UROLOGY

Response (R image only)
Lateral CT pelvis and abdomen.
Male patient.
Large homogenous mass arising from the pelvis.
Should state that this is clearly the bladder.
Lumbar osteoarthritis with osteophytes and possible cord or nerve root compression. Calcified aorta.
Possibly enlarged prostate.

ResponseVoiding difficulty +/- lower abdominal pain
Post void residual volume >300 mL

ResponseInfective - UTI/prostatitis

• Dysuria, frequency, haematuria, clots, fever, systemic symptoms, flank pain

Medication - Anticholinergic/sympathomimetics/NSAIDS

• Recent commencement/change in dose. Symptoms of overdose (Dry mouth, blurred vision)

Neurologic - Cauda equina

• Saddle weakness, back pain, incontinence

Structural - BPH/Haematuria/phimosis/urethral stricture/stone in ureter

• LUTS, worse flow, chronic

Clot retention (? cause of clot)
Malignant - Bladder tumour

• Haematuria, weight loss, bone pain

Constipation

• Didn’t shit for a while

Inefficient detrusor muscle (Usually + precipitant above)

ResponseSepsis/UTI/Pyelonephritis
Trauma - False passage, urethral/prostatic trauma from malpositioning
Post insertion hemorrhage (typ if bladder >1L)
Paraphymosis

ResponseCatheter care instructions
Spare leg bags
Trial of void/urology outpatients arranged 7-14 days
Tamsulosin 400 mg if no contraindications
Discussion of complications + indications for return (Fevers, not draining, large clots)
Avoid constipation
Antibiotic cover (if required)
Discuss risk of recurrence.
IDC must be draining well and not in diuresis