Urethra lesions
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Urethral strictures can be traumatic, inflammatory, or neoplastic in nature. Inflammatory strictures are usually located in the proximal bulbar urethra and are caused by infections like gonorrhea or chlamydia. Traumatic strictures occur after catheterization or surgery and are commonly found in the posterior urethra. Both inflammatory and traumatic strictures can be multiple, vary in length, and lead to complications such as fistulas or pseudodiverticula if left untreated.
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urology.Urethral strictures.(dr.ismaeel)
Urethral strictures can be caused by injury or infection leading to scar tissue formation in the urethra. Common causes include trauma, instrumentation, surgery, and STDs. Presentation includes obstructive voiding symptoms. Diagnosis involves history, exam, and imaging tests. Treatment depends on location and severity but may include dilation, incision, stents, reconstruction, or tissue grafts. Complications can include recurrence, infection, and incontinence if not properly managed.
Urethral stricture
Urethral stricture is an abnormal narrowing of the urethra caused by fibrosis due to injury or inflammation. It is most common in males and usually occurs around age 50. Symptoms include poor urine stream and retention. Diagnosis involves tests like cystoscopy and retrograde urethrogram. Treatment depends on location and severity but may include dilation, internal urethrotomy, or open urethroplasty surgery to repair or bypass the stricture. Effective drainage of the bladder is important to manage this condition.
Management of anterior urethral stricture by AUA 2014
Management of Anterior urethral strictures AUA update series 2014
Introdution
Epidemiology and etiology
Diagnosis
Treatment
Complication
Conclusion
Urethral strictureblock4
Urethral stricture is a narrowing of the urethra caused by inflammation or scarring that results in difficult or painful urination. It can be caused by injuries, medical procedures, infections, or birth defects. Symptoms include bloody or dark urine, difficulty urinating, and pelvic or abdominal pain. Risks include infections of the bladder, prostate, or kidneys. Treatments may include dilation to widen the urethra, surgery to remove or bypass the stricture, or stents or catheters to keep the urethra open.
Pathology of Urethral strictures
This document discusses urethral strictures, which are abnormal narrowings of the urethra caused by scarring that replaces the normal tissue. It outlines the main causes of strictures as infections, inflammation, trauma, and rarely congenital abnormalities or cancer. The pathogenesis involves any injury or inflammation that damages the urethral lining, triggering fibrosis and scar formation that narrows the urethral lumen over time. Left untreated, strictures can lead to complications like urinary retention, infections, kidney damage, and rarely fistulas or cancer. The document provides classifications and epidemiological data on urethral strictures.
Urethral Stricture
Urethral stricture is an abnormal narrowing of the urethra caused by fibrosis and scarring from injury, infection, or inflammation. It occurs more often in males due to their longer urethra. Clinical features include dysuria, weak urine stream, urinary retention, and urinary tract infections. Management involves temporary measures like catheterization or definitive treatments like dilation, urethrotomy, or open urethroplasty depending on the location and severity of the stricture. Complications can include recurrent strictures, infections, fistulas, and renal impairment if left untreated.
Urethral stricture period 1
Urethral stricture is an abnormal narrowing of the urethra that can be caused by inflammation, scar tissue from injury or surgery, or pressure from a tumor. Symptoms include a decreased urinary stream, incomplete emptying of the bladder, and difficulty urinating. Treatment involves surgery to widen the urethra if symptoms cannot be controlled. Urethral stricture affects around 4% of Canadians between the ages of 18-75, with risk increasing with age.
Discuss the principles of use of grafts and flaps in urethral reconstruction
This document outlines principles for using grafts and flaps in male urethral reconstruction. It discusses preoperative, intraoperative, and postoperative principles. Preoperative principles include ensuring the indication is met and selecting an appropriate technique. Intraoperative principles include good anesthesia, hemostasis, and avoiding tension on flaps. Postoperative care includes dressing and follow-up. Factors like infection, tension, and vascular supply influence graft/flap success. Oral mucosa and skin are both used as grafts, with no consensus on superiority. Dorsal and ventral approaches have similar success rates.
Recommended
urology.Urethral strictures.(dr.ismaeel)
Urethral strictures can be caused by injury or infection leading to scar tissue formation in the urethra. Common causes include trauma, instrumentation, surgery, and STDs. Presentation includes obstructive voiding symptoms. Diagnosis involves history, exam, and imaging tests. Treatment depends on location and severity but may include dilation, incision, stents, reconstruction, or tissue grafts. Complications can include recurrence, infection, and incontinence if not properly managed.
Urethral stricture
Urethral stricture is an abnormal narrowing of the urethra caused by fibrosis due to injury or inflammation. It is most common in males and usually occurs around age 50. Symptoms include poor urine stream and retention. Diagnosis involves tests like cystoscopy and retrograde urethrogram. Treatment depends on location and severity but may include dilation, internal urethrotomy, or open urethroplasty surgery to repair or bypass the stricture. Effective drainage of the bladder is important to manage this condition.
Management of anterior urethral stricture by AUA 2014
Management of Anterior urethral strictures AUA update series 2014
Introdution
Epidemiology and etiology
Diagnosis
Treatment
Complication
Conclusion
Urethral strictureblock4
Urethral stricture is a narrowing of the urethra caused by inflammation or scarring that results in difficult or painful urination. It can be caused by injuries, medical procedures, infections, or birth defects. Symptoms include bloody or dark urine, difficulty urinating, and pelvic or abdominal pain. Risks include infections of the bladder, prostate, or kidneys. Treatments may include dilation to widen the urethra, surgery to remove or bypass the stricture, or stents or catheters to keep the urethra open.
Pathology of Urethral strictures
This document discusses urethral strictures, which are abnormal narrowings of the urethra caused by scarring that replaces the normal tissue. It outlines the main causes of strictures as infections, inflammation, trauma, and rarely congenital abnormalities or cancer. The pathogenesis involves any injury or inflammation that damages the urethral lining, triggering fibrosis and scar formation that narrows the urethral lumen over time. Left untreated, strictures can lead to complications like urinary retention, infections, kidney damage, and rarely fistulas or cancer. The document provides classifications and epidemiological data on urethral strictures.
Urethral Stricture
Urethral stricture is an abnormal narrowing of the urethra caused by fibrosis and scarring from injury, infection, or inflammation. It occurs more often in males due to their longer urethra. Clinical features include dysuria, weak urine stream, urinary retention, and urinary tract infections. Management involves temporary measures like catheterization or definitive treatments like dilation, urethrotomy, or open urethroplasty depending on the location and severity of the stricture. Complications can include recurrent strictures, infections, fistulas, and renal impairment if left untreated.
Urethral stricture period 1
Urethral stricture is an abnormal narrowing of the urethra that can be caused by inflammation, scar tissue from injury or surgery, or pressure from a tumor. Symptoms include a decreased urinary stream, incomplete emptying of the bladder, and difficulty urinating. Treatment involves surgery to widen the urethra if symptoms cannot be controlled. Urethral stricture affects around 4% of Canadians between the ages of 18-75, with risk increasing with age.
Discuss the principles of use of grafts and flaps in urethral reconstruction
This document outlines principles for using grafts and flaps in male urethral reconstruction. It discusses preoperative, intraoperative, and postoperative principles. Preoperative principles include ensuring the indication is met and selecting an appropriate technique. Intraoperative principles include good anesthesia, hemostasis, and avoiding tension on flaps. Postoperative care includes dressing and follow-up. Factors like infection, tension, and vascular supply influence graft/flap success. Oral mucosa and skin are both used as grafts, with no consensus on superiority. Dorsal and ventral approaches have similar success rates.
Urethroplasty treatment 2016
Long segment urethral strictures with a very narrow lumen pose an immense challenges for buccal mucosa augmentation urethroplasty.
Larger discrepancy in size of the graft and the native urethral plate makes it difficult to place the sutures and also makes the graft vulnerable to contracture and fibrosis.
Increasing the width of the urethral plate by a vertical midline mucosal incision and applying an additional inlay buccal mucosal graft may lessen the discrepancy and help in improving the adequacy of the urethral lumen.
Other option to deal with these kind of strictures is dorsal onlay and ventral inlay.
Spongiofibrosis is never full thickness except in traumatic injury ( straddle injury/blunt trauma)
Partial thickness Spongiofibrosis and scarred mucosa can be removed completely and replaced by buccal mucosa.
Lithotomy position
Epidural + general anesthesia.
Vertical perineal incision. Mobilization of bulbar urethra
Dorsal ( one side kulkarni’s technique)or ventral urethrotomy
Vertical midline incision or complete removal of scarred urethral plate with removal of thin layer of spongiofibrosis.
Inlay and onlay grafting done
Urethra closed over 16 fr
Results were analysed on the basis of pre and post operative uroflowmetry.
Any kind of instrumentation was considered as failure.
Mean follow up 630 days.
22 patients have significant better flow rate after surgery
One patient developed ring stricture near proximal anastomosis and managed by urethral dilatation.
One patient developed abscess followed by urine leak and was managed conservatively with indwelling catheter and antibiotics.
Combined urethroplasty avoid complete transection of urethra.
It widens the native urethral plate in an anatomical manner
Reduces the disparity between urethral plate and onlay buccal mucosa.
improves the success rate of long and very narrow bulbar urethra strictures
Urethra stricture overview
This document discusses stricture urethra and its management. It provides details on the epidemiology, etiology, clinical evaluation and surgical options for urethral strictures. Key points include that bulbar strictures are the most common, iatrogenic causes have increased in prevalence, clinical evaluation involves uroflowmetry, retrograde urethrogram and cystoscopy, and surgical options range from dilation and direct visual internal urethrotomy for short strictures to various types of urethroplasty using grafts or flaps for longer or complex strictures.
Surgical management of urethral stricture
This document summarizes the surgical management of urethral strictures. It discusses investigations like retrograde urethrography and various types of urethroplasty procedures including dilation, internal urethrotomy, lasers, stents, and open reconstruction. Specific procedures covered include anastomotic urethroplasty, substitution urethroplasty using grafts and flaps, and augmented anastomotic urethroplasty. Complications of different procedures like buccal mucosal graft urethroplasty, fasciocutaneous urethroplasty, and anterior and posterior urethroplasty are also summarized.
Management of stricture urethra
This document discusses the management of urethral strictures. It defines urethral strictures and describes their etiology, including congenital causes and acquired causes like infection, inflammation, trauma, and iatrogenic factors. Treatment options for urethral strictures include instrumentation methods like dilation and internal urethrotomy as well as open reconstruction techniques like excision and anastomosis or substitution urethroplasty using grafts or flaps. The document provides details on various surgical techniques and factors that influence treatment outcomes.
Urethral stricture
The urethra's main job in males and females is to pass urine outside the body. This thin tube also has an important role in ejaculation for men. When a scar from swelling, injury or infection blocks or slows the flow of urine in this tube, it is called a urethral stricture. Some people feel pain with a urethral stricture.
Urethral Stricture Causes, Risk Factors, And Diagnosis
Urethra is a tube that connects the bladder and the urinary meatus, and carries urine from the urinary bladder to be expelled from our body. Urethra is usually wide enough for normal quantity if urine to flow through freely and easily. However, when the urethra narrows pertaining to certain condition, it may restrict the flow of urine. Such a condition is known as urethral stricture. The condition affects men mainly.
Urethral stricture
A urethral stricture is a narrowing of the urethra caused by scarring that can develop from infections, injuries, or other trauma. Men are more susceptible to urethral strictures since their urethras are longer. Common causes include sexually transmitted diseases, catheterization, or other instrumentation of the urethra. Symptoms include a slow or weak urine stream, pain while urinating, and blood in the urine. Diagnosis involves imaging tests of the urethra. Treatment options depend on the severity and location of the stricture, and may include gradual stretching through dilation, cutting the scar tissue, or surgical reconstruction of the urethra.
Ureteral injury)
This document discusses ureteral injuries, including their causes, presentation, diagnosis, and management. The most common cause of ureteral injury is iatrogenic from difficult pelvic surgery. Clinical presentation depends on the type and severity of injury, and may include hematuria, urine leakage, infection, or renal failure. Diagnosis involves imaging like CT, IVU, or retrograde pyelography. Management aims to restore ureteral continuity through techniques like stenting, excision with reanastomosis, or interposition grafts depending on the level and extent of injury. Proper identification and protection of the ureter during surgery can help prevent these
Orchitis & epididymitis
This document provides information about orchitis, including its causes, symptoms, diagnosis, and treatment. Orchitis is an inflammation of the testicles that is usually caused by a virus like mumps or bacteria that spreads from an associated epididymitis. Common symptoms include pain and tenderness in the testicles and scrotum. Diagnosis involves examination of the testicles and scrotum along with potential laboratory tests. While viral orchitis cannot be cured, it will resolve on its own. Bacterial orchitis is treated with antibiotics and anti-inflammatory medications.
Diagosis of urethral stricture
This document provides a summary of evaluation methods for urethral stricture. It discusses dye contrast studies like retrograde urethrogram and voiding films. It also mentions invasive studies like retrograde and flexible antegrade endoscopy. Non-invasive studies discussed include ultrasound, MR urethrogram, and urodynamic studies. Key findings from these evaluation methods are highlighted, such as the site, number, length, and degree of spongiofibrosis of strictures. The document also provides examples of how evaluation methods can help with decisions regarding timing of surgery.
Urethral injury
This document discusses urethral injury, including its definition, classification, etiology, management, and complications. Urethral injury occurs when there is trauma that breaches the structural integrity of the urethra. It is an increasingly common urologic injury due to factors like industrialization and advances in surgery. Urethral injuries are classified based on location (anterior vs posterior) and type (contusion, partial rupture, complete rupture). Timely diagnosis and management are important to reduce long-term morbidity. Complications can include stricture, erectile dysfunction, and incontinence.
Scrotal swellings 4- varicocele
Varicocele is a small scrotal swelling characterised by the bag of worms feel. It is more common on Lt side and is associated with infertility
Acute scrotal pain
The acute scrotum is the painful, swollen scrotum or its contents of sudden onset. The “acute scrotum” may be viewed as the urologist’s equivalent to the general surgeon’s “acute abdomen.” Scrotal emergencies are rare but potentially life and fertility threatening. The most common causes of acute scrotal pain in adults are testicular torsion and epididymitis.
Patients with scrotal pain less than the age of 16 have torsion until proven otherwise. Scrotal pain with nausea & vomiting is specific for torsion.
A small but real, negative exploration rate is acceptable to minimize the risk of missing a critical surgical diagnosis. TIME IS TESTICLE
Penile fracture
This document provides an overview of penile fracture, including relevant anatomy, causes, clinical presentation, diagnosis, treatment options, and postoperative care. It begins with an outline of the topics covered. The main points are: penile fracture involves a rupture of the corpus cavernosum during erection, most common causes are sexual intercourse and trauma from bending, patients experience pain, swelling and detumescence, diagnosis is usually clinical but imaging can help, and surgical repair within 24 hours has the best outcomes and aims to repair tears while preventing erectile dysfunction and abnormal healing.
Epididymitis
Epididymitis is an inflammation of the epididymis, the coiled tube behind the testicle that stores and carries sperm. It is most common in men ages 20-39 and is usually caused by a bacterial infection spreading from the urinary tract or an STD. Symptoms include testicle pain and tenderness, painful urination, and fever. Doctors evaluate with exams, tests, and imaging to diagnose and rule out other conditions, then treat with antibiotics and anti-inflammatories. Leaving epididymitis untreated can cause permanent damage.
Ureteric injury (1)
1. Injury to the ureter is a serious complication that can result in high morbidity and potential loss of renal function.
2. The ureter is most commonly injured during gynecological or abdominal surgeries, though trauma from blunt force or penetrating injuries can also cause damage.
3. Diagnosis of ureteral injury relies on imaging like CT scans and retrograde ureterography to identify signs of extravasation or deviation, though hematuria alone is a poor indicator.
Management of urethral injury
This document provides an overview of the management of urethral injuries. It begins with an introduction noting that urethral injuries are uncommon but management can be challenging. It then covers relevant anatomy, classifications of injuries, causes, clinical features, investigations, and various treatment approaches depending on the type and severity of injury. For posterior urethral injuries specifically, it describes classification systems and discusses options like suprapubic diversion, endoscopic realignment, and open urethroplasty. Complications are also reviewed. The conclusion emphasizes the need for proper initial assessment and management of these injuries.
Urethral strictures
This document discusses urethral strictures, which are narrowings of the urethra caused by scarring. It covers the anatomy and epidemiology of urethral strictures and their various causes including iatrogenic, traumatic, inflammatory, and idiopathic factors. Diagnostic tests like retrograde urethrography and treatments options are outlined, including dilation, direct vision internal urethrotomy, and urethroplasty surgery. Urethroplasty is considered the gold standard treatment but has the highest success rate for short, simple strictures.
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.
Urological injuries
Infections are common in women of all ages starting from young girls to newly married [HONEYMOON CYSTITIS] to elderly postmenopausal women.
In each group the cause may be different and requires thorough examination.
Some women also suffer from TUBERCULOSIS of urinary tract.
Uro Urethral Stricture
This document discusses urethral stricture, including its anatomy, causes such as trauma or inflammation, pathology involving fibrosis and scarring of the urethral lumen, clinical features like poor urinary stream, and potential complications. Investigations may include urine tests, urosonology, and urethrogram. Treatment options involve dilation, urethrotomy, stents, and for strictures over 2cm, urethroplasty using grafts or flaps.
Urethral strictures
This document discusses urethral strictures, which are pathological narrowing or obliteration of the urethra caused by scar tissue formation. It defines urethral strictures and describes their causes, presentation with obstructive voiding symptoms, and various treatment methods including dilation, urethroplasty surgery using grafts or flaps, and staged repair if the penis is abnormal. It emphasizes careful preoperative, intraoperative, and postoperative care to minimize complications of recurrence, bleeding, infection, and wound issues.
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Urethroplasty treatment 2016
Long segment urethral strictures with a very narrow lumen pose an immense challenges for buccal mucosa augmentation urethroplasty.
Larger discrepancy in size of the graft and the native urethral plate makes it difficult to place the sutures and also makes the graft vulnerable to contracture and fibrosis.
Increasing the width of the urethral plate by a vertical midline mucosal incision and applying an additional inlay buccal mucosal graft may lessen the discrepancy and help in improving the adequacy of the urethral lumen.
Other option to deal with these kind of strictures is dorsal onlay and ventral inlay.
Spongiofibrosis is never full thickness except in traumatic injury ( straddle injury/blunt trauma)
Partial thickness Spongiofibrosis and scarred mucosa can be removed completely and replaced by buccal mucosa.
Lithotomy position
Epidural + general anesthesia.
Vertical perineal incision. Mobilization of bulbar urethra
Dorsal ( one side kulkarni’s technique)or ventral urethrotomy
Vertical midline incision or complete removal of scarred urethral plate with removal of thin layer of spongiofibrosis.
Inlay and onlay grafting done
Urethra closed over 16 fr
Results were analysed on the basis of pre and post operative uroflowmetry.
Any kind of instrumentation was considered as failure.
Mean follow up 630 days.
22 patients have significant better flow rate after surgery
One patient developed ring stricture near proximal anastomosis and managed by urethral dilatation.
One patient developed abscess followed by urine leak and was managed conservatively with indwelling catheter and antibiotics.
Combined urethroplasty avoid complete transection of urethra.
It widens the native urethral plate in an anatomical manner
Reduces the disparity between urethral plate and onlay buccal mucosa.
improves the success rate of long and very narrow bulbar urethra strictures
Urethra stricture overview
This document discusses stricture urethra and its management. It provides details on the epidemiology, etiology, clinical evaluation and surgical options for urethral strictures. Key points include that bulbar strictures are the most common, iatrogenic causes have increased in prevalence, clinical evaluation involves uroflowmetry, retrograde urethrogram and cystoscopy, and surgical options range from dilation and direct visual internal urethrotomy for short strictures to various types of urethroplasty using grafts or flaps for longer or complex strictures.
Surgical management of urethral stricture
This document summarizes the surgical management of urethral strictures. It discusses investigations like retrograde urethrography and various types of urethroplasty procedures including dilation, internal urethrotomy, lasers, stents, and open reconstruction. Specific procedures covered include anastomotic urethroplasty, substitution urethroplasty using grafts and flaps, and augmented anastomotic urethroplasty. Complications of different procedures like buccal mucosal graft urethroplasty, fasciocutaneous urethroplasty, and anterior and posterior urethroplasty are also summarized.
Management of stricture urethra
This document discusses the management of urethral strictures. It defines urethral strictures and describes their etiology, including congenital causes and acquired causes like infection, inflammation, trauma, and iatrogenic factors. Treatment options for urethral strictures include instrumentation methods like dilation and internal urethrotomy as well as open reconstruction techniques like excision and anastomosis or substitution urethroplasty using grafts or flaps. The document provides details on various surgical techniques and factors that influence treatment outcomes.
Urethral stricture
The urethra's main job in males and females is to pass urine outside the body. This thin tube also has an important role in ejaculation for men. When a scar from swelling, injury or infection blocks or slows the flow of urine in this tube, it is called a urethral stricture. Some people feel pain with a urethral stricture.
Urethral Stricture Causes, Risk Factors, And Diagnosis
Urethra is a tube that connects the bladder and the urinary meatus, and carries urine from the urinary bladder to be expelled from our body. Urethra is usually wide enough for normal quantity if urine to flow through freely and easily. However, when the urethra narrows pertaining to certain condition, it may restrict the flow of urine. Such a condition is known as urethral stricture. The condition affects men mainly.
Urethral stricture
A urethral stricture is a narrowing of the urethra caused by scarring that can develop from infections, injuries, or other trauma. Men are more susceptible to urethral strictures since their urethras are longer. Common causes include sexually transmitted diseases, catheterization, or other instrumentation of the urethra. Symptoms include a slow or weak urine stream, pain while urinating, and blood in the urine. Diagnosis involves imaging tests of the urethra. Treatment options depend on the severity and location of the stricture, and may include gradual stretching through dilation, cutting the scar tissue, or surgical reconstruction of the urethra.
Ureteral injury)
This document discusses ureteral injuries, including their causes, presentation, diagnosis, and management. The most common cause of ureteral injury is iatrogenic from difficult pelvic surgery. Clinical presentation depends on the type and severity of injury, and may include hematuria, urine leakage, infection, or renal failure. Diagnosis involves imaging like CT, IVU, or retrograde pyelography. Management aims to restore ureteral continuity through techniques like stenting, excision with reanastomosis, or interposition grafts depending on the level and extent of injury. Proper identification and protection of the ureter during surgery can help prevent these
Orchitis & epididymitis
This document provides information about orchitis, including its causes, symptoms, diagnosis, and treatment. Orchitis is an inflammation of the testicles that is usually caused by a virus like mumps or bacteria that spreads from an associated epididymitis. Common symptoms include pain and tenderness in the testicles and scrotum. Diagnosis involves examination of the testicles and scrotum along with potential laboratory tests. While viral orchitis cannot be cured, it will resolve on its own. Bacterial orchitis is treated with antibiotics and anti-inflammatory medications.
Diagosis of urethral stricture
This document provides a summary of evaluation methods for urethral stricture. It discusses dye contrast studies like retrograde urethrogram and voiding films. It also mentions invasive studies like retrograde and flexible antegrade endoscopy. Non-invasive studies discussed include ultrasound, MR urethrogram, and urodynamic studies. Key findings from these evaluation methods are highlighted, such as the site, number, length, and degree of spongiofibrosis of strictures. The document also provides examples of how evaluation methods can help with decisions regarding timing of surgery.
Urethral injury
This document discusses urethral injury, including its definition, classification, etiology, management, and complications. Urethral injury occurs when there is trauma that breaches the structural integrity of the urethra. It is an increasingly common urologic injury due to factors like industrialization and advances in surgery. Urethral injuries are classified based on location (anterior vs posterior) and type (contusion, partial rupture, complete rupture). Timely diagnosis and management are important to reduce long-term morbidity. Complications can include stricture, erectile dysfunction, and incontinence.
Scrotal swellings 4- varicocele
Varicocele is a small scrotal swelling characterised by the bag of worms feel. It is more common on Lt side and is associated with infertility
Acute scrotal pain
The acute scrotum is the painful, swollen scrotum or its contents of sudden onset. The “acute scrotum” may be viewed as the urologist’s equivalent to the general surgeon’s “acute abdomen.” Scrotal emergencies are rare but potentially life and fertility threatening. The most common causes of acute scrotal pain in adults are testicular torsion and epididymitis.
Patients with scrotal pain less than the age of 16 have torsion until proven otherwise. Scrotal pain with nausea & vomiting is specific for torsion.
A small but real, negative exploration rate is acceptable to minimize the risk of missing a critical surgical diagnosis. TIME IS TESTICLE
Penile fracture
This document provides an overview of penile fracture, including relevant anatomy, causes, clinical presentation, diagnosis, treatment options, and postoperative care. It begins with an outline of the topics covered. The main points are: penile fracture involves a rupture of the corpus cavernosum during erection, most common causes are sexual intercourse and trauma from bending, patients experience pain, swelling and detumescence, diagnosis is usually clinical but imaging can help, and surgical repair within 24 hours has the best outcomes and aims to repair tears while preventing erectile dysfunction and abnormal healing.
Epididymitis
Epididymitis is an inflammation of the epididymis, the coiled tube behind the testicle that stores and carries sperm. It is most common in men ages 20-39 and is usually caused by a bacterial infection spreading from the urinary tract or an STD. Symptoms include testicle pain and tenderness, painful urination, and fever. Doctors evaluate with exams, tests, and imaging to diagnose and rule out other conditions, then treat with antibiotics and anti-inflammatories. Leaving epididymitis untreated can cause permanent damage.
Ureteric injury (1)
1. Injury to the ureter is a serious complication that can result in high morbidity and potential loss of renal function.
2. The ureter is most commonly injured during gynecological or abdominal surgeries, though trauma from blunt force or penetrating injuries can also cause damage.
3. Diagnosis of ureteral injury relies on imaging like CT scans and retrograde ureterography to identify signs of extravasation or deviation, though hematuria alone is a poor indicator.
Management of urethral injury
This document provides an overview of the management of urethral injuries. It begins with an introduction noting that urethral injuries are uncommon but management can be challenging. It then covers relevant anatomy, classifications of injuries, causes, clinical features, investigations, and various treatment approaches depending on the type and severity of injury. For posterior urethral injuries specifically, it describes classification systems and discusses options like suprapubic diversion, endoscopic realignment, and open urethroplasty. Complications are also reviewed. The conclusion emphasizes the need for proper initial assessment and management of these injuries.
Urethral strictures
This document discusses urethral strictures, which are narrowings of the urethra caused by scarring. It covers the anatomy and epidemiology of urethral strictures and their various causes including iatrogenic, traumatic, inflammatory, and idiopathic factors. Diagnostic tests like retrograde urethrography and treatments options are outlined, including dilation, direct vision internal urethrotomy, and urethroplasty surgery. Urethroplasty is considered the gold standard treatment but has the highest success rate for short, simple strictures.
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.
Urological injuries
Infections are common in women of all ages starting from young girls to newly married [HONEYMOON CYSTITIS] to elderly postmenopausal women.
In each group the cause may be different and requires thorough examination.
Some women also suffer from TUBERCULOSIS of urinary tract.
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Urethral Stricture Causes, Risk Factors, And Diagnosis
Urethral Stricture Causes, Risk Factors, And Diagnosis
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Uro Urethral Stricture
This document discusses urethral stricture, including its anatomy, causes such as trauma or inflammation, pathology involving fibrosis and scarring of the urethral lumen, clinical features like poor urinary stream, and potential complications. Investigations may include urine tests, urosonology, and urethrogram. Treatment options involve dilation, urethrotomy, stents, and for strictures over 2cm, urethroplasty using grafts or flaps.
Urethral strictures
This document discusses urethral strictures, which are pathological narrowing or obliteration of the urethra caused by scar tissue formation. It defines urethral strictures and describes their causes, presentation with obstructive voiding symptoms, and various treatment methods including dilation, urethroplasty surgery using grafts or flaps, and staged repair if the penis is abnormal. It emphasizes careful preoperative, intraoperative, and postoperative care to minimize complications of recurrence, bleeding, infection, and wound issues.
Uretheral stricture
The document discusses urethral stricture, which refers to scarring in the urethra that narrows the passageway for urine. It describes the anatomy of the male urethra and its divisions. Common causes of urethral stricture include trauma, infections like gonorrhea, prolonged catheterization, and complications after surgery. Left untreated, stricture can lead to urinary retention, infections, kidney damage from back pressure, and fistula formation. Symptoms include weak urinary stream and sudden retention.
(Urethral Stricture) Estrechez uretral. clase
Este documento describe la estrechez uretral, incluyendo sus causas congénitas como las válvulas de uretra posterior y estrecheces congénitas, y sus causas adquiridas como traumas, infecciones y BXO. Explica estudios como la uretrografía y cistofibroscopía para diagnosticarla, y tratamientos como la dilatación, uretrotomía interna, stent, resección y anastomosis primaria, colgajos e injertos, meatotomía, meato perineal y talla vesical
AUA Guideline Male Urethral Strictures
(in English)
Weergave van de aanbevelingen (met belangrijkste items) van de genoemde richtlijn
Presentation on the recommendations (and main items) of the in the title mentioned guideline
Urethral Tramua
Urethral injuries can be caused by blunt trauma such as motor vehicle accidents or falls, or penetrating injuries near the urethra. Injuries are classified as either posterior injuries involving the membranous or prostatic urethra, often associated with pelvic fractures, or anterior injuries distal to the membranous urethra from blunt perineal trauma. Diagnosis involves retrograde urethrography to detect extravasation of contrast at the injury site. Treatment depends on injury location and patient stability, often initially involving suprapubic catheter placement, with delayed repair of posterior injuries once hematomas resolve and associated injuries stabilize. Proper early management can lead to good long-term outcomes while
Review urotrauma
The document reviews urological trauma, focusing on renal trauma. It provides details on the epidemiology, classification, investigations, and management of renal trauma. Key points include:
- Renal trauma accounts for 1-5% of all trauma cases and is most commonly caused by blunt mechanisms like motor vehicle collisions.
- CT scan with IV contrast is the standard imaging investigation, while angiography is recommended for persistent bleeding.
- Conservative management is recommended for stable patients with low grade injuries. Higher grade injuries or instability may require angiography or surgery.
- Operative intervention is indicated for hemodynamic instability, expanding hematomas, or high grade vascular injuries. Renal reconstruction should be attempted when possible.
Upper gu trauma
This document discusses genitourinary trauma, focusing on injuries to the upper and lower urinary tract. It covers the etiology, clinical findings, imaging, and management of renal injuries, ureteral injuries, and bladder injuries. Renal injuries are the most common genitourinary injuries and are often caused by blunt trauma from motor vehicle accidents. Contrast-enhanced CT is the preferred imaging method to evaluate renal injuries. Most renal injuries can be managed non-operatively with bed rest and IV fluids, while operative management is indicated for persistent bleeding or expanding hematomas.
Genitourinary tract trauma
This document discusses injuries to the genitourinary tract, including the kidney, ureter, bladder, and urethra. Kidney injuries are often caused by trauma and present with hematuria, pain, and palpable masses. Imaging studies like CT scans are used for diagnosis. Complications include hemorrhage, hydronephrosis, and abscesses. Ureter injuries can be caused by surgery or trauma and present with anuria, oliguria, pain, and hydronephrosis. Diagnosis involves tests like retrograde uretherography and treatment includes surgeries like ureteroureterostomia. Bladder injuries from trauma or surgery can be intraperitoneal or extraper
Trauma
The document discusses various types of genitourinary trauma including renal trauma, bladder injuries, urethral injuries, testicular injuries, and penile fracture. Renal trauma is classified into 5 grades based on the severity of injury and most blunt renal traumas are managed conservatively. Bladder injuries are diagnosed using cystograms and managed either with catheter drainage or operative repair depending on the injury. Urethral injuries can involve the anterior or posterior urethra and are treated with suprapubic cystostomy or urethroplasty. Testicular injuries require early exploration and surgery if ruptured. Penile fractures require prompt surgical repair to prevent complications.
Male genital trauma
This document provides an overview of genitourinary trauma, including injuries to the penis, testicles, urethra, bladder, ureters and kidneys. It discusses the causes, signs, investigations and management for each type of injury. Penile fractures require surgical repair to prevent long-term complications. Testicular injuries may require ultrasound or surgical exploration. Urethral injuries are classified using the Goldman system and managed conservatively or surgically depending on severity. Bladder injuries often require retrograde cystography and may be managed conservatively or surgically. Renal injuries are graded based on CT or IVP findings and most grade I-II injuries can be managed conservatively while grade III or higher often require
Urethral Trauma
This document summarizes the key topics in a rotation in urology, including the anatomy of the lower urinary tract and male genitalia, etiology of urethral injuries, clinical manifestations of urethral trauma, evaluation modalities, and management principles and techniques for urethral trauma including urethroplasty. Guidelines from the European Association of Urology are referenced.
RGU MCU and its interpretation in pathology of Urinary Bladder & Urethra
This document discusses the embryology, anatomy, imaging modalities, and contrast agents used in evaluating the urinary bladder and urethra. It provides details on retrograde urethrography technique, including indications, equipment, preparation, procedure, filming, and potential complications. Common congenital and acquired diseases of the urinary bladder are also summarized, such as bladder exstrophy, urachal anomalies, diverticula, fistulas, and calculi.
10 genitourinary trauma
This document discusses genitourinary trauma. It covers renal trauma in detail, including that renal injuries make up about 10% of emergency room visits for trauma. It presents the American Association for the Surgery of Trauma classification system for renal injuries in detail. It also discusses trauma to the bladder and ureters, management principles, and complications.
Bladder injury by dhanush
This document discusses bladder injury, including causes, mechanisms, clinical features, investigations, and management. Bladder injury can occur from trauma like road accidents, falls, or instrumentation. Clinical features include suprapubic pain and inability to urinate. Investigations include cystography and CT scan. Treatment involves repairing the injury surgically, usually with sutures, drainage, and antibiotics to prevent complications.
Urethral & bladder injury
Urethral and bladder injuries can occur from pelvic fractures or direct trauma. Posterior urethral injuries commonly occur from shearing forces in pelvic fractures and require initial suprapubic cystostomy with delayed repair to avoid complications. Anterior urethral injuries from straddle injuries may be contusions or lacerations, treated with catheterization or cystostomy depending on severity. Bladder injuries are often extraperitoneal from pelvic fractures and present as hematuria, diagnosed by cystography or CT cystography and treated with catheter drainage. Intraperitoneal bladder injuries require surgery.
Genito urinary tract trauma
This document discusses genito urinary tract trauma. It describes different mechanisms of trauma including penetrating injuries, blunt trauma from acceleration/deceleration or rotational forces, and blast, chemical or thermal injuries. For renal trauma, it defines grades 1 through 5 for injuries ranging from minor to major. Clinical presentations include flank pain, abdominal pain, hematuria and distension. Investigations include blood tests, urine tests, imaging like ultrasound, IVU and CT scan. Complications of renal trauma can include urinoma, hematoma, abscess, hydronephrosis and arteriovenous fistula. Treatment depends on the type and severity of injury, and may involve emergency stabilization, observation, or surgery to address complications.
Bladder and injuries
The document provides information about the anatomy, blood supply, innervation and functions of the urinary bladder. It discusses the location of the bladder in the pelvis. It describes the parts of the bladder including the body, fundus, neck, apex and surfaces. It explains micturition and various factors involved in bladder filling and emptying. The document also discusses bladder injuries including risk factors, signs, management and repair techniques. It provides details about vesicovaginal fistula including causes, types, presentations and approaches to repair.
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RGU MCU and its interpretation in pathology of Urinary Bladder & Urethra
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- 1. Urethral strictures David Sutton Ch 32 / page 1017 Presented By DR Laith Fadhel Al Hialy MBchB . PGCR
- 2. Urethral stricture / 3 types traumatic / inflammatory / Neoplastic
- 3. Inflammatory •Situated at anterior urethra •Most commonly in the proximal bulbar • multiple , any length • causes ,Gonococci , Chlamydia , TB 2% Reiter's syndrome , syphilis , chemical
- 4. Traumatic • at membranous urethra / posterior urethra •Most commonly following catheterization, surgery , • multiple , or single , usually short • complication / transaction , psedodiverticula , fistula , sinuses
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