Dr mohammad alshahwani بسم الله الرحمن الرحيم Dr mohammad alshahwani

URINARY SYMTOMS&INVESTIGATIONS dr.mohamed fawzi alshahwani LECTURE ONE URINARY SYMTOMS&INVESTIGATIONS dr.mohamed fawzi alshahwani Dr mohammad alshahwani

Dr mohammad alshahwani URINARY SYSTEM US is extra peritoneal system composed of two kidneys located in the upper abdomen protected by thoracic cage, each weighs about 150 g. Each kidney supplied by main renal artery from aorta, divided into 5 segmental branches and drained by renal vein to the inferior vena cava. Dr mohammad alshahwani

Normal capacity about 350-400 cc URINARY BLADDER Muscular organ located in the pelvis, acts as urine reservoir during resting time and discarding urine via urethra during the process of urination by the action of detruser muscles contraction. Normal capacity about 350-400 cc Dr mohammad alshahwani

Dr mohammad alshahwani

Dr mohammad alshahwani urethra Dr mohammad alshahwani

Dr mohammad alshahwani URINARY SYMTOMS HAEMATURIA PAIN ALTERED BLADDER FUNCTION INCONTINENCE Nocturnal enuresis ASSOCIATED SYMTOMS Dr mohammad alshahwani

Dr mohammad alshahwani HAEMATURIA MACROSCOPICAL MICROSCOPICAL TERMINAL TOTAL EARLY INTERMITANT PERSISTANT Dr mohammad alshahwani

Dr mohammad alshahwani pain Renal pain Ureteric colic Bladder pain Perineal pain Urethral pain Dr mohammad alshahwani

Incontinence involuntary loss of urine Continuous incontinence . Stress incontinence . Urge incontinence. Overflow urinary incontinence Dr mohammad alshahwani

Associated symptoms&sign GIT Autonomic Organ relationship Peritoneal irritation Mass or swelling Failure to thrive Uremia Dr mohammad alshahwani

INVESTIGATION urine examination DIPSTIC…RBC,,,protein,,,nitrite,,,,screenig GUE CYTOLOGICAL BACTERIOLOGICAL BIOCHEMICAL HAEMOGLOBIN;MYIGLOBIN;BILIRUBIN;GLUCOSE;ELECTROLYTE protein 24h urine for calcium; uric acid; oxalate,protein Dr mohammad alshahwani

Dr mohammad alshahwani INVESTIGATION Renal function test MORE THAN 70%OF RENAL FUNCTION MUST BE LOST BEFOR RENAL FAILURE BECOME EVIDENT BLOOD UREA& SERUM CRIATININ Isotope study (EDTA),(DMSA) Dr mohammad alshahwani

INVESTIGATION radiological KUB BONES SOFT TISSUE STONES IVU RETROGRADE URETERPYELOGRAPHY ANTEGRADE PYELGRAPGY CYSTOGRAPHY (MCUG) URETHROGRAPHY Dr mohammad alshahwani

Dr mohammad alshahwani INVESTIGATION ULTRASONOGRAPHY Color Doppler uls TRANSRECTAL ULTRASONOGRAPHY CT SCAN TUMOR SIZE;SITE;INVATION LYMPH NODE INVATION OF THE RENAL VEIN&VENA CAVA STAGING&FOLLOW UP OF TESTICULAR TUMOR MRI Dr mohammad alshahwani

Dr mohammad alshahwani INVESTIGATION RADIOISOTOP SCANNING FUNCTION OF INDIVIDUAL RENAL UNIT DTPA LABELLED WITH TECHNETIUM-99 ISOTOP BONE SCANING FOR STAGING KIDNEY&PROSTATE CANCER Urodynamic study ENDOSOPY Dr mohammad alshahwani

URINARY TRACT IMAGING KUB (kidneys, ureters, and bladder) A plain radiograph of the abdomen and pelvis includes the area above both adrenal glands and extends to 2 cm below the symphysis pubis \ Dr mohammad alshahwani

Dr mohammad alshahwani / KUB: site, skin, sex, stones, psoas shadow, skeleton, and soft tissue shadow. Dr mohammad alshahwani

Dr mohammad alshahwani 3-IVU: No., size, site, function of the kidneys, anatomy of the collecting system, hydronephrosis, and filling defects. C.I.: allergy and renal failure. Dr mohammad alshahwani

Dr mohammad alshahwani

Dr mohammad alshahwani

Dr mohammad alshahwani

RETROGRADE URETERPYELOGRAPHY invasive Dr mohammad alshahwani

Dr mohammad alshahwani CYSTOURETHROGRAPYH Contrast-enhanced imaging of the lower urinary tract provides valuable information on the function and anatomy of the bladder and urethra Voiding Cystourethrography Dr mohammad alshahwani

Dr mohammad alshahwani ANGIOGRAPHY Currently, CT, MRI, and ultrasonography have supplanted angiography for most diagnostic indications, providing equivalent and at times greater information with markedly decreased morbidity and risk. Dr mohammad alshahwani

Dr mohammad alshahwani NUCLEAR IMAGING \. Technetium Tc 99m Diethylenetriaminepenta-acetic Acid 99mTc-DTPA Technetium Tc 99m Mercaptoacetyltriglycine 99mTc-MAG3 Technetium Tc 99m Dimercaptosuccinic Acid 99mTc-DMSA It gives the split function of each kidney Dr mohammad alshahwani

Dr mohammad alshahwani

Dr mohammad alshahwani

Dr mohammad alshahwani Color doppler ult Dr mohammad alshahwani

MAGNETIC RESONANCE IMAGING \ Dr mohammad alshahwani

Dr mohammad alshahwani COMPUTED TOMOGRAPHY Non Contrasted Oral Contrast Agents Intravenous Contrast Agents CT can accurately characterize the nature of tissue in the lesion. CT is useful in the preoperative evaluation and staging of tumors. CT has replaced IV urography as the primary modality for the assessment of suspected renal injuries and their complications For the evaluation of patients with acute flank pain, unenhanced spiral CT is more sensitive in detecting calculi than EXU Dr mohammad alshahwani

Urethroscope, cystoscope ureteroscope and renoscope. Endoscope…invasive Urethroscope, cystoscope ureteroscope and renoscope. Dr mohammad alshahwani

Dr mohammad alshahwani

Dr mohammad alshahwani

Dr mohammad alshahwani

Dr mohammad alshahwani nephroscopy : Dr mohammad alshahwani

Dr mohammad alshahwani : Urodynamic studies: To study the function of the vesico-urethral unit. Include cystometry, flow rate and EMG of pelvic floor. Dr mohammad alshahwani