Renal + Urology Flashcards
What is the difference between BPE, BPH and BPO?
BPE: enlarged prostate, Diagnosis given when you can feel enlargement
BPH: given once histology has been done
BPO: when shown in urodynamic studies
What is Brady therapy?
This is when you put radio therapy seeds into the prostate. Gradually radiates the prostate over time.
What are some hormonal therapies you can use on a patient with prostate cancer?
- LH agonist: causes a surge in testosterone. SE ED. Need to given alongside an anti androgen.
- GNRH antagonist: good to castrate within 24 hours. For example you can give degarelix.
What are 5 cancers that commonly lead to cord compression?
Breast Prostate Kidney Thyroid Lung
If a patient had recurrent UTIs what would you be concerned about?
CANCER
What is phimosis?
This is when you have a non retractable foreskin. very common in long boys. Normally till the age of 2
Do you have to treat phimosis?
No- you only need to treat it if the patient has local pain, haematuria or urinary obstruction
Other than congenital causes. What is another cause of Phismosis?
Recurrent infections
How can a phimosis present?
It can present as ballooning on urination.
Non retractible foreskin.
Painful erections, pain or recurrent UTIs
What is paraphimosis?
Tight prepuce is retracted and unable to be replaced when the glans swells
Who is paraphimosis common in?
- Diabetics as can get recurrent Balanitis infection
2. Vigourous sexual activity
How would paraphimosis present?
Pain and oedema around the prepuce
Pain on erection
If left can lead to necrosis
How would you manage paraphimosis?
- gentle compression with saline swab. Followed by reduction in the prepuce
- Surgery
What is priapism?
unwanted painful erections of the penis not associated with sexual desire for more than 4 hours.
What are two main causes of priapism?
- Sickle Cell Disease
- Viagra
- trauma
How does priapism present?
Presents with unwanted painful erection for more than 4 hours
How do we investigate priapism?
Corporeal Blood Gas
How do you manage priapism?
- Corporeal Aspiration
- Intracavernosal injection of adrenaline
- Surgery to create a shunt
What is fournier’s gangrene?
This is necrotising fasciitis of the perineum
Who is Founier’s Gangrene common in?
Patients who are immune suppressed.
trauma or chronic disease.
How does fournier’s gangrene present?
It presents with pain out of proportion to what you can see.
It does not respond to abx and they are systemically unwell
If you suspect fournier’s gangrene how do you manage it?
- Resus + Stabalise
- Explorative surgery
- broad spectrum abx
In a penile fracture does it go towards or away from the lesion?
Away from the lesion
What are two common causes of penile fracture?
- Forceful masturbation
- Female on top in sex and then slipping out and hitting perineum
- Falling on an erect penis
How does a penile fracture present?
You get a sudden pain and swelling
You lose your erection. The penis goes to the unaffected side of the lesion.
You get a firm immobile haematoma on the shaft (rolling sign) and butterfly sign if the urethra is involved.
What is rolling sign seen in penile fracture?
This the haematoma found at the shaft of the penis
What is the investigation of choice in a patient with a penile fracture?
- Cavernoscography
What med is used in stress incontience?
Duloxetine
What medication is used in urge incontience?
Oxybutyin
What is the main med used for overactive incontience?
Oxybutynin
