Urology

Question 1

Case of 12 years old boy on skate downstairs he fall dawn and had perineum trauma, with bruises over the scrotum, perineum, lower abdomen. Retrograde cystourethrogram show extravasation of the dye. Where is the injury?

A. Penile urethra

B. Urinary bladder

C. Prostatic urethra

D. Ureters.

Answer 1

Answer: a

Anterior urethral (composed of the penile and bulbar urethra) injuries. This type of injury is seen most commonly in blunt trauma, but is not usually associated with pelvic fractures. It results from a strong blow to the perineum that causes the bulbar urethra to be crushed against the inferior border of the pubic symphysis. This typically occurs in a fall astride, a straddle injury from a vehicle accident, an assault, or from bicycle handlebars.

Question 2

Child complain of unilateral scrotal swelling , does not transilluminate , what is your plan ?

A. Discharge the patient

B. Give antibiotic

C. Do laparotomy

D. U/s and think about surgery

Answer 2

Answer: d

Clinical evaluation may be diagnostic (eg, in varicocele, lymphedema, inguinal hernia); otherwise, testing is typically done. Ultrasonography is done when :

The diagnosis is uncertain

Usually when hydrocele is present (to diagnose causative scrotal lesions)

The mass does not transilluminate

If ultrasonography confirms a solid testicular mass, further testing is done for testicular cancer , including the following:

β-Human chorionic gonadotropin level (hCG)

α-Fetoprotein level

LDH level

CT of the abdomen

Question 3

young patient complains of scrotal pain, examination is normal, US normal , urine analysis show pyuria . what is the next step :

A. Refer to surgery

B. Give him azithromycine and cefxime

Answer 3

Answer: B. Give him azithromycine and cefixime✅

This is a case of epididydimitis. In males 14-35 years of age, the most common causes are Neisseria gonorrhoeae and Chlamydia trachomatis.

The recommended treatment in this age group is ceftriaxone, 250 mg intramuscularly, and doxycycline, 100 mg twice daily for 10 days.

A single 1-g dose of azithromycin may be substituted for doxycycline.

In those under age 14 or over age 35, the infection is usually caused by one of the common urinary tract pathogens, and levofloxacin, 500 mg once daily for 10 days, would be the appropriate treatment.