URETHRA & PENIS Flashcards

1
Q

⭐ Length of MALE URETHRA

⭐ Length of FEMALE URETHRA

A

⭐ Length of MALE URETHRA
🎯 18-21 cm

⭐ Length of FEMALE URETHRA
🎯 3-4 cm

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2
Q

Parts of URETHRA
🧠⚡ PM-BP⚡

A
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3
Q

⭐ Proximal URETHRA means

⭐ Distal URETHRA means

A

⭐ Proximal URETHRA means
🎯 Prostatic Urethra ➕ Membranous Urethra

⭐ Distal URETHRA means
🎯 Bulbar Urethra ➕ Penile Urethra

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4
Q

⚡⚡ MOST DISTENSIBLE PRT OF URETHRA

⚡⚡ LEAST DISTENSIBLE PRT OF URETHRA

A

⚡⚡ MOST DISTENSIBLE PRT OF URETHRA
🎯 PROSTATIC Urethra

⚡⚡ LEAST DISTENSIBLE PRT OF URETHRA
🎯 MEMBRANOUS Urethra

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5
Q

⚡⚡ LONGEST PART of URETHRA

⚡⚡ SMALLEST PART of URETHRA

A

⚡⚡ LONGEST PART of URETHRA
🎯 Penile URETHRA

⚡⚡ SMALLEST PART of URETHRA
🎯 Membranous URETHRA

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6
Q

⚡⚡ MOST COMMON PART OF URETHRA to get injured in TRAUMA

A

BULBAR URETHRA

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7
Q

⚡⚡ MOST NARROWEST PART OF URETHRA

A

External Urinary Meatus

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8
Q

Veromontanum (OR) Seminal Colliculus

A

Raised Portion distal to PROSTATIC URETHRA

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9
Q

Distal limit in TURP (Chances of INCONTINENCE ⬆️ if injured distal to this point)

A

Veromontanum

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10
Q

Layers of PENIS

A
  1. Skin
  2. Superficial Fascia (DARTOS)
  3. Areolar tissue
  4. Deep Fascia (BUCK’S)
  5. TUNICA ALBUGINEA
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11
Q

If tunica albuginea ruptures during TRAUMA, leads to

A

Fracture PENIS

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12
Q

⭐ Single VENTRAL Cylinder in PENIS

⭐ PAIRED Dorsal Cylinder in PENIS

A

⭐ Single VENTRAL Cylinder in PENIS
🎯 CORPUS SPONGIOSUM

⭐ PAIRED Dorsal Cylinder in PENIS
🎯 CORPORA CAVERNOSA

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13
Q

URETHRA passes through which cylinder in PENIS

A

Corpus Spongiosum

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14
Q

PHIMOSIS
Meaning

A

Inability to retract FORESKIN

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15
Q

PHIMOSIS is PHYSIOLOGICAL TILL AGE

A

2years (In some: 6yrs)

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16
Q

🧑🏻‍⚕️ Clinical Features of PHIMOSIS

A
  1. Asymptomatic
  2. Symptomatic
    ✨ Balloning of Foreskin while passing urine
    ✨ UTI Recurrent
    ✨ Balanoposthitis (Infection of the GLANS Penis (OR) Prepuce)
    ✨ Hydronephrosis
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17
Q

Indications for SURGERY in PHIMOSIS

A
  1. All Symptomatic cases
  2. > 6yrs ➕ Asymptomatic
  3. Religious reasons
  4. Therapeutic (in Penile Cancer to give Radiotherapy)
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18
Q

💊💉 MANAGEMENT of PHIMOSIS

🧠⚡ PGS⚡

A

Surgery:
1. Conventional CIRCUMCISION
2. Plastibel
3. Gomco clamps
4. Staplers

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19
Q

INCISION to Foreskin is always given

A

DORSALLY

✨ Ventral Incision is not given DUE TO:
1. FRENULAR Vessels ➕
2. Urethra ➕

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20
Q

COMPLICATIONS of CIRCUMCISION

A
  1. Hemorrhage: Frenular Vessels
  2. Infections
  3. CHORDEE: Bending of Penis
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21
Q

PARAPHIMOSIS
🧠⚡PARA⚡

A

Foreskin forms CONSTRICTION RING around the PENIS (ex: After Catheterization)

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22
Q

🧑🏻‍⚕️ Clinical Features of PARAPHIMOSIS

A

MEDICAL EMERGENCY

  1. Swollen Edematous Foreskin
  2. CONSTRICTION of Penis
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23
Q

💊💉 MANAGEMENT of PARAPHIMOSIS

A
  1. Apply JELLY & Deposit Foreskin
  2. Ice bags & Gentle Compression
  3. Puncture in Swollen Foreskin
  4. Dorsal slit procedure
  5. Circumcision
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24
Q

⚡⚡ MOST COMMON CONGENITAL UROGENITAL ANOMALY

A

Hypospadias

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25
Q

Hypospadias
Meaning

A

Urethral Opening is present BELOW (Ventrally Placed)

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26
Q

ASSOCIATIONS OF HYPOSPADIAS

A
  1. Cryptorchidism
  2. Inguinal Hernia
  3. Micropenis
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27
Q

⚡⚡ MOST COMMON & MILDEST FORM OF HYPOSPADIAS

⚡⚡ MOST SEVERE FORM OF HYPOSPADIAS

A

⚡⚡ MOST COMMON & MILDEST FORM OF HYPOSPADIAS
🎯 Glanular HYPOSPADIAS

⚡⚡ MOST SEVERE FORM OF HYPOSPADIAS
🎯 PERINEAL

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28
Q

Types of HYPOSPADIAS
🧠⚡Distal: GCS ⚡
🧠⚡Mid: MiD ⚡
🧠⚡Proximal: PPSP⚡

A
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29
Q

🧑🏻‍⚕️ Clinical Features of HYPOSPADIAS

A
  1. Downward Directed Stream of Urine
  2. Difficulty during Intercourse
  3. INFERTILITY
  4. Chordee: Bent penis
  5. Hooded Prepuce
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30
Q

Rule: More Proximal the HYPOSPADIAS,

A
  1. More SEVERE Clinical Manifestations
  2. More SEVERE Chordee
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31
Q

Chordee

A

Bent penis

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32
Q

Best time for Surgery in HYPOSPADIAS

A

6-12 months

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33
Q

Principles of SURGERY in HYPOSPADIAS
🧠⚡SOGU⚡

A
  1. Skin cover
  2. Orthoplasty: Chordee Correction
  3. Glanuloplaty
  4. URETHROPLASTY: Re-position Urethral Opening & Tubularise Urethra
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34
Q

Any GENITAL SURGERY in a child should always be done before

A

18 months (1.5yrs)

⭐ at 18 months, develops Genital Awareness

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35
Q

Surgeries for HYPOSPADIAS

A
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36
Q

⚡⚡ MOST COMMON COMPLICATION OF HYPOSPADIAS SURGERY

⚡⚡ MOST COMMON LONG TERM COMPLICATION OF HYPOSPADIAS SURGERY

A

⚡⚡ MOST COMMON COMPLICATION OF HYPOSPADIAS SURGERY
🎯 Urethrocutaneous Fistula

⚡⚡ MOST COMMON LONG TERM COMPLICATION OF HYPOSPADIAS SURGERY
🎯 Stricture Formation

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37
Q

COMPLICATION OF HYPOSPADIAS SURGERY

A

✨ Urethrocutaneous fistula
✨ Hemorrhage
✨ Infection
✨ Chordee recurrance
✨ Stricture Formation

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38
Q

EPISPADIAS
🧠⚡ pEE: when you have Epispadias, you hit your Eye when you pEE”⚡

A

Abnormal opening of penile urethra on dorasl surface of penis due to faulty positioning of the genital tubercle

✨ Exstrophy of the bladder is associated with Epispadias

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39
Q

ECTOPIA VESICAE
Synonyms

A

✨ Bladder EXOSTROPHY
✨ ⚡⚡ MOST Severe form of EPISPADIAS

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40
Q

MOST Severe form of EPISPADIAS

A

ECTOPIA vesicae

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41
Q

ASSOCIATIONS of ECTOPIA VESICAE

A
  1. UNDESCENDED TESTIS
  2. Bifid Clitoris
  3. Congenital Hernias
42
Q

Identify

A

ECTOPIA Vesicae

43
Q

URETHRAL INJURY

A
44
Q

Vermooten Sign
⭐ seen in

A

⭐ Proximal Urethra Injury: Per Rectal Examination

✨ High Riding Prostate / Floating Prostate

45
Q

⭐ Signs of PROXIMAL URETHRA INJURY

⭐ Signs of DISTAL URETHRA INJURY

A

⭐ Signs of PROXIMAL URETHRA INJURY
🎯 deep Perineal Hematoma in Anterior Abdominal wall & Upper ⅓rd of THIGH

⭐ Signs of DISTAL URETHRA INJURY
🎯 BUTTERFLY HEMATOMA (involving PENIS & SCROTUM)

46
Q

Straddle injury to Penis leads to

A

Distal URETHRA Injury

47
Q

🧑🏻‍⚕️ Clinical Features of URETHRAL INJURY

🧠⚡P²⚡

A
  1. Passing Urine Difficulty
  2. Passing Blood at TIP of MEATUS
48
Q

🩺 IOC for URETHRAL INJURY

A

Retrograde URETHROGRAM (Contrast)

49
Q

⚡⚡ MOST COMMON SITE OF URETHRAL INJURY

A

Bulbo-membranous junction

50
Q

Foley’s CATHETER is NEVER USED in Urethral Injury, Why?

A

Converts a PARTIAL TEAR into a FULL TEAR

51
Q

Indications for SUPRAPUBIC CATHETERIZATION in URETHRAL INJURY

A
  1. Inability to pass urine
  2. Bladder is DISTENDED
52
Q

Buccal MUCOSAL GRAFT used for URETHROPLASTY is known as

A

BARBAGLI’S TECHNIQUE

53
Q

💊💉 MANAGEMENT of URETHRAL STRICTURE

⭐ SHORT & PARTIAL
⭐ SHORT & COMPLETE
⭐ LONG & COMPLETE

A

⭐ SHORT & PARTIAL
🎯 OPTICAL INTERNAL URETHROTOMY (OIU) (OR) VISUAL INTERNAL URETHROTOMY (VIU)

⭐ SHORT & COMPLETE
🎯 Spatulation & END to END Anastamosis

⭐ LONG & COMPLETE
🎯 URETHROPLASTY

54
Q

🧑🏻‍⚕️ Clinical Features of # SHAFT OF PENIS

🧠⚡Injury to CORPORA & TEAR in Tunica Albuginea⚡

A
  1. Popping Sound ➡️ Penis becomes FLACCID
  2. EGGPLANT Deformity ➕ (if HEMATOMA ➕)
55
Q

💊💉 MANAGEMENT of # SHAFT OF PENIS

A

SURGERY
Repair Tunica albuginea
Repair CORPORA

56
Q

AUBERGINE SIGN

A

Eggplant deformity in # SHAFT of Penis

57
Q

Problem in POSTERIOR URETHRAL VALVES (PUV)

A

One way valves
⬇️
Does NOT allow the patient to PASS URINE

58
Q

Classification used for PUV

A

Young’s CLASSIFICATION

59
Q

PUV CLASSIFICATION

A
60
Q

⚡⚡ MOST COMMON Type of PUV

A

Type 1

61
Q

Type 3 PUV is also known as

A

Cobb’s Collar

62
Q

🧑🏻‍⚕️ Clinical Features of PUV

A
  1. Recurrent UTI with SEPSIS
  2. Hydronephrosis
  3. Palpable ABDOMINAL MASS
  4. ESRD
63
Q

Identify

A

Keyhole deformity
⬇️
PUV

64
Q

💊💉 MANAGEMENT of PUV

A

Endoscopic FULGRATION

65
Q

PEYRONIE’S DISEASE
Problem?

A

Calcific Deposition in the CORPORA CAVERNOSA

66
Q

Cause of PEYRONIE’S DISEASE

A
  1. Idiopathic
  2. IgG4 related Disorder
  3. Trauma
67
Q

🩺 IOC for PEYRONIE’S DISEASE

A

CT/MRI

68
Q

💊💉 MANAGEMENT of PEYRONIE’S DISEASE

A

Medical: Calcium Channel Blockers
⬇️
Surgical: NESBITT PROCEDURE

69
Q

NESBITT PROCEDURE used for

A

PEYRONIE’S DISEASE

⭐ Non-absorbable suture bites are made on opposite side of bend
⬇️
Fibrosis on this side
⬇️
Balance out

70
Q

Priapsim
Definition

A

Prolonged & Painful ERECTION of PENIS > 4hrs

71
Q

Ischemia (OR) Necrosis can occur in PRIAPISM, if erection lasts

A

> 6 hrs

72
Q

Types of PRIAPISM

A

✨ High FLOW
✨ Low FLOW / Ischemic

73
Q

Which type of PRIAPISM MOST COMMON

A

Low Flow

74
Q

Which investigation is used to identify BLOCK in Low Flow PRIAPISM

A

ANGIOGRAPHY

75
Q

💊💉 MANAGEMENT of PRIAPISM

A
  1. Sedate the Patient
  2. Inject Adrenaline / Phenylephrine
    ⬇️
    ⬇️ if fails
    SHUNT SURGERY
    ✨ GRAY HACK SHUNT
    ✨ WINTER SHUNT
76
Q

✨ GRAY HACK SHUNT
🧠⚡GCS ⚡

A

Corporo-Saphenous Shunt

77
Q

✨ WINTER SHUNT

🧁WCG🧁

A

Corporo-Glanular Shunt

78
Q

💊💉 MANAGEMENT of HIGH FLOW PRIAPISM DUE TO FISTULA

A

Embolization

79
Q

Premalignant conditions leading to PENILE CANCER

A
  1. Bowen’s Disease
  2. Erythroplasia of Queyrat
  3. Balanitis Xerotica Obliterans
  4. Genital Warts: HPV infection
  5. Leukoplakia
80
Q

⭐ Bowen’s Disease presents as

⭐ Erythroplasia of Queyrat presents as

A

⭐ Bowen’s Disease presents as
🎯 REDDISH PAPULES on SHAFT
🎯 SUNBURNT APPEARANCE

⭐ Erythroplasia of Queyrat presents as
🎯 REDDISH PAPULES on GLANS

81
Q

⚡⚡ MOST COMMON GENE AFFECTED IN PENILE CANCER

A

P53

82
Q

Buschke Lowenstein Tumour

A

✨ HPV Infection
✨ Slow Growing
✨ Grows Outwards
✨ Better Prognosis

83
Q

🧑🏻‍⚕️ Clinical Features of PENILE CANCER

A
  1. Foul-smelling
  2. Ulcero-proliferative growth
  3. Inguinal Lymph node ENLARGEMENT
84
Q

🩺 IOC for PENILE CANCER

🩺 IOC for STAGING of PENILE CANCER

A

🩺 IOC for PENILE CANCER
🎯 INCISIONAL BIOPSY
(Avoid Biopsy from Necrotic Area)

🩺 IOC for STAGING of PENILE CANCER
🎯 MRI

85
Q

Which staging is used for PENILE CANCER

A

Jackson’s staging

86
Q

JACKSON’S STAGING

A

T1: SKIN
T2: CORPORA
T3: URETHRA
T4: ADJACENT STRUCTURES Involved

87
Q

💊💉 MANAGEMENT of BOWEN’S DISEASE (OR) IN-SITU PENILE CANCER

A

5-FLUOROURACIL Cream

88
Q

💊💉 MANAGEMENT of SLOW GROWING PENILE CANCER INVOLVING GLANS

A

Glansectomy

89
Q

SURGICAL MANAGEMENT OF PENILE CANCER

A

🎯 Distal CANCERS: Partial PENECTOMY

🎯 Proximal CANCERS with > 2cm STUMP: Partial PENECTOMY

🎯 Proximal CANCERS with < 2cm STUMP: Total Amputation with Perineal urethrostomy

90
Q

Margin STATUS in PENILE CANCER

A

1cm Margin & 2cm STUMP should be left

91
Q

Seen in

A

PIE in SKY appearance in IVP
MEMBRANOUS URETHRA injury

✨ Elevation of the urinary bladder by a large pelvic hematoma also suggests urethral injury

92
Q

Superior DISPLACEMENT of PROSTATE DOES NOT OCCUR
Why?

A

PROSTATIC Urethra is DENSELY adhered to PUBIS via
✨ Puboprostatic Ligament
✨ UROGENITAL diaphragm

93
Q

RIDIMG PROSTATE or FLOATING PROSTATE
MEANING?

A

Apex of PROSTATE being ≥ +1 SD farther from ANAL VERGE

94
Q

Which INVESTIGATION is preferred for
⭐ ANTERIOR URETHRA
⭐ POSTERIOR URETHRA

A

⭐ ANTERIOR URETHRA
🎯 RGU

⭐ POSTERIOR URETHRA
🎯 MCU

95
Q

Fowler’s SYNDROME seen in

A

♀️ with PCOS

96
Q

Fowler’s SYNDROME
Problem

A

Abnormal MYOTONIC DISCHARGE OF URETHRAL SPHINCTER
⬇️
Functional Obstruction of URETHRA

97
Q

🧑🏻‍⚕️ Clinical Features of FOWLER’S SYNDROME

A

Urinary RETENTION

98
Q

🩺 IOC for FOWLER’S SYNDROME

A

Emg

99
Q

💊💉 MANAGEMENT of Fowler’s SYNDROME

A

Sacral Neuromodulation

100
Q

Identify

A

URETHRAL carbuncle

101
Q

💊💉 MANAGEMENT of URETHRAL CARBUNCLE

A

Excision using CAUTERY

102
Q

Soft Raspberry like PEDUNCULATED SWELLING in POSTERIOR URETHRAL WALL

A

Urethral CARBUNCLE