Urology II Flashcards
1st line investigation
Uss
imaging modalitits for urinary bladder
- US (transabdominal/ transrectal)
- voiding cystogram and retrograde urethrogram
- CT
- MRI
- Radionuclide examinations(functional
- ateriography
Uses of Uss in Lower GUT
Measurement UB wall thickness
Dx UB tumors and diverticulum
Measurement of PVRV (post voiding residual volume)
In case of trauma
Dx of some disease of genital tract
Types of US in lower GUT
Transabdominal
Trans rectal
Uses of VCUG
- Find the cause of urinary problem (repeated UTI and incontinence)
- Check for vesicoureteral reflux
- Check for structural problems of the bladder and urethra
- Follow up on other problems found during by different test
VCUG = Voiding Cystourethrogram
Parts of urethra:
Anterior urethra
Penile urethra
Bulbar urethra
posterior urethra
Membranous urethra
prostatic urethra
waht is the shape of the dome of bladder?
rounded in male
flat or concave in female
bladder is free or fixed?
relativly free, the neck is fixed by: puboprostatic ligaments (males) or pubovesical ligaments (females)
the most appropriate way to evaluate the urethra:
- Retrograde urethrography for anterior urethra
- Voiding uretrocytography for posterior urethra
When is the bladder thickness considered abnormal?
if > 3 mm when full or distended
Or > 5 mm when empty or non-distended.
Bladder Mural calcification may be seen in
Schistosomiasis
Chronic cystitis can cause:
A bladder neoplasm, foreign body, or diverticulum
cystitis by US:
- thick wall (diffuse or rarly focal)
- intra-luminal depris
- mural calcification (schistosomiasis)
- thimbled bladder (TB)
Contracted “Thimble” bladder result from
In cystitis secondary to tuberculosis
Modalities that are useful to assess for the presence of a fistula.
MRI and CT
if you see thickning + nodular + calcification in the UB
chistosomiasis cystitis
types of bladder cancer
- Transitional cell carcinoma (most common)
- Squamous cell carcinoma
- adenocarcinoma
- small cell carcinoma (rare)
review
PET scan is the best for diagnosis of urinary tract tumor (T/F)
False becouse FDG is excreted and acumulated in the bladder making it unsuitable.
ok PET is not used at all in UB tumors?
incorrect it play a role in assessment of distal metastasis
for locally staging of bladder cancer we use
MRI (the best)
define the Bladder diverticula
An outpouching from the bladder wall( mucosa herniates through the bladder wall).
causes of Bladder diverticula
- conginital (hutch diverticulum)
- obstruction
complications of Bladder diverticula
- stone formation
- infection
- tumors
causes of bladder calcification
- in the lumen: stones (most common)
- in the wall: schistosomiasis or tumor
define neurogenic bladder
UB dysfunction due to nerve injury (CNS/PNS)
types of neurogenic bladder
- large atonic
- hypertrophic (due to outflow obstruction)
special sign for neurogenic bladder
Christmas tree bladder
types of bladder rapture
- Intraperitoneal –> in the dome –> usually due to cystoscopy
- Extraperitoneal –> in the base (anterolateral) –> usually to to pelvic fracture
can the bladder rapture be diagnosed by US
yes but the site of tear may not be seen
which type of bladder rapture is more dangerous
Intraperitoneal (needs surgical repair)
causes of Bladder Outlet Obstruction
- BPH
- Ca prostate
- prostitis
- Bladder neck stenosis
- Urethral stricture
- Urethral stone
- Bladder tumors
- Neurogenic bladder
signs of Bladder Outlet Obstruction by US
- thick trabeculated wall
- residual urine
- dilatation of collecting system
what is the excellent modality for prostate imaging
MRI
by US what is the volume of prostate in case of BPH?
> 30ml (width * height * length * 0.52)
review
what is the most common cancer?
- the most common is the lung cancer
- the most common 1ry tumor in men is the prostate
- the most common malignancy in men between 20 - 35y is the testicular tumors
review
what is the 1st cause of cancer-related death?
- the first in both sex is the lung cancer
- the second cause of cancer-related death in male –> prostate
about Nuclear medicine
no flash cards for Nuclear medicine
can you summarize it?
causes of urethral stricture
- post traumatic –> proximal penile urethra
- post infection –> any portion (common in anterior urethra)
review
the most appropriate way to evaluate the urethra
- Retrograde urethrography for anterior urethra
- Voiding uretrocytography for posterior urethra
commonest cause of bladder outflow obstruction in male neonates
Congenital posterior urethral valve
the most common tisticular tumor is
testicular seminomas
US of hydrocele
- simple fluid collection
- avascular on doppler
- may contain septation & calcification or cholesterol
US of testicular torsion
- doppler: vascular flow at periphry but lack of flow at the central potion
- echogenicity: normal at acute phase, in missed torsion may see hemorrhage (small spots of hyperechoic)
