Urological Emergencies

Question 1

what is acute urinary retention?

Answer 1

the inability to urinate with increasing pain

Question 2

what is acute urinary retention a possible complication of?

Answer 2

benign prostate hyperplasia

Question 3

what are the two possible causes of acute urinary retention?

Answer 3

spontaneous

precipitated by an event

Question 4

what is the management for acute urinary retention?

Answer 4

catheter insertion

Question 5

what investigations are done for frank haematuria?

Answer 5

CT urogram

cystoscopy

Question 6

when is testicular torsion most common?

Answer 6

puberty

Question 7

how does testicular torsion present?

Answer 7

sudden onset pain
nausea
vomiting
pain referral to lower abdomen

Question 8

what is seen on examination of testicular torsion?

Answer 8

testes high in the scrotum

absent cremasteric reflex

Question 9

what investigation may be done for testicular torsion?

Answer 9

doppler USS

Question 10

how can epididymitis present?

Answer 10

dysuria
pyrexia
history of UTI or catheter

Question 11

what is seen on examination of epididymitis?

Answer 11

cremasteric reflex present

Question 12

what investigations are done for epididymitis?

Answer 12

doppler

urine culture + chlamydia PCR

Question 13

what is the management for epididymitis?

Answer 13

analgesia
scrotal support
ofloxacin for 14 days

Question 14

how is idiopathic scrotal oedema managed?

Answer 14

self limiting

Question 15

what causes idiopathic scrotal oedema?

Answer 15

unknown

Question 16

what is paraphimosis?

Answer 16

painful swelling of the foreskin distal to a phimotic ring

Question 17

what is a common cause of paraphimosis?

Answer 17

foreskin retracted for catheterisation etc. and not replaced in its natural position

Question 18

what is priapism?

Answer 18

prolonged unwanted erection for over four hours

often painful

Question 19

what are four possible causes of priapism?

Answer 19

trauma
haematological diseases
neurological conditions
idiopathic

Question 20

what are the two types of priapism?

Answer 20

ischaemic

non ischaemic

Question 21

what are other names for ischaemic priapism?

Answer 21

veno occlusive

low flow

Question 22

what is the pathophysiology behind ischaemic priapism?

Answer 22

vascular stasis and decreased venous outflow in the penis

Question 23

how does ischaemic priapism present?

Answer 23

corpus cavernosum rigid and tender

often painful

Question 24

what is the pathophysiology behind non ischaemic priapism?

Answer 24

traumatic disruption of vasculature causes unregulated blood entry

Question 25

what two investigations are done for priapism?

Answer 25

aspirate blood from the corpus cavernosum | doppler USS

Question 26

what is seen on aspiration in ischaemic priapism?

Answer 26

dark blood | low oxygen, high CO2

Question 27

what is seen on aspiration in non ischaemic priapism?

Answer 27

normal arterial blood

Question 28

what is seen on doppler in ischaemic priapism?

Answer 28

minimal/absent blood flow

Question 29

what is seen on doppler in non ischaemic priapism?

Answer 29

normal/high flow

Question 30

what is the management for ischaemic priapism?

Answer 30

aspiration injections of alpha agonists surgery - shunt

Question 31

what is the management for non ischaemic priapism?

Answer 31

observe - often resolves spontaneously | selective embolisation

Question 32

what is fournier's gangrene?

Answer 32

a form of necrotising fasciitis occurring around the male genitalia

Question 33

what are four risk factors for fournier's gangrene?

Answer 33

diabetes trauma periurethral extravasation perianal infection

Question 34

what is seen on examination of fournier's gangrene?

Answer 34

swelling crepitus dark purple areas

Question 35

what is the treatment for fournier's gangrene?

Answer 35

antibiotics | surgical debridement

Question 36

what increases mortality in fournier's gangrene?

Answer 36

diabetes | alcoholism

Question 37

what is emphysematous pyelonephritis?

Answer 37

acute necrotising perirenal infection

Question 38

what is the most common cause of emphysematous pyelonephritis?

Answer 38

e coli

Question 39

what are the main risk factors for emphysematous pyelonephritis?

Answer 39

diabetes | ureteric obstruction

Question 40

how does emphysematous pyelonephritis present?

Answer 40

fever vomiting flank pain

Question 41

what is the investigation of choice for emphysematous pyelonephritis?

Answer 41

CT

Question 42

how is emphysematous pyelonephritis managed?

Answer 42

ICU admission | nephrectomy if it doesnt settle

Question 43

what causes a perinephric abscess?

Answer 43

rupture of cortical abscess | haematogenous spread of infection

Question 44

what investigation should be done for a perinephric abscess?

Answer 44

CT scan

Question 45

how is a perinephric abscess managed?

Answer 45

antibiotics | drainage

Question 46

what investigation is done for renal trauma?

Answer 46

CT with contrast

Question 47

what is bladder injury commonly associated with?

Answer 47

pelvic fractures