Urological Emergencies - Penile and Testicular Flashcards
How quickly can ischaemia occur in testicular torsion?
Just 4hrs as the spermatic cord becomes twisted
What age is most likely to get testicular torison?
Adolescence
A boy wakes up in the middle of the night complaining of severe testicular pain. You suspect testicular torsion. What other symptoms could you see on examination that would back up your thinking?
- Red hot high riding testicle
- Loss of cresmastic reflex -> when brush inner thigh ball rises up
- horizontal lie of testicle
- so tender won’t let you touch it
What should be done if you suspect testicular torsion?
Immediate surgery
What is the name of the scortal infection which leads to necrosis of the perineum?
What diabetic drug has a link with it?
Fournier’s Gangrene
SLGT2-i
Patient presents with foul smelling perineum, the area is swollen and there is crepitus present.
What is your next step?
Refer for emergency immediate surgery
Debridement of the whole area
(Fourniers Gangrene)
What is the name of the condition where the foreskin gets stuck behind the glans?
Under what conditions does it most commonly occur?
How is it managed?
Paraphimosis
In hospital when staff don’t retract foreskin back after catheterisation
Penile block and gently try and retract - if not cut foreskin
Priapism is the name for a prolonged unwanted erection of >4hrs. There are 2 categories. What one is deemed an emergency?
EMERGENCY = Ischaemic/low flow - venous statis (more common)
Non-ischaemic/high flow = unregulated blood entry and filling
What can occur if ischaemic priapism is left too long?
Penile prosthesis
How can you tell between the two types of priapism?
Aspirate blood from corpus cavernosum
If low O2 - ischaemic
What is the name of the pattern of bruising which you will see in urethral injury?
How would the prostate feel?
Butterfly pattern haematoma
High riding (no longer attached to the urethra so jumps up)
How is urethral injury managed?
Catheter insertion - try normal way first v gently if not working -> suprapubic
What may be seen on the penis if the patient has a urethral injury?
Blood at urethral meatus (japs eye)
How may a patient present with a penile fracture?
Cracking/popping sound may be heard
Rapid loss of erection
Discolouration + swelling
When do the majority of penile fractures take place?
During sex
