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GK—F3 E1 Urology > Urology Treatments > Flashcards

Urology Treatments Flashcards

1
Q

3 Tx for hydrocele

A
  1. If Asx: reassurance and surveillance
  2. needle aspiration w/sclerosing agent
  3. hydrolectomy: transcrotal incision
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2
Q

Varicocele if asx

A

surveillance

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3
Q

management of young adult with palpable varicocele and normal semen analysis

A

perform semen analysis q 1-2 yrs

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4
Q

management of pre-sexual adolescents and children w/normal testis size and varicocele

A

measure tesitcular size annually

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5
Q

varicocele

PLUS 1 or more of the following conditions:

symptomatic

palpable

abnormal semen analysis (w or w/o evaluation of infertile couple)

small testis

A

ligate vein through open/laporoscopic surgery

percutaneous embolization

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6
Q

Phimosis

OR

“muzzle”

A

circumcision

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7
Q

Paraphimosis = EMERGENCY!

A

reduction necessary:

squeeze edema out of glans, thumb on glands, fingers on prepuce, push/pull.

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8
Q

Paraphimosis if manual reduction not successful

A

dorsal slit/circumcision

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9
Q

Testicular torsion

A

manual detorsion: “open the book”

surgery

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10
Q

testicular torsion if testis viable (detorsed in <6 hrs)

A

orchiopexy of both sides

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11
Q

testicular torsion if testis not viable (detorsed >24 hrs)

A

orchiectomy + orchiopexy of contralateral testis

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12
Q

1st line tx for cystitis

A

Bactrim (TMP/SMZ) x 3 days

Nitrofurantoin x 5-7 days

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13
Q

Enterococcus cystitis

A

ampicillin + amoxycillin

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14
Q

Beta-lactamase inhibitors for beta-lactamase bacteria: tx of cystitis

A

Augmentin (clavulanic acid + amoxicillin)

Sulbactam

Tazobactam

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15
Q

Last line of tx for cystitis

A

16 y/o or older: FQ (cipro, levo) b/c of tendinitis/tendon rupture

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16
Q

Tx for persistent sx post-tx cystitis

A

urgency: antimuscarinics
dysuria: phenazopyridine (turns urine orange)

pelvic pain: NSAIDS

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17
Q

Complicated cystitis

A

remove catheter

replace catheter

abx

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18
Q

urethritis caused by gonorrhea

A

ceftriaxone IM x 1 dose

alt: cefixime

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19
Q

urethritis caused by chlamydia

A

azithromycin 1 dose

OR

doxycycline x 7 days

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20
Q

When do you test for cure if you received cefixime for urethritis caused by gonorrhea?

A

1 week post tx

AND

3mos post tx

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21
Q

when do you f/up for uncomplicated urethritis caused by chalmydia?

A

f/up testing not required.

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22
Q

when do you f/u w/ pregnant pt after tx her for urethritis caused by chamlydia?

A

3-4 wks post tx

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23
Q

Epididymitis caused by STD (gonorrhea or chlamydia)

A

ceftriaxone + doxycycline

24
Q

Epididymitis due to non-STD cause

A

Levofloxacin

25
Q

severe cases of Epididymitis

A

IV abx

26
Q

chronic epididymitis conservative tx

(>3mo)

A

analgesics, scrotal support, abx

27
Q

chronic epididymitis due to obstruction

(>3 mo)

A

vasovasostomy/epididymectomy

28
Q

chronic epididymitis due to intermittent torsion

(>3mos)

A

orchiopexy

29
Q

Pt w/acute bacterial prostatitis + significant fever, highly elevated WBC, sepsis

A

admit + IV abx

30
Q

acute bacterial prostatitis + urinary retention

A

suprapubic tube > urethral catheter

31
Q

acute bacterial prostatitis; when no longer acutely toxic

A

switch from IV abx to po abx

32
Q

acute bacterial prostatitis on discharge

A

4-6 wk course of abx

33
Q

chronic bacterial prostatitis (4)

A

Abx: FQ (cipro, levo), TMP/SMZ

NSAIDS

A-blockers (-zosins)

anticholinergics/antimuscarinics

34
Q

inflammatory chronic pelvic pain syndrome (non bacterial prostatitis)

A

empiric abx: FQ or SMX/TMP x 6-8 wks

35
Q

inflammatory chronic pelvic pain syndrome

A
36
Q

noninflammatory chronic pelvic pain syndrome (prostadynia)

A

NSAIDS
anticholinergics

A-blockers

sitz baths

37
Q

pyelonephritis & mildly ill

A

FQ x 7 days

38
Q

pyelonephritis mod/severely ill

A

IV abx: FQ, aminoglycoside

39
Q

Renal Abscess

A

IV abx

Percutaneous drainage

surgical drainage

40
Q

Chronic pyelonephritis

A

manage UTI RF

control HTN

nephrectomy

41
Q

BPH (4)

A

watchful waiting

lifestyle modifications

medications

surgery

42
Q

BPH watchful waiting

A

monitor sx

recheck labs and testing

43
Q

BPH lifestyle modification (5)

A

avoid fluid intake & diuretics in evening to prevent nocturia

elevate legs in evening

avoid caffeine, alcohol, spicy/acidic foods

double void

avoid pseudophedrine/alpha agonists/anticholinergics

44
Q

BPH Medications (3)

A

phytotherapy (saw palmetto)

alpha blockers (-zosin): controls urinary effects

5-ARI (tadalafil, finasteride)

Combination: dutasteride + tamsulosin

45
Q

BPH surgery (7)

A

Transurethral Microwave Thermotherapy (TUMT)

Transurethral Incision of Prostate (TUIP)

Urolift ®

Transurethral Resection of Prostate (TURP)

Photoselective Vaporization of Prostate (PVP)

Open simple prostatectomy

Holmium Laser Enucleation of Prostate (HoLEP)

46
Q

BPH surgery gold standard

A

TURP

Transurethral Resection of Prostate

47
Q

TUMT for BPH

A

minimally invasive, outpatient, awake

48
Q

TUIP for BPH

A

good for smaller collar type prostate

less chance of retrograde ejaculation

49
Q

Urolift for BPH

A

permanent implant into prostate

50
Q

TURP for BPH

A

electrocautery energy scoops out “chips” of prostatic tissue

chips go into bladder and are evacuated out & sent to pathology

51
Q

3 complications/side effects of TURP for BPH

A

retrograde ejaculation

TUR syndrome

Hematuria

52
Q

Describe TUR syndrome from TURP for BPH

A

hyponatremia

mental confusion

HTN

visual changes

53
Q

PVP for BPH

A

can be done on anticoagulated pt

54
Q

What surgery is done for pts with BPH who have very large prostates > 80 cc

A

open simple prostatectomy

55
Q

What surgery is done for pts with BPH who have very large prostates > 80, 100, 200g?

A

HoLEP

56
Q
A

GK—F3 E1 Urology (4 decks)

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