HTHSCI 1DT3 Lecture Notes - Lecture 18: Hypercalcaemia, Dimercaptosuccinic Acid, Adenocarcinoma
26 Dec 2020
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Lumps in the groin and scrotum 106. Bladder outflow obstruction precedes severe suprapubic pain c distended palpable bladder. Frequency, hesitancy, poor stream, terminal dribbling, overflow incontinence. Acute retention on a chronic background may go unnoticed for days due to lack of pain. Se cr may be up to 1500um. Renal function should return to normal over days. Kidneys produce a lot of urine in the acute phase after relief of obstruction. Must keep up c losses to avoid dehydration. Diuresis may loss of na and hco3. Blood: fbc, u+e, psa (prior to pr) Use correct catheter: e. g. 3-way if clots. Tamsulosin: risk of recatheterisation after retention. More likely to be successful if predisposing factor and lower residual volume (<1l) High detrusor pressure @ end of micturition. Bilateral hydronephrosis and renal function. Low detrusor pressure @ end of micturition. Large volume retention c very compliant bladder. Often do poorly due to poor detrusor function. Adhesion of small bowel to abdo wall.
