Surgery- Urology & Male Repro Flashcards
Ddx male hematuria
Bladder Cancer Bladder infection Ureterolithiasis Glomerulonephritis BPH
S&S Bladder cancer
- Older pt
- Hx smoking/ exposure to industrial chemicals
- Painless hematuria (intermittent; frable tumor vessels)
- Suprapubic pain
- Voiding symptoms
- RBC on UA nothing else
S&S Bladder infections
Suprabupic pain
Dysuria
UA signs of infection (pyuria, leukocyte esterase, bacteriuria)
Hematuria
S&S ureterilithiasis
Flank pain
Radiates to groin
Crystals on UA
hematuria
S&S Glomerulonephritis
Hematuria
RBC casts
proteinuria
Preceding URI
S&S BPH
Hematuria
incomplete voiding
nocturia
dribbling
screening for bladder cancer
Does not provide survival benefit even among his-risk populations and is not recommended.
low sensitivity/ specificity and generally detected early with slow progression.
Risk factors for acute urinary retention
Male Advance age (>80) BPH Hx of neurologic disease Surgery Meds (anesthetics, opioids, anticholinergics)
S&S acute urinary retention
Confusion and Agitation Tachycardia Lower Abd (suprapubic) tenderness Inability to void Postop
Diagnosis acute urinary retention
Bladder ultrasound ≥ 300 mL of urine
Foley is diagnostic if u/s cant be done/ inaccurate.
Tx acute urinary retention
Foley catheter
S&S posterior urethral injury
Blood at the urethral meatus Inability to void Perineal brusing High riding prostate Pelvic fracture
Anatomy of a posterior urethral injury
Upward shift of the bladder and prostate can lead to urethral tearing at the bualbomembranous junction (transition point between the anterior and posterior urethra)
Management of posterior urethra meatus
Retrograde urethrography (extravasation of contrast). If suspected do not cath
