Pelvis space occupying lesion

14

What is the management of acute urinary retention?

Establish drainage
- Indwelling urethral catheter
- Intermittent self-catheterisation
- Suprapubic catheter
Look for evidence of complicated retention
- Obstructive nephropathy
- Sepsis

15

What do you do if you cannot pass the urinary catheter?

?Hx of stricture/TURP
Evidence of trauma?
- Blood on catheter?
Ask for help
Try different size

16

What is obstructive nephropathy?

Back pressure from acute urinary retention sufficient to cause renal dysfunction
Defined by
- Elevated creatinine
- Bilateral hydronephrosis

17

What is the management for obstructive nephropathy?

Admit
Monitor urine hourly
Replace urine output with 1/2 volume normal saline
Monitor UEC regularly
Beware increased volume and decreased Na
Replace Mg phosphate as required

18

What are the long-term treatment options for acute urinary retention?

Alpha-blocker and trial of void
Surgery
- TURP
- Laser
- Open
Long-term catheter