Uro Flashcards
(29 cards)
What is a hydrocele?
It is a collection of serous fluid between the tunica albuginea and the tunica vaginalis.
What is found on examination of a hydrocele?
A hydrocele is fluctuate, trans illuminates, and is dull to percussion. The testis cannot be palpated separately. Can’t get above the swelling if it is primary / communicating (ie in patent process vaginalis)
What does the fluid look like when aspirated from a hydrocele?
Straw coloured with flecks of cholesterol.
Which testicular cancer is radiosensitive
Seminomas are sensitive.
What hormones does a teratoma testicular cancer produce?
bHCG, LDH, AFP
Most common testicular cancer in older men?
DLBCL
What are the two week wait criteria for testicular cancer?
Non-painful enlargement or change in shape / texture of testis
What is the difference on USS between seminomas and teratomas?
Seminomas have a homogenous appearance, teratomas have a heterogenous appearance.
What causes epididymis-orchitis?
STIs, UTIs, mumps, TB
What is the mechanism behind testicular torsion?
The spermatic cord becomes twisted and cuts off the blood supply to the testicle
What are Undescended testes a risk factor for?
Testicular cancer, testicular torsion.
What is the bell-clapper deformity?
Lack of anchoring of tunica vaginalis (containing spermatic cord) to posterior aspect of testicle. It predisposes to testicular torsion
What is Phehns sign?
Relief of testicular pain on elevation. Positive in epididymo-orchitis. Negative in torsion.
What is an orchidopexy?
Fixation of testicle to prevent torsion
What is a testicular varicocele?
Abnormal enlargement of the pampiniform venous plexus which drains the testicules.
When would you be worried about a varicocele?
New onset after age of 40 - can be caused by compression of left renal vein by pelvic / abdominal malignancy (e.g. RCC)
How is Prostate Cancer graded?
The gleason score - it is a histological numerical score based off the two most common patterns of architecture seen in the tumour.
what are prostate symptoms?
hesitancy, dribbling, nocturne, urgency, frequency, poor stream
Which blood test monitors extra capsular spread in prostate cancer?
acid phosphatase
what is the management for prostate cancer?
conservative - support groups, monitor, education
medical - hormonal therapy (Goserelin - a GnRH analogue, Cyproterone - an anti-antidrogen); RT (external beam, brachytherapy)
Surgical - radical prostatectomy (only for local disease; can be done retropubic, peritoneal or laparoscopic )
what is post-TURP syndrome?
it is hyponatraemia (<125) caused by absorption of the irrigation fluid through the damaged prostate. it presents with confusion, nausea, headache, bradycardia, hypertension. it is treated with hypertonic saline and haemodialysis.
what advice should you give patients for the two weeks following a TURP?
no sex, no driving, expect haematuria
what is the management of BPH?
Conservative - avoid caffeine and alcohol, void twice in a row, bladder retraining
Medical - alpha blockers (Doxazosin, Tamsulosin, Terazosin - relax muscle surrounding the prostate), finasteride (5-alpha reductase inhibitors - suppress serum DHT to shrink prostate)
surgery - TURP, TULIP, retropubic prostatectomy
where is bladder cancer the most common cancer?
Egypt, due to schistosomiasis causing squamous cell carcinoma.
