Urological Conditions Flashcards
What is Hypospadias?
Hypospadias is a congenital abnormality of the penis which occurs in approximately 3/1,000 male infants.
What are characteristic features of Hypospadias?
- a ventral urethral meatus
- a hooded prepuce
What is the management of Hypospadias?
Management:
- once hypospadias has been identified, infants should be referred to specialist services
- corrective surgery is typically performed when the child is around12 monthsof age
What urological condition is a complete contra-indication for circumcision?
Hypospadias- ventral urethral meatus
What is circumision?
removal of the foreskin
What is Paraphimosis?
This is the inability to pull forward a retracted foreskin over the glans penis.
(*saw this in clinic)
what is the cause of paraphimosis?
Cause:
It is most often caused due to the presence of atight constricting bandas part of the foreskin thatprevents the retractionover the glans
What clinical procedure increases the risk of paraphimosis?
Phimosis, indwellingurethral catheter(due to non-replaced foreskin),poor hygiene, and prior paraphimosis.
What is the management of Paraphimosis?
Management:
1st line- reduction surgery (ASAP) as can lead to urological emergency if untreated
What is Phimosis?
Non-retractile foreskin and ballooning during micturition
What is balantitis?
This is inflammation of the glans penis.
What is Priapism?
b) how many hours is it needing to be sustained for to be diagnosed
This is an uncontrolled erection for > 4 hours and is not associated with sexual stimulation
What are the X2 types of priapism?
Ichaemic priapism is typically due to impaired vasorelaxation and therefore reduced vascular outflow resulting in congestion and trapping of de-oxygenated blood within the corpus cavernosa.
Non-ischaemic priapism is due to high arterial inflow, typically due to fistula formation often either as the result of congenital or traumatic mechanisms.
Which type of priapism is a urological emergency?
ischaemic- necrosis risk
excessive consumption (e.g. Sildenafil) increases the risk of what urological condition?
priapism- sustained erection >4 hours without sexual stimulation
What is the 1st line gold standard investigation for Priapism?
Investigations:
1st line- Cavernosal Blood Gases (this differentiates between ischaemic and non-ischaemic types)
What is the management of priapism?
a) ischemic (urological emergency)
b) non-ischemia
Ischaemic Priapism (medical emergency)- as can cause necrosis
1st line- aspiration of blood from the cavernosa, this is often combined with injection of a saline flush to help clear viscous blood that has pooled.
Non-Ischaemic (Not medical emergency)
1st line- observation
What is Peyronie’s disease?
Peyronie’s disease: Presents with a significant BEND in the penis during erection, which can interfere with sexual function.
Urethral opening located at - ‘distal VENTRAL surface of the penis’ is buzzword for?
Hypospadias (congenital defect)
What condition is known to present alongside Hypopsodias?
Cryptorchidism (present in 10%) and inguinal hernia.
This is known as ‘undescended testes’ due to one embyological malformation increasing the risk of others developing.
Cryptorchidism is associated with which congenital condition?
hypopsodias - distal ventral urethral opening
Cryptorchidism - this is undescended testes
What are the medical benefits of circumcision?
Medical Benefits:
- reduces the risk of penile cancer
- reduces the risk of UTI
- reduces the risk of acquiring sexually transmitted infections including HIV
