Urology Flashcards
hydroceles features
transilluminate
distinct in size changes
softer /less tense when the patient is lying down (supine)
what cyst can you get above the lump of?
epidymal cysts
single / multiple cysts
painless
lie above and behind the cysts
which infections predispose to formation of stag horn calculi?
renal pelvis
at least 2 calyces
alkalise urine - proteus infections
which drug class is quickest to act in BPH?
alpha 1 antagonist like tamsulosin
why does finesteride take 6 month to work?
5-alpha reductase inhibitors take longer to show effects
reduce prostate volume rather than symptom relief
most common form of prostate cancer?
adenocarcinoma
if a scrotal swelling is separate from testicle then it can’t be?
epididymal cyst
epididymo-orchitis
testiculor tumour
most common type of renal cancer?
renal cell carcinoma
- adenocarcinoma
spread of RCC?
direct extension
OR
haematogenous
> lung
>bone
>brain
LUTs symptoms and pmhx of gonorrhoea?
urethral stricture
epididymal cyst presentation?
separate form the body of the testicle
does not transilluminate
separate from body of testes
what can help differentiate between ischaemic and non ischaemic priaprism?
cavernosal blood gas analysis
in ischaemic priapism
pO2 and pH would be reduced whilst pCO2 would be increased
mx of ischaemic priaprism?
aspiration of blood from cavernosa
injection of saline flush
intracavernosal injection of phenylepinephrine
surgery
organic causes of erectile dysfunction
most common cause?
vascular
neurogenic
structural / hormonal
slidenefil moa?
pde-5 inhibitor
when is a referral to urology in the first instance appropriate?
ED
always an issue with achieving erections
absence of morning erections
prostatitis
fever and pain in perineum and scrotom
dysuria
urinary frequency
acute urinary retention
can happen secondary to UTI
due to swelling
> urethritis
acute urinary retention
BPH
stricture/constipation / mass (fibroids)
medication to commonly cause urinary retention?
anticholinergics
tricyclic antidepressants
antihistamines
opiods
benzos
adults presenting with hydrocele?
refer immediately
for USS to exclude tumour
what does hydronephrosis mean?
ureter is completely occluded
urgent decompression needed
JJ stent
mx of hydronephrosis?
USS - image
IVU
nephrostomy tube
anti androgen treatment needs to be prescribed with?
goserelin
synthetic GnRH agonist
> give with crproterone acetate
seminomas have a better prognosis than teratomas
T/F?
true
germ cell tumour > more sensitive to radiation and chemo
less aggressive
cremasteric reflex
genitofemoral nerve carries afferent
genital branch carries efferent
chronic urinary retention
high pressure presents with impaired renal function and bilateral hydronephrosis
if there is a mix storage and voiding symptom issue
how to manage?
1st line is tamsulosin ( alpha blocker0
2nd line is
alpha blocker with antimuscarinic like tolterodine / darifenac
best investigation for hydronephrosis?
USS renal tract
prostate cancer
co morbid
1st line
watchful waiting
hormonal therapy for prostate cancer?
androgen deprivation therapy with radiotherapy
> grade 2 and above
when is urethral catheter contraindicated?
pelvic trauma
urethral stricture hx
resistance to passage
high riding prostate
blood at meatus
prostitis management?
14 days of ciprofloxacin
bacterial prostitis?
gram negative
prostate gland via urethra
E.Coli most common isolated pathogen
digital rectal examination findings for prostatitis?
tender
boggy
prostate gland
what is a normal post void volume in ptrs >65
<100ml
what is a normal post void volume in <65?
50ml
vasectomy as contraception
use additional contraception until semen analysis reveals azoospermia
> twice
usually atkes 12 weeks
