222b urotrauma

Question 1

penile fracture

Answer 1

tunica albuginea thins out during erection
blunt trauma shear tunica
sudden increase in intracevernousal P –> ruptures corporeal rupture

popping sound
w/ pain and swelling
eggplant deformatity
+/- hematuria

Question 2

penile amputation

Answer 2

self mutation in psychiatric illness
preserve amputed penis on ica
urinary diversion
control of bleeding
debridement of amputated penile shaft 
id neurovascular bundle 

managment: direct anastomsosis (+ microsurgical reapproximation of neurovascular bundle –> improved results)

Question 3

penetrating penile trauma

Answer 3

gun and stab wounds – must know velocity of bullet

must do surgical exploration

hematuria has no indication of damage

image

Question 4

image for xray

Answer 4

penetrating trauma
blunt trauma w/ gross hematuria
blunt trauma with micogematuria and shock
decelerating injuries
kids with hematuria

Question 5

absolute indications for renal explore following trauma?

Answer 5

non-viable tissue
persistent renal bleeding
life trheating bleeding
extracapsular urine extravasation
incomplete staging
renal pedicle avulsion
UPJ rupture (rapid decel injury) 
expanding retroperitoenal hematoma

Question 6

surgical exploraiton

Answer 6

midline incision + explore bowel

Question 7

scortal trauma

Answer 7

salvage is best with timely surgery (<48hours)

Question 8

bladder injury

Answer 8

trauma
pelvic fracture = gross hematuria = cystogram
get a pre and post drainage filsm

Question 9

what divides antieror and postieror urethra? what breaks in trauma?

Answer 9

extranal urethra spinchter

membranous urethra

put in a suprapubic tube and wait 6 months to repair