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Y4R4 - Surgery II 👨‍⚕️ > L7: Lower Urinary Tract trauma > Flashcards

L7: Lower Urinary Tract trauma Flashcards

1
Q

Types of Bladder Rupture

A
  • Extra & Intra peritoneal
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2
Q

Causes of Intraperitoneal Bladder Rupture

A
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3
Q

Causes of Intraperitoneal Bladder Rupture

  • Blunt Trauma
A
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4
Q

Causes of Intraperitoneal Bladder Rupture

  • Spontaneous
A
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5
Q

Causes of Extraperitoneal Bladder Rupture

A
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6
Q

Extraperitoneal Bladder Rupture

  • Pelvic Fracture
A
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7
Q

Extraperitoneal Bladder Rupture

  • Iatrogenic
A
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8
Q

Extraperitoneal Bladder Rupture

  • Most Common Cause
A
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9
Q

Symptoms of Bladder Trauma

A
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10
Q

Signs of Bladder Trauma

A
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11
Q

Grading of Bladder Trauma

A
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12
Q

Grading of Bladder Trauma

  • Grade I
A
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13
Q

Grading of Bladder Trauma

  • Grade II
A
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14
Q

Grading of Bladder Trauma

  • Grade III
A
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14
Q

Grading of Bladder Trauma

  • Grade IV
A
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15
Q

Grading of Bladder Trauma

  • Grade V
A
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16
Q

INVx for Bladder Trauma

A
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17
Q

INVx for Bladder Trauma

  • Plain abdominal Film
A

Reveals evidence of pelvic fracture.

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18
Q

INVx for Bladder Trauma

  • Ascending cystogram
A
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19
Q

Ascending cystogram in Bladder Trauma

A
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20
Q

Ascending cystogram in Bladder Trauma

  • Indication
A
  • Ascending cystogram should be sought in every case of suspected bladder injury with hematuria.
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21
Q

Ascending cystogram in Bladder Trauma

  • Method
A
  • 200- 300 of water-soluble contrast are infused into the bladder (by gravity) and evidence of extravasation is noticed.
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22
Q

Ascending cystogram in Bladder Trauma

  • Findings
A
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23
Q

Ascending cystogram in Bladder Trauma

  • PM Film
A

PM film is very important for demonstration of extravasation that would be otherwise masked by the bladder contour.

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24
Q

INVx in Bladder Trauma

  • Pelvic CT
A

Could be helpful in detecting associated injury.

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25
Q

INVx in Bladder Trauma

  • US
A

No Role

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26
Q

Complications of Bladder Trauma

A
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27
Q

Complications of Bladder Trauma

  • Pelvic abcess
A

…

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28
Q

Complications of Bladder Trauma

  • Urinary ascites
A
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29
Q

Complications of Bladder Trauma

  • Septic Peritonitis
A
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30
Q

Complications of Bladder Trauma

  • Urinary Incontinence
A

Could be seen in cases of combined extraperitoneal bladder injury with posterior urethral injury

31
Q

TTT of Bladder Trauma

32
Q

TTT of Bladder Trauma

  • Emergency Measures
A

Treatment of hemorrhagic shock (I.v. fluids, blood transfusion, antibiotics)

33
Q

TTT of Bladder Trauma

  • Actual TTT
34
Q

TTT of Bladder Trauma

  • TTT of Intraperitoneal Bladder Rupture
35
Q

TTT of Bladder Trauma

  • TTT of Extraperitoneal Bladder Rupture
36
Q

Etiology of Obstetric Trauma

37
Q

Pathology of Obstetric Trauma

A
  • The fistula could be either posterior or domal.
  • It may involve the trigone and may rarely involve one of the ureters.
38
Q

Dx of Obstetric Trauma

39
Q

Dx of Obstetric Trauma

  • Symptoms
A

Urinary leakage following vaginal delivery or CS:
- Within days to few weeks after the injury.

40
Q

Dx of Obstetric Trauma

  • Vaginal Examination
A

May detect a defect in the vaginal wall.

41
Q

Dx of Obstetric Trauma

  • INVx
42
Q

TTT of Obstetric Trauma

43
Q

TTT of Obstetric Trauma

  • conservative
A

Urethral catheter for 2 weeks may be tried once leakage starts (as early as possible).
- This usually works if the fistula is small.

44
Q

TTT of Obstetric Trauma

  • Surgery
45
Q

Def of Exercise Hematuria

A
  • Jogger’s hematuria: is a term describing post exercise hematuria most commonly seen in marathon runners.
  • Foreign body in the bladder.
46
Q

Anatomical Overview of the urethra

47
Q

Etiology of Anterior Urethral Injury

48
Q

Pathology of Anterior Urethral Injury

49
Q

CP of Anterior Urethral Injury

50
Q

CP of Anterior Urethral Injury

  • Symptoms
51
Q

CP of Anterior Urethral Injury

-Signs

52
Q

INVx for Anterior Urethral Injury

53
Q

INVx for Anterior Urethral Injury

  • Ascending urethrogram
54
Q

INVx for Anterior Urethral Injury

  • Normal Landmarks of Urethra in retrograde urethrogram
55
Q

INVx for Anterior Urethral Injury

  • Normal Landmarks of Urethra in anterograde urethrogram
A
  • Bladder neck is opened and the verrumontanum is visualized.
  • The cone of the bulbar urethra is not seen.
56
Q

Classification of anterior urethral injuries

57
Q

Complications of Anterior Urethral Injury

A
  • Hemorrhage.
  • Sepsis and infection.
  • Urethral stricture.
58
Q

TTT of Anterior Urethral Injury

59
Q

TTT of Anterior Urethral Injury

  • Main Rule
A

No urethral catheter should be inserted in the urethra, when urethral bleeding is noticed

60
Q

TTT of Anterior Urethral Injury

  • Delayed Management
61
Q

Etiology of Posterior Urethral Injury

62
Q

Pathology of Posterior Urethral Injury

63
Q

CP of Posterior Urethral Injury

64
Q

CP of Posterior Urethral Injury

  • Symptoms
65
Q

CP of Posterior Urethral Injury

  • Signs
66
Q

INVx of Posterior Urethral Injury

67
Q

Grading of Posterior Urethral Injury

68
Q

Grading of Posterior Urethral Injury

  • Grade I
69
Q

Grading of Posterior Urethral Injury

  • Grade II
70
Q

Grading of Posterior Urethral Injury

  • Grade III
71
Q

Complications of Posterior Urethral Injury

72
Q

TTT of Posterior Urethral Injury

73
Q

TTT of Posterior Urethral Injury

  • delayed Management
74
Q

Scrotal Trauma

  • Etiology & Management
75
Q

Testicular Trauma

  • Etiology
  • TTT

Y4R4 - Surgery II 👨‍⚕️ (32 decks)

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