What should be assessed via abdominal ultrasound in a patient with BPH and renal failure?

In evaluating a patient with benign prostatic hyperplasia (BPH) and renal failure, assessing for hydronephrosis is crucial. BPH can lead to urinary obstruction due to an enlarged prostate, which may cause back pressure on the urinary tract. This obstruction can result in hydronephrosis—swelling of the kidneys due to the accumulation of urine when the flow of urine is obstructed. The abdominal ultrasound is an effective imaging modality to visualize the kidneys and assess for any swelling or changes indicative of hydronephrosis.

Detecting hydronephrosis would guide further management, such as determining the need for drainage or surgical intervention to relieve the obstruction and preserve renal function. This is especially important in a patient with renal failure, as timely intervention can prevent further deterioration of kidney function.

While bladder wall thickness, kidney size, and prostate volume are also significant in the context of BPH and renal health, they do not play as direct a role in assessing acute complications related to urinary obstruction. Therefore, the emphasis on hydronephrosis makes it the most critical assessment in this scenario.