Special Investigations in Urology Flashcards
What are the advantages of a Doppler US?
Free available
Non-ionizing radiation
Accurate anatomical function
No contrast agents required
Blood flow characteristics may be determined
What are the disadvantages of a US?
Operator dependent
Dependent on quality of US equipment
No renal function information
Limited visualization of structures
What are the indications for a US?
Kidney pathology
- Hydronephrosis
- Renal mass/ calculi
- Intrarenal/Perinephric abscess
Kidney intervetions
- PCNL
- Renal biopsy
Adrenal pathology
* Esp in infants
Ureters
- Calculi
- Ureterocele
Bladder
- Masses/diverticula
- Residual volume measurememt
Prostate
* Transrectal US
Seminal vesicles
- Transrectal US
- Fertility
Scrotum
* Doppler - testicular torsion
What are the indications for an Intravenous pyelogram (IVP)/Excretory urethrogram (EUG)?
Haematuria due to suspected upper tract urothelial tumour
Urolithiasis
* can plan PCNL
Suspected renal injury
- extravasation
- perinephric haematoma
What is a retrograde pyelogram?
Opacification of ureter and pyelocaliceal system by the retrograde injection of contrast through the ureteric catheter
Used to better demarcate suspected renal pelvic / ureteric abnormalities
What is an ascending pyelogram?
Retrograde filling of the bladder through a urethral catheter using a minimum of 350ml of contrast
Indicated in suspected bladder rupture and assessment of bladder diverticulum
Discuss Micturating cystourethrogram (MCUG) / Voiding cystourethrogram (VCUG)
Provides anatomical information aboute the bladder and urethra
The bladder is filled to capacity with contrast through a urethral catheter - catheter is removed and radiograph images are taken while voiding
Detects vesico-ureteric reflux (VUR)
Indications
- Suspected PUV (males)
- Evaluation of neuropathic bladder
- Exclusion of VUR
- Evaluation of female incontinence
- Suspected urethral diverticulum (males)
Discuss a urethrogram for males
Ascending Retrograde
* Provides information about the penile and bulbar urethra
Descending Prograde
- Bladder filled via a suprapubic cystostomy catheter
- Provides information about the prostatic and membranous urethra
Indications
- Urethral trauma
- Urethral stricture
- Urethral diverticulum
- Urethral fistula
