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Two damaging effects of obstruction are:
- 1. Stasis of urine = Urine stops;
- -predisposes to infections & stone formation
2. Development of backpressure = back flow of urine. interferes with flow, destroys tissues, and predisposes to hydronephrosis (cystic distention caused by urine in renal pelvic area)
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Predisposing factors for urinary obstruction
- 1. Congenital defects in urinary tract structure
- 2. Pregnancy
- 3. BPH- enlarged prostate
- 4. Tumors
- 5. Kidney Stones
- 6. Trauma
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Clinical manifestations of Obstruction
- Symptoms depend on the site of obstruction, cause, and how rapidly obstruction occurs.
- UO is NOT!- because it can be normal or high with obstruction
- 1. Pain
- 2. n & v
- 3. Hypertension
- 4. Signs and symptoms of UTI- pain on urination, feel like you need to go when you don't
- 5. Manifestations of renal dysfunction
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Diagnosis of Stones
- -Hx and Sx
- -Urinalysis
- -GFR, Cr, BUN
- - Abdominal x-ray
- - CT scan, ultrasound, urography,
- - IVP
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Treatment of Obstruction
- - Less than 5mm stones will usually pass on own.
- -If stone removal is necessary options = ureteroscopic removal, lithotripsy, open if very large
- Pain control, antibiotics, increased fluid intake
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Prevention of reoccurence of kidney stones:
- -Fluid intake
- - Dietary changes
- - Medications
- - pH alteration in urine
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How does the Renal/Urinary system protect itself from infection?
- -- Renal parenchyma (tissue) not exposed to bacteria
- -- Downward flow of urine from kidney via Gravity and peristalsis (waves of involunatry contraction)
- --Distal valves of ureter: close with urination to prevent backflow
- -- Sphincters at neck of bladder
- -- Emptying of bladder
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**How do microorganisms invade the urinary system?
- 1. Up from the urethra
- 2. From the blood stream
- 3. From invasive procedures
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