urology Flashcards
What is prostate cancer
Adenocarcinoma that arises commonly in the peripheral zone of the prostate
What are the symptoms of prostate cancer
- Usually asymptomatic as location is away from urethra
- late features: LUTS incomplete emptying, post voided dribbling
- Back pain: metastatic disease
- weight loss, malaise, haematuria
What investigations are done for prostate cancer
- history + exam
- PR exam
- PSA
- Transrecal uss + biopsy
- CT and MRI for staging
What is the Gleason score
Hisotlogical analysis of biopsy. Using two most common cell architecture and giving each a score of 1-5. Both scores are then added to give a score of 2-10
2= best prognosis 10= worse prognosis
How do we manage prostate cancer?
Localised disease:
- active surveillance
- radical prostatectomy
- radiotherapy
Locally advanced disease
- hormonal therapy: bilateral orchedectomy
- Radical prostatectomy
- radiotherapy
Metastatic disease
- orchedectomy
- GNRH analogue
What other things cause a rise in PSA
- UTI
- PRostitis
- Vigorous PR exam
- BPH
What are the different types of bladder cancer
- Transitional cell carcinoma >90%
- Sqamous cell carcinoma
- Adenocarcinoma
What are some risk factors for bladder cancer
- Male
- > 50
- Workplace carcinogens: hair dyed, rubber, hydrocarbons
- Cylophosphomide
- smoking
- schistosomiasis infection
What are the key investigations in bladder cancer
- urinalysis
- flexible cystoscope
- TURBT
- MRI
- CT
What are some symptoms of bladder cancer
- Painless macroscopic haematuria
- weight loss, malaise
- back pain
- Urinary symptoms: dysuria
Management of bladder ca
Localised;
- Trans urethral resection TURBT
- Intravesicular chemotherapy
Muscle invasive:
- Radical cystectomy
- Radiotherapy
- Chemotherapy
What is renal cell carcinoma
Adenocarcinoma of the proximal convoluted tubules in the kidney. The most common histological types = clear cell
What are some symptoms of Renal cell carcinoma
- Triad: haematuria, loin pain and mass
- constitutional symptoms: weight loss, malaise, fever
- left varicoceal (as left testicular vein comes off left renal vein)
- Paraneoplastic features
Management of RCC
- localised disease: partial or total nephrectectomy
- immunological therapy
What is epididymo-orchitis
Inflammation of the testes and the epididymis
