10. Urinary Retention Flashcards Preview

ESA 3- Urinary system > 10. Urinary Retention > Flashcards

Flashcards in 10. Urinary Retention Deck (7)
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1
Q

describe the differences between acute and chronic urinary retention presentation, management and consequences

A

Acute

1) painful
2) requires urgent catheterisation - or bladder can be permanently damaged
3) increased pressure can cause backup - hydronephrosis - and kidney failure (as starling forces in kidney are disrupted)

Chronic

1) painless
2) does not require catheterisation
3) incomplete voiding (urine seen on post-void residual scan) can cause urinary incontinence or UTIs

2
Q

why can ageing cause urinary retention

A

detrusor muscle weakness

3
Q

why can medications cause urinary retention

A

interfere with nerve signals to bladder and prostate

4
Q

suggest neurological causes for urinary retention

A
  1. brain dysfunction (pontine storageand micturition centres)
  2. spinal cord dysfunction:
    - sacral spinal cord damage/compression - detrusor areflexia
    - suprasacral damage - detrusor-sphincter dysynergia (bladder contracts but sphincter doesn’t relax)
    - spina bifida, etc.
  3. peripheral nerves dysfunction (sensory afferents or motor efferents): eg diabetic cystopathy, MS, tabes dorsalis
5
Q

name an important complication of urinary retention - how should this be treated

A
  • infected obstructed system - UROSEPSIS - has high mortality if left untreated
  • can develop into PYONEPHROSIS - standing column of septic urine in upper urinary tract, inc. kidney
  • Ps need urgent stabilisation and decompression: NEPHROSTOMY - artificial opening between kidney and skin allowing for urinary diversion directly from renal pelvis
6
Q

why is there a risk of diuresis and dehydration after catheterisation

A

high pressure in renal system can cause kidney dysfunction and loss of corticomedullary conc. gradient

7
Q

name the 2 types of catheterisation - which is preferable long term?

A
  • through urethra
  • supra-pubically: preferable as long term option (e.g. in MS, neurologic Ps) as decreased risk of infection and allows sexual function