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Related Concept Videos

Urinary Tract Infection IV: Nursing Management01:17

Urinary Tract Infection IV: Nursing Management

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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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Urinary Tract Calculi V: Nursing Management01:28

Urinary Tract Calculi V: Nursing Management

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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 VI: Surgical Management01:25

Urinary Tract Calculi VI: Surgical Management

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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 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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Urinary Tract Infection III: Diagnostic Studies and Interprofessional Care01:30

Urinary Tract Infection III: Diagnostic Studies and Interprofessional Care

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A healthcare provider can diagnose a urinary tract infection (UTI) through several methods:Medical History and Symptoms: The provider will take a detailed medical history and ask about symptoms such as frequent urination, burning sensation during urination, and lower abdominal pain.Urinalysis: A clean-catch urine sample is collected in a sterile container and tested for the presence of bacteria, white blood cells (leukocytes), nitrites, blood, and protein. The presence of leukocytes and...
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Anatomy of the Genitourinary System II: Bladder and Urethra01:19

Anatomy of the Genitourinary System II: Bladder and Urethra

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The lower urinary system consists of the urinary bladder and urethra, which are essential in storing and expelling urine from the body. Together with the internal and external sphincters, these structures work together to regulate urination effectively.Anatomy of the BladderThe urinary bladder is a muscular, stretchable organ behind the pubic bone and in front of the rectum. In females, the bladder is positioned anterior to the vagina and inferior to the uterus, while in males, it is located...
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Save the Bladder: Continent Urinary Diversion as Best Practice for Patients With Refractory Neurogenic Lower Urinary

Brian W Chao1, Sean P Elliott1

  • 1Department of Urology, University of Minnesota Medical School, Minneapolis, Minnesota, USA.

Neurourology and Urodynamics
|December 9, 2025
PubMed
Summary

For refractory neurogenic lower urinary tract dysfunction, bladder-sparing continent urinary diversion is recommended. This approach enhances quality of life and patient autonomy through improved bladder management and continence.

Keywords:
continentintermittent urethral catheterizationneurogenicurinary bladderurinary diversionurinary reservoir

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Area of Science:

  • Urology
  • Neurosurgery
  • Reconstructive Surgery

Background:

  • Refractory neurogenic lower urinary tract dysfunction (NLUTD) poses significant clinical challenges.
  • Nonsurgical treatments often fail to adequately manage severe NLUTD.

Purpose of the Study:

  • To advocate for bladder-sparing, continent urinary diversion as the optimal surgical management for refractory NLUTD.
  • To highlight the benefits of continent urinary diversion in improving patient quality of life and autonomy.

Main Methods:

  • Review of contemporary literature on neurogenic lower urinary tract dysfunction management.
  • Analysis of longitudinal institutional experience with surgical interventions for NLUTD.

Main Results:

  • Bladder-sparing continent urinary diversion involves procedures like bladder augmentation, continent catheterizable channels, and bladder neck reconstruction.
  • These procedures enable clean intermittent catheterization, improve continence, and enhance independent bladder management.
  • Patient-reported outcomes demonstrate significant quality of life improvements with continent diversion.

Conclusions:

  • Continent urinary diversion is a patient-centered surgical option prioritizing autonomy and quality of life.
  • It should be considered the primary surgical choice for patients with refractory neurogenic lower urinary tract dysfunction.