L7: Lower Urinary Tract trauma Flashcards
1
Q
Types of Bladder Rupture
A
- Extra & Intra peritoneal
2
Q
Causes of Intraperitoneal Bladder Rupture
A
3
Q
Causes of Intraperitoneal Bladder Rupture
- Blunt Trauma
A
4
Q
Causes of Intraperitoneal Bladder Rupture
- Spontaneous
A
5
Q
Causes of Extraperitoneal Bladder Rupture
A
6
Q
Extraperitoneal Bladder Rupture
- Pelvic Fracture
A
7
Q
Extraperitoneal Bladder Rupture
- Iatrogenic
A
8
Q
Extraperitoneal Bladder Rupture
- Most Common Cause
A
9
Q
Symptoms of Bladder Trauma
A
10
Q
Signs of Bladder Trauma
A
11
Q
Grading of Bladder Trauma
A
12
Q
Grading of Bladder Trauma
- Grade I
A
13
Q
Grading of Bladder Trauma
- Grade II
A
14
Q
Grading of Bladder Trauma
- Grade III
A
14
Q
Grading of Bladder Trauma
- Grade IV
A
15
Q
Grading of Bladder Trauma
- Grade V
A
16
Q
INVx for Bladder Trauma
A
17
Q
INVx for Bladder Trauma
- Plain abdominal Film
A
Reveals evidence of pelvic fracture.
18
Q
INVx for Bladder Trauma
- Ascending cystogram
A
19
Q
Ascending cystogram in Bladder Trauma
A
20
Q
Ascending cystogram in Bladder Trauma
- Indication
A
- Ascending cystogram should be sought in every case of suspected bladder injury with hematuria.
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.
22
Q
Ascending cystogram in Bladder Trauma
- Findings
A
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.
24
INVx in **Bladder Trauma**
- Pelvic CT
Could be helpful in detecting associated injury.
25
INVx in **Bladder Trauma**
- US
No Role
26
Complications of **Bladder Trauma**
27
Complications of **Bladder Trauma**
- Pelvic abcess
...
28
Complications of **Bladder Trauma**
- Urinary ascites
29
Complications of **Bladder Trauma**
- Septic Peritonitis
30
Complications of **Bladder Trauma**
- Urinary Incontinence
Could be seen in cases of combined extraperitoneal bladder injury with posterior urethral injury
31
TTT of **Bladder Trauma**
32
TTT of **Bladder Trauma**
- Emergency Measures
Treatment of hemorrhagic shock (I.v. fluids, blood transfusion, antibiotics)
33
TTT of **Bladder Trauma**
- Actual TTT
34
TTT of **Bladder Trauma**
- TTT of Intraperitoneal Bladder Rupture
35
TTT of **Bladder Trauma**
- TTT of Extraperitoneal Bladder Rupture
36
Etiology of **Obstetric Trauma**
37
Pathology of **Obstetric Trauma**
- The fistula could be either posterior or domal.
- It may involve the trigone and may rarely involve one of the ureters.
38
Dx of **Obstetric Trauma**
39
Dx of **Obstetric Trauma**
- Symptoms
Urinary leakage following vaginal delivery or CS:
- Within days to few weeks after the injury.
40
Dx of **Obstetric Trauma**
- Vaginal Examination
May detect a defect in the vaginal wall.
41
Dx of **Obstetric Trauma**
- INVx
42
TTT of **Obstetric Trauma**
43
TTT of **Obstetric Trauma**
- conservative
Urethral catheter for 2 weeks may be tried once leakage starts (as early as possible).
- This usually works if the fistula is small.
44
TTT of **Obstetric Trauma**
- Surgery
45
Def of **Exercise Hematuria**
- Jogger's hematuria: is a term describing post exercise hematuria most commonly seen in marathon runners.
- Foreign body in the bladder.
46
Anatomical Overview of the urethra
47
Etiology of **Anterior Urethral Injury**
48
Pathology of **Anterior Urethral Injury**
49
CP of **Anterior Urethral Injury**
50
CP of **Anterior Urethral Injury**
- Symptoms
51
CP of **Anterior Urethral Injury**
-Signs
52
INVx for **Anterior Urethral Injury**
53
INVx for **Anterior Urethral Injury**
- Ascending urethrogram
54
INVx for **Anterior Urethral Injury**
- Normal Landmarks of Urethra in retrograde urethrogram
55
INVx for **Anterior Urethral Injury**
- Normal Landmarks of Urethra in anterograde urethrogram
- Bladder neck is opened and the verrumontanum is visualized.
- The cone of the bulbar urethra is not seen.
56
Classification of anterior urethral injuries
57
Complications of **Anterior Urethral Injury**
- Hemorrhage.
- Sepsis and infection.
- Urethral stricture.
58
TTT of **Anterior Urethral Injury**
59
TTT of **Anterior Urethral Injury**
- Main Rule
No urethral catheter should be inserted in the urethra, when urethral bleeding is noticed
60
TTT of **Anterior Urethral Injury**
- Delayed Management
61
Etiology of **Posterior Urethral Injury**
62
Pathology of **Posterior Urethral Injury**
63
CP of **Posterior Urethral Injury**
64
CP of **Posterior Urethral Injury**
- Symptoms
65
CP of **Posterior Urethral Injury**
- Signs
66
INVx of **Posterior Urethral Injury**
67
Grading of **Posterior Urethral Injury**
68
Grading of **Posterior Urethral Injury**
- Grade I
69
Grading of **Posterior Urethral Injury**
- Grade II
70
Grading of **Posterior Urethral Injury**
- Grade III
71
Complications of **Posterior Urethral Injury**
72
TTT of **Posterior Urethral Injury**
73
TTT of **Posterior Urethral Injury**
- delayed Management
74
**Scrotal Trauma**
- Etiology & Management
75
**Testicular Trauma**
- Etiology
- TTT
