Diagnostic Approach for Urinary Tract Obstruction in Unexplained Renal Failure - Flowchart

Diagnostic Approach for Urinary Tract Obstruction in Unexplained Renal Failure - Flowchart

Diagnostic Approach for Urinary Tract Obstruction in Unexplained Renal Failure - Flowchart

«Flowchart»

Unexplained Renal Failure
(suspect obstruction if bladder or prostate enlarged, evidence of tumor, or urinalysis nondiagnostic)

Unexplained Renal Failure
(suspect obstruction if bladder or prostate enlarged, evidence of tumor, or urinalysis nondiagnostic)

Unexplained Renal Failure
(suspect obstruction if bladder or prostate enlarged, evidence of tumor, or urinalysis nondiagnostic)

Unexplained Renal Failure

Obstruction below bladder neck

Obstruction below bladder neck

Obstruction below bladder neck

Identify specific cause of obstruction (consider CT evaluation)

Identify specific cause of obstruction (consider CT evaluation)

Identify specific cause of obstruction (consider CT evaluation)

No further workup for obstruction

No further workup for obstruction

No further workup for obstruction

End

End

End

Insert bladder catheter

Insert bladder catheter

Insert bladder catheter

Diuresis

Diuresis

Diuresis

No diuresis; do renal ultrasound

No diuresis; do renal ultrasound

No diuresis

Hydronephrosis; obstruction above bladder neck

Hydronephrosis; obstruction above bladder neck

Hydronephrosis

No hydronephrosis

No hydronephrosis

No hydronephrosis

Identify site and relieve obstruction

Identify site and relieve obstruction

Identify site and relieve obstruction

Antegrade urogram

Antegrade urogram

Antegrade urogram

Retrograde urogram

Retrograde urogram

Retrograde urogram

High clinical suspicion

High clinical suspicion

High clinical suspicion

Low clinical suspicion of obstruction

Low clinical suspicion of obstruction

Low clinical suspicion of obstruction