Beruflich Dokumente
Kultur Dokumente
Patrick H OReilly
Obstructive Uropathy
Menelaos Philippou
Upper Tract
Abstract
Acute
Unequivocal
Non-Function
Equivocal
Interactive
Figure 1
MEDICINE 35:8
Chronic
Lower Tract
Table 1
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Chronic retention
Chronic retention is characterized by the incomplete emptying of
the bladder following voiding. A persistent post void residual
of over 300 ml is diagnostic. Chronic retention can be divided
into low pressure and high pressure according to the detrusor
pressure at the end of micturition.
In the case of high-pressure chronic retention (HPCR), the
pressure increases even more during micturition and eventually
upper tract dilatation and impaired renal function result.8,9 The
process is slow and silent and patients often have few symptoms
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Further reading
OReilly PH, ed. Obstructive uropathy. Berlin: Springer-Verlag, 1986.
Prigent QA, Piepz A. Functional imaging in nephrourology. Oxford:
Taylor and Francis, 2006.
Weiss RM, George NJR, OReilly PH. Comprehensive urology. London:
Mosby, 2001.
References
1 Jones DA, George NJR. Interactive obstructive uropathy in man:
a review. Br J Urol 1992; 69: 33745.
2 Smith RC, Levine J, Dalrymple NC, et al. Acute flank pain: a modern
approach to diagnosis and management. Semin Ultrasound CT MR
1999; 20: 10835.
3 Claudon M, Mandry D, Dacher J-N. The contribution of radiology
in functional imaging in nephrourology. In: Prigent A, Piepz A,
Functional imaging in nephrourology. New York, NY: Taylor and
Francis, 2006.
4 OReilly PH, Testa HJ, Lawson RS, et al. Diuresis renography in
equivocal urinary tract obstruction. Br J Urol 1978; 50: 7680.
5 OReilly PH. Standardisation of the renogram technique for
investigating the dilated upper tract and assessing the results of
surgery. BJU Int 2003; 91: 23943.
6 Murray K, Massey A, Feneley RCL. Acute urinary retention a
urodynamic assessment. Br J Urol 1984; 56: 46873.
MEDICINE 35:8
Practice points
Obstructive uropathy can affect the upper urinary tract, or the
lower urinary tract
Upper tract obstruction may be unequivocal or equivocal
Upper tract assessment may include ultrasound scanning, CT
urography and diuresis renography. Intravenous urography is
still available but used less than in the past
Lower tract obstruction may be acute or chronic
Acute obstruction rarely affects the upper tract, but chronic
obstruction does. This distinction dictates the methods of
assessment
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