What is the most common urological emergency presenting to A&E?
Acute urine retention
What are the symptoms of acute urine retention?
No urine output
Increasing bladder pain - midline, suprapubic
What commonly causes acute urine retention in men?
Benign prostatic hyperplasia
Apart from BPH, what are some other causes of acute urine retention?
Excessive fluid intake - think alcohol
Acute urine retention is either ___ or ___.
spontaneous , precipitated
What are some events which can precipitate acute urine retention?
Sympathomimemetic / anticholinergic medication
How is acute urine retention treated?
What can be prescribed along with a catheter to treat acute urine retention?
What are some consequences following treated acute urine retention?
Post-obstructive diuresis (risk of dehydration)
What is a common renal cause of loin pain?
Renal calculus causing ureteric colic
How is the pain of ureteric colic managed?
NSAID - diclofenac, inhibits prostaglandins which mediate ureteric pain
Opiate analgesia if NSAIDs not effective
What drug can be prescribed to encourage the passing of small renal calculi?
If a renal calculus is large, how is it likely to be treated?
ureteric stent, stone removal
What imaging method is gold standard for finding renal stones?
CT scan +/- contrast
What signs and symptoms would encourage you to intervene to remove a renal stone?
Fever and other signs of infection and sepsis
Haematuria is a common presentation - what investigation is used to find the cause?
What special type of catheter is used to treat frank haematuria?
3-way irrigated catheter
helps to break up clots
What is a presentation caused by twisting of the spermatic cord?
What usually causes testicular torison?
Which group is it common in?
Where is pain felt in testicular torsion?
may radiate to lower abdomen
How is suspected testicular torison investigated?
How is testicular torsion treated?
Surgically, within 4-6 hours of onset
What must be done if the testis is black on exploration?
What sign is produced by torsion of the appendix testis?
Blue dot sign
What infectious disease presents like testicular torsion?
How do you tell the difference?
Signs of infection, history of infectio,n, pyuria cremasteric reflex PRESENT
How is suspected epididimytis investigated?
How is epididimytis treated?
If confirmed to be an STI: oral doxycycline
If confirmed to be a UTI: oral oxfloxacin or ciprofloxacin
What is a common cause of scrotal tenderness and pruritus in children which self-resolves?
Idiopathic scrotal oedema
What is painful swelling of the foreskin called?
How is paraphimosis (painful swelling of the foreskin) treated?
Attempt to reduce swelling to move foreskin back over glans:
iced glove, punctures, compression, dorsal slit