Renal Flashcards
sx of BPH
- weak/intermittent urine flow
- hesitancy
- terminal dribbling
- incomplete emptying
- urgency
- frequency
- nocturia
- urgency incontinence
Investigations of BPH
- urine dip
- PSA
- U&E
- IPSS
What is the IPSS
International Prostate Symptom Score (IPSS): classifying the severity of lower urinary tract symptoms and assessing the impact on quality of life
Management of BPH
1ST LINE: alpha-1 antagonists e.g. tamsulosin, alfuzosin
- 5 alpha-reductase inhibitors e.g. finasteride
Surgery : transurethral resection of prostate (TURP)
What is cystitis
inflammation of the bladder
Sx of cystitis
- urinary urgency
- dysuria
- polyuria
- haematuria
- suprapubic pain
Cystitis investigations
- urinalysis
- urine culture
- cystoscopy if underlying cause is suspected
Cystitis management
Nitrofurantoin/Trimethoprim
What is balanitis?
inflammation of the glans penis
Management of cystitis in pregnancy
Nitrafurantoin (trimethoprim contraindicated)
How is balanitis diagnosed?
clinical diagnosis
- swabs taken if suspected infective cause
- extensive skin change and doubt about cause = biopsy
Management of balanitis if ?candidiasis
topical clotrimazole
Bacterial balanitis management
oral flucloxacillin or clarithromycin (penicillin allergic)
Anaerobic balanitis management
saline washing and metronidazole if not settling
Management of dermatitis balanitis
topical corticosteroids
Lichen sclerosus balanitis management
high potency topical steroids or circumcision
Most common causes of balanitis
infective (bacterial and candidal)
Sx of balanitis
- penile soreness and itch
- urinary sx (dysuria, dypareunia)
Clinical signs of balanitis
- redness and swelling of glans penis
- tightening of foreskin/ unable to retract (phimosis)
- meatal stenosis (often in Lichen Sclerosus)
Most common pathogen associated with prostatitis
E.coli
Clinical features of prostatitis
- pain maybe be referred to perineum, penis, rectum, back
- obstructive voiding sx
- fever
- tender, boggy prostate gland
Investigation in suspected acute prostatitis
- MSU (urine dip, culture, sensitivity)
- blood culture
- FBC
- DRE
- consider STI screen
Management of acute prostatitis
14 day course quinolone - ciprofloxacin
Management of chronic prostatitis
- analgesia (paracetemol/NSAIDs)
- alpha blocker - doxazosin
- abx (trimethoprim/doxycyline)