
Emergency Urology
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Content
- Emergency UROLOGY
- Title Page
- Copyright
- Contents
- Contributing Authors
- Acknowledgements
- Abbreviations
- Preface
- Chapter 1: Assessing the Unwell Urological Patient
- ABCDE
- HISTORY
- Urinary symptoms
- Pain
- Loin pain
- Scrotal pain
- History of previous urological input or intervention
- Past medical history
- Drug history
- EXAMINATION
- Systemic/general examination
- Kidneys
- Bladder
- Prostate
- Vaginal examination (where clinically relevant)
- Penis
- Scrotum
- Groins
- ROUTINE INVESTIGATIONS
- Bladder scan
- Flow analysis
- Urinalysis
- Urinary or serum beta-human chorionic gonadotrophin (ß-HCG)
- FAST scan (focused assessment with sonography for trauma)
- Blood tests
- IMAGING INVESTIGATIONS
- Computed tomography (CT)
- Ultrasound scan (USS)
- Urethrogram/cystogram
- Magnetic resonance imaging (MRI)
- SEPSIS
- Management
- Early recognition
- Urgent intervention
- Timely escalation
- Chapter 2: Upper Urinary Tract Emergencies
- ACUTE KIDNEY INJURY
- Definition and staging
- Epidemiology
- Causes and classification
- Pre-renal AKI
- Intrinsic AKI
- Acute tubular necrosis
- Contrast-induced AKI (CI-AKI)
- Post-renal AKI
- Presentation
- Investigation
- Management
- Hyperkalaemia
- RENAL COLIC
- Background
- Epidemiology
- Causes
- Presentation
- Symptoms
- Examination
- Investigation
- Treatment
- Scenario 1: Ureteric stone
- Scenario 2: Sepsis with an obstructing stone
- Scenario 3: Staghorn calculi
- Follow-up
- KIDNEY INFECTIONS
- Pyelonephritis
- Causes
- Presentation
- Symptoms
- Examination
- Investigation
- Treatment
- Follow-up
- Specific subtypes of pyelonephritis
- Emphysematous pyelonephritis (EPN)
- Xanthogranulomatous pyelonephritis (XGP)
- Renal/peri-renal abscess
- References
- Chapter 3: Lower Urinary Tract Emergencies
- URINARY RETENTION
- Acute urinary retention
- Presentation
- History
- Examination
- Investigation
- Management
- Benign prostatic enlargement
- Clot retention
- Urethral stricture
- UTI
- Constipation
- Neurological
- Chronic urinary retention
- Symptoms
- Investigation
- Management
- Post-obstructive diuresis
- Management
- Retention with catheterisable stomas
- Important
- HAEMATURIA
- Causes
- Managing patients in the emergency setting
- Bladder washout for clot retention
- Further investigation and management of acute presentation of haematuria
- Managing patients in primary care
- URINARY TRACT INFECTION AND CYSTITIS
- Acute bacterial cystitis
- Causes
- Presentation
- Symptoms
- Examination
- Investigation
- Management
- Catheter-associated UTI
- PROSTATITIS
- Acute bacterial prostatitis
- Presentation
- Examination
- Investigation
- Management
- URETHRITIS
- Presentation and examination
- Investigation
- Management
- References
- Chapter 4: Genitoscrotal Emergencies
- ACUTE SCROTUM
- Testicular torsion
- Pathophysiology
- History
- Examination
- Investigation
- Management
- Torsion of testicular appendage (torted hydatid of Morgagni)
- History
- Examination
- Investigation
- Management
- Epididymo-orchitis
- History
- Examination
- Investigation
- Management
- Scrotal abscess
- History
- Examination
- Investigation
- Management
- Hydrocoele/infected hydrocoele
- History
- Examination
- Investigation
- Management
- Scrotal haematoma
- History
- Examination
- Investigation
- Management
- PENILE EMERGENCIES
- Penile fracture
- History
- Examination
- Investigation
- Management
- Paraphimosis
- Presentation
- Management
- Balanitis
- Diagnosis
- Management
- PRIAPISM
- Types of priapism
- Presentation
- Causes
- History
- Examination
- Investigation
- Management
- Low-flow (ischaemic) priapism
- Stuttering priapism
- Non-ischaemic (high-flow) priapism
- FOURNIER'S GANGRENE
- Pathophysiology
- History
- Examination
- Management
- References
- Chapter 5: Trauma in Urology
- UPPER URINARY TRACT TRAUMA
- Causes
- Presentation
- History
- Examination
- Investigation
- Management
- Renal trauma
- Ureteric trauma
- LOWER URINARY TRACT TRAUMA
- Causes
- Presentation
- Bladder injuries
- Urethral injuries
- Patterns of haematoma associated with anterior urethral injury
- Investigation
- Management
- GENITOSCROTAL TRAUMA
- Testicular trauma
- Presentation
- Investigation
- Management
- Surgical approach
- Zipper injury
- Penile trauma
- Penile amputation
- Management
- Penetrating injury
- Soft tissue injury
- Chapter 6: Special Circumstances
- PAEDIATRIC UROLOGICAL EMERGENCIES
- Acute scrotum in childhood
- Testicular torsion
- Neonatal testicular torsion
- Torted testicular appendage
- Infection
- Trauma
- Idiopathic scrotal oedema
- Henoch-Schönlein purpura (HSP)
- Penile and foreskin problems in children
- Post-circumcision complications
- Paraphimosis
- Voiding problems in children
- Urinary retention
- UROLOGICAL EMERGENCIES IN PREGNANCY
- Pyelonephritis in pregnancy
- History
- Examination
- Investigation
- Management in moderate to severe pyelonephritis
- Acute kidney injury in pregnancy
- History
- Examination
- Investigation
- Management
- Urolithiasis in pregnancy
- History
- Examination
- Investigation
- Management
- Temporary drainage versus definitive treatment
- NEUROGENIC BLADDER
- Autonomic dysreflexia
- Presentation
- Management
- Cauda equina
- Acute spinal cord injury
- Management
- Assessment of other general problems relating to the urinary tract in neuropathic patients
- History
- Examination
- Investigation
- Management
- Protection of the upper renal tracts:
- Management of stress incontinence (i.e. due to sphincter weakness).
- Prevention of recurrent lower urinary tract infections
- ONCOLOGICAL EMERGENCIES
- Malignant spinal cord compression
- History
- Examination
- Investigation
- Management
- Bilateral malignant ureteric obstruction
- History
- Examination
- Investigation
- Management
- POST-OPERATIVE EMERGENCIES
- Inpatient post-operative complications
- Bleeding/haematuria
- Catheter falls out after surgery
- TUR syndrome
- Anuria/oliguria (normal adult urine output = 0.5ml/kg/h)
- Post-catheterisation diuresis
- Compartment syndrome
- Urinary tract infection and sepsis
- Outpatient post-operative complications
- Bleeding/haematuria
- Poor cosmesis and concerns after day-case procedures
- TUBES, PROSTHESES AND ALTERED URINARY TRACT ANATOMY
- Ureteric stents
- Problems
- Nephrostomy tubes
- Problems
- Ileal conduit
- Problems
- History
- Examination
- Investigation
- Management
- Bladder substitute/neobladder
- Problems
- History
- Examination
- Investigation
- Management
- Bladder augmentation (cystoplasty)
- Problems
- History
- Examination
- Investigation
- Management
- Continent catheterisable channels (Mitrofanoff and Monti)
- Problems
- Management
- Artificial urinary sphincters
- Problems
- Management
- References
- Chapter 7: Procedures in Urology
- URETHRAL CATHETERISATION
- Types of catheter
- Specialist catheters
- Technique of urethral catheterisation
- Documentation
- Tips and tricks
- Difficult female catheterisation
- Unable to site a catheter and no specialist help available
- SUPRAPUBIC CATHETERISATION
- Techniques for insertion of a percutaneous SPC
- Trocar-based technique
- Seldinger-based technique
- Replacement/exchange of an existing suprapubic catheter
- Documentation
- CATHETER COMPLICATIONS
- Complications of urethral catheter insertion
- False passage
- Management
- Balloon inflated in the prostatic urethra
- Management
- Difficult female catheterisation
- Management
- Tight phimosis/non-retractile foreskin
- Management
- Paraphimosis
- Management
- Buried penis/genitoscrotal oedema
- Management
- Decompression haematuria
- Management
- Hypospadias
- Meatal stenosis
- Catheter inserted into a ureter
- Management
- Allergic reaction
- Complications of catheters in situ
- Bladder spasms/urinary bypassing/catheter expulsion
- Management
- Blood/debris in the catheter tubing and bag
- Management
- Blockages
- Encrustation and stone formation
- Management
- Catheter-associated UTI (CAUTI)
- Management
- Soft tissue erosion/penile spatulation
- Psychological impact
- Complications of urethral catheter removal
- Unable to deflate balloon and remove catheter
- Management
- Tip left inside the bladder
- Management
- Suprapubic catheter problems
- Management
- LOCAL ANAESTHETIC PENILE BLOCKS
- Indication
- Anatomy
- Technique
- Subcutaneous penile ring block
- Complications
- References
- Chapter 8: Interventional Uroradiology Procedures
- NEPHROSTOMY
- Indications
- Patient preparation
- Procedure
- Outcome
- ANTEGRADE URETERIC STENT INSERTION
- Indications
- Patient preparation
- Procedure
- Outcome
- ILEAL CONDUIT ACCESS AND URETERIC STENTING
- Indications
- Patient preparation
- Procedure
- Outcome
- MITROFANOFF IMAGING/ACCESS
- Indications
- Patient preparation
- Procedure
- Outcome
- RENAL EMBOLISATION
- Indications
- Patient preparation
- Procedure
- Embolic agents
- Outcome
- DRAINAGE OF COLLECTIONS
- Indications
- Patient preparation
- Procedure
- Outcome
- References
- Appendix 1: EXAMPLE EMERGENCY DEPARTMENT PROTOCOL FOR SUSPECTED SEPSIS
- Appendix 2: THE ABCDE APPROACH
- Underlying principles
- First steps
- Airway (A)
- Breathing (B)
- Circulation (C)
- Disability (D)
- Exposure (E)
- Additional information
- Index
- Back Cover
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