Surgical Conditions of the Urinary System

by / Tuesday, 06 July 2010 / Published in Surgery

Surgical Conditions of the Urinary System

Testicular Torsion

  • Usually occurs in a younger patient
  • Acute edema and severe testicular pain
  • Patient usually experiences nausea and vomiting due to the degree of the pain
  • ABSENCE of the cremasteric reflex
  • Presence of scrotal swelling
  • Testicle may have a horizontal lie

Diagnosis:

  • Ultrasound to assess arterial patency
  • Upon elevation of the teste, the pain is not alleviated

Treatment:

  • 1st step is to secure the circulation
  • 2nd step is to evaluate the need for excision of the testicle if it is dead

Epididymitis

  • Unilateral pain of the testicle
  • Dysuria
  • Painful and swollen epididymus
  • Less common in prepubertal children as opposed to torsion

Diagnosis:

  • Swab for Chlamydia and Gonorrhea

Treatment:

  • NSAIDs and antibiotics

Prostate Cancer

  • Obstructive symptoms
  • Rock-hard nodule in the prostate

Diagnosis:

  • PSA
  • Serum phosphatase
  • Azotemia
  • Transrectal ultrasound

Treatment:

The only surgical requirement is a radical prostatectomy in very severe cases – risk of incontinence and/or impotence

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