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Renal Disease; Fluid and Electrolyte Disorders
Published in John S. Axford, Chris A. O'Callaghan, Medicine for Finals and Beyond, 2023
Cancer can arise at any point along the renal tract and can bleed into the renal tract. It should always be considered if there is haematuria or altered urinary flow. Primary cancers of the ureter or urethra are rare. Children can develop Wilms’ tumour of the kidney.
Surgery
Published in Andrew Schofield, Paul Schofield, The Complete SAQ Study Guide, 2019
Andrew Schofield, Paul Schofield
Derek, aged 52, is referred to the urology department by his GP. This year, he has had four urinary tract infections (UTIs). Name two causes of recurrent urinary tract infection in men. (2)Name three common organisms found in UTI. (3)You suspect Derek may have a urethral stricture. Name two causes of urethral stricture. (2)Name one other clinical feature of urethral stricture. (1)You decide to send Derek for a cystoscopy. List two other investigations for possible urethral stricture. (2)Name two complications of urethral stricture. (2)Cystoscopy reveals a stricture in the anterior urethra, and it also shows a large out-pouching of bladder mucosa. What is this and what has caused it? (2)Name a treatment for urethral stricture. (1)
Fluid balance and continence care
Published in Barbara Smith, Linda Field, Nursing Care, 2019
The urethra extends from the bladder to the urinary meatus (opening). The urethra is shorter in females (3.7 cm), due to the anatomical position in which it lies. In males, it is 20 cm in length. The urethra serves as a passageway for the elimination of urine (micturition) and is comprised of smooth muscle.
Foreign body granuloma development after calcium hydroxylapatite injection for stress urinary incontinence: A literature review and case report
Published in Arab Journal of Urology, 2023
David A. Csuka, John Ha, Andrew S. Hanna, Jisoo Kim, William Phan, Ahmed S. Ahmed, Gamal M. Ghoniem
The MAUDE adverse events database contains two potentially relevant complication reports. The first patient received three sequential 1.0 mL CaHA injections. Sometime during the next calendar year, the patient was diagnosed with urethral prolapse via periurethral exam, which was assessed by the physician to be of mild severity and not CaHA-related. The urethral prolapse was untreated and resolved shortly. The patient was later diagnosed with caruncle via periurethral exam, which was assessed to be of mild severity and probably not CaHA-related. The caruncle was untreated and resolved shortly [20]. The second patient was unable to urinate without a catheter for 10 days after the CaHA injection, and experienced hematuria with loss of bulking agent particles into the urine due to a urethral tear [21]. Both patients were not formally included as the presence of an FBG requiring surgical intervention was inexplicit.
Physiotherapeutic assessment and management of overactive bladder syndrome: a case report
Published in Physiotherapy Theory and Practice, 2023
Bartlomiej Burzynski, Tomasz Jurys, Karolina Kwiatkowska, Katarzyna Cempa, Andrzej Paradysz
In ultrasound imaging using a convex transducer, the bladder volume was estimated at 380 ml and patient’s subjective feeling of bladder pressure was identified as 9. During examination, the patient presented correct phasic and tonic activity and elevation of the pelvic floor muscles. No retention of urine after urination was found. The length of the urethra, which was 2.5 cm, was measured using an endovaginal transducer. In the cough stress test, correct reaction of the urethra and activity of the musculus pubovaginalis and musculus puboanalis was observed, with no urine leakage and no depression of the lesser pelvic organs. In the per vaginum examination, the patient did not report any pain during palpation and showed correct phasic and tonic activity of the pelvic floor muscles. During palpation of the anterolateral abdominal wall area, the patient did not report pain symptoms in examined structures on the left side; however, on the right side, pain had decreased to 2/10 on the NRS. The superficial back line myofascial meridian was still painful on both the sides, but the patient defining the lower intensity of pain on the NRS, i.e. 5/10 on the left side and 4/10 on the right side. The patient also reported pain improvement during the lateral line assessment: on the NRS, the intensity of pain on both the left and the right side had decreased to 5/10. Palpation of the musculus piriformis did not trigger any pain symptoms. In view of the above, the physiotherapist recommended continuation of the individualized set of exercises and a further follow-up visit after about three months.
What are the challenges in the pharmacotherapeutic management of male genital tuberculosis?
Published in Expert Opinion on Pharmacotherapy, 2023
Aditya Prakash Sharma, Rajeev Kumar
Genital TB does not universally respond to pharmacotherapy and may require additional surgery [14]. There is limited data on the effectiveness of pharmacotherapy in managing infertility caused by genital TB [15]. The sequelae of TB in the genital organs often results from inflammation, scarring, and distortion of the anatomy and may no longer be amenable to medical therapy [16]. Surgical treatments such as vaso-vasostomy, vaso-epididymal anastomosis, and transurethral resection or incision of ejaculatory duct have been described for patients developing male infertility secondary to genital tuberculosis [6]. Structural abnormalities can also cause cosmetic deformities (Figure 1), functional obstructions, and anatomic obstructions which persist despite adequate pharmacotherapy. Scrotal and prostatic abscesses may require drainage if they do not respond to medical treatment. Cases of urethral strictures requiring urethroplasty have also been reported [17].