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Related Concept Videos

Urinary Tract Calculi I: Introduction01:28

Urinary Tract Calculi I: Introduction

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Renal calculi, or kidney stones, are solid deposits of minerals and salts formed inside the kidneys. In medical terminology, "calculus" refers to the stone itself, while "lithiasis" describes the process of stone formation. Depending on their location within the urinary system, these stones may be classified as either urolithiasis, when situated within the urinary tract, or nephrolithiasis, when located within the kidneys. Each term signifies the specific impact of the stone.Predisposition...
522
Urinary Tract Infection I: Introduction01:26

Urinary Tract Infection I: Introduction

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Urinary tract infections (UTIs) impact various parts of the urinary system, including the kidneys, ureters, bladder, and urethra. These infections are generally bacterial, with Escherichia coli being the most common causative agent, often originating from the gastrointestinal tract. However, other bacteria, such as Staphylococcus saprophyticus, Klebsiella pneumoniae, and Proteus mirabilis, are also known to cause UTIs. The type, location, and underlying complexity of the UTI guide both...
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Urinary Tract Infection II: Pathophysiology01:25

Urinary Tract Infection II: Pathophysiology

714
The pathophysiology of urinary tract infections (UTIs) encompasses several progressive stages, beginning with bacterial colonization and culminating in potential systemic complications if untreated. UTIs are primarily initiated by bacteria, such as Escherichia coli, which often originate from the gastrointestinal tract and migrate to the urinary system through the periurethral area. This migration can occur via several routes, including improper hygiene practices, sexual activity, or...
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Urinary Tract Calculi V: Nursing Management01:28

Urinary Tract Calculi V: Nursing Management

302
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 VI: Surgical Management01:25

Urinary Tract Calculi VI: Surgical Management

488
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...
488
Urinary Tract Infection IV: Nursing Management01:17

Urinary Tract Infection IV: Nursing Management

463
In managing urinary tract infections (UTIs) in nursing, a comprehensive assessment is essential. Begin by gathering subjective data, such as the patient’s complaints of dysuria (painful urination), urinary frequency, urgency, suprapubic pain, and any lower abdominal discomfort. This information can be complemented by questions regarding previous UTIs, sexual activity, and personal hygiene practices, which can provide insight into risk factors. Objective assessment should focus on signs...
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Congenital urinary tract obstruction.

Ka Wang Cheung1, Rachel Katie Morris2, Mark David Kilby2

  • 1Department of Obstetrics and Gynaecology, Queen Mary Hospital, The University of Hong Kong, Hong Kong SAR, China; The Fetal Medicine Centre, Birmingham Women's and Children's Foundation Trust, Edgbaston, Birmingham, B15 2TG, UK.

Best Practice & Research. Clinical Obstetrics & Gynaecology
|March 2, 2019
PubMed
Summary
This summary is machine-generated.

Congenital bladder neck obstruction, or lower urinary tract obstruction (LUTO), poses risks to newborns. Prenatal interventions like fetal shunts may improve survival but concerns about long-term kidney function persist.

Keywords:
Congenital abnormalitiesFetal therapyPrenatal ultrasonographyUrinary bladder neck obstruction

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Area of Science:

  • Pediatric Urology
  • Fetal Medicine
  • Congenital Anomalies

Background:

  • Congenital bladder neck obstruction (lower urinary tract obstruction [LUTO]) is a group of anomalies with prenatal ultrasound findings like megacystis and hydronephrosis.
  • Untreated LUTO leads to high perinatal morbidity and mortality due to pulmonary hypoplasia and infant renal failure.

Purpose of the Study:

  • To review the current understanding of congenital LUTO, including diagnostic criteria, prenatal interventions, and outcomes.
  • To highlight the need for improved methods for case selection and prognosis prediction in fetal therapy for LUTO.

Main Methods:

  • Review of retrospective and prospective cohort studies.
  • Analysis of a small randomized controlled trial on fetal interventions.
  • Discussion of ultrasonographic features and fetal urinalysis for prognosis.

Main Results:

  • Prenatal interventions such as fetal vesicoamniotic shunts and cystoscopic fulguration may improve perinatal survival.
  • Concerns remain regarding high rates of renal impairment in surviving pediatric patients.

Conclusions:

  • Fetal interventions offer potential benefits for LUTO but do not fully resolve long-term renal concerns.
  • A clinical prospective scoring/staging system is needed to enhance prenatal diagnosis and optimize fetal therapy selection.