Urologic Emergencies
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The Male Reproductive System
Management of Men’s Reproductive 3 Health Problems Men’s Reproductive Health Curriculum Management of Men’s Reproductive 3 Health Problems © 2003 EngenderHealth. All rights reserved. 440 Ninth Avenue New York, NY 10001 U.S.A. Telephone: 212-561-8000 Fax: 212-561-8067 e-mail: [email protected] www.engenderhealth.org This publication was made possible, in part, through support provided by the Office of Population, U.S. Agency for International Development (USAID), under the terms of cooperative agreement HRN-A-00-98-00042-00. The opinions expressed herein are those of the publisher and do not necessarily reflect the views of USAID. Cover design: Virginia Taddoni ISBN 1-885063-45-8 Printed in the United States of America. Printed on recycled paper. Library of Congress Cataloging-in-Publication Data Men’s reproductive health curriculum : management of men’s reproductive health problems. p. ; cm. Companion v. to: Introduction to men’s reproductive health services, and: Counseling and communicating with men. Includes bibliographical references. ISBN 1-885063-45-8 1. Andrology. 2. Human reproduction. 3. Generative organs, Male--Diseases--Treatment. I. EngenderHealth (Firm) II. Counseling and communicating with men. III. Title: Introduction to men’s reproductive health services. [DNLM: 1. Genital Diseases, Male. 2. Physical Examination--methods. 3. Reproductive Health Services. WJ 700 M5483 2003] QP253.M465 2003 616.6’5--dc22 2003063056 Contents Acknowledgments v Introduction vii 1 Disorders of the Male Reproductive System 1.1 The Male -
Urinary Incontinence: Impact on Long Term Care
Urinary Incontinence: Impact on Long Term Care Muhammad S. Choudhury, MD, FACS Professor and Chairman Department of Urology New York Medical College Director of Urology Westchester Medical Center 1 Urinary Incontinence: Overview • Definition • Scope • Anatomy and Physiology of Micturition • Types • Diagnosis • Management • Impact on Long Term Care 2 Urinary Incontinence: Definition • Involuntary leakage of urine which is personally and socially unacceptable to an individual. • It is a multifactorial syndrome caused by a combination of: • Genito urinary pathology. • Age related changes. • Comorbid conditions that impair normal micturition. • Loss of functional ability to toilet oneself. 3 Urinary Incontinence: Scope • Prevalence of Urinary incontinence increase with age. • Affects more women than men (2:1) up to age 80. • After age 80, both women and men are equally affected. • Urinary Incontinence affect 15% to 30% of the general population > 65 years. • > 50% of 1.5 million Long Term Care residents may be incontinent. • The cost to care for this group is >5 billion per year. • The total cost of care for Urinary Incontinence in the U.S. is estimated to be over $36 billion. Ehtman et al., 2012. 4 Urinary Incontinence: Impact on Quality of Life • Loss of self esteem. • Avoidance of social activity and interaction. • Decreased ability to maintain independent life style. • Increased dependence on care givers. • One of the most common reason for long term care placement. Grindley et al. Age Aging. 1998; 22: 82-89/Harris T. Aging in the eighties. NCHS # 121 1985. Noelker L. Gerontologist 1987; 27: 194-200. 5 Health related consequences of Urinary Incontinence • Increased propensity for fall/fracture. -
Ultrasonography and Elastography Imaging
Jemds.com Case Report Post Traumatic Hematocele - Ultrasonography and Elastography Imaging Shivesh Pandey1, Suresh Vasant Phatak2, Gopidi Sai Nidhi Reddy3, Apoorvi Bharat Shah4 1, 2, 3, 4 Department of Radio diagnosis, Jawaharlal Nehru Medical College, Sawangi (Meghe), Wardha, Maharashtra India. INTRODUCTION Hematocele with blunt scrotal trauma is an uncommon cause of the testicular pain. Corresponding Author: Elastography is the new recent advance in the field of ultrasound. USG and Dr. Suresh Vasant Phatak, elastography findings of the acute hematocele is described in this aricle. Department of Radiodiagnosis, Jawaharlal Testicular trauma is the third most common cause of acute scrotal pain,1 and Nehru Medical College, Sawangi (Meghe), high-frequency ultrasonography (USG) with a linear array transducer is the first Wardha, Maharashtra – 442001, India. E-mail: [email protected] preferred modality for testicular trauma evaluation. Extra testicular haematoceles or blood collections inside the tunica vaginalis are the most common findings in the DOI: 10.14260/jemds/2021/340 scrotum after blunt injury.2 On clinical assessment, haematocele appears as a hard mass like swelling and causes pain in the scrotum. In the majority of cases, How to Cite This Article: spontaneous resolution occurs with the support of conservative therapy,3 even if Pandey S, Phatak SV, Reddy GSN, et al. Post treated conservatively, may result in infection, discomfort, or atrophy in undiagnosed traumatic hematocele - usg and broad hematoceles and testicular hematomas over time.4 elastography imaging. J Evolution Med A testis with its coverings, epididymis, and spermatic cord are all contained in Dent Sci 2021;10(21):1636-1638, DOI: 10.14260/jemds/2021/340 each hemiscrotum. -
CMS Manual System Human Services (DHHS) Pub
Department of Health & CMS Manual System Human Services (DHHS) Pub. 100-07 State Operations Centers for Medicare & Provider Certification Medicaid Services (CMS) Transmittal 8 Date: JUNE 28, 2005 NOTE: Transmittal 7, of the State Operations Manual, Pub. 100-07 dated June 27, 2005, has been rescinded and replaced with Transmittal 8, dated June 28, 2005. The word “wound” was misspelled in the Interpretive Guidance section. All other material in this instruction remains the same. SUBJECT: Revision of Appendix PP – Section 483.25(d) – Urinary Incontinence, Tags F315 and F316 I. SUMMARY OF CHANGES: Current Guidance to Surveyors is entirely replaced by the attached revision. The two tags are being combined as one, which will become F315. Tag F316 will be deleted. The regulatory text for both tags will be combined, followed by this revised guidance. NEW/REVISED MATERIAL - EFFECTIVE DATE*: June 28, 2005 IMPLEMENTATION DATE: June 28, 2005 Disclaimer for manual changes only: The revision date and transmittal number apply to the red italicized material only. Any other material was previously published and remains unchanged. However, if this revision contains a table of contents, you will receive the new/revised information only, and not the entire table of contents. II. CHANGES IN MANUAL INSTRUCTIONS: (N/A if manual not updated.) (R = REVISED, N = NEW, D = DELETED) – (Only One Per Row.) R/N/D CHAPTER/SECTION/SUBSECTION/TITLE R Appendix PP/Tag F315/Guidance to Surveyors – Urinary Incontinence D Appendix PP/Tag F316/Urinary Incontinence III. FUNDING: Medicare contractors shall implement these instructions within their current operating budgets. IV. ATTACHMENTS: Business Requirements x Manual Instruction Confidential Requirements One-Time Notification Recurring Update Notification *Unless otherwise specified, the effective date is the date of service. -
Chapter 99 – Urological Disorders Episode Overview Urinary Tract Infections in Adults 1
Crack Cast Show Notes – Urological Disorders – August 2017 www.crackcast.org Chapter 99 – Urological Disorders Episode Overview Urinary Tract Infections in Adults 1. Differentiate between the three major causes of dysuria in women? (ddx of dysuria) 2. List 3 common UTI pathogens, and list 3 additional pathogens in complicated UTIs 3. Define uncomplicated UTI and antibiotic options 4. Define complicated UTI and antibiotic options 5. List two antibiotic options for uncomplicated and complicated pyelonephritis. 6. How is pyelonephritis managed in pregnancy? What are safe antibiotic options for bacteriuria in pregnancy? Prostatitis 1. Describe the diagnosis and management of prostatitis Renal Calculi 1. Name the areas of narrowing in the ureter 2. Name 6 risk factors for urolithiasis 3. List 8 alternative diagnoses (other than renal colic) for pain associated with urolithiasis 4. What are indications for hospitalization of patients with urolithiasis Bladder (Vesical) Calculi 1. Describe this condition and its management Acute Scrotal Pain 1. List causes of acute scrotal swelling by age groups (infant, child, adolescent, adult) 2. Describe the physiology, diagnosis and management of testicular torsion 3. Describe the treatment for sexually vs. non-sexually acquired epididymitis Acute Urinary Retention 1. Describe the physiology of urination 2. List 10 causes of acute urinary retention in adults 3. List 6 causes of urinary retention in women Hematuria 1. List causes of red-coloured urine without hematuria 2. List risk factors for urinary tract malignancy Wisecracks: 1. When is a urine culture indicated (box 89.1) 2. What is a CAUTI and how is it managed? 3. What are two medication classes of drugs for prostatic enlargement? 4. -
Lower Urinary Tract Function in Patients with Pituitary Adenoma
390 J Neurol Neurosurg Psychiatry: first published as 10.1136/jnnp.2004.044644 on 16 February 2005. Downloaded from PAPER Lower urinary tract function in patients with pituitary adenoma compressing hypothalamus T Yamamoto, R Sakakibara, T Uchiyama, Z Liu, T Ito, T Yamanishi, T Hattori ............................................................................................................................... J Neurol Neurosurg Psychiatry 2005;76:390–394. doi: 10.1136/jnnp.2004.044644 Background: The micturition reflex is under the tonic influence of suprapontine structures including the anteromedial frontal cortex, basal ganglia, and hypothalamus. However, there have been few reports about the role of the hypothalamus on the lower urinary tract (LUT) function in humans. See end of article for Objective: To investigate LUT function in patients with pituitary adenomas. authors’ affiliations ....................... Methods: Urodynamic studies were carried out in three patients with LUT symptoms who had pituitary adenomas extending upwards to the hypothalamus. Correspondence to: Results: All three male patients (age 28 to 62 years) developed LUT symptoms (urinary urgency and Dr Ryuji Sakakibara, Neurology Department, frequency (3); urinary incontinence (3); voiding difficulty and retention (2)) along with weight loss, Chiba University, 1–8–1 psychiatric symptoms, unsteady gait, and/or visual disturbances. One had the syndrome of inappropriate Inohana Chuo-ku, Chiba secretion of antidiuretic hormone, but none had diabetes insipidus. Two had resection of the tumour and 260–8670, Japan; sakakibara@faculty. subsequent radiation therapy, but LUT dysfunction persisted. The third patient had partial resection of the chiba-u.jp tumour to ameliorate hydrocephalus. Urodynamic studies showed detrusor overactivity during the storage phase in all patients; during the voiding phase there was underactive detrusor in two and non-relaxing Received 2 May 2004 sphincter in one. -
GERONTOLOGICAL NURSE PRACTITIONER Review and Resource M Anual
13 Male Reproductive System Disorders Vaunette Fay, PhD, RN, FNP-BC, GNP-BC GERIATRIC APPRoACH Normal Changes of Aging Male Reproductive System • Decreased testosterone level leads to increased estrogen-to-androgen ratio • Testicular atrophy • Decreased sperm motility; fertility reduced but extant • Increased incidence of gynecomastia Sexual function • Slowed arousal—increased time to achieve erection • Erection less firm, shorter lasting • Delayed ejaculation and decreased forcefulness at ejaculation • Longer interval to achieving subsequent erection Prostate • By fourth decade of life, stromal fibrous elements and glandular tissue hypertrophy, stimulated by dihydrotestosterone (DHT, the active androgen within the prostate); hyperplastic nodules enlarge in size, ultimately leading to urethral obstruction 398 GERONTOLOGICAL NURSE PRACTITIONER Review and Resource M anual Clinical Implications History • Many men are overly sensitive about complaints of the male genitourinary system; men are often not inclined to initiate discussion, seek help; important to take active role in screening with an approach that is open, trustworthy, and nonjudgmental • Sexual function remains important to many men, even at ages over 80 • Lack of an available partner, poor health, erectile dysfunction, medication adverse effects, and lack of desire are the main reasons men do not continue to have sex • Acute and chronic alcohol use can lead to impotence in men • Nocturia is reported in 66% of patients over 65 – Due to impaired ability to concentrate urine, reduced -
Penile Fracture Anurag Chahal,1 Sahil Gupta,2 Chandan Das1
Images in… BMJ Case Reports: first published as 10.1136/bcr-2016-215385 on 13 May 2016. Downloaded from Penile fracture Anurag Chahal,1 Sahil Gupta,2 Chandan Das1 1Department of DESCRIPTION Radiodiagnosis, All India A 32-year-old man presented to our emergency Institute of Medical Sciences, New Delhi, India department, with pain, swelling and a dorsal curva- 2Department of Surgical ture in his penis. He had severe pain and lost Disciplines, All India Institute tumescence with a snapping sound during vigorous of Medical Sciences, New sexual intercourse. On examination, he had a swel- Delhi, India ling with ecchymosis on the ventral aspect of his fi Correspondence to penis causing an acute dorsal angulation ( gure 1). Dr Sahil Gupta, There was no blood at the meatus/haematuria. [email protected] Taking the typical history and examination findings Figure 3 Ultrasound images showing ventral into account, the diagnosis of penile fracture was Accepted 1 May 2016 haematoma (H) displacing the corpus spongiosum (CS), made. Ultrasound showed a focal tear in the medial and central urethra (U) displaced towards the left with wall of the right corpora cavernosa with haema- the corpora cavernosa (CC) seen dorsally. toma tracking ventrally and displacing the corpora spongiosa to the other side (figures 2 and 3). The patient was taken for emergent haematoma diagnosis is usually clinical and requires prompt evacuation and corporal repair. surgical intervention.3 Sometimes, the presentation Penile fracture occurs when an erect penis under- may be occult and the patient may present with goes a blunt trauma during sexual intercourse or pain with or without swelling. -
Urinary Incontinence Embarrassing but Treatable 2015 Rev
This information provides a general overview on this topic and may not apply to Health Notes everyone. To find out if this information applies to you and to get more information on From Your Family Doctor this subject, talk to your family doctor. Urinary incontinence Embarrassing but treatable 2015 rev. What is urinary incontinence? Are there different types Urinary incontinence means that you can’t always of incontinence? control when you urinate, or pee. The amount of leakage Yes. There are five types of urinary incontinence. can be small—when you sneeze, cough, or laugh—or large, due to very strong urges to urinate that are hard to Stress incontinence is when urine leaks because of control. This can be embarrassing, but it can be treated. sudden pressure on your lower stomach muscles, such as when you cough, sneeze, laugh, rise from a Millions of adults in North America have urinary chair, lift something, or exercise. Stress incontinence incontinence. It’s most common in women over 50 years usually occurs when the pelvic muscles are weakened, of age, but it can also affect younger people, especially sometimes by childbirth, or by prostate or other pelvic women who have just given birth. surgery. Stress incontinence is common in women. Be sure to talk to your doctor if you have this problem. Urge incontinence is when the need to urinate comes on If you hide your incontinence, you risk getting rashes, too fast—before you can get to a toilet. Your body may only sores, and skin and urinary tract (bladder) infections. -
Review of Systems
code: GF004 REVIEW OF SYSTEMS First Name Middle Name / MI Last Name Check the box if you are currently experiencing any of the following : General Skin Respiratory Arthritis/Rheumatism Abnormal Pigmentation Any Lung Troubles Back Pain (recurrent) Boils Asthma or Wheezing Bone Fracture Brittle Nails Bronchitis Cancer Dry Skin Chronic or Frequent Cough Diabetes Eczema Difficulty Breathing Foot Pain Frequent infections Pleurisy or Pneumonia Gout Hair/Nail changes Spitting up Blood Headaches/Migraines Hives Trouble Breathing Joint Injury Itching URI (Cold) Now Memory Loss Jaundice None Muscle Weakness Psoriasis Numbness/Tingling Rash Obesity Skin Disease Osteoporosis None Rheumatic Fever Weight Gain/Loss None Cardiovascular Gastrointestinal Eyes - Ears - Nose - Throat/Mouth Awakening in the night smothering Abdominal Pain Blurring Chest Pain or Angina Appetite Changes Double Vision Congestive Heart Failure Black Stools Eye Disease or Injury Cyanosis (blue skin) Bleeding with Bowel Movements Eye Pain/Discharge Difficulty walking two blocks Blood in Vomit Glasses Edema/Swelling of Hands, Feet or Ankles Chrohn’s Disease/Colitis Glaucoma Heart Attacks Constipation Itchy Eyes Heart Murmur Cramping or pain in the Abdomen Vision changes Heart Trouble Difficulty Swallowing Ear Disease High Blood Pressure Diverticulosis Ear Infections Irregular Heartbeat Frequent Diarrhea Ears ringing Pain in legs Gallbladder Disease Hearing problems Palpitations Gas/Bloating Impaired Hearing Poor Circulation Heartburn or Indigestion Chronic Sinus Trouble Shortness -
Urologic Disorders
Urologic Disorders Abdulaziz Althunayan Consultant Urologist Assistant professor of Surgery Urologic Disorders Urinary tract infections Urolithiasis Benign Prostatic Hyperplasia and voiding dysfunction Urinary tract infections Urethritis Acute Pyelonephritis Epididymitis/orchitis Chronic Pyelonephritis Prostatitis Renal Abscess cystitis URETHRITIS S&S – urethral discharge – burning on urination – Asymptomatic Gonococcal vs. Nongonococcal DX: – incubation period(3-10 days vs. 1-5 wks) – Urethral swab – Serum: Chlamydia-specific ribosomal RNA URETHRITIS Epididymitis Acute : pain, swelling, of the epididymis <6wk chronic :long-standing pain in the epididymis and testicle, usu. no swelling. DX – Epididymitis vs. Torsion – U/S – Testicular scan – Younger : N. gonorrhoeae or C. trachomatis – Older : E. coli Epididymitis Prostatitis Syndrome that presents with inflammation± infection of the prostate gland including: – Dysuria, frequency – dysfunctional voiding – Perineal pain – Painful ejaculation Prostatitis Prostatitis Acute Bacterial Prostatitis : – Rare – Acute pain – Storage and voiding urinary symptoms – Fever, chills, malaise, N/V – Perineal and suprapubic pain – Tender swollen hot prostate. – Rx : Abx and urinary drainage cystitis S&S: – dysuria, frequency, urgency, voiding of small urine volumes, – Suprapubic /lower abdominal pain – ± Hematuria – DX: dip-stick urinalysis Urine culture Pyelonephritis Inflammation of the kidney and renal pelvis S&S : – Chills – Fever – Costovertebral angle tenderness (flank Pain) – GI:abdo pain, N/V, and -
Overactive Bladder
Overactive Bladder Introduction Symptoms You Might Notice “Overactive bladder” (OAB) or “unstable bladder” • A strong urge to urinate with little warning. refers to the feeling of needing to urinate much more • More frequent urination. often than is average. Since a medical name for the • Possible dribbling or loss of a large amount of urine. bladder muscle is the “detrusor,” you may also hear this • Difficulty postponing urination. This becomes a major condition called names like “detrusor overactivity” or issue for people with OAB, and can limit activities and “detrusor instability.” travel. OAB is a complex problem, but generally, the • Usually, no physical pain is associated with this bladder may contract/squeeze prematurely and hard problem, but it can be very emotionally and socially enough to make urine leak out before you can make it to disturbing. the bathroom. This type of urine loss is called “urge • Need to get up more than once at night to urinate. incontinence.” • Some people may experience an uncomfortable OAB can occur at any age. Some people are born sensation of urgency. with conditions that affect nerve and muscle signals, resulting in frequent urination, accidents, and bed Possible Causes Your Health Care Provider wetting in children. Other people may not develop OAB May Look For until they are older. The body and its muscles change • Usually no outward physical signs of OAB. with aging, making OAB quite common in older adults. • In older men, this type of bladder problem may be Additionally, certain disease processes or treatments associated with prostate enlargement. may change the bladder to be more sensitive, leading to • In older women, OAB may be related to skin, blood OAB symptoms.