UROLOGY Flashcards
(27 cards)
benign prostatic hypertrophy is not what
irregular prolif of what
symptoms of prostatism
not pre malignant
glandular and stroll tissue
difficulty strain,g poor stream, overflow incontincance, acute/chronic retention
BPH cause
cx
rx
hormone imbalance
bladder hypertrophy - diverticulum, hydrometer, hydrophesis, infection
tamulosin, finsatride, transurethral resection
overflow cause
symptoms
rx
bladder outflow obstruction
huge palpable bladder, chronic retention, insensible incontinance, often wet at night, renal impairment
assess renal function, catheterise, teach intermittent self catheterisation
extrauretheral causes of incontincance
ectopic ureter - rare, congenital
vesicovaginal fistula - prolonged obstructive labour
stress incontinance
leaking on exertion, sneaking
urodynamic studies
weight loss, stop smoking, exercises, surgical repair
urge incontinance
accompanied or proceeded by urgency. freq small voided volumes. urgency. enuresis
detrusor overactivity: idiopathic, paraplegia, destruction of S2, S3. pelvic surgery pelvic fracture, afferent stimulation
urodynamic studies
avoid caffeine, bladder retraining, oxybutinin, pacemaker, surgery - enterocytoplasty
kidneys stones risks
ix
increased calcium, hypothyroid, gout
CT urogram - gold standard
calcium oxalate calcium phosphate uric acid strivate cystine xantine
commonest and radiopaque. acidic urine alkali urine - proteus radiolucent kidney infection genetic disease radiolucent. v rare
prostate cancer mainly what
where
lymph spread
haem spread
multifocal adenocarcinoma
70% in peripheral zone
sacral, iliac, paraaortic
bone (lumbar spine and pelvis), lungs, liver
prostate cancer DRE PSA imaging TRUB
assym crazy nodular mass
sensitivity 90% specific 40%. also increased in catheter, infection
USS, skeletal XR, bone scan
10-12 biopsies taken.
management of prostate cancer
hormone therapy - anti androgen cyproterone. oestrogens
radio - bone mets
transurethral resection
radical prostectomy
testicular tumours symptoms
10% present due to what
non GCT
painless testicular enlargement hydrocele gynacamastia
neck nodes.
10% - lymphoma, leukaemia, stromal, mets
ix for testicular tumours
USS, CXR, CT
AFP: yolk sac
bHCG: trophoblastic
PLAP: seminoma
treatment general of testicular tumours
orchidectomy inguinal approach better
radio/chemo
seminoma
rare before puberty lymph paraartic haem lungs, liver potato radiosensitive
teratoma
childhood
trophoblastic
chemo
mixed
seminoma with variant of teratoma
RPLND
residual LNs may harbour tumour 1/3 fibrous, 1/3 mature benign tumour 1/3 residual teratoma
bladder cancer papillary
50% malignant
striped
thicker lining than normal epithelium
bladder cancer non papillary
solid/mixed
all considered malignant
transitional bladder cell cancer tends to be what
bilateral and multicentric
risk factors for bladder cancer
symptoms
75% what
ix
dye rubber industry. schitwosmasosis. smoking
painless haematuria
in trigone area - obstruction
urinalysis, cytoscopy
haematuria causes
cancer infection stones trauma GN PKD
erectile dysfunction causes
rx
DM, CVS, surgery, drug SE
sildenafil viagra SA
varalenafil SA
avanafil SA
tadalafil LA
