Six Uro emergencies! Flashcards
What are the 6 uro emergencies
- High obstructive stone with fever
- Testicular Torsion
- Fournier’s gangrene
- Acute Urinary Retention
- Priapism
- Paraphimosis
What is an obstructive stone with fever
Essentially infected urine upstream of an obstruction
you cant drain the infection so it forms an abscess
How do you treat obstructive stone with fever
Drain with nephrostomy tube or ureteral stent
IV abx
What is testicular torsion
acute onset severe testicular pain in 12-18 y/o
can be 2/2 bell clapper deformity
Torsion PE shows
firm tender testicle high ridine horizontal NO cremaster reflex NO pain relief with elevation of testis (Prehn's sign) thick knotted spermatic cord epididymis not posterior to testis
You can tell it’s epididymitis and not torsion by
Doppler
Nuclear scan
Prehn’s sign (pain relief w/ lifting the testicle)
How do you treat torsion
Manually detorse (open the book) on the way to the OR Scrotal exploration, detorsion, and orchidopexy
What is Fournier’s gangrene
Necrotizing fasciitis of male genitalia and perineum involving subcutaneous tissues and advancing w/in minutes!
RF for fournier’s gangrene are
Diabetes (wounds)
alohol abuse
immunocompromised state
How does Furnier’s present
painful swelling and induration of the penis, scrotum, or perineum cellulitis eschar necrosis ecchymosis crepitus cutaneous anesthesia foul odor fever (+/- if immunocompromised) On imaging: gas in subcutaneous tissue
How do you treat Fournier’s gangrene
IV abx to cover aerobic and anaerobic
surgical debridement
wet to dry dressings
whirlpool therapy
What causes acute urinary retention
BPH
Anticholinergic drugs
How can you tell it’s acute urinary retention
Normal bladder capacity, visible on bladder scan (US)
How do you manage acute urinary retention
lidocaine gel
foley catheter
coude catheter (curve facing up)
suprapubic tube
What is a priapism
persistent penile erection lasting >4 hours, unrelated to sexual activity
