Urology

Question 0

1. Types of urinary tract stones

2. Conditions associated with higher incidence of stones

Answer 0

1. Staghorn, calcium, urate, magnesium ammonium phosphate, cysteine/Xanthine
2. Congenital abnormalities and anything which causes urinary stasis, chronic infection, urinary stasis, foreign bodies, dietary causes etc

Hyperparathyroidism (hypercalcaemia)
Xanthinuria
Cysteinuria
Gout (uric acid stones)
Hyperoxaluria

Question 1

Indications for removing urinary tract stones

Answer 1

1. Flow obstruction
2. Infection
3. Persistent/recurrent pain
4. Likely to cause future obstruction or infection
5. “Metabolic stones” that are likely to expand rapidly
6. Jobs where colic would be disastrous (eg. Pilots etc)
7. One kidney pts

Question 2

Causes of detrusor overactivity

Answer 2

Neuropathic lesions: MS, CVA, spinal injuries, Parkinsonism etc.

Bladder outflow obstruction in men (BOO), chronically as there is muscular hypertrophy and increasing bladder irritability.

Question 3

Treatment of detrusor overactivity

Answer 3

1. Bladder training/behavioural therapies
2. Anticholinergics, CCB, anti-diuretics, HRT
3. Augmentation cystoplasty

Question 4

Urethral causes of incontinence

Answer 4

Urethral sphincter incompetence (ie. stress incontinence)
Detrusor overactivity
Overflow (prolapse, drugs, strictures etc)
UTI
Urethral diverticulum
Functional

Question 5

Extra-urethral causes of incontinence

Answer 5

1. Congenital abnormalities (eg. Ectopic ureteric, bladder exstrophy)
2. Fistula formation (ureteric/vesical/vaginal)