Urology- Emergencies

Question 1

what is acute urinary retention

Answer 1

inability to urinate with inc pain

Question 2

types of acute urinary retention

Answer 2

spontaneous

precipitated

Question 3

what drugs cause urinary retention/ LUTS

Answer 3

sympathomimetics and anti-cholinergic effects

Question 4

mx of acute urinary retention

Answer 4

catheter + alpha blocker

Question 5

main complication of acute urinay retention

Answer 5

post-obstructive diuresis:

• BOO pt + uraemia, CCF, HT
• monitor UO

Question 6

acute loin pain is commonly due to..

Answer 6

ureteric colic

Question 7

mx of acute loin pain

Answer 7

NSAIDs, + opiates + alpha-blocker the are expected to pass

if no passage in 1month consider surgical intervention (or if unrelieved pain, pyre, nausea)

Question 8

frank haematuria aetiology

Answer 8

stones, infection, tumours, BPH, polycystic kidneys, trauma

Question 9

how to manage frank haematuria

Answer 9

clot retention: use a 3-way irrigating haematuria catheter

Question 10

acute scrotum can be due to many things, mainly…

Answer 10

testicular torsion

Question 11

what is testicular torsion/torsion of spermatic cord

Answer 11

when testis and cord rotate around blood supply

Question 12

what is a Bell-Clapper Deformity

Answer 12

when tunica vaginalis sits high

Question 13

some s/s of testicular torsion

Answer 13

sudden onset pain, nausea/vomiting, referred pain to lower abdomen

Question 14

main sign of testicular tosion

Answer 14

absence of cremasteric reflex

Question 15

mx of testicular torsion

Answer 15

prompt exploration- necrosis of testicle may begin within 4hrs of presentation

Question 16

torsion of appendix testes often has…

Answer 16

a blue dot sign

Question 17

what differentiates the presentation of torsion of appendix testes from normal tastes

Answer 17

mobile testes and cremasteric reflex present

Question 18

what is epidydimitis

Answer 18

Pyrexia more common & pyuria- inflammation of the epidydimis due to UTI, urethritis, catheterisation

Question 19

paraphimosis is…

Answer 19

painful swelling of foreskin distal to phimotic ring due to retracted foreskin for catheterisation and forget to put it down into natural position

Question 20

what is Fourniere’s gangrene

Answer 20

necrotising fasciitis of male genitalia- starts as cellulitis then progresses to fever, crepitus in scrotum and dark purple areas

Question 21

mx of Fourniere’s gangrene

Answer 21

abx + surgical debridement