COSULTANT UROLOGIST

 Diseases of lower urinary tract

 Infection.  Tumor  Trauma  Urolithiasis

 UTI inflammatory response of the urothelium to bacterial invasion that is usually associated with bacteriuria and pyuria

 Bacteriuria is the presence of bacteria in the urine  symptomatic or asymptomatic  Pyuria, the presence of white blood cells (WBCs) in the urine  Cystitis usually associated with dysuria, frequency, and/or urgency. Suprapubic pain and hematuria are less common

 Diagnosis direct or indirect analysis of the urine and is confirmed by urine culture. Urine Collection Voided and Catheterized Specimens Suprapubic Aspiration

 Symptoms  Treatment antibiotic anticholinergic ?

 condition diagnosed on a clinical basis  often exacerbated by bladder filling and associated with urinary frequency  bladder and/or urethral and/or pelvic pain, irritative voiding symptoms, and sterile urine cultures

 30% to 40% of all extrapulmonary TB.  occurs secondary to TB of the kidney  Mycobacterium tuberculosis in the urine.  sterile pyuria often accompanied by hematuria and proteinuria

 Cystoscopy :  limited role in the diagnosis of TB.  no pathognomonic findings that are specific for tuberculosis  Treatment  antituberculous chemotherapy  Augmentation cystoplasty ( <100ml )

 chronic infection Schistosoma.  Symptoms:-  Diagnosis:-  The presence of terminally spined eggs in the urinary sediment is diagnostic of active S. haematobium infection

 Treatment :-  Medical-> antischistosomal drugs (Praziquantel )  Surgical-> for ureteral stricture

 Infection.  Tumor  Trauma  Urolithiasis

 BENIGN TUMORS :- 1 - Epithelial Metaplasia 40% of women and 5% of men have squamous metaplasia of the bladder, which is usually related to infection, trauma, and surgery  2- Leukoplakia keratin deposition that appears as a white flaky substance floating in the bladder

3- Papilloma is a benign proliferative growth. 4- Nephrogenic Adenoma caused by chronic irritation. composed of glandular-appearing tubules similar to renal tubules. 5- Cystitis Cystica and Glandularis. 6- Leiomyoma

 TCC  7% of all cancers  Males are 3 to 4 times> females.  causes: …………  Gross, painless hematuria is the primary symptom in 85%  20% will have a urologic malignancy, and 12% will have a bladder tumor

 Treatment:  TUR-BT  Chemotherapy – UB. instelation  Radical cystectomy.  Partial cystectomy.  radiotherapy

 Sarcoma s  most common mesenchymal tumor. Small Cell Carcinoma metastatic disease, even if there is no radiologic evidence of disease outside the bladder. Squamous Cell Cancer

 Infection.  Tumor  Trauma  Urolithiasis

Protected from external trauma. 80% to 94% of patients have significant associated nonurologic injuries obstetric and gynecologic complications are the most common causes of bladder injuries. Extraperitoneal. Intraperitoneal

 the most reliable indicator is gross hematuria, which is present in nearly all cases

 car accidents, falls, or industrial accidents.  blood at the meatus,  inability to urinate,  and palpably full bladder  Ascending uretherogram.

 Infection.  Tumor  Trauma  Urolithiasis

 BLADDER CALCULI  5% of all urinary stone disease  Primary  No functional, anatomic, or infectious factors.  Most common in children younger than the age of 10  Rarely recur after treatment

 typically found in men older than the age of 60.  lower urinary tract obstruction. 3%-7% of patients will report a history of renal colic foreign body in the bladder Neurogenic Bladder and Spinal Cord Injury

 Intermittency,  frequency,  urgency,  dysuria,  decreased force of the urinary stream, incontinence,  and lower abdominal pain

 Cystolithotomy  Cystolithlapaxy.  Shockwave Lithotripsy

 99% of asymptomatic adult men noted to have some degree of prostatic calcification at the time of autopsy, regardless of age  most prostatic calculi are asymptomatic

 Migratory Calculi  Primary Urethral Calculi  Symptoms  Treatment

Catheter Size Based on Age AGE IN YRCATHETER SIZE (FR) < >