Escolar Documentos
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Cultura Documentos
Urology
Dr. Syah Mirsya Warli, SpU
Dr. Bungaran Sihombing,SpU
Div. of Urology, Surgery Dept.
Medical Faculty,
University of Sumatera Utara
Ref :
Genitourinary Emergencies
Pain
Testicular Torsion
Hematuria
Urinary Retention
Testicular Torsion
Incidence 1: 4000
Most serious of acute problems
affecting the scrotal contents
2 peak incidences
Neonatal period
Puberty
Testicular Torsion
Testicular Torsion
Symptom complex
Testicular Torsion
Physical examination
Edematous scrotum
Tender, swollen testis
Testis high in scrotum with
horizontal lie classical sign
Cremasteric reflex (-)
bell-clapper deformity
Pain not relieved with elevation of
scrotum
TORSION
Testicular Torsion:
Diagnosis
Testicular Torsion:
Management
Gross Hematuria
Etiology :
1. Common cause infections, stones,
malignancies (bladder, kidney), BPH,
trauma, post op
2. Less cause radiation or
chemical cystitis, sickle cell disease,
coagulopathy.
Gross Hematuria
Urinary Retention
History :
age, general health
premorbid voiding symptoms
history of urethral strictures
previous episodes of retention
prior urologic manipulation or surgery (TURP, radical
prostatectomy)
medication (sympathomimetics, anticholinergics)
incontinence
Urinary Retention
Etiology
Anatomic obstruction :
1.
2.
3.
4.
Functional obstruction :
1.
2.
3.
4.
Urinary Retention :
Management
Priapism
Foreskin Emergencies
Phimosis
Foreskin Emergencies
Paraphimosis
Phimosis: inability to
retract foreskin
Tx: dorsal slit or
circumcision
Foreskin Emergencies
Zipper Injuries
Foreskin Emergencies
External rings
Foreskin Emergencies
Intraurethral foreign bodies
Evaluate radiographically
Dont catheterized place SPT if retention
If distal to the external sphincter object
will be palpable & can often be removed
endoscopically
If proximal to the sphincter open
extraction
Foreskin Emergencies
Post-circumcision complications
Foreskin Emergencies
Post-circumcision complications
Disruption of incision
- if small no th/
- if major place a few interrupted
suture under penile block
Infection
- uncommon & usually minor
- th/ : oral cephalosporine
the end
wr 2009