Introduction in Urology
Introduction in Urology
• Percussion :
upon filling 150 ml at least
• Technique :
dorsal lithotomy
above the symphysis even
umbilicus on the midline
Conversion tympanism
into dullness
Digital rectal exam
Sphincter tonicity
Rectal polyps
Hemorrhoids
Fistulas
Prostate :
morphology:
• 2 lobes and sulcus, like chestnut(4 .cm)
• soft likes cluneal muscle
prostatic nodule :
cancer,
chronic prostatitis
granulomatis ,TB
stone
Vaginal exam
• Girls :
hymen , clitoris, labia
• Women:
Uterus: ptosis
Cervix : tumor
Salpinx :salpingitis
discharges :
Bartolan gland : infection
Anterior wall :cystocele
Posterior wall :Rectocele
Anal Levators : tonicity
Meatus : mucosa, mobility
Incontinence test :
External genital Organs exam
• Inspection :
meatus, volume of uroflow
ulceration
curvature
penis volume
• Palpitation
penis
fibrosis : Peyrony disease
penis tumors
Scrotum :
wall : edema , cysts
hydrocele ,hernia ( transillumination test)
Epididyme (pain. thickness)
testis (anatomical position. Tumor )
Spermatic cord :
spermatocele, hernia, varicocele
Neurological exam
• Sensation
Regions belonging : S2-S3-S4 in perineum
• Tonicity
anal sphincter
• Bulbo-cavernous reflex
neurological spinal arcus
Lymph nodes exam
• Inguinal nodes
penis and scrotum lesions
• Per-aortal nodes
testis
• Internal hypogastric nodes
prostate , bladder
• over clavicle nodes
subsequent other nodes
Investigations
Urine
• chemicals Dipsticks : change colour in the
presence of blood, protein or nitrites.
• The presence of protein and nitrites indicates
the likelihood of infection.
• The significance of microscopic haematuria.
• indication of the pH and specific gravity.
Urine
• Flowmetry
• Cystometry
• Urethral profile
• Videouradynamics
Flowmetry
Etiology :
• extra obstacle: pelvic tumor, uterus ptosis
• Intra obstacle : prostate ,
• Neurogenic bladder
• Foreign body : urethral stone
• drugs : anticholinergics
Treatment :
• drainage
• management of etiology
Urinary incontinence
• Involuntary emission of urines by natural tracts
• In men :
overflow incontinence :
consequent to chronic retention
stress incontinence :
over intra abdominal effort :
Urinary incontinence
• In women :
stress inc.:
sphincter insufficiency or urethral hyper
mobility consequent to pelvic-perineal weakness
Treatment :
drugs : anti- cholinergics
Rehabilitation
Surgery
Urinary incontinence
Urgent incontinence : in 2 sex
brutal desire that we can not resist resulting to
urinary leakage
Etiology :
irritant cause : stone, infection,
Neurologic origin : instability, dyssenergia
Urethral discharge
• blood
• gonorrhea : yellowish brown secretions
• nongonorrhea : non thick mucosal secretion