MLA Urology Flashcards
What are some causes of acute urinary retention?
BPH
Tumours
Stricture
Opiates
Sedating anti-histamines
Prostatitis
Constipation
Stroke
Diabetes
MS
Vaginal childbirth
Cauda equina
What is the management of BPH?
1st line: lifestyle changes
Then offer alpha blockers (Tamsulosin) and 5-slpha reductase inhibitors (Finasteride)
Surgery: Transurethral resection of the prostate (TURP) or transurethral incision of the prostate (TUIP)
How long does Tamsulosin take to work compared to Finasteride?
Tamsulosin is immediate
Finasteride takes months
What are some testicular dirsoders and their causes?
-Torsion
- Epididymis-orchitis: caused by UTI or STI
- Varicocele
- Hydrocele: transilluminating swelling
- Epidermal cysts
- Spermatocele: collection of sperm. risk is vasectomy
- Tumour: non-tender and firm
- Inguinal hernia
How can renal cell carcinoma present in the tests?
Swollen uncomfortable scrotum feels like a bag of worms and patient has been loosing weight
What is the Cremasteric reflex?
Causes the testicles to move up and down in response to stimuli
Eg. stroke the inner thigh or cold temperature
What is Prehn’s test?
Reduction in pain when the testicles are listed
Indicated epididemo-orchitis
What is a bell-clapper deformity?
When one of the testicles is raised and lying sideways
Predisposes someone to torsion
Which tumour markers correlates with which testicular cancer?
- Beta-HCG - elevated in 100% choriocarcinomas and more likely raised in non-germ cell tumours
- Alpha-fetoprotein - elevated in non-germ cell tumours
- Lactate dehydrogenase - shows tumours volume and necrosis
What are the different types of testicular cancers?
Germ-cell
- Seminoma
- Non-seminoma Eg. choriocarcinoma or teratoma (benign)
- Mixed germ cell tumour
Non-germ cell tumours
- Leydig tumours (benign, produces testosterone)
- Sertoli (benign)
- Granulose cell tumours (malignant, secrete hormones)
