Gynecology and Genitourinary Surgery Flashcards
List the 6 main structures of the female reproductive system.
Vulva Vagina Cervix Uterus Tubes Ovaries
List the 4 supporting ligaments of the uterus:
Round, broad, cardinal, uterosacral ligaments
List the 3 parts of cervix:
Internal os; external os; endocervical canal
List 4 parts of the uterus:
Fundus, cornua, body (corpus), cervix
List the three layers of the uterine body
Endometrium, myometrium, perimetrium
Adnexa
new term meaning accessory structures: Tubes and Ovaries
Physiology of the: Vulva Vagina Cervix Uterus Tubes Ovaries
Vulva–Facilitate sexual intercourse
Vagina –Intercourse; menstrual discharge, and delivery of infant
Cervix–Holds developing fetus inside uterus
Uterus–Support developing embryo/fetus
Tubes–Fertilization, peristalsis of zygote (fertilized ovum) to uterus
Ovaries–Store, mature, and release ovum “egg”
menstrual; Dyspareunia PID (CIS) Dysplasia Intraepithelial Neoplasia Pruritus
Pertaining to to the menses or menstruation Difficult or painful sexual intercourse Pelvic inflammatory disease Carcinoma in situ Condition; ill, bad, or poor; growth Pertaining to; within; epithelium Condition; new; growth Severe itching
Ectopic pregnancy
A fertilized egg attached outside the uterus
Define D&C
Dilation of the cervix and curettage of the uterus
Gradual expansion of the cervical opening to provide access to the uterus to remove a tissue sample
Anatomy/Physiology of D&C
Vagina Cervix Internal os External os Endocervical canal Uterus Endometrium (inner layer) Physiology: Reproduction; conception and growth of infant
Pathophysiology/Indication for D&C
diagnostic for: DUB: dysfunctional uterine bleeding Dysmenorrhea, amenorrhea Menorrhagia, hypermenorrhea Metrorrhagia Assessment of infertility treatment for: Miscarriage (D&E) Uterine polyps (called a polypectomy) Post partum bleeding (D&C) Retained placenta (D&E) Abnormal uterine bleeding (ablation) Uterine cancer (place radium implants) Retrieval of “lost” IUD
Procedure Steps D&C
Retract vagina (Auvard and Heaney or Sims)
Grasp cervix (Schroeder tenaculum)
Sound uterus (Sims uterine sound)
Take endocervical specimen (Kervorkian curette and telfa)
Dilate cervix (Hegars or Hanks)
FYI: May check for polyps (Randall stone forceps)
Curette uterine cavity (Sims curettes and telfa)
FYI: May clean out with Bozeman/raytex or stick sponge
Dress with OB pad
Define Conization of the Cervix
Removal of a cone-shaped piece of cervical tissue for diagnosis
Anatomy/Physiology of Conization of the Cervix
Vagina Cervix Internal os External os endocervical canal
Pathophysiology/Indication for Conization of the Cervix:
Cervical dysplasia (severe) AKA: Carcinoma in situ (CIN grade 3) Changes in cervical epithelium Cone biopsy checks to see if the changes have infiltrated to the cervix
Procedure Steps Conization of the Cervix
Place retractors (Auvard and Heaneys)
Grasp cervix with tenaculum (mark area with staining agent)
Excise cone (ESU, knife, laser, etc.)
Hemostasis (ESU), pack PRN, dress (NuGauze packing, peri pad)
Define Cervical Cerclage (Shirodkar)
Placement of a ligature at the internal os of the cervix
Anatomy and physiology of Cervical Cerclage (Shirodkar)
Vagina
Cervix
Internal os
Pathophysiology/Indication for Cervical Cerclage (Shirodkar)
Post-conceptional incompetent cervix
Procedure steps Cervical Cerclage (Shirodkar)
Retract, grasp cervix Incise anterior mucosa, retract bladderIncise posterior mucosa, place Allises Place and tie ligature 5 mm Mersilene tape on huge needle Close mucosa
Define Hysteroscopy/endometrial ablation
hysteroscopy-Visual exam, uterine cavity
Endometrial ablation-destruction of the inner layer of the uterus
Anatomy/physiology Hysteroscopy/endometrial ablation
Vagina Cervix Internal os External os Endocervical canal Uterus Endometrium (inner layer) Physiology: Reproduction; conception and growth of infant
Pathology/Indication Hysteroscopy/endometrial ablation
DUB
Hysteroscopy also used to Diagnose cause of infertility and Treatment for “lost” IUDs; intrauterine adhesions; intrauterine polyps
Procedure steps Hysteroscopy/endometrial ablation
Retract, grasp cervix, sound uterus, dilate cervix
Insert hysteroscope
Distend uterine cavity, EUA
Suction curettage of uterine cavity
Insert balloon, apply heat to destroy endometrium
(FYI: usually done without hysteroscopy)
Remove instruments; clean patient, dress
Define diagnostic laparoscopy (GYN)
Visual exam of the abdominal cavity
With particular attention to the organs of the female reproductive system
Anatomy/physiology diagnostic laparoscopy
Vagina Cervix Internal os; External os; Endocervical canal Uterus Uterine tubes Ovaries Bladder Ureters Physiology: Reproduction; conception/growth of infant
Pathology/indication diagnostic laparoscopy
diagnostic for:Unexplained gynecologic pain
Assessment of infertility
PID-Pelvic inflammatory disease
Evaluation of masses
such as ovarian cysts, ovarian mass, or fibroids
Procedure steps diagnostic laparoscopy
Place vaginal speculum, grasp cervix
Apply uterine manipulator (change outer gloves)
Lift abdominal wall (may use 2 towel clips)
Make incision (umbilicus, 12 blade)
Insert Veress needle; verify placement in peritoneal cavity; insufflate abdomen with CO2; (remove Veress needle)
Insert 10/12mm trocar, laparoscope and camera
Suprapubic incision; place 5mm port and insert accessory instruments (such as probe)
EUA, treat PRN
Could be tubal dye studies; remove ovarian cyst; do tubal ligation; laser endometriosis and other options
I/H/desufflate/C/D
Remove uterine manipulator
Define Oophorectomy (laparoscopic)
Excision of ovary through MIS technique
Anatomy/physiology Oophorectomy (laparoscopic)
Vagina Cervix Internal os; External os; Endocervical canal Uterus Uterine tubes Ovaries Bladder Physiology: Reproduction; conception/growth of infant
Pathology/indication Oophorectomy (laparoscopic)
Ovarian cyst
Others, not common:
Strangulated ovary
Infection, adhesion, endometriosis (endometrioma)
Define Salpingectomy (laparoscopic)
Excision of uterine tube through MIS technique
Anatomy/physiology Salpingectomy (laparoscopic)
Vagina Cervix Internal os; External os; Endocervical canal Uterus Uterine tubes Ovaries Bladder Physiology of tubeObtain ovum, peristalsis of ovum, fertilization location and peristalsis of fertilized ovum to uterus
Pathology/indication Salpingectomy (laparoscopic)
Chronic salpingitis (PID)
Define Tubal pregnancy (laparoscopic)
AKA. ectopic pregnancy
Excision of a fertilized ovum that is seated outside the uterus, usually seated in the uterine tube; through MIS
Anatomy/physiology Tubal pregnancy (laparoscopic)
Vagina Cervix Internal os; External os; Endocervical canal Uterus Uterine tubes Ovaries Bladder Physiology: Reproduction; conception/growth of infant
Pathology/indication Tubal pregnancy (laparoscopic)
a fertilized ovum that is seated outside the uterus
Define Tubal sterilization (lap) (tubal ligation)
Occlusion/interruption of the uterine tubes through MIS technique
Anatomy/physiology Tubal sterilization (lap)
Vagina Cervix Internal os; External os; Endocervical canal Uterus Uterine tubes Ovaries Bladder Physiology: Reproduction; conception/growth of infant
Indication Tubal sterilization (lap)
Patient desire to be sterilized (i.e., to be made unable to conceive another child)
Define Abdominal Hysterectomy
Excision of the entire uterus through an open incision
Anatomy/physiology Abdominal Hysterectomy
Uterus, tubes, ovaries Cervix, vagina Ligaments: round, broad, cardinal, uterosacral Bladder, ureters Physiology: reproduction
Pathology/indication Abdominal Hysterectomy
PID (causing chronic pelvic pain) Endometriosis (causing chronic pelvic pain) Large fibroids DUB (dysfunctional uterine bleeding) Uterine or cervical cancer
Define Tuboplasty
Surgical repair of uterine tubes with use of a microscope
Anatomy/physiology Tuboplasty
Uterus, tubes, ovaries Cervix, vagina Ligaments: round, broad, cardinal, uterosacral Bladder, ureters Physiology: reproduction
Pathology/indication Tuboplasty
Tubal blockage d/t PID (pathology; PID may be more common than adhesions from previous surgery)
Patient changed mind about fertility post tubal ligation (indication)
Define Myomectomy
Excision of uterine fibroids (AKA: myomas)
Anatomy/physiology Myomectomy
Uterus, tubes, ovaries Cervix, vagina Ligaments: round, broad, cardinal, uterosacral Bladder, ureters Physiology: reproduction
Pathology/indication Myomectomy
Uterine fibroids affecting fertility;
AKA: fibromyoma; uterine leiomyoma
Define Vaginal Hysterectomy
Excision of uterus through an incision in the vaginal wall
Anatomy/physiology Vaginal Hysterectomy
Uterus, tubes, ovaries Cervix, vagina Ligaments: round, broad, cardinal, uterosacral Bladder, ureters perineum Physiology: reproduction
Pathology/indication Vaginal Hysterectomy
Uterine prolapse
Symptomatic uterine leiomyomas
Endometriosis
Define A&P repair (colporrhaphy)
Anterior and Posterior repair
Reconstruction of the anterior and posterior aspects of the vaginal vault
suturing of the vagina walls
Anatomy/physiology A&P repair (colporrhaphy)
vagina, bladder, and/or rectum
Pathology/indication A&P repair (colporrhaphy)
Cystocele (anterior) herniation of the bladder into vagina
Rectocele (posterior) herniation of the rectum into vagina
Enterocele herniation of the intestine into
Define Robot laparoscopic hysterectomy
Excision of uterus through the vagina, with MIS techniques for dissection from pelvic cavity
Anatomy/physiology Robot laparoscopic hysterectomy
Vagina
Cervix
Internal os; External os; Endocervical canal
Uterus
Ligaments: round, broad, cardinal, uterosacral
Uterine tubes
Ovaries
Bladder
Ureters
Physiology: Reproduction; conception/growth of infant
Pathophysiology/indication Robot laparoscopic hysterectomy
Absence of genital prolapse
(ligaments too tight to pull uterus into vagina easily)
Presence of intra-abdominal scarring
Such as post c-section (bladder adhesions) or PID scars
Large fibroids or adnexal massesCancer; endometrial or cervical
Procedure steps Robot laparoscopic hysterectomy
Insert a vaginal manipulator into the cervix and a vaginal balloon occluder into the vagina
Establish laparoscopic access
laparoscopic access
Dock the robots and position the instruments in the robotic arms and through the ports
Manipulate the uterus as the surgeon directed
Transect the round ligament using bipolar cautery
Identify the ureters
Hydrodissect broad ligament; free bladder from uterus
Transect the uterosacral and cardinal ligaments and blood vessels
Open vaginal vault (FYI: colpotomy; will lose pneumoperitoneum)
Move to vaginal approach, transect remaining attachments (including vessels), remove uterus; close vault
Restore pneumoperitoneum to
Irrigate surgical site with normal saline
Achieve hemostasis
Close incision and apply dressings (Dermabond, Steri-strips, Obi/peri pad)
Define Cesarean section
Delivery of a fetus (or fetuses) through abdominal and uterine incisions
Anatomy/physiology Cesarean section
Uterus Tubes & ovaries Bladder Cervix Uterine vessels (huge) Placenta; umbilical cord Physiology: reproduction
Pathology/indication Cesarean section
Elective
Malpresentation (malposition)
Fetus is not in correct position for delivery
Cephalopelvic disproportion (CPD)
fetus’ head is too big to pass through mother’s pelvic outlet
multiple fetuses (quadruplets; quintuplets; etc.)
Placenta previa
A portion of the placenta is seated over the cervix
Toxemia
pre-eclampsia – hypertension, edema, proteinuria
Eclampsia – all signs listed above plus seizures
Active Herpes or presence of genital warts
Some patients with diabetes
Some previous C-sections
Urgent
Dystocia; AKA failure to progress
Cervical dystocia: fails to soften to dilate and efface
Uterine dysfunction: won’t contract effectually even with oxytocin
Emergent
Fetal distress
Diagnosed by fetal heart rate/tone and blood chemistry (pH)
Abruptio placenta (AKA: placental abruption)
Placenta detaches before delivery; varying degrees from minor detachment to major detachment
Prolapsed cord
Umbilical cord drops out ahead of baby
Procedure steps Cesarean section
Using a #10 blade on a #3 knife handle a Pfannenstiel incision is made
Achieve hemostasis PRN using ESU
The incision is carried deeper with ESU and tissue forceps
Fascia is identified and incised
Goalet or Army-Navy retractors is used to retract the abdominal wall
Superior edge of fascia is grasped (Kochers x 2), fascia is bluntly dissected from underlying rectus muscle
ESU used on perforating vessels, transect septum, repeat on inferior edge of fascia
Rectus abdominis muscles are separated at midline by blunt dissection
Peritoneum is identified, grasped (hemostat x 2), and lifted
Incise peritoneum and extend with Metzenbaum scissors
Place self-retaining retractor for abdominal wall
After open peritoneum:
Separate bladder flap and retract it inferiorly
Palpate the uterus to determine the fetal placement and position
Incise uterus with knife, extend with bandage scissors
The obstetrician places their hand into the uterus and manipulates the fetus
Remove retractors, deliver baby’s head
Clamp and cut cord the umbilical cord using Metzenbaum scissors or Lister bandage scissors, pass baby off to neonatal team
Clamp uterine walls (Ring forceps or Penningtons)
Deliver placenta, inspected it, and removed from the back table
Close uterus in layers using absorbable sutures
FYI: First closing count
Suture to reattach bladder flap
Irrigate the surgical site
Achieve hemostasis
Close the abdominal wall, followed by the skin
Stiches or skin staplers may be used to lose the skin
Dressings (ABD pad, 4x4 gauze or long tegaderm) and perineal pad is applied.
Define cystoscopy
Visual exam of the urinary bladder
Anatomy/physiology cystoscopy
Urethra Bladder Bladder trigone Ureters Ureteral orifices (openings) Physiology Storage and emptying of urine
Pathophysiology/indication cystoscopy
Diagnostic exam for:
Recurrent UTI; hematuria
Urinary retention
Cystitis, tumors, fistulae, stones, incontinence
Define Ureteroscopy
Visual exam of ureter/s and renal pelvis
Anatomy/physiology Ureteroscopy
Urethra Bladder Bladder trigone Ureters Ureteral orifices (openings) Renal pelvis Physiology Transport of urine to bladder
Pathophysiology/indication Ureteroscopy
Ureteral obstruction due to calculi or strictures
Define ESWL
Extracorporeal shock wave lithotripsy
To crush stone using shockwaves outside the body
Anatomy/physiology ESWL
Urethra Bladder Bladder trigone Ureters Ureteral orifices (openings) Physiology Transport of urine to bladder
Pathophysiology/indication ESWL
Urinary calculus/calculi; kidney or ureteral
Define Cystectomy w/ileal conduit
Excision of bladder with diversion of urine into an isolated segment of bowel
Anatomy/physiology Cystectomy w/ileal conduit
Bladder, ureters, urethra
Ileum and mesentery
Physiology: evacuation of urine
Pathophysiology/indication Cystectomy w/ileal conduit
Bladder cancer
Procedure steps Cystectomy w/ileal conduit
I/H/D/R per Pfannenstiel incision; EUA
Isolate bladder from attachments and excise bladder
Identify, mobilize and transect ureters; (create mesenteric tunnel)
Resect segment of ileum keeping mesenteric blood supply intact
Re-anastomose original ileum; close mesentery
Sew ureters into the isolated segment of ileum
Bring ileal pouch to abdominal wall and create small ostomy
Place ureteral catheters as stents; I/H/drain/C/D
Define Urethral-Vesical angle repair (Suburethral Sling)
Placement of a supportive device to correct improper urethrovesical (UV) angle
Anatomy/physiology Urethral-Vesical angle repair
Bladder Urethra Bladder neck Vagina Physiology: controlled release of urine from bladder
Pathophysiology/indication Urethral-Vesical angle repair
Female urinary incontinence d/t urethral hypermobility
Diagnostic tests: H&P; voiding cystometrogram
Define Nephrectomy
Excision of kidney
Anatomy/physiology Nephrectomy
Kidney; Gerota’s capsule/fascia Renal pelvis; ureter Renal artery and vein (renal pedicle) Vena cava and aorta Physiology of kidney: formation and excretion of urine
Pathology/Indication Nephrectomy
Renal cancer
Procedure steps Nephrectomy
Mark the incision site with a skin marker
Using #15 blade on a #3 knife handle a flank incision is made
Achieve hemostasis using ESU
The incision is carried deeper through the fat, latissimus dorsi, external oblique, and internal oblique muscles
Retract the skin, subcutaneous layers, and rib
Incise the transverses abdomens fascia
Expose the Gerota’s capsule by dissecting paranephric fat
Isolate, clamp, cut, ligate ureter
Isolate, clamp, triply ligate, cut renal artery then renal vein
heavy silk ties - #1 or #2
Remove the kidney
Close the incision by layer
Gerota’s capsule
External oblique muscle
Skin
Place a drain
Apply dressings (4x4 gauze, Long tegaderm, ABD pad, and Surgical tape)
Define Kidney transplant
Placement of a living-related or cadaveric donor kidney into the recipient’s iliac fossa
Anatomy/physiology Kidney transplant
Donor kidney and pedicle, recipient’s iliac artery and vein, bladder, ureter
Physiology of kidney: formation and excretion of urine
Pathophysiology/indication Kidney transplant
End-stage renal disease (pathology)
To restore renal function (indication)
Define Adrenalectomy (endoscopic)
Excision of one or both adrenal glands via MIS approach
Anatomy/physiology Adrenalectomy (endoscopic)
Adrenal gland, upper pole of kidney
Physiology: his is an endocrine gland, so the function is secretion of adrenal hormones
Pathophysiology/indication Adrenalectomy (endoscopic)
Hypersecretion
Neoplasms
Pheochromocytoma
Definition TURP
TUR/BT:
Transurethral resection of the prostate
Transurethral resection of bladder tumors
Anatomy/physiology TURP/ and bladder tumor
Prostate gland Penis Urethra Bladder neck Bladder Physiology: Secretion of seminal fluid
Pathophysiology/indication TURP/ and bladder tumor
TURP: Benign prostatic hypertrophy (BPH) (Hyperplasia) TURBT: Bladder tumors
Define Prostate seeding
Percutaneous implantation of radioactive seeds in prostate gland
brachytherapy
Anatomy/physiology Prostate seeding
rectum, scrotum, and prostate
Physiology: secretion of seminal fluid
Pathophysiology/indication Prostate seeding
Stage A or B prostate cancer
Define Laparoscopic prostatectomy/robotic
Removal of the prostate gland through MIS approach with robotic assistance
Anatomy/physiology Laparoscopic prostatectomy/robotic
Prostate gland and capsule
Seminal vesicles, rectum
Penis, urethra, bladder neck, bladder
Physiology: Secretion of seminal fluid
Pathophysiology/indication Laparoscopic prostatectomy/robotic
Prostate cancer
Procedure steps Laparoscopic prostatectomy/robotic
A 24 Fr Foley catheter is inserted into the patient
Establish laparoscopic access • Dock the robots and position the instruments in the robotic arms and through the ports
Replace the 30 degree camera with a 0 degree
Grasp and pull the bowel superiorly
Identify the rectum
Incise the peritoneum
Identify and divide the vas deferens and seminal vesicles and dissect gland
Preserve the neurovascular bundle
Replace the 0 degree camera with a 30 degree
Incise the transverse peritoneum
Divide the umbilical ligament
Incise bladder neck, transect urethra distal to prostate
A surgical entrapment bad is inserted through the sheath and the prostate is placed inside
The specimen is remove
Perform urethrovesical anastomosis and test it
The sheaths are removed and each incision site is checked for hemostasis
Desufflate
A new Foley is inserted
Each port site is closed and dressing is applied (derma bond, steri-trips).
Define Orchiectomy (scrotal)
Excision of one or both testes through a scrotal incision
Anatomy/physiology Orchiectomy (scrotal)
Scrotum
Tunica vaginalis
Testes
Epididymis
Spermatic cord: Vas deferens, Testicular vessels, Cremaster muscle
Physiology: Reproduction; production of sperm and endocrine function to produce testosterone
Pathophysiology/indication Orchiectomy (scrotal)
Unilateral: Testicular cancer
trauma, infection (both quite rare)
Bilateral: Testosterone sensitive metastatic prostate cancer
castration-resistant prostate cancer (CRPC) emerging
Define Hydrocelectomy
Excision of the tunica vaginalis to remove a fluid-filled sac surrounding the testis
Anatomy/physiology Hydrocelectomy
Scrotum, tunica vaginalis, testes, epididymis
Physiology: Reproduction; production of sperm and endocrine function to produce testosterone
Pathophysiology/indication Hydrocelectomy
A fluid-filled sac surrounding the testis called a hydrocele
Define Orchiopexy
Fixation or suspension of testis
Anatomy/physiology Orchiopexy
Scrotum, tunica vaginalis, testes, epididymis
Physiology: Reproduction; production of sperm and endocrine function to produce testosterone
Pathophysiology/indication Orchiopexy
Cryptorchidism (undescended testis/testes)
Define Penectomy
Excision of the penis (all or part)
Anatomy/physiology Penectomy
Penis, urethra, corpora, ligaments and dorsal vessels, perineum, scrotum
Physiology: reproduction and urination
Pathophysiology/indicationPenectomy
Penile cancer
Define Circumcision
Excision of the foreskin of the glans penis
Anatomy/physiology Circumcision
urethra, Penis and foreskin
scrotum
Pathophysiology/indication Circumcision
Phimosis (foreskin can’t be retracted)
Balanoposthitis (inflammation with discharge)
Paraphimosis (foreskin can’t be reduced back)
Patient request
Define Penile prosthesis insertion
Placement of a device to enable sexual penetration
Anatomy/physiology Penile prosthesis insertion
Penis, urethra, corpora, ligaments and dorsal vessels, perineum, scrotum
Physiology: reproduction and urination
Pathophysiology/indication Penile prosthesis insertion
Organic sexual impotence d/t physiologic cause such as:
Nerve damage post-prostatectomy
Priapism, Peyronie’s disease, trauma
HTN/blood pressure medication; Diabetes; and more
Ectopic pregnancy
A pregnancy in which the fertilized egg implants outside the uterus.
Pfannenstiel steps
Incision made with 10 blade on #3 handle, hemostasis, deepen with ESU and tissue forceps
Fascia is identified, incised, and incision extended
Small retractor placed in lateral corners to view
Superior edge of fascia is grasped (Kochers x 2), fascia is bluntly dissected from underlying rectus muscle
ESU used on perforating vessels, transect septum, repeat on inferior edge of fascia
Rectus abdominis muscles are separated at midline by blunt dissection
Peritoneum is identified, grasped (hemostat x 2), and lifted
Incise peritoneum and extend with Metzenbaum scissors
(FYI: caution don’t damage bladder inferiorly)
Place self-retaining retractor for abdominal wall
TAH BSO
Total abdominal hysterectomy with bilateral salpingooophorectomy
RSO
right salpingooophorectomy
LSO
eft salpingooophorectomy
LAVH
laparoscopic-assisted vaginal hysterectomy
VBAC
Vaginal birth after cesarean
Anatomy and Physiology of GU
Kidneys: filter waste from the body by excretion of urine
Adrenal glands: part of the endocrine system
Ureters: Peristalsis to carry urine to bladder
Urinary bladder: Reservoir for urine
bladder trigone:
Ureteral orifices (openings) and the urethral orifice
Urethra: Exit of urine from body
list 5 anatomic features of the kidney
Perirenal fat – serves to protect kidneys
Fascia renalis (Gerota’s capsule)– keeps kidneys in position
Hilum – concave area where vessels enter/exit
Renal artery and vein – blood supply to kidneys
Together with nerves + lymph vessels are called the pedicle
Renal pelvis and calyces – funnel for urine
UPJ
UVJ
- ureteropelvic junction
- ureterovesical junction
Male Reproductive System Anatomy/physiology
Prostate gland: Production of alkaline fluid for sperm viability
Testes: Produce sperm and secrete hormones (reproductive & endocrine)
Epididymis (head, body, tail): Seminal fluid secretion
Vas deferens: Sperm transport to seminal vesicle
Penis: Urination and reproduction
Three vascular bodies of the penis
corpora cavernosum (2) Spongiosum
UA UTI PSA BUN KUB IVU RU
Urinalysis urinary tract infection prostate specific antigen blood urea nitrogen x-ray of kidneys, ureters, bladder intravenous urogram retrograde urogram
Sterile water is used for?
Saline is used for?
TURP use either
Cystoscopy and RU Sterile water is hypotonic Basic ureteroscopy Saline is isotonic, but is electrolytic 3% Sorbitol or 1.5% Glycine
Incisions used in GU: state purpose for each
Inguinal
Orchiopexy; radical orchiectomy
Scrotal
Vasectomy; testicular biopsy; simple orchiectomy; orchiopexy
Pfannenstiel (provided):
Open procedures on the bladder such as cystectomy
Gibson
Placement of donor kidney (still extraperitoneal)
Flank
Access to adrenal glands, kidney, and proximal ureter
FYI: can be subcostal, transcostal, or intercostal depending upon location of kidney (high-lying or low-lying); note that the left kidney is positioned higher than the right kidney because liver is on the right side
Lumbar
Adrenalectomy; renal biopsy; small low-lying kidney for nephrectomy
Ostomy
to create an opening
Pyelo
renal pelvis
Otomy
cutting into