Urology: Haematuria/Dr Lun: Ingunoscrotal lumps, prostate cancer Flashcards
Haemtaturia?
Hx?
Pain? Where? Aiteology? Trauma? Claculus? Infection? Clot? neoplasia? trauma
Stones hx?
Can tell from end of bed - writhing cannot sit still- cannot be comfortable
How do you localize a stone? Investigations?
IVP
CT (vats majority)
Plain KUB
US- very poor for calculi
Treatment of stones:
4mm < less in size
Conservative? Acute? Surgical management? read
Infection in the urinary system:
Like quinolones
Further causes:
Common medical causes of hameturia
- Diabetic nephropathy
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Hameturia
Haematuria:
Vascular - causes of haemtaturia
Haematuria: Infectious causes: think
Schisotosmiasis
Hameturia: Stones: cause haematuria
Haemtauria:
Neoplasia?
Harmatomas?
Bladder- haemturia: malignancy / Urethral/penile cancer
RCC
- types
- size >2cm
Features on xray?
RCC presentation:
Classic
presentation?
Local effects?
RCC- big ones likely to cause paraneoplastic syndome
RCC survival: Poor onces any spread
management?
RCC investigations? Explain-
Prostatic carcinoma:
- Grows slowly
- many men will die of unrelated causes
- second only to lung cancer in males
- 20 000 diagnosed a year
Prostate: zones-
anatomy- transition zone - can grow
Androgen receptors in prostate cancer:
Plays an important role in management
Risk factors: For prostate cancer
Natural history of prostate cancer:
Symptoms? List 6
No real symptoms!!! mostly asymptomatic
To screen: Who should it be offered to? Informed consent? Age group that should benefit?
Screening take home message:
Diagnosis: of Prostate cancer:
Investigations? PSA+DRE+ TRUS biopsy (brutal and basic)
Prostate staging: CT abdo/
MRI!!!!!
- MRI
- PSMA
What is a PIRADs scoring?
Diagnostic tools:
Types of therapy:
surgery, chemno, radiation
Watchful waiting: What should that include?
- Regular PSA-
- Regular imaging?
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Surgery: Complications?
- Risk of imcompetence
- Risk of incontinence
- Risk of strictures
- Prostatic Knicks:
Complications: Incontinence
Impotentence, strictures,
Radiotherapy:
Brachytherapy: criteria?
radioactive pellets in prostate - left behind
Brachytherapy: Advantages
Brachytherapy: Side effects?
Brachytherapy- Disadvantages?
BPH: Symptoms?
What is IPSS Questionaire?
BPH
BPH- DDx? Think outflow obstruction
BPH management:
TURP bipolar gold standard
Plenty of different surgeries:
Medications- many-
contraindications to minimally invasive BPH surgery
Scrotal lumps: