BPH and obstructive uropathy
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The document discusses obstructive uropathy and benign prostatic hyperplasia (BPH). It defines obstructive uropathy as structural or functional hindrance of normal urine flow. The most common causes of obstruction vary with age, from valves/strictures in children to BPH/prostate cancer in older adults. BPH is a non-cancerous enlargement of the prostate and its symptoms are related to bladder outlet obstruction. Treatment involves eliminating the obstruction either temporarily with stents/tubes or permanently with surgery or procedures like resection or ablation.
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![[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],© OBSTRUCTIVE UROPATHY By Mohammed Ibrahim, MBBcH Revised by M.A.Wadood , MD, MRCS By Moh.Ibrahim, MBBcH Revised by M.A.Wadood , MD, MRCS](data:image/gif;base64,R0lGODlhAQABAIAAAAAAAP///yH5BAEAAAAALAAAAAABAAEAAAIBRAA7)
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This document provides information on the histological classification and diagnostic evaluation of solitary space-occupying lesions of the liver. It discusses the classification of hepatocellular, bile duct, and miscellaneous lesions. It also outlines the diagnostic steps including history, examination, labs, imaging studies and algorithms for the workup of solitary and multiple liver lesions on ultrasound. Several clinical cases are then presented and discussed.
New MRCS Part A Exam format
The format of the MRCS Part A Examination will change from January 2017. This is a brief summary of the implemented changes.
For more information, please visit: http://www.intercollegiatemrcsexams.org.uk/
You can apply for an exam at: https://postgradexams.rcsi.ie/
MRCS preparation eMrcs questions surgery
A 53-year-old man is readmitted 10 days after reversal of a loop colostomy with vomiting and abdominal pain. Examination shows a tender swelling at the colostomy site. The most likely diagnosis is an obstructed incisional hernia, as the symptoms and findings point to obstruction and loop colostomy reversals carry a high risk of hernia development due to increased risk of postoperative infection.
Emergencies (non traumatic)
This document discusses various urological emergencies including traumatic injuries like renal injuries and testicular injuries as well as non-traumatic conditions like urinary retention, renal colic, testicular torsion, priapism, and paraphimosis. It provides details on the causes, presentations, diagnoses, and management approaches for each condition. Key surgical procedures mentioned include scrotal exploration for testicular torsion, shunt placement for refractory priapism, and circumcision for paraphimosis. The document is intended as an educational guide on genitourinary emergencies for medical students and residents.
MRCS Syllabus and recommended textbooks
Detailed information about the syllabus for the MRCS Examination Part A and Part B. This has been extracted from the official ICBSE 'Guide to the intercollegiate MRCS examination'.
Applications for the exams are open at: https://postgradexams.rcsi.ie
Investigations of lymphatics
This document discusses various tests and imaging modalities used to evaluate lymphedema. Lymphoscintigraphy using radioactive tracer particles is now the gold standard as it can evaluate lymphatic anatomy and flow dynamics in a noninvasive way. Other tests mentioned include blood tests, urine dipstick, ultrasound, CT, and MRI which can identify causes of lymphedema like tumors or assess lymphatic channels. Biopsies may be used if malignancy is suspected. Surgical techniques like lymph node dissection or cyst removal can help resolve lymphedema in some cases.
Local Flaps For Lower Limb Reconstruction Version1
This document discusses various anatomical principles and commonly used local flaps for reconstruction in the lower leg. It describes several options for flaps based on specific vascular structures in the posterior calf, gastrocnemius, soleus, and surrounding the lesser saphenous vein. Perforator flaps involving the peroneal, anterior tibial, and posterior tibial arteries are also mentioned. The use of these flaps depends on the specific part of the leg needing reconstruction.
Tips for orthopedics exam
This document provides tips and information for an orthopedics exam, including details on fractures of the humerus, supracondylar fractures, compartment syndrome, complications of fractures like DVT and fat embolism, and management techniques like internal and external fixation. Key points covered include the risk of nerve injury with humeral fractures, signs of different types of shock, prevention of bed sores, and differences between intracapsular and extracapsular neck of femur fractures. The document aims to highlight important clinical points and x-ray findings for various orthopedic injuries and procedures.
Valgus vs. Varus
This document defines and distinguishes between valgus and varus deformities by describing how the distal end of the bone is positioned relative to the body's midline. Valgus refers to when the distal end moves laterally away from the midline, while varus means it moves medially towards the midline. Examples provided are genu valgus and genu varus at the knee, as well as coxa valgus and coxa varus at the hip.
Access to urinary system v2
The document discusses various surgical approaches and techniques in urology. It describes approaches to the kidney such as flank, anterior transperitoneal, and thoraco-abdominal approaches. It also discusses approaches to the ureter, bladder, prostate, penis, inguinoscrotal structures, and endoscopic techniques such as flexible urethroscopy, rigid and flexible ureteroscopy, percutaneous nephrolithotomy, and laparoscopy. Diagrams illustrate the various incision sites and instrumentation used.
Mrcs Part A Experience
This document provides advice and recommendations from Kareem Hamimy for preparing for the MRCS Part A exam. It includes the following:
- Hamimy passed the MRCS Part A exam in January 2014 after 4 months of preparation, finding 4 months to be sufficient time to study.
- The emrcs.com website is recommended as the most useful studying aid, providing excellent practice questions similar to the exam and feedback.
- Recommended revision books are listed for anatomy, physiology, and pathology. Essential Revision Notes and Oxford Training in Surgery are also suggested.
- Recommended question books include resources from emrcs.com, Oxford, Pastest, and others.
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Intercollegiate MRCS Examiners Newsletter Volume 2
Intercollegiate MRCS Examiners Newsletter Volume 2
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Tips on using the MRC pre-ortho Trainer in myofunctional orthodontics
Local Flaps For Lower Limb Reconstruction Version1
Local Flaps For Lower Limb Reconstruction Version1
Similar to BPH and obstructive uropathy
Case presentation 222
1. The 37-year-old male patient has a history of kidney transplant in 2016 and has been experiencing recurrent urinary tract infections (UTIs) since then.
2. He is currently admitted with elevated kidney function and oliguria. Examination shows elevated creatinine and urea levels.
3. Imaging reveals grade 3 vesicoureteral reflux and a biopsy is planned along with investigations to determine the cause of his acute kidney injury.
The role of surgery in male infertility
There are several surgical procedures that can help treat male infertility by improving sperm production, delivery, or retrieval. Varicocele repair is the most common as it can improve semen parameters and pregnancy rates in 15% of infertile males. Vasectomy reversal has a 50-70% chance of pregnancy depending on if vasovasostomy or more involved vasoepididymostomy is needed. Ejaculatory duct obstruction may be treated with transurethral resection to relieve partial or complete blockage found in 1-5% of cases. For azoospermia, testicular sperm extraction techniques like microsurgical epididymal sperm aspiration combined with ICSI can achieve pregnancies in 76% of couples
03 genital fistula isam
This document provides an overview of genitourinary fistulas, including their causes, types, symptoms, diagnosis, and treatment. It discusses that the most common types of genitourinary fistulas are vesicovaginal, ureterovaginal, and urethrovaginal fistulas. The main causes are gynecological or obstetric surgery and trauma. Symptoms include urinary incontinence and irritation. Diagnosis involves tests like dye tests and imaging. Treatment involves conservative management or complex surgical repair procedures. Post-operative care is important to ensure proper healing. Prevention focuses on avoiding prolonged labor and risky childbirth procedures in developing countries.
Prostate pathology, Dr. Sufia Husain, March 2018
The document provides information about prostate pathology, including benign prostatic hyperplasia (BPH) and prostate cancer. It discusses the anatomy and zones of the prostate gland. It then summarizes the epidemiology, pathogenesis, histopathological features, clinical presentation, and treatment of BPH and prostate cancer. Key points include that BPH typically occurs in the transitional zone and involves nodular enlargement, while prostate cancer most commonly arises in the peripheral zone.
Retroperitoneal fibrosis
This document provides information about retroperitoneal fibrosis (RPF), including its pathogenesis, clinical presentations, investigations, and management. RPF is characterized by extensive fibrosis in the retroperitoneum that can encase the aorta, vena cava, and ureters. Patients typically present with nonspecific symptoms like back pain, but late presentations can include urinary obstruction and vascular complications. Diagnosis is often made using CT or MRI imaging showing soft tissue surrounding retroperitoneal structures. Treatment involves medications like corticosteroids to reduce inflammation or surgical procedures to decompress the urinary system if obstructed.
Updated mx of ut fibroids
Uterine fibroids are benign tumors that develop from the muscular layer of the uterus. They are quite common, affecting 20-40% of women. While the exact cause is unknown, risk factors include genetic factors, hormones, and growth factors. Fibroids can be asymptomatic or cause heavy bleeding, pain, and pressure symptoms. Diagnosis involves physical exam, ultrasound, MRI and other imaging tests. Treatment options range from observation and medication to minimally invasive procedures like uterine artery embolization and myolysis to more invasive options like myomectomy and hysterectomy. Fibroids may also complicate pregnancy by increasing risks of miscarriage, preterm labor, and difficult delivery. Their removal during c-section is sometimes recommended if interfering
Management of bening prostatic hyperplasia
This document provides an overview of benign prostatic hyperplasia (BPH) management presented by Dr. Muhammad Ujjudud Musa. It discusses the surgical anatomy, pathology, history, examination, investigations, and various treatment options for BPH including watchful waiting, medical therapy, minimally invasive treatments, and surgery. Surgical treatments covered include transurethral incision of the prostate, transurethral resection of the prostate, and open prostatectomy. Post-operative care and complications are also reviewed.
Anuria & acute retention
The document discusses acute urinary retention and acute renal failure. It defines the conditions and outlines their causes, which can be pre-renal, renal, or post-renal in nature. The evaluation and management of the conditions is also described. Causes include issues like decreased perfusion, obstruction, toxicity, and inflammation. Treatment involves supportive care, addressing the underlying cause, and dialysis in some situations to manage electrolyte and acid-base imbalances.
Postnatal mangement of anh (2)
1. Antenatal hydronephrosis is a common prenatal finding that requires postnatal evaluation to identify potential kidney abnormalities.
2. Most cases of antenatal hydronephrosis are transient and resolve without intervention, while others may indicate issues like urinary tract obstruction that require treatment.
3. Postnatal evaluation includes ultrasound, voiding cystourethrogram, diuretic renography and other tests to determine the severity and cause of hydronephrosis and assess kidney function.
VUR in Children-Overview
Vesicoureteric reflux (VUR) is a common condition in children where urine flows backward from the bladder into the ureters or kidneys. It can lead to urinary tract infections and renal scarring. The document discusses the anatomy, pathophysiology, diagnosis and management of VUR. Management involves continuous antibiotic prophylaxis, endoscopic injection, or open surgical correction depending on the grade of reflux and individual patient factors. Spontaneous resolution is more likely for lower grades of reflux and in younger children. Bowel and bladder dysfunction can complicate management and decrease resolution rates.
Obstructive Uropathy of Urology
Property of Prof Dr. Ahmed Ragab Ali, Department of Urology, Faculty of Medicine, University of Zagazig, Egypt
Endoscopy in Gastrointestinal Oncology - Slide 12 - J. Baillie - Distinguishi...
Endoscopy in Gastrointestinal Oncology - Slide 12 - J. Baillie - Distinguishi...European School of Oncology
The document discusses various imaging modalities and diagnostic techniques for evaluating biliary strictures, including:
- Transabdominal ultrasound, endoscopic ultrasound, CT scan, MRCP, and PTC can be used to image the biliary tree
- ERCP allows visualization and sampling of strictures
- IDUS and choledochoscopy provide intraductal imaging
- Biopsy techniques like brush cytology, needle biopsy, and FISH increase diagnostic yield over cytology alone
- Emerging techniques like confocal microscopy and proteomics show promise but are more expensiveOvarian Mass - EDITED.pptx
This document discusses a case of a 17-year-old girl who presented with acute lower abdominal pain. On examination, a 10cm mass was detected in her right lower abdomen. Laboratory tests showed no abnormalities. Transvaginal ultrasound revealed a large multilocular solid mass in the right ovary. Color Doppler showed signs of borderline tumor with torsion. She underwent emergency laparoscopy and right salpingo-oophorectomy. Histopathology confirmed torsion of a serous borderline ovarian tumor. The document then provides further details on the common presentations, differential diagnosis, investigations, risk factors, staging, management and prognosis of ovarian masses and cancers.
Lower gi bleed
Lower gastrointestinal bleeding can have various causes like diverticulosis, angiodysplasia, inflammation, and cancers. A thorough history, physical exam, and initial tests like colonoscopy are important to determine the source and severity of bleeding. Colonoscopy allows for both diagnosis and potential treatment but often requires bowel prep, while angiography and CT angiography can localize active bleeding but lack therapeutic options. Together, these diagnostic tests aim to safely identify the cause and guide appropriate clinical management of lower GI bleeding.
Buddchiari syndrome percutaneous stenting
This document describes a case of Budd-Chiari syndrome treated with percutaneous hepatic vein stenting. A 50-year-old female presented with right upper quadrant pain and loss of appetite. Imaging showed hepatic vein occlusion and ascites. Percutaneous access was obtained and a self-expanding stent was placed across the occlusion, restoring antegrade flow. The patient's symptoms improved and ascites resolved post-procedure. Percutaneous stenting is an effective alternative to surgery for selected Budd-Chiari syndrome patients that can help preserve liver function by relieving congestion.
9 renal transplant
Renal transplantation involves selecting recipients by diagnosing their primary kidney disease, ruling out active infections or malignancies, and assessing operative risks. Suitable living donors undergo evaluation with CT angiography and surgery to remove a kidney, with efforts to minimize warm ischemia time and preserve vessel length. The donated kidney is preserved through simple cold storage before transplantation via vascular anastomosis and ureter reimplantation during the recipient's operation. Lifelong immunosuppression is required post-operatively to prevent rejection, while infection risk remains.
UTI
The document discusses urinary tract infections (UTIs). It defines UTIs and describes their epidemiology, features, risk factors, and common bacterial pathogens. It then discusses acute pyelonephritis, chronic pyelonephritis, and acute bacterial cystitis in more detail, covering their pathology, clinical features, investigations, diagnosis, complications, and treatment.
Intravenous urography (IVU) by Dr Bishnu Khatiwada, Conventional IVU, CT-IVU,...
Intravenous Urography, IVU, Indications, Contraindications, Technique, Complications, CT-IVU, KUB, Phases of IVU, IVU findings, Drooping flower appearence, Spider leg appearence, Cobra head appearence, Hypertensive nephrogram, Modifications of IVU
Management of Non Muscle Invasive Bladder Cancer
Approach to non- muscle invasive bladder cancer and management .Details about Risk Stratification , TURBT & Intravesical Therapy.
Intravenous urography
This document provides an overview of intravenous urography (IVU), including indications, contraindications, technique, projections, and modifications. IVU involves intravenous injection of contrast medium to visualize the urinary tract. It is declining in use due to newer modalities like CT and MRI, adverse effects of contrast, and cost. The document outlines patient preparation, standard projections including nephrogram, 5-minute, compression, and post-void films. It also discusses non-routine projections, contrast agents, and radiation protection. Complications and aftercare are briefly mentioned.
Similar to BPH and obstructive uropathy (20)
Endoscopy in Gastrointestinal Oncology - Slide 12 - J. Baillie - Distinguishi...
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Intravenous urography (IVU) by Dr Bishnu Khatiwada, Conventional IVU, CT-IVU,...
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More from Ahmed Tawfeek
Prostate cancer update
Prostate cancer updates were presented. Key points include:
1) The Gleason score is used to assess tumor aggressiveness and has shifted to include higher scores over time.
2) Screening results do not support widespread mass screening, but early detection may be offered to informed men with baseline PSA testing at age 40 and screening intervals of 8 years if initial PSA is low.
3) For localized disease, treatment options include active surveillance, radical prostatectomy, or radiation therapy depending on risk level and life expectancy. Deferred treatment may be appropriate for many cases.
Modern management of stone disease
The document discusses guidelines for treating kidney stones. It recommends considering treatment for stones over 15 mm, stones under 15 mm if observation is not preferred, or if the stone has persisted for over 2-3 years. Factors such as patient preference, comorbidities, profession, and ability to travel should also be considered. Treatment options depend on stone size, with percutaneous nephrolithotomy recommended for stones over 2 cm and shock wave lithotripsy or ureteroscopy for smaller stones. The document provides details on the techniques and outcomes of these procedures.
Childhood enuresis
This document discusses childhood bedwetting or enuresis. It notes that bedwetting is common in children under 12 years old and more common in boys. The main causes of primary nocturnal enuresis are a small bladder capacity, decreased awareness of a full bladder while sleeping, excess urine production at night, and genetic factors. Management options include reassurance, timed toilet visits, limiting fluids before bed, enuresis alarms, dry bed training, and short-term drug treatments like desmopressin or imipramine. Enuresis alarms are the most effective long-term treatment, helping over 60% of children become dry, while drug treatments only treat symptoms temporarily.
Superficial bladder cancer
Bladder cancer is the fourth most common cancer in men and tenth most common in women. The recurrence rate for superficial bladder cancer is high, with 80% having at least one recurrence. Staging is based on tumor grade, invasion depth, and presence of carcinoma in situ. Treatment depends on stage, with transurethral resection of bladder tumors as first-line treatment for visible tumors and close surveillance after due to high recurrence rates.
Urologic symptoms and examination
Urological symptoms can involve pain, changes to urination, changes in urine appearance, or abnormalities of the male genitalia. A complete history divides into chief complaint, history of present illness, past medical history, family history, and review of systems. Physical exam includes inspection and palpation of the abdomen with specific examination of the kidneys, bladder, and genitalia. Common urological complaints involve sites of pain, irritative urinary symptoms, obstructive symptoms, incontinence, hematuria, and sexual or genital abnormalities.
BPH and Obstructive Uropathy
The document discusses obstructive uropathy and benign prostatic hyperplasia (BPH). It defines obstructive uropathy as structural or functional hindrance of normal urine flow. BPH is defined as a slowly progressive nodular hyperplasia of the periurethral zone of the prostate. The document outlines causes, symptoms, diagnostic tests and treatments for both conditions. Treatments include medications, minimally invasive surgeries such as transurethral resection of the prostate, and open surgeries like prostatectomy.
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Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...
Overall life span (LS) was 1671.7±1721.6 days and cumulative 5YS reached 62.4%, 10 years – 50.4%, 20 years – 44.6%. 94 LCP lived more than 5 years without cancer (LS=2958.6±1723.6 days), 22 – more than 10 years (LS=5571±1841.8 days). 67 LCP died because of LC (LS=471.9±344 days). AT significantly improved 5YS (68% vs. 53.7%) (P=0.028 by log-rank test). Cox modeling displayed that 5YS of LCP significantly depended on: N0-N12, T3-4, blood cell circuit, cell ratio factors (ratio between cancer cells-CC and blood cells subpopulations), LC cell dynamics, recalcification time, heparin tolerance, prothrombin index, protein, AT, procedure type (P=0.000-0.031). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and N0-12 (rank=1), thrombocytes/CC (rank=2), segmented neutrophils/CC (3), eosinophils/CC (4), erythrocytes/CC (5), healthy cells/CC (6), lymphocytes/CC (7), stick neutrophils/CC (8), leucocytes/CC (9), monocytes/CC (10). Correct prediction of 5YS was 100% by neural networks computing (error=0.000; area under ROC curve=1.0).
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The Electrocardiogram - Physiologic Principles
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Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar lead (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
6. Describe the flow of current around the heart during the cardiac cycle
7. Discuss the placement and polarity of the leads of electrocardiograph
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10. Define the mean QRS vector
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12. Comprehend the vectorial analysis of the normal ECG
13. Determine the mean electrical axis of the ventricular QRS and appreciate the mean axis deviation
14. Explain the concepts of current of injury, J point, and their significance
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
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