Path of Ureter, Bladder, + Urethra Flashcards
Hydronephrosis in children/infants
Ureteropelvic junction Obstruction
Ureteritis Forms
Follicularis: Lymphocytes w/ Germinal centers
Cystica: Cystic transformation of nests/Brunn
Neoplasms of Ureter
- Fibroepithelial Polyps: Most common bening neoplams of Ureter
- Urothelial Carcinoma: Older individuals
most common and serious congenital anomaly of the bladder
- Vesicoureteral reflux
- a defect in the valve between ureters and bladder.
4 YO child w/ sudden pyelonephritis
Vesiculoureteral reflux
Urachal Anomalies
- Open Urachus -> Fistula to umbilicus
- Open Urachus -> Adenocarcinoma
Cystitis Clinical Triad
- Urinary Freq (every 15-20 min)
- Localized pain over subgastric region
- Dysuria
Forms of Cystitis
- Bacterial (80% E. Coli)
- Hemorrhagic
- Interstitial
- Malakoplakia
- Polypoid cystitis
Hemorrhagic Cystitis
Path
- Path: Bleeding f/ mucosa related to toxicity of cyclophosphamide (acrolein) or radiotherapy
Interstitial cystitis
- EPI
- S/S
- Histo
- EPI: Middle-age women
- S/S: Suprapubic pain, urgency. dysuria, hematuria
- Histo: Transmural inflammation; Hunner Ulcer
Malakoplakia
- A/S
- Path
- Other
- Morph
- A/S: Imunosuppressionl E. Coli Infx
- Path: Defects in M0 function
- Other: Rx are ineffective
- Morph: Soft, yellow, raied mucosal plaques; ***Michaelis-Gutman Bodies
Metaplastic lesions of Urinary Bladder
Cystitis glandularis and cystitis cystica are common lesions of the urinary bladder in which nests of urothelium(nests of Von Brunn)grow downward into the lamina propria.
Nephrogenic adenoma importance
- sheds renal tubule cells
- Can mimic malignant process of infiltration of lamina propria + detrusor
Bladder Cancer Risk Factors
- Smoking
- Industrial Aryl Amines
- Schitosoma Heam. -> Squamous Carcinoma
- Long-term Analgesics
- Irradiation
- Immunosuppressants
Urothelial Bladder Neoplams Treatment
Ta/T1 -> Tranurethral resection (TURBT)
Recurrent Tumors -> intravesical instillation of attenuated strain of TB
Muscle-invasive -> Radical cystectomy
Advanced -> Chemo; Palliative
Bladder Cancer Grading
- T System
- Grades
- Tis - in situ Ta - non-invasive T1 - subepithelial CT T2a - superficial muscle T2b - Deep Muscle T3 - perivesical tissue T4 - adjacent organs - Grade 1 -> Up tp Ta - Grade 2 -> Upt o T2b - Grade 3: T3
Male congenital anomolies in distal urethral tract
Hypospadia: Ventral opening on Penis
Epispadia: Dorsal opening
Urethral Stenosis
- Causes
- Tx
- Cause: Intrumentation, STI, hypospadia, trauma, + radiation
- Tx: Urethrotomy
Urethritis:
- S/S
- Types
- S/S: discharge, local pain, itching, frequency; Cystitis, prostatitis
- Types: Gonococcal OR Non-gonococcal (Chlamydia or Mycoplasma)
Urethral Caruncle
- a small, polypoid,benign vascular growth that usually occurs at the back part of the distal most end of the urethral meatus.
- Women after menopause due to estrogen def
- Tx estrogen cream + Sx
Urethral tumor sites/types
- Proximal -> Urothelial Carcinoma like bladder
- Distal: Squamous Cell Carcinoma
