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Flashcards in Urology Deck (246):
1

What is a cystogram?

Contrast study of the bladder

2

What are ureteral stents?

Plastic tubes placed via cystoscope into the ureters for stenting, identification, etc.

3

What is a cystoscope?

Scope placed into the urethra and into the bladder to visualize the bladder

4

What is a perc nephrostomy?

Catheter placed through the skin into the kidney pelvis to drain urine with distal obstruction

5

What is a retrograde pyelogram?

Dye injected into the ureter up into the kidney, and films taken

6

What is a RUG?

Retrograde UrethroGram
Dye injected into the urethra and films taken.
Rules out urethral injury, usually in trauma patients.

7

What is a Gomco clamp?

Clamp used for circumcision.
Protects penis glans.

8

What is a Bell clapper's deformity?

Condition of congenital absence of gubernaculum attachment to scrotum

9

What is Fournier's gangrene?

Extensive tissue necrosis/infection of the perineum in patients with diabetes

10

What is a Foley catheter?

Straight bladder catheter placed through the urethra

11

What is a Coude catheter?

Basically, a Foley catheter with hook on the end to get around a large prostate

12

What is a suprapubic catheter?

Bladder catheter place through the skin above the pubic symphasis into the bladder

13

What is posthitis?

Foreskin infection

14

What is a hydrocele?

Clear fluid in the processus vaginalis membrane

15

What is a communicating hydrocele?

Hydrocele that communicates with peritoneal cavity and, thus, gets smaller and larger as fluid drains and then reaccumulates

16

What is a non-communicating hydrocele?

Hydrocele that does not communicate with the peritoneal cavity.
Remains the same size.

17

What is a varicocele?

Abnormal dilation of the pampiniform plexus to the spermatic vein in the spermatic cord.
Described as a "bag of worms".

18

What is a spermatocele?

Dilatation of epididymis or vas deferens

19

What is epididymitis?

Infection of the epididymis

20

What is Prehn's sign?

Elevation of the painful testicle that reduces the pain of epididymitis

21

What is a TRUS?

TransRectal UltraSound

22

What is a DRE?

Digital Rectal Examination

23

What is orchitis?

Inflammation/infection of the testicle

24

What is pseudohermaphroditism?

Genetically one sex, partial or complete opposite-sex genitalia

25

What is urgency?

Overwhelming sensation to void immediately

26

What is dysuria?

Painful urination (usually burning sensation)

27

What is frequency?

Urination more frequently than usual

28

What is polyuria?

Urination in larger amounts than usual

29

What is nocturia?

Awakening to urinate

30

What is hesitancy?

Delay in urination

31

What is pneumaturia?

Air passed with urine via the urethra

32

What is pyuria?

WBCs in urine (UTI: > 10 WBCs/HPF)

33

What is cryptorchidism?

Undescended testicle

34

What is an IVP?

IntraVenous Pyelogram:
Dye is injected into the vein, collects in the renal collecting system, and an x-ray is taken

35

What is hematuria?

RBCs in urine

36

What is the space of Retzius?

Anatomic extraperitoneal space in front of the bladder

37

What is enuresis?

Involuntary urination while asleep

38

What is incontinence?

Involuntary urination

39

What is a TURP?

TransUrethral Resection of the Prostate

40

What is PVR?

PostVoid Residual

41

What is priapism?

Prolonged, painful erection

42

What is paraphimosis?

Foreskin held (stuck) in the retracted position

43

What is phimosis?

Inability to retract the foreskin

44

What is balanitis?

Inflammation/infection of the glans penis

45

What is balanoposthitis?

Inflammation/infection of the glans and prepuce of the penis

46

What is a UTI?

Urinary Tract Infection

47

What is Peyronie's disease?

Abnormal fibrosis of the penis shaft, resulting in a bend upon erection

48

What is BPH?

Benign Prostatic Hyperplasia

49

What is epispadias?

Abnormal urethral opening on the dorsal surface of the penis

50

What is hypospadias?

Abnormal urethral opening on the ventral surface of the penis.
May occur in anterior, middle or posterior of penis.

51

What is erectile dysfunction?

Inability to achieve an erection

52

What is sterility?

Inability to reproduce

53

What is an appendix testis?

Common redundant testicular tissue

54

What is VUR?

VesicoUreteral Reflux

55

What are the layers of the scrotum?

(1) Skin, (2) Dartos fascia, (3) External spermatic fascia, (4) Cremaster muscle, (5) Internal spermatic fascia, (6) Parietal and Visceral layers of tunica vaginalis, (7) Tunica albuginea

56

What is the differential diagnosis of scrotal mass?

Cancer, torsion, epididymitis, hydrocele, spermatocele, varicocele, inguinal hernia, testicular appendage, swollen testicle after trauma, non-testicular tumor (e.g. rhabdomyosarcoma, leiomyosarcoma, liposarcoma)

57

What are the causes of hematuria?

Bladder cancer, trauma, UTI, cystitis from chemotherapy or radiation, stones, kidney lesion, BPH

58

What is the most common cause of severe gross hematuria without trauma, chemotherapy, or radiation?

Bladder cancer

59

What is the differential diagnosis for bladder outlet obstruction?

BPH, stone, foreign body, urethral stricture, urethral valve

60

What is the differential diagnosis for ureteral obstruction?

Stone, tumor, iatrogenic (suture), stricture, gravid uterus, radiation injury, retroperitoneal fibrosis

61

What is the differential diagnosis for kidney tumor?

Renal cell carcinoma, sarcoma, adenoma, angiomyolipoma, hemangiopericytoma, oncocytoma

62

What is renal cell carcinoma?

Most common solid renal tumor (90%).
Originates from proximal renal tubular epithelium.

63

What is the epidemiology of renal cell carcinoma?

Primarily a tumor of adults 40-60 years with 3:1 M:F ratio.

64

What percentage of renal cell tumors are bilateral?

1%

65

What are the risk factors for renal cell carcinoma?

Male, smoking, von Hippel-Lindau syndrome, polycystic kidney

66

What are the symptoms of renal cell carcinoma?

Pain, hematuria, weight loss, flank mass, HTN

67

What is the classic triad of renal cell carcinoma?

1. Flank pain
2. Hematuria
3. Palpable mass

68

How are most cases of renal cell carcinoma diagnosed?

Found incidentally on an imaging study

69

What radiologic test are performed for renal cell carcinoma?

IVP, Abdominal CT with contrast

70

What is stage I renal cell carcinoma?

Tumor < 2.5 cm no nodes, no metastases

71

What is stage II renal cell carcinoma?

Tumor > 2.5 cm limited to kidney, no nodes no metastases

72

What is stage III renal cell carcinoma?

Tumor extends into IVC or main renal vein.
Positive regional lymph nodes but < 2 cm in diameter and no metastases.

73

What is stage IV renal cell carcinoma?

Distant metastasis or positive lymph node > 2 cm in diameter, or tumor extends past Gerota's fascia

74

What is the metastatic workup for renal cell carcinoma?

CXR, IVP, CT, LFTs, calcium

75

What are the sites of metastases for renal cell carcinoma?

Lung, liver, brain, bone.
Tumor thrombus entering renal vein or IVC is not uncommon.

76

What is the unique route of spread with renal cell carcinoma?

Tumor thrombus in IVC lumen

77

What is the treatment of renal cell carcinoma?

Radical nephrectomy (excision of the kidney, adrenal gland, including Gerota's fascia) for stages I-IV

78

What gland is removed with a radical nephrectomy?

Adrenal gland

79

What is the unique treatment of metastatic spread of renal cell carcinoma?

1. alpha-interferon
2. LAK cells (lymphokine-activated killer) and IL-2

80

What is a syndrome of renal cell carcinoma and liver disease?

Stauffer's syndrome

81

What is the concern in an adult with new onset left varicocele?

Left renal cell carcinoma (the left gonadal vein drains into the left renal vein)

82

What is the most common histology in bladder cancer?

Transitional cell carcinoma (90%).
Remaining cases are squamous or adenocarcinomas.

83

What are the risk factors for bladder cancer?

Smoking, industrial carcinogens (aromatic amines), schistosomiasis, truck drivers, petroleum workers, cyclophosphamide

84

What are the symptoms of bladder cancer?

Hematuria +/- irritative symptoms, frequency

85

What is the classic presentation of bladder cancer?

Painless hematuria

86

What tests are included in the workup for bladder cancer?

Urinanalysis and culture, IVP, cystoscopy with cytology and biopsy

87

What is stage 0 bladder cancer?

Superficial, carcinoma in situ

88

What is stage I bladder cancer?

Invades subepithelial connective tissue, no positive nodes, no metastases

89

What is stage II bladder cancer?

Invades superficial or deep muscularis propria, no positive nodes, no metastases

90

What is stage III bladder cancer?

Invades perivesical tissues, no positive nodes, no metastases

91

What is stage IV bladder cancer?

Positive nodal spread with distant metastases and/or invades abdominal pelvic wall

92

What is the treatment of stage 0 bladder cancer?

TURB and intravesical chemotherapy

93

What is the treatment of stage I bladder cancer?

TURB

94

What is the treatment of stage II and III bladder cancer?

Radical cystectomy, lymph node dissection, removal of prostate/uterus/ovaries/anterior vaginal wall, and urinary diversion (e.g. ileal conduit) +/- chemotherapy

95

What is the treatment of stage IV bladder cancer?

+/- cystectomy and systemic chemotherapy

96

What are the indications for partial cystectomy?

Superficial, isolated tumor, apical with 3-cm margin from any orifices

97

What is TURB?

TransUrethral Resection of the Bladder

98

If after a TURB the tumor occurs, then what?

Repeat TURB and intravesical chemotherapy (mitomycin C) or bacillus Calmette-Guerin

99

What is and how does bacillus Calmette-Guerin work?

Attenuated TB vaccine.
Thought to work by immune response.

100

What is the incidence of prostate cancer?

Most common GU cancer.
Most common carcinoma in men in the US.

101

What is the epidemiology of prostate cancer?

Present in 33% of men 70-79 years and 66% of men 80-89 years; more common in African Americans

102

What is the histology of prostate cancer?

Adenocarcinoma (95%)

103

What are the symptoms of prostate cancer?

Often asymptomatic.
Nodule found on routine DRE.
Usually begins in the periphery of the gland and moves centrally, thus obstructive symptoms occur late.

104

What percentage of patients have metastasis of prostate cancer at diagnosis?

40%

105

What are the common sites of metastasis of prostate cancer?

Osteoblastic bony lesions, lung, liver, adrenal glands

106

What provides lymphatic drainage of prostate?

Obturator and hypogastric nodes

107

What is the significance of Batson's plexus?

Spinal cord venous plexus.
Route of isolated skull/brain metastasis.

108

What are the steps in early detection of prostate cancer?

1. Prostate-specific antigen (most sensitive and specific marker)
2. DRE

109

When should men get a PSA-level check?

Controversial:
1. All men > 50 years
2. > 40 years if first-degree family history or African American

110

What percentage of patients with prostate cancer will have an elevated PSA?

60%

111

What is the imaging test for prostate cancer?

TRUS

112

How is the diagnosis of prostate cancer made?

Transrectal biopsy

113

What is the Gleason score?

Histologic grades 2-10:
Low score: well-differentiated
High score: poorly-differentiated

114

What are the indications for transrectal biopsy with normal DRE?

PSA > 10 or abnormal TRUS

115

What is stage I prostate cancer?

Tumor involves < 50% of 1 lobe, no nodes, no metastases, PSA < 10, Gleason < 7

116

What is stage II prostate cancer?

Tumor within prostate, lobe < 50% but PSA > 10, or Gleason > 6, or > 50% of 1 lobe, no nodes, no metastases

117

What is stage III prostate cancer?

Tumor through prostate capsule or into seminal vesicles, no nodes, no metastases

118

What is stage IV prostate cancer?

Tumor extends into adjacent structures (other than seminal vesicles) or positive nodes or positive metastases

119

What does radical prostatectomy remove?

1. Prostate gland
2. Seminal vesicles
3. Ampullae of the vasa deferentia

120

What is androgen ablation therapy?

1. Bilateral ochiectomy or
2. LHRH agonists

121

How do LHRH agonists work?

Decrease LH release from pituitary, which then decreases testosterone production in the testes

122

What is the treatment for stage I prostate cancer?

Radical prostatectomy

123

What is the treatment for stage II prostate cancer?

Radical prostatectomy +/- lymph node dissection

124

What is the treatment for stage III prostate cancer?

Radiation therapy +/- androgen ablation

125

What is the treatment for stage IV prostate cancer?

Androgen ablation, radiation therapy

126

What is the medical treatment for systemic metastatic disease from prostate cancer?

Androgen ablation

127

What is the option for treatment in the early stage prostate cancer patient > 70 years with comorbidity?

Radiation therapy

128

What is benign prostatic hyperplasia?

Disease of elderly men in which the prostate gradually enlarges, creating symptoms of urinary outflow obstruction

129

What is the size of a normal prostate?

20-25 g

130

Where does BPH occur?

Periurethrally

131

What are the symptoms of BPH?

Obstructive-type symptoms (e.g. hesitancy, weak stream, nocturia, intermittency, UTI, urinary retention)

132

How is the diagnosis of BPH made?

History, DRE, elevated PVR, UA, cystoscopy, U/S

133

What lab tests should be performed for BPH?

UA, PSA, BUN, Cr

134

What is the differential diagnosis of BPH?

Prostate cancer (biopsy); neurogenic bladder (history of neurologic disease); acute prostatitis (hot, tender gland); urethral stricture (RUG, history of STD); stone; UTI

135

What are the treatment options for BPH?

alpha-1 blockade, antiandrogens, TURP, TUIP, open prostate resection, transurethral balloon dilation

136

Why do alpha-adrenergic blockers work for BPH?

Relaxes sphincter and prostate capsule

137

What is finasteride (Proscar)?

5-alpha-reductase inhibitor.
Blocks transformation of testosterone to DHT.
May shrink and slow progression of BPH.

138

What is terazosin (Hytrin)?

alpha-blocker.
May increase urine outflow by relaxing prostatic smooth muscles

139

What are the indications for surgery in BPH?

Urinary retention, hydronephrosis, UTIs, severe symptoms

140

What is TUIP?

TransUrethral Incision of Prostate

141

What percentage of tissue removed for BPH will have malignant tissue on histology?

Up to 10%

142

What are the possible complications of TURP?

Failure to void, bleeding, clot retention, UTI, incontinence

143

What is the incidence of testicular cancer?

Rare; 2-3/100,000 men per year

144

What is the most common solid tumor of men 20-40 years?

Testicular cancer

145

What are the risk factors for testicular cancer?

Cryptorchidism

146

Does orchiopexy as an adult remove the risk of testicular cancer?

No

147

What are the symptoms of testicular cancer?

Painless mass, swelling, firmness of testicle

148

What percentage of patients with testicular cancer present with an acute hydrocele?

10%

149

What percentage of patients with testicular cancer present with symptoms of metastatic disease (e.g. back pain, anorexia)?

10%

150

What are the classifications of testicular cancer?

Germ cell tumors (seminomatous, non-seminomatous, teratoma, mixed, choriocarcinoma); Non-germinal (Leydig cell, Sertoli cell, gonadoblastoma)

151

What is the major classification of testicular cancer based on therapy?

Seminomatous and non-seminomatous

152

What are the tumor markers for testicular tumors?

1. B-HCG
2. AFP

153

What are the tumor markers by tumor type?

B-HCG: choriocarcinoma, embryonal carcinoma, seminomatous carcinoma
AFT: embryonal carcinoma, yolk sac tumors, non-seminomatous carcinoma

154

What is the difference between seminomatous and non-seminomatous germ cell testicular tumor markers?

Non-seminomatous: 90% have positive AFP and/or B-HCG.
Seminomatous: 10% are AFP positive.

155

Which testicular tumors almost never have an elevated AFP?

Choriocarcinoma and seminoma

156

In which testicular tumor is B-HCG almost always found elevated?

Choriocarcinoma

157

How often is B-HCG elevated in patients with pure seminoma?

10%

158

How often is B-HCG elevated with nonseminoma?

65%

159

What other testicular tumor markers may be elevated and useful for recurrence surveillance?

LDH, CEA, HCS, GGT, PLAP

160

What are the steps in workup for testicular cancer?

PE, scrotal U/S, check tumor markers, CXR, CT

161

What is stage I testicular cancer?

Any tumor size, no nodes, no metastases

162

What is stage II testicular cancer?

Positive nodes, no metastases, any tumor

163

What is stage III testicular cancer?

Distant metastases

164

What is the initial treatment for all testicular tumors?

Inguinal orchiectomy (removal of testicle through a groin incision)

165

What is the treatment of stage I and II seminoma?

Inguinal orchiectomy and radiation to retroperitoneal nodal basins

166

What is the treatment of stage III seminoma?

Orchiectomy and chemotherapy

167

What is the treatment of stage I and II nonseminoma?

Orchiectomy and retroperitoneal lymph node dissection vs. close followup for retroperitoneal nodal involvement

168

What is the treatment of stage III nonseminoma?

Orchiectomy and chemotherapy

169

What percentage of stage I seminomas are cured after treatment?

95%

170

Which type of testicular cancer is most radiosensitive?

Seminoma

171

Why not remove testis with cancer through a scrotal incision?

Could result in tumor seeding of the scrotum

172

What is the major side effect of retroperitoneal lymph node dissection?

Erectile dysfunction

173

What is testicular torsion?

Twisting of the spermatic cord, resulting in venous outflow obstruction, and subsequent arterial occlusion, leading to infarction of the testicle

174

What is the classic history of testicular torsion?

Acute onset of scrotal pain usually after vigorous activity or minor trauma

175

What is a bell-clapper deformity?

Bilateral non-attachment of the testicles by the gubernaculum to the scrotum

176

What are the symptoms of testicular torsion?

Pain in the scrotum, suprapubic pain

177

What are the signs of testicular torsion?

Very tender, swollen, elevated testicle, non-illumination, absence of cremasteric reflex

178

What is the differential diagnosis of testicular torsion?

Testicular trauma, inguinal hernia, epididymitis, appendage torsion

179

How is the diagnosis of testicular torsion made?

Surgical exploration, U/S (solid mass) and Doppler flow study, cold Tc-99m scan

180

What is the treatment for testicular torsion?

Surgical detorsion and bilateral orchiopexy to the scrotum

181

How much time is available from the onset of symptoms to detorse the testicle?

< 6 hours will bring about the best results

182

What are the chances of testicle salvage after 24 hours of torsion?

< 10%

183

What are the signs and symptoms of epididymitis?

Swollen, tender testicle, dysuria, scrotal pain, fever, chills, scrotal mass

184

What is the cause of epididymitis?

Bacteria from the urethra

185

What are the common pathogens of epididymitis in elderly patients and children?

E. coli

186

What are the common pathogens of epididymitis in young men?

Gonorrhea, chlamydia

187

What is the major differential diagnosis for epididymitis?

Testicular torsion

188

What is the workup for epididymitis?

U/A, urine culture, swab if STD suspected, +/- U/S with Doppler or nuclear study to rule out torsion

189

What is the treatment for epididymitis?

Antibiotics

190

What are the causes of priapism?

Low flow (e.g. leukemia, drugs, sickle-cell disease, erectile dysfunction treatment gone wrong)
High flow (e.g. pudendal artery fistula, usually from trauma)

191

What is the first-line treatment for priapism?

1. Aspiration of blood from corporus cavernosum
2. alpha-adrenergic agent

192

What are the 6 major causes of erectile dysfunction?

1. Vascular (decreased blood flow or lead of blood from the corpus cavernosus)
2. Endocrine (low T)
3. Anatomic (structural abnormality of the erectile apparatus, e.g. Peyronie's disease)
4. Neurologic (damage to nerves, e.g. post-operative, IDDM)
5. Medications (clonidine)
6. Psychologic (performance anxiety)

193

What lab tests should be performed for erectile dysfunction?

Fasting glucose (rule out diabetic neuropathy); serum testosterone; serum prolactin

194

What is the incidence of calculus disease?

10%

195

What are the risk factors for calculus disease?

Poor fluid intake, IBD, hypercalcemia, renal tubular acidosis, small bowel bypass

196

What are the 4 types of stones?

1. Calcium oxalate/phosphate (secondary to hypercalcemia)
2. Struvite, MgAmPh (infection stones; seen in UTI with urea-splitting bacteria; may cause staghorn calculi; high urine pH)
3. Uric acid (stones are radiolucent, seen in gout, Lesch-Nyhan, chronic diarrhea, cancer, low urine pH)
4. Cystine (genetic predisposition)

197

What type of stones are not seen on AXR?

Uric acid

198

What stone is associated with UTIs?

Struvite

199

What stones are seen in IBD and bowel bypass?

Calcium oxalate

200

What are the symptoms of calculus disease?

Severe pain (patient cannot sit still); renal colic (typically pain in the kidney/ureter that radiates to the testis or penis); hematuria

201

What are the classic findings with calculus disease?

Flank pain, stone on AXR, hematuria

202

How is the diagnosis of calculus disease made?

KUB, IVP, U/A and culture, BUN/Cr, CBC

203

What is the significance of hematuria and pyuria?

Stone with concomitant infection

204

What is the treatment for calculus disease?

Narcotics for pain, vigorous hydration, observation.
Further options: ESWL (lithotripsy), ureteroscopy, percutaneous lithotripsy, open surgery, metabolic workup for recurrence

205

What are the indications for intervention in calculus disease?

Urinary tract obstruction, persistant infection, impaired renal function

206

What are the contraindications of outpatient treatment of calculus disease?

Pregnancy, diabetes, obstruction, severe dehydration, severe pain, urosepsis/fever, pyelonephritis, previous urologic surgery, only one functioning kidney

207

What are the 3 common sites of obstruction in calculus disease?

1. UPJ (UreteroPelvic Junction)
2. UVJ (UreteroVesicular Junction)
3. Intersection of the ureter and the iliac vessels

208

What are the common types of incontinence?

Stress, overflow, urge

209

What is stress incontinence?

Loss of urine associated with coughing, lifting, exercise, etc.
Seen most often in women, secondary to relaxation of pelvic floor following multiple deliveries.

210

What is overflow incontinence?

Failure of the bladder to empty properly.
May be caused by bladder outlet obstruction (BPH or stricture) or detrusor hypotonicity.

211

What is urge incontinence?

Loss of urine secondary to detrusor instability in patients with stroke, dementia, Parkinson's disease, etc.

212

What is mixed incontinence?

Stress and urge incontinence combined

213

How is the diagnosis of incontinence made?

H&P, U/A, PVR, urodynamics, cystoscopy or VCUG may be necessary

214

What is the Marshall test?

Women with stress incontinence placed in the lithotomy position with a full bladder leaks urine when asked to cough

215

What is the treatment for stress incontinence?

Bladder neck suspension

216

What is the treatment for urge incontinence?

Anticholinergics, alpha-agonists

217

What is the treatment for overflow incontinence?

Self-catheterization, surgical relief of obstruction, alpha-blockers

218

What is the etiology of UTI?

Ascending infection, instrumentation, coitus in females

219

What are the 3 common pathogens in UTI?

1. E. coli
2. Proteus
3. Klebsiella, Pseudomonas

220

What are the predisposing factors for UTI?

Stones, obstruction, reflux, diabetes, pregnancy, indwelling catheter or stent

221

What are the symptoms of UTI?

Lower UTI: frequency, urgency, dysuria, nocturia
Upper UTI: back or flank pain, fever, chills

222

How is the diagnosis of UTI made?

Symptoms, U/A (> 10 WBCs/HPF)

223

When should workup be performed for UTI?

After first infection in male patients (unless Foley in place).
After first pyelonephritis in prepubescent females.

224

What is the treatment for UTI?

Lower: 1-4 days of oral antibiotics
Upper: 3-7 days of IV antibiotics

225

Why should orchiopexy be performed?

Decrease the susceptibility to blunt trauma; increase the ease of followup exams

226

What type of bony lesions is seen in metastatic prostate cancer?

Osteoblastic (radiopaque)

227

What percentage of renal cell carcinoma show evidence of metastatic disease at presentation?

33%

228

What is the most common site of distant metastasis in renal cell carcinoma?

Lung

229

What is the most common solid renal tumor in children?

Wilms' tumor

230

What are posterior urethral valves?

Most common obstructive urethral lesion in infants and newborns.
Occurs only in males, found at the distal prostatic urethra.

231

What is the most common intraoperative bladder tumor?

Foley catheter

232

What provides drainage of the left gonadal vein?

Left renal vein

233

What provides drainage of the right gonadal vein?

IVC

234

What are the signs of urethral injury in the trauma patient?

High-riding, ballottable prostate, blood at the urethral meatus, severe pelvic fracture, ecchymosis of scrotum

235

What is the evaluation for urethral injury in the trauma patient?

RUG

236

What is the evaluation for a transected ureter intraoperatively?

IV indigo carmine and then look for leak of blue urine in the operative field

237

What aid is used to help identify the ureters in a previously radiated retroperitoneum?

Ureteral stents

238

How can a small traumatic extraperitoneal bladder rupture be treated?

Foley catheter

239

How should a traumatic intraperitoneal bladder rupture be treated?

Operative repair

240

What percentage of patients with an injured ureter will have no blood on U/A?

33%

241

What is the classic history of papillary necrosis?

Patient with diabetes taking NSAIDs or patient with sickle cell trait

242

What unique bleeding problem can be seen with prostate surgery?

Release of TPA and urokinase (treat with e-aminocaproic acid)

243

What is the scrotal blue dot sign?

Torsed appendix testis

244

What is Peyronie's disease?

Curved penile orientation with erection due to fibrosis of corpora cavernosa

245

What is a ureterocele?

Dilation of the ureter (treat with endoscopic incision or operative excision)

246

What is "three-way" irrigating Foley catheter?

Foley catheter that irrigates and then drains