Urological emergancies Flashcards
treatment of acute urinary retention
catheterisation
complication of acute urinary retention thats been treated
post obstructive diuresis (pee out too much)
investigation for someone with acute scrotal pain
ultrasound
most common cause of acute scrotal pain <30
testicular torsion
risk factor for testicular torsion
bellclapper deformity in tall young skinny boys
teenager wakes up in the middle of the night with excruciating scrotal pain
red and bruised
testicular torsion
systemically unwell baby
what do you always do
why
look under nappy for testicular torsion
excruciating scrotal pain
red and bruised scrotum
blue dot on inspection
torsion of appendage (mullerian duct remnants)
similar to testicular torsion just less severe
treatment of torsion of appendage in scrotum
nothing - will fall off itself
surgery if severe pain
who get epididymitis
> 16 y/o (not kids)
what does epididymitis present similar to
how do you tell the difference
testicular torsion
during surgery for testicular torsion (or on Doppler US)
may be a fever in epididymitis
aetiology of epididymitis
STI in young
UTI in old
idiopathic
investigations for epididymitis
Doppler US to tell difference from testicular torsion (increased blood flow)
urine culture/PCR
treatment of epididymitis
analgesia
antibiotics - ofloxacin
not surgery, though they usually end up with surgery bc of ?testicular torsion
presentation of idiopathic scrotal oedema
red groin
swollen/water filled testes
itchy
no tenderness, little pain (can come and go)
symptomatic treatment of idiopathic scrotal oedema
antihistamines
pain relief if necessary
cure of idiopathic scrotal oedema
NOT surgery, self limiting
what is paraphimosis
painful swelling of foreskin
why does paraphimosis happen
foreskin is retracted and not put back in place
treatment of paraphimosis
symptomatic - ice
surgery - dorsal slit, circumcision
painful swelling of foreskin
paraphimosis
prolonged erection >4hours not associated with sexual arousal
priapism
2 types of priapism
ischaemic
non ischaemic
investigation to determine the type of priapism
blood aspiration then ABGs
low O2 in ischaemic priapism
cause of non ischaemic priapism
increased blood from trauma
presentation of non ischaemic priapism
not painful
semi hard penis
presentation of ischaemic priapism
painful
rigid and tender penis (apart from glans)
cause of ischaemic priapism
decreased blood drainage from penis
ischaemic priapism treatment
blood aspiration and saline irrigation
non ischaemic priapism treatment
cold pack, compression
necrotising fasciitis in male genitalia
fourniers gangrene
xray/US of fourniers gangrene
gas forming organisms
presentation of necrotising fasciitis in male genitalia (fourniers gangrene)
swelling
crepitus
dark purple areas
precursor to fourniers gangrene (necrotising fasciitis of male genitalia)
cellulitis
treatment of fourniers gangrene (necrotising fasciitis of male genitalia)
antibiotics and surgical debridement
investigations for staging of kidney trauma
CT
pubic rami fracture causing … damage
inability to pee
bruising under testicles
‘high riding’ prostate
blood at meatus
urethral damage
when penis slips out of vagina and strikes the pubis
cracking/popping sound
penile fracture
penile fracture presentation
discolouration
swelling
blood at meatus
treatment of penile fracture
emergency surgery
pain management
investigation for testicular injury
US to look at vasculature damage
