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Tests and procedures used to check function of the urinary system
 

Tests and procedures used to check function of the urinary system

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There are many tests that can be done to check that the urinary system is functioning as well as possible. The tests vary from a simple blood test to more invasive procedures. All tests performed are ...

There are many tests that can be done to check that the urinary system is functioning as well as possible. The tests vary from a simple blood test to more invasive procedures. All tests performed are done with your consent and should be fully explained to you beforehand. You may not necessarily have all the tests and or procedures performed.

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    Tests and procedures used to check function of the urinary system Tests and procedures used to check function of the urinary system Document Transcript

    • shinecharity.org.uk info@shinecharity.org.uk 42 Park Road Peterborough PE1 2UQ 01733 555988Tests and procedures used to checkfunction of the urinary systemThere are many tests that can be done to check that theurinary system is functioning as well as possible. The testsvary from a simple blood test to more invasive procedures.All tests performed are done with your consent and should befully explained to you beforehand. You may not necessarilyhave all the tests and or procedures performed.Investigations then tested to measure the amount of creatinine in it. A blood sample isUrine tests (also called urinalysis) taken at the same time to compare levels. The creatinine levels areUrine Microscopy – White and red raised if there is advanced renalblood cells and bacteria in the urine (kidney) disease because creatininecan indicate problems such as urine cannot be excreted (got rid of) byinfection and stones. the kidneys which are seriously damaged.Urine Culture and Sensitivity –This is where a sample of urine is Blood teststaken to see if there are any harmfulbacteria (germs) growing in it. TheBlood consists of plasma in whichsame sample can be used to find the blood cells are suspended.out what antibiotics will kill the bugs The most numerous cells are the(sensitivity). red blood cells which help carry oxygen around your body. About aCreatinine Clearance – Urine is hundredth of the cells are white cells:collected for a period of 24 hours their main job is to fight infection.
    • Tests and procedures used to checkfunction of the urinary systemBlood is taken for the following by the kidneys. Urea rises if renaltests:– function is impaired. Electrolytes are a common name for the body’sFull Blood Count (FBC) – This salt, such as sodium. If you aremeasures your haemoglobin (found dehydrated, the sodium and ureain your red blood cells) levels to may be raised.make sure you are not anaemic;the number size and shape of your Imaging testsred cells, to make sure they workproperly, and the number of your Urodynamics – Urodynamics meanswhite cells. If there are more white the study of the pressure and flowcells than normal, it may be a sign of urine in the lower renal tract, (theof infection somewhere. bladder, and the tube through which you pass urine, called the urethra).C-Reactive Protein – The level A urodynamics study helps toin the blood rises if there is an determine if your current treatmentinfection, and drops again when the is working for you, or if changesinfection passes. CRP can be high need to be made. The objectivefor other reasons, such as just after of a urodynamics study is toan operation. reproduce the patient’s complaints or symptoms. Video urodynamicsErythrocyte Sedimentation Rate may provide additional information(ESR) – This is another test that that helps to further understand thecan be used to look for infection. It problem. Urodynamics is used tomeasures the rate at which red cells answer three questions:settle out of suspension in bloodplasma. If they settle more quickly - At what pressure does the bladderthan “normal”, infection may be store urine?present, though as with CRP it canbe raised for other reasons. - Are there any abnormal dynamics such as overactivity or poor bladderUrea and Electrolytes (U and E) compliance which can damage the– Urea is the main end product of kidneys?protein breakdown and is excreted
    • - How does the bladder empty? Afterwards, you will be asked to lie on a table while fully clothed, andUrodynamics are classified in two an ultrasound image of the bladderdifferent categories: non-invasive, will be performed. An ultrasound isand invasive, and the procedure a diagnostic test that uses soundoften varies among hospitals. waves to get an image of the bladder. It is used to measure thePrior to starting urodynamics, a amount of urine remaining in thedetailed interview must be done bladder. An uItrasound is done byby the healthcare team. The gently moving an instrument (whichinterview is important because it looks like a microphone) over yourgives vital information about your lower tummy, which will be coatedmedical history, home and school with a cool gel.or work environment, attitudetoward the urologic condition, and This appointment usually takesyour willingness to cooperate with about half an hour, and whentreatments. children are undergoing the procedure, parents usually stayNon-invasive or simple in the room. No catheters areurodynamics is done to evaluate required for this procedure. Basedurine flow. You will usually be asked on the results of the non-invasiveto go for the test with a full bladder study, the urologist will either beif you can manage it. You will be able identify the treatment youasked to pass urine into a machine require, or will need to performthat looks like a toilet which can invasive urodynamics in order tomeasure the rate at which your get additional information that isurine flows and the amount you only available from more detailedpass. At least two free voids (wees) assessment.are necessary to understand theflow pattern. Also, some hospitals Invasive Urodynamics requires thestick patches on the outer thighs insertion of a catheter (into theand buttocks to measure muscle bladder), usually in the suprapubiccontractions while you urinate. region. A suprapubic catheter is
    • Tests and procedures used to checkfunction of the urinary systemnormally inserted under anaesthesia whether the bladder is large or24 hours before the urodynamics small. It is a non-invasive procedurestudy is done. For some people who which uses ultrasound waves. Gelhave no sensation in the urethra, is put on to your tummy and a smalla urinary catheter may be used smooth instrument is pressed overinstead of suprapubic. However, the skin.that often produces anxiety andcauses error in measurement. The Cystogram – This is an x-raycatheter is used to fill and empty examination where dye is put in thethe bladder, and also to measure bladder through a catheter. This canpressure in the bladder and urethra. be done to detect reflux (backward flow) of urine from the bladder upAnother catheter is passed into the ureters to the kidneys.your rectum (back passage); thismeasures abdominal pressure. The following tests are rarely used:Sometimes, a gastrostomy tubecan be used instead; or for those Cystoscopy – An instrumentwith an ACE, the catheter can be which looks like a small telescopeinserted into the ACE channel. When is passed into the bladder via thethe test is finished the catheters urethra (tube through which urineare removed. The whole test takes leaves the bladder) to have a lookbetween half an hour to one hour. at the bladder.Since invasive urodynamics cancause anxiety, it is important to Diethylene Triamine Pentacetichave a qualified and cohesive team Acid (DTPA) Scan – A radio nuclideof professionals. They will show (DTPA) is injected into the body, andyou the testing environment before a special camera shows it flowingthe assessment is done, answer through the kidneys. This is a usefulany questions, and give detailed test to show if there any stones ininformation about the test and what the kidneys. The DTPA scan is notyou can expect. used as much as a DMSA scan. A DMSA (Dimercaptosuccinic Acid)Bladder Scan –This measures the scan is similar to the DTPA scan.bladder volume, and can indicate
    • Retrograde Pyelography – Under general anaesthetic, fine catheters Surgical proceduresare passed through the bladder,up the ureters into the pelvis of the Following the results of any testskidneys (on the bottom edge of the that you have done, your doctorkidney). Dye is injected directly into may decide that one or more of thethe renal pelvis and x-ray pictures following procedures is necessary.are taken. Once again, they will be carried out with your consent and should beLoopogram – This is an injection fully explained prior to the start ofof dye into the loop of a urostomy. the operation.It can show reflux back into thekidneys, how they empty, and if Vesicostomy – A small cut madethere is thinning of the tubes out of in the tummy and into the bladder.the kidney. This allows urine to drain from the bladder and relieves high pressureIntravenous Pyelogram (IVP) – within the bladder.A dye which shows up on x-raysis injected into a vein. When the Cystoplasty – See “Bladderdye has worked its way around the Augmentation” information sheet.body, a succession of x-ray picturesare taken of the urinary tract. The Supra pubic Catheterisation – AIVP reveals details of the kidneys, catheter is passed into the bladderureters and bladder. It tests kidney via a small incision (cut) on thefunction and reveals the presence of tummy. A leg bag is attached andstones in the kidneys or ureters and urine drains out continuously.other abnormalities of the urinarytract. It can take 15 to 20 minutes Indwelling Catheterisation – Afor the injected dye to reach the catheter (tube) is passed into thekidneys. After the test you may be bladder via the urethra to drainasked to pass urine, and another urine. The catheter remains in thex-ray taken to see if you have any bladder and a bag is attached tourine left in your bladder. collect the urine. The bag is usually strapped to the leg, and is hidden
    • by clothing. The catheter is usually Ileal Conduit – The ureter ischanged about every 3 months. implanted into a segment of bowel which is then opened out on to theIntermittent surface of the skin to form a stoma.Self-Catheterisation – See The urine can then drain from the“Intermittent Self Catheterisation” kidney to a collection applianceinformation sheet. (“stoma bag”) fixed over the stoma. This way the urine does not go intoThe following are rarely used: the bladder at all.Ureterostomy – Under generalanaesthetic, a ureter is brought outon to the surface of the skin. Urinedrains directly from the kidney intoa suitable appliance, eg bag.Urethroplasty – This is just anotherway of saying a surgical repair ofthe urethra.Help usShine relies on people’s generosity and support so we can help our clientswho depend on us for help and advice - people with hydrocephalus, spinabifida, their families and carers. To donate to Shine please visitwww.shinecharity.org.uk or call 01733 421329.This information has been produced by Shine’s medical advisers andapproved by Shine’s Medical Advisory Committee of senior medicalprofessionals.Shine - Registered charity no.249338To see our full range of information sheets and to find out how to donate toShine please visit www.shinecharity.org.uk