Urology Flashcards
What is an inguinal hernia
Herniation of contents through inguinal canal
RF for inguinal hernia
Male
Prematurity
Are most inguinal hernias direct or indirect
Indirect
Main risk associated with inguinal hernias
Incarceration
What is incarceration
Can obstruct the bowel and/or testis
Cutting off blood supply
(Strangulation)
Clinical features inguinal hernia
GROIN swelling
Visible most:
Straining
Crying
Is for inguinal hernia
O/E
<1yrs inguinal hernia R
Urgent referral for repair
No place for observation
> 1yrs inguinal hernia Rx
Elective referral
Repair
Incarcerated inguinal hernia Rx
Reduce and repair on same admission
Emergency
What is a hydrocele
When fluid accumulates around the testis
Who is a hydrocele very common in
New borns
Esp prematurity
Are hydroceles in babies typically communicating or non-communicating
Communicating
What is a communicating hydrocele
When fluid from the abdomen communicated with the scrotal sac
Clinical features of hydrocele
Scrotal swelling
Painless
Bluish colour
Ix for hydrocele
O/E
Torch
USS
Rx for hydrocele
Conservative until 5yrs
Harmless: 96% will disappear spontaneously
Is hydrocele persists or is complicated what is the Rx
Surgery
Indications for orchidoplexy
Fertility Malignancy Trauma Torsion Cosmetic
Describe fertility and cryptorchidism
Loss 1% germ cells/month if undescent
Describe Malignancy and cryptorchidism
Rate of testicular cancer 3x more common
Describe trauma and cryptorchidism
Much safer being in the scrotum than being in the groin
Describe torsion and cryptorchidism
More susceptible to testicular torsion
What is cryptorchidism
Failure of descent of testis into the scrotum
What is a true cryptorchidism
Stopped short on normal path
True undescent
What is retractile cryptorchidism
Normal testis that have been pulled into a suprascrotal position by cremasteric reflex
What is ectopic cryptorchidism
In the wrong place
Diverted to an aberrant position
Ix for cryptorchidism
USS
O/E
Rx for cryptorchidism
Orchidoplexy surgery
What is circumcision
Removal foreskin
1 absolute indication for circumcision
Balanitis Xerotica Obliterans (BXO)
Relative indications for circumcision
Balanoprosthitis
Religious
UTI
What a testicular torsion
Urological emergency
Twisting of the testicle on the spermatic cord
Why is testicular torsion a urological emergency
Twisting of the testicle on the spermatic cord leading to constriction of the vascular supply and time-sensitive ischaemia and/or necrosis of testicular tissue
Clinical features of testicular torsion
Acute pain scrotum Acute pain testicles Swelling Nausea/Vomiting Abdominal pain
Ix for testicular torsion
Doppler USS
Rx for testicular torsion
Initial stabilisation
Urological consultation
Semi-elective scrotal exploration
Supportive care
What is a hydrospadias
Urethral meatus in the wrong place
Classification types of hydrospadias
Subcoronal
Midshaft
Penoscrotal
What 3 separate problems are encountered with hydrospadias
Urethral meatus incorrect place
Foreskin gathered at back of penis
Penis may be bent when erect
What do you NOT do in hydrospadias
DO NO circumcise
Rx for hydrospadias
Do not circumcise
Surgical (1 o 2 stages)
