Flashcards in Renal Outflow Disease Deck (16)
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1
What are the different types of urinary tract diseases
Urinary tract infection
Urinary tract obstruction - renal stones, tumours and prostatic hypertrophy
Urinary tract malignancy
2
How can urine samples indicate a urinary tract disease
Sterile - detecting any bacteria implies infection
Skin contamination possible
White cells in urine
Blood in urine (microscopic only)
Collect MID-stream urine sample (MSSU)
3
Describe the causes of urinary tract infections
Common in women than men
Usually E.coli (85%)
Staph, fungi, virus and TB also possible
Cystitis is bladder inflammation
Predisposing factors - poor bladder emptying and low urinary flow rates
4
What are the symptoms of UTIs
Dysuria
Urinary frequency
Cloudy urine
Offensive smelling urine
Supra-pubic pain
5
What can infected urine cause
Cystitis
Renal infection
Prostate infection
Urethritis can occur in isolation - gonococcal
6
What are the treatments for UTIs
Diagnosis - MSSU only, microscopy, culture and sensitivity
Increase fluid intake
Frequent micturation
Occasionally antibiotics required - trimethoprim, amoxicillin
7
What are common causes of urinary tract obstruction
Renal calculi
Prostatic disease -hypertrophy or malignancy
Urinary tract strictures
External compression
8
Give examples of prostate disease
Prostatitis- inflammation of the prostate
Benign prostatic hypertrophy - hyperplasia of the prostate
Prostatic cancer - adenocarcinoma
9
Who is more likely to get benign prostatic hypertrophy
Almost a normal thing
80% of men over age 80 have BPH
100% if they live long enough
10
What are the symptoms of benign prostatic hypertrophy
Symptoms of urine outflow obstruction
Slow stream
Hesitancy
Frequency
Urgency
Nocturnal
Incomplete voiding
11
How is benign prostatic hypertrophy treated
Initially drug based - a-blocking drugs, anti Cholinergic, diuretics
Surgery - prostatectomy
TURP - transurethral prostatectomy
Robot-assisted prostatectomy (RALP)
Open prostatectomy
12
Who is most likely to have a prostatic malignancy
Starts after age 45
90% of men >90 years have this at autopsy
Most asymptomatic - not cause of death
10% of men have symptomatic disease
2nd commonest male cancer in the USA
89% 5 year survival
63% 10 year survival
13
Describe prostate cancer screening
PSA blood test not always diagnostic
Prostatic specific antigens
Useful for monitoring disease activity in those known to have the disease
mpMRI - now recommended for early detection of prostate cancer
14
What are the treatments for prostatic malignancy
Surgery - radical prostatectomy
Radiotherapy
Hormone treatment - anti-androgens and LHRH analogues, block hormone dependant tumour growth
15
What is a common side effect of prostatic malignancy
Widespread bone metastasis - osteosclerosis
16
