Urinary tract obstruction
Introduction
Introduction to urinary tract obstruction Through the blood of the kidney parenchyma, through the filtration of the kidney, the waste generated by the metabolism of the blood and a part of the water are formed into urine, which is excreted through the renal pelvis, ureter, bladder, and urethra. Generally speaking, the urinary tract refers to the urinary tract from the renal pelvis to the urethra. This route of urine drainage and discharge. Various lesions in any part of the route, which affect the drainage and discharge of urine, can cause obstruction of the urinary tract. basic knowledge Sickness ratio: 0.1% Susceptible people: no special people Mode of infection: non-infectious Complications: urinary tract infection
Cause
Causes of urinary tract obstruction
Bladder and urethral lesions (25%):
Neurogenic bladder - nerve damage caused by congenital meningocele, acquired trauma, drug effects, bladder stones, bladder neck tumor, ureteral bulging, bladder clot obstruction, bladder neck contracture. Stenosis of the urethra, urethral stricture, posterior urethral valve, prostatic hypertrophy or prostate cancer, urethral injury, urethral foreign body, urethra stones, etc.
Ureteral and renal lesions (15%):
Ureteral calculi, tumors, trauma, mis-ligation during surgery, extensive fibrous lesions after retroperitoneal. Kidney stones, renal pelvic tumors, clot obstruction due to tumor hemorrhage, congenital stenosis at the junction of the pelvis and ureter.
Obstruction of the urinary tract caused by lesions other than the urinary system (35%):
Post-peritoneal or pelvic mass compression of the ureter, cervical cancer infiltrates into the posterior wall of the bladder, causing obstruction of the unilateral or bilateral ureter into the bladder.
Prevention
Urinary tract obstruction prevention
1, half a year to review 1 increase in exercise, long-term bedridden should always turn over.
2, a large number of drinking water urolithiasis patients increased by 50% of urine, the incidence of urinary stones will drop by 86%, especially before going to sleep to drink more water to develop drinking habits to maintain daily urine volume of not less than 2000 ~ 2500ml.
3, adjust the diet calcium oxalate stone patients should eat less spinach, reed, tofu chocolate and other foods containing oxalic acid or calcium; calcium urate stones patients should avoid eating meat crab spinach animal internal organs such as liver and kidney.
4. Actively treat various infectious diseases.
5, it is not appropriate to take long-term use of sulfonamides, acetazolamide and other drugs that easily cause urinary crystallization.
Complication
Urinary tract obstruction complications Complications, urinary tract infections
Common urinary tract infections and other complications.
Symptom
Symptoms of urinary tract obstruction Common symptoms Urine flow is fluctuating dysuria and urinary retention urinary dysfunction prostatic hyperplasia bloating cystine storage disease
The lower abdomen is full, the percussion is dull, sometimes the bottom of the bladder can reach the umbilical plane, and the penis, the urethra and the urethra are examined for the presence of a hard cord-like urethral scar tissue to exclude the urethral stricture, and the rectal examination can know the size of the prostate. The shape of the normal prostate is like a chestnut. The bottom is at the top and the tip is downward. The bottom diameter is about 4cm, the longitudinal diameter is 3cm, and the anteroposterior diameter is 2cm. The two sides of the leaf can be touched with a depression, the so-called central groove. When the prostate is proliferated. Not only the gland enlarges, but also the central ditch becomes shallow. In the case of acute urinary retention, the prostate is often affected by the fullness of the bladder. It should be checked again after trying to empty the bladder. Prostate, check whether the real increase, so as not to diagnose the mistake.
Examine
Urinary tract obstruction
Consideration should be given to the possibility of a neurological bladder, detailed neurological examination is necessary, urine routine, cystography, urinary tract plain film, intravenous urography.
Diagnosis
Diagnosis and diagnosis of urinary tract obstruction
Considering the possibility of neurogenic bladder, detailed neurological examination is necessary. Some drugs, such as antihistamine phenothiazine, ganglion block drugs such as guanethidine, reserpine, anticholinergic Drugs such as probensin, etc., also cause dysuria and even urinary retention in some patients. In elderly patients, the prostate may have increased, and these drugs are likely to induce acute urinary retention.
