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Nursing Assessment of the Genitourinary System II: Inspection and Palpation01:26

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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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The genitourinary system is critical to maintaining fluid balance, waste elimination, and reproductive function. Nurses play a vital role in assessing this system, beginning with a thorough health history. This process involves gathering patient information, identifying risk factors, and recognizing symptoms of genitourinary disorders. Early detection is vital for timely interventions and management.1. Gathering Patient InformationA complete health history includes the patient’s personal,...
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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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Disorders of the Urinary System01:20

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The urinary system is responsible for eliminating waste and excess fluids from the body. However, disorders of the urinary system can arise due to various reasons like infections, stress, age, congenital abnormalities, and lifestyle.
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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 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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Sacrospinous Hysteropexy With Mesh vs Vaginal Hysterectomy for Treatment of Uterovaginal Prolapse: 10-Year Results of a Randomized Clinical Trial.

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Risk Factors for Urinary Retention After Colpocleisis.

Angela DiCarlo-Meacham1, Katherine Dengler1, Eva Welch1

  • 1From the Department of Obstetrics and Gynecology, Division of Female Pelvic Medicine and Reconstructive Surgery, Walter Reed National Military Medical Center, Bethesda, MD.

Female Pelvic Medicine & Reconstructive Surgery
|July 14, 2021
PubMed
Summary
This summary is machine-generated.

Transient urinary retention affects over half of patients after colpocleisis surgery. Concomitant hysterectomy significantly increases the risk of this postoperative complication.

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Area of Science:

  • Urogynecology
  • Pelvic reconstructive surgery
  • Surgical outcomes

Background:

  • Transient urinary retention is a common complication following pelvic organ prolapse surgery.
  • Limited data exists on the incidence and risk factors for urinary retention specifically after colpocleisis procedures.

Purpose of the Study:

  • To identify risk factors associated with transient urinary retention after colpocleisis.
  • To determine the incidence rate of transient urinary retention following colpocleisis.

Main Methods:

  • Retrospective chart review of 172 patients undergoing colpocleisis between 2015 and 2019.
  • Exclusion criteria included prolonged catheterization, pre-existing catheter use, or suprapubic catheter placement.
  • Analysis of patient and procedural factors, with transient urinary retention defined by failed postoperative voiding trial.

Main Results:

  • The incidence of transient postoperative urinary retention was 55%.
  • Rates varied by procedure type: 36.7% (LeFort), 51.5% (posthysterectomy), and 64.9% (concomitant hysterectomy).
  • Concomitant hysterectomy was a significant risk factor (OR 2.9, P=0.015); age, prolapse severity, and anti-incontinence procedures were not associated.

Conclusions:

  • Transient urinary retention is prevalent after colpocleisis, occurring in over half of patients.
  • Performing a hysterectomy concurrently with colpocleisis elevates the risk of postoperative urinary retention.
  • Findings aid in patient counseling and surgical decision-making regarding risk management.