If no abnormality is found then a flexible cystoscopy under local anaesthetic may be performed, but if either the imaging or this endoscopic examination suggest a bladder lesion the patient will require a transurethral biopsy and examination under anaesthetic for both treatment and diagnosis. In any of the above scenarios it is important to remember that if a particular investigation pathway leads to a negative result, consideration should be given to carrying out the test of the other pathways, thus flexible cystoscopy for a patient with persistent microscopic haematuria. Renal Tumours The commonest primary renal tumour is renal cell carcinoma, an adenocarcinoma of collecting tubule origin. It commonly presents with haematuria although most are nowadays picked up incidentally by ultrasound scanning. Diagnosis is made by ct scanning and treatment is by surgical excision. Transitional Cell carcinoma of the renal collecting system usually gives haematuria. Diagnosis may be difficult, requiring retrograde imaging and ureteroscopy. Treatment is by either local excision or, for high grade or larger lesions, nephro-ureterectomy.
urine protein excretion will be informative, as may serum electrophoresis and autoantibodies. Ultrasound will show renal cortical thickness and density. In the majority of cases a renal biopsy with immunoglobulin histochemistry will be necessary to make a definitive diagnosis: the need for this will be balanced against the patients state of health and the perceived risks of the possible disease or procedure. In cases of microscopic haematuria without proteinuria, and all macroscopic cases, a surgical investigation plan can be followed. This is based around the exclusion of malignant or stone disease, and centres on cystoscopy to directly inspect the bladder. Other imaging may be done either by intravenous urography or a combination of plain abdominopelvic radiography and ultrasound of the urinary tract. An argument can now be made for the use of spiral computerised tomography, which while giving a slightly higher radiation doe compared to a standard ivu has a higher snestivity and specificity for many urinary lesions than other imaging methods. In the event of a renal lesion being suggested, computerised tomography will usually give a definitive diagnosis without the need for biopsy, although this may vary. In suspected ureteric lesions, further information can be gained by either retrograde contrast radiography or direct inspection via the ureteroscope.
This is now an option in the outpatients department at the listerHospital, bringing comfort and affordability to private patients with this worrying condition. Investigations of haematuria, after a general physical examination (not forgetting blood pressure, the prostate in a male and the gynaecological organs in a female the first investigation in a patient with reported haematuria is urinary examination. This must include microscopy for red and white blood cells and bacteria. The presence of any crystals, ova or parasites should be noted and culture of a mid stream specimen carried out. If schistosomiasis or tuberculosis are suspected a first void urine sample is usually requested. The level of protein in the urine must be assessed, but in heavy haematuria it may be difficult to be sure if light proteinuria is due to the haemoglobin present. If no red blood cells are found in the urine but haemoglobin is present the patient should be investigated for causes of haemoglobinuria. Further investigation can be done either in the hospital or primary care environment, hair depending on the interests of the general practitioner and the speed of availability of tests. In any case a close liaison between primary care and specialist is essential: at Kings College hospital we encourage telephone calls whether for referral or simply advice, and i am always happy to discuss individual patients. All patients should have a full blood count with an erythrocyte sedimentation rate. Serum urea, creatinine and electrolyte s should be measured, along with albumin, calcium and liver haar function tests if the patient is unwell or in renal failure.
Urinary retention - wikipedia
Haematuria, introduction, haematuria is singapore a common condition and one which must be taken seriously. While there are some spurious reasons for patients reporting blood in the urine (eating beetroot, dye ingestion most patients reporting macroscopic haematuria will be correct. An exception may be in women after the menopause confusing vaginal bleeding with blood in the urine, but this is rare. Haematuria is usually divided into macroscopic (where the urine is discoloured) and microscopic (where the blood is found only on dipstick or microscopy examination. Further clinically relevant distinctions can be made between painful and painless haematuria, and haematuria of glomerular and post-glomerular origin. This essay will discuss the basic investigation and causes of true haematuria. While macroscopic haematuria is usually regarded as more urgent a problem than microscopic, the need for speedy investigation will be influenced by the patients general condition. The management of haematuria has been revolutionised by the advent of flexible cystoscopy, meaning that patients can be speedily assessed (and usually reassured) with a local anaesthetic outpatient procedure.
Urinary retention - wikipedia
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Incomplete Emptying post, void
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Residual volume article about residual volume by The
There is no definite cut-off between what is clearly normal and ouidad clearly abnormal, nor a value above which management targeted towards reducing the residual urine (e.g. By catheter drainage) should be implemented. Measurement of postvoid residual volume. Diagnosis is obvious in patients who cannot void. Showing an elevated residual urine volume. A volume 50 mL is normal ;. Is, normal post void residual volume your major concern? Solve your problem quick easy with online consultation. Get your query answered 247 with Expert Advice and Tips from doctors for.
If you have urinary problems, your doctor may need to know how much urine stays in your bladder after you pee. A post-void residual urine test gives the answer. A volume 50 mL is normal ; 100 mL is usually acceptable in patients 65 but abnormal in younger patients. Other tests (eg, urinalysis, blood tests, ultrasonography, urodynamic testing, cystoscopy, cystography) are done based on vrouw clinical findings. A post-void residual urine greater than 50 ml is a significant amount of urine and increases the potential for recurring urinary tract infections. In adults older than 60 years, 50-100 ml of residual urine may remain after each voiding because of the decreased contractility of the detrusor muscle. Residual urine volume reflects bladder and outlet activity during. The normal adult bladder can contain.
Diagnostic investigations in urology knowledge for
There alopecia is no definite cut-off between what is clearly normal and clearly abnormal, nor a value above which management targeted towards reducing the residual urine (e.g. By catheter drainage) should be implemented. In older people with less effective bladder emptying, there is a greater tolerance for higher values. In general, 200 ml clearly abnormal. However, even for a value of 200 ml further assessment and treatment may not necessarily be undertaken. In a frail older person living alone who would not be able to manage catheter care, or who would not be a candidate for any surgical intervention.