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The nursing assessment of the genitourinary (GU) system involves a systematic inspection and palpation to identify abnormalities in the kidneys, bladder, and surrounding structures.InspectionMouth: Inspect for signs of kidney dysfunction, such as stomatitis (inflammation of the mouth) and ammonia breath, which may occur in advanced kidney disease due to the buildup of urea, breaking down into ammonia.Skin: Check for pallor, which could indicate anemia caused by kidney disease. Look for...
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Renal calculi, commonly termed kidney stones, are crystalline solid masses that form in the kidneys but can occur at any point within the urinary system, encompassing the kidneys, ureters, bladder, and urethra.The pathophysiology of renal stones involves several key factors: supersaturation of the urine with stone-forming constituents, changes in urine pH, a decrease in urine volume, and the presence of substances that promote or inhibit stone formation.Supersaturation of Urine: This is the...
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Urinary Tract Calculi V: Nursing Management01:28

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AssessmentSubjective Data: Obtain a detailed health history, including any recent or chronic urinary tract infections, periods of immobilization, previous episodes of renal calculi, and medical conditions such as gout, benign prostatic hyperplasia, or hyperparathyroidism. Review the medication history for drugs that may influence stone formation, including allopurinol, analgesics, loop diuretics, or thiazide diuretics. Document the use of long-term indwelling catheters and any past surgical...
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Urinary Tract Calculi III: Medical Management01:30

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The diagnosis of renal calculi involves several imaging techniques, including non-contrast CT scans and ultrasound. These methods help visualize kidney stones, assess their size and location, and detect possible obstructions. Additionally, Measuring urine pH is useful for diagnosing specific stone types, such as struvite (alkaline pH) and uric acid stones (acidic pH). Cystine stones are primarily linked to cystinuria, a genetic condition. A urinalysis helps detect blood in the urine (hematuria)...
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Procedures for Kidney StonesMedical intervention is necessary when kidney stones or renal calculi are too large to pass spontaneously (typically greater than 5 millimeters) when stones are accompanied by symptomatic infection (such as fever or pyelonephritis), when they impair kidney function, or when they cause persistent symptoms like severe pain, nausea, or urinary retention. Additionally, patients with only one kidney or those who cannot be treated with medical management also require...
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Urinary Bladder01:23

Urinary Bladder

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The urinary bladder is a hollow, muscular sac that temporarily stores urine before it is expelled from the body. It can hold approximately 600 mL of urine prior to micturition. The bladder is retroperitoneal and located behind the pubic symphysis in the pelvic floor.
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Spinal arteriovenous malformation presenting with urinary retention.

Apostolos Vrettos1

  • 1Department of Urology, James Paget University Hospital, Gorleston-on-Sea, Great Yarmouth, Norfolk, NR31 6LA, UK.

Urology Annals
|July 26, 2016
PubMed
Summary

Recurrent urinary retention in a young female was linked to a rare spinal arteriovenous malformation (AVM). This case highlights AVM as a critical differential diagnosis for unexplained urinary retention after common causes are ruled out.

Keywords:
Spinal arteriovenous malformationspinal magnetic resonance imaging scanurinary retention

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Area of Science:

  • Neurology
  • Urology
  • Vascular Malformations

Background:

  • Urinary retention is a common urological complaint.
  • Extensive workups often fail to identify the cause in some patients.
  • Neurological deficits can be subtle and overlooked.

Observation:

  • A young female presented with recurrent urinary retention.
  • Initial urological investigations were inconclusive.
  • Subtle, long-standing neurological findings were noted.

Findings:

  • Spinal magnetic resonance imaging revealed a spinal arteriovenous malformation (AVM).
  • The AVM extended from the L4/L5 to the S1/S2 vertebral levels.
  • Spinal AVM is an uncommon cause of urinary retention.

Implications:

  • This case underscores the importance of considering spinal AVM in the differential diagnosis of refractory urinary retention.
  • Early identification of spinal AVM can prevent diagnostic delays and guide appropriate management.
  • Integrating neurological assessment with urological evaluation is crucial for complex cases.