Flashcards
Genitourinary System: Ureteric Obstruction
Cards in this deck (5)
- 1Causes of ureteric obstruction.Unilateral
* Extramural:
> Aberrant vessels at the PUJ
> Extrinsic tumour - carcinoma of the cervix, prostate, large bowel, or retroperitoneal endometriosis
> Idiopathic retroperitoneal fibrosis
> Post-radiation fibrosis
> Retrocaval ureter
> Abdominal aortic aneurysm
* Intramural:
> Transitional cell carcinoma of the renal pelvis or ureter
> Urinary calculi
> Ureteric stricture
> Aperistaltic segment - almost always congenital
Bilateral
* All causes of unilateral obstruction may cause bilateral hydronephrosis
* Congenital posterior urethral valve
* Congenital or acquired urethral stricture
* Benign enlargement of the prostate
* Locally advanced prostate CA
* Large bladder tumours
* Gravid uterus
OHOCS - 2Clinical features of ureteric obstruction.* Loin P
* Fever &/or rigors (if complicated by infxn)
* Sx & signs of renal failure (if obstruction longstanding)
OHOCS - 3Ix of ureteric obstruction.* Serum biochemistry & haematology
* MSU
* KUB X-ray/IVU
* US &/or CT scan
* Isotope renogram
* Retrograde pyelogram
OHOCS - 4Rx of emergency presentation of ureteric obstruction.* Emergency Rx is indicated if there are signs of infxn, established renal failure, uncontrollable Sx
* Rx is drainage of the kidney via a percutaneous nephrostomy or retrograde ureteric stent
OHOCS - 5Elective Rx of ureteric obstruction.* Definitive Rx is directed at the underlying cause. Possible interventions include:
> Rx of calculi
> Ureteric stenting (unilateral or bilateral)
> Ureterolysis & ureteric transfer (for retroperitoneal fibrosis)
> Prostatic resection
> Bladder drainage using a urethral or suprapubic catheter
* In cases where renal function cannot be restored, a nephrectomy is performed to avoid infective complications
OHOCS
Information
- Description
- SGUL LOB's for Genitourinary System: Ureteric Obstruction.
- Created by
- Andrew Street · Jan 2017
- Updated
- Jan 12, 2017
- Views
- 1
- Rating