Introduction to Urology

Question 1

What 5 things will be on your genitourinary history?

Answer 1

1. abdomen/flank
2. suprapubic
3. perineal/scrotal
4. voiding
5. sexual

Question 2

What 5 things do we examine in the abdomen/flank?

Answer 2

1. pain
2. nausea/vomiting
3. distention
4. prior surgeries
5. duration of symptoms

Question 3

What 4 things do we examine in the suprapubic region?

Answer 3

1. pain
2. fullness
3. distention
4. length of symptoms

Question 4

What 4 things do we examine in the perineal/scrotal region?

Answer 4

1. pain
2. swelling
3. length of sympthoms
4. laterality

Question 5

What 4 things do we examine with voiding?

Answer 5

1. irritative symptoms (dysuria, urgency, frequency).
2. obstructive symptoms (hesitancy, intermittency, weak stream, incomplete emptying).
3. hematuria (gross vs microscopic, initial vs. terminal, clots vs. no clots, prior surgery, stones, trauma, anticoagulants, prior malignancies).
4. urinary incontinence (urge, stress, overflow, mixed, function)

Question 6

What things do we examine in male sexual function?

Answer 6

• erectile dysfunction (ED)
• premature ejaculation
• anejaculation/retrograde ejaculation
• curvature
• pain
• hematospermia
• medications/alcohol/drugs
• medical problems

Question 7

What things do we examine in female sexual function?

Answer 7

• dyspareunia
• cystocele “dropped bladder”
• pre/post menopausal
• prior surgeries
• medications

Question 8

What should you feel for in the abdominal/flank area?

Answer 8

• masses: liver, spleen and kidney
• tenderness
• rigidity
• hernias: inguinal right vs. left or ventral.

Question 9

What should you examine in the anus and perineum?

Answer 9

• fissures
• edema
• hemorrhoids
• sphincter tone
• warts

Question 10

For what should we examine in the testes?

Answer 10

• tenderness
• symmetry
• hydrocele
• mass
• hernias

Question 11

For what should examine in the epididymis?

Answer 11

• enlarged
• indurated
• tender
• mass
• spermatocele

Question 12

For what should we examine the penis?

Answer 12

• circumcised
• phimosis
• paraphimosis
• peyronies
• warts

Question 13

What is phimosis?

Answer 13

• the foreskin cannot be fully retracted over the glans penis.

Question 14

What is paraphimosis?

Answer 14

• urologic emergency in which the retracted foreskin of an uncircumcised male cannot be returned to its normal anatomic position.

Question 15

What is peyronie’s disease?

Answer 15

• development of fibrous scar tissue inside the penis that causes curved, painful erections.

Question 16

What should we examine with regard to the urethral meatus?

Answer 16

• size
• location
• hypospadius
• lesion
• discharge

Question 17

How do we grade (size) the prostate?

Answer 17

1. • median sulcus
2. • median sulcus
3. moderate growth of sulcus
4. large growth of sulcus

Question 18

For what should we examine on the prostate?

Answer 18

• texture: firm, hard, boggy

- nodules: size, location, symmetry

Question 19

Should you ever examine the prostate if the pt has a fever, chills, and bacteria, RBCs, and WBCs in the urine?

Answer 19

• NO, bc the patient likely has prostatitis and you can cause sepsis.

Question 20

Should you examine the prostate after severe pelvic trauma with blood at the tip of the penis (urethral meatus)?

Answer 20

• YES, bc the urethra may have torn.

* may also do RETROGRADE URETHROGRAM

Question 21

What should we look for on the female external genitalia?

Answer 21

• rash
• warts
• lesions

Question 22

What should we look for at the female urethral meatus?

Answer 22

• size
• caruncle
• tenderness

Question 23

What are the 3 grade of a female cystocele? (he said just know that when a pt’s bladder drops, it’s called a cystocele)

Answer 23

• grade 1= no real evidence of prolapse
• grade 2= partial prolapse of ant. vagina
• grade 3= complete vaginal prolapse

Question 24

What else besides cystocele should you examine in the female vagina?

Answer 24

• discharge
• foreign bodies
• distended bladder
• further gyn exam if necessary