urology surgery Flashcards
common complication following relief of urinary obstruction
what monitoring should be performed daily?
diuresis, during which salt and water are lost, risking hypovolaemia, dehydration and electrolyte imbalances
these can lead to falls in elderly patients
daily U&Es
scrotal findings of of inguinal hernia
cannot get above the lump
scrotal swellings that transilluminate
hydroceles
first line investigations for testicular masses
testicular USS
sterilisation following vasectomy
only once it is confirmed with clear semen analysis
most common form of prostate cancer
adenocarcinoma
BPH medical mx
alpha-1 antagonists, e.g. Tamsulosin
5 alpha-reductase inhibitors, e.g. Finasteride
seminoma tumour markers
AFP and HCG are typically normal
which type of testicular tumour are AFP and HCG raised
non-seminomatous germ cell tumours
e.g. teratoma, yolk sac tumour
most common constituent of stag-horn calculi
struvite - magnesium ammonium phosphate
most common constituent of renal calculi
calcium oxalate
chronic urinary retention long-term mx
intermittent self-catheterisation
characteristics of testicular torsion
acute testicular pain
unilateral swelling
retracted testicle
absent cremasteric reflex
mx of prostatitis
14 days ciprofloxacin
overactive bladder mx
moderate fluid intake and bladder retraining
antimuscarinics - Oxybutynin
urinary incontinence following STI is due to
urethral stricture
imaging for renal stones
USS
Non-contrast CT KUB
most common renal cancer
adenocarcinoma (RCC)
mx for RCC
radical nephrectomy
mx of obstructive urinary calculi with signs of infection
nephrostomy (urgent renal decompression) and IV ABX
most common causes of ED
vascular causes
which initial investigation must be done in all patients with urinary incontinence
urinalysis to rule out UTI and diabetes mellitus
what stage of RCC do most patients present at
stage IV
how long should you postpone PSA test after prostatitis and UTI
at least 1 month
what is stranding of periureteric fat seen in
recent ureteric stone passage
hormonal therapy of prostate cancer
GnRH agonist (Goserelin) and anti-androgen (cyproterone acetate)
how long must patients abstain from ejaculation or vigorous exercise before PSA test
48 hours
most common organism causing infection of stag horn calculi
proteus mirabilis
features of lichen sclerosus in men
most common in uncircumcised men
tight white ring around the tip of the foreskin
phimosis
method for removing renal stones in pregnant women
ureteroscopy
what is TURP syndrome
trans-urethral resection of prostate
caused by irrigation with large volumes of glycine causing hyponatraemia
features of RCC
haematuria
loin pain
abdominal mass
signs of bladder rupture
pelvic fracture
lower abdominal peritonism
unable to pass urine
features of transitional cell carcinoma
arise from urothelium
more commonly presents with painless haematuria
may block urinary outflow leading to hydronephrosis and painful haematuria
features of epididymal cyst
separate
can get above mass
when is nephrostomy used
acute upper urinary tract obstruction causing hydronephrosis
ureteric obstruction due to stones with infection
hernia in children
indirect inguinal hernia
INdirect = INfants
