A Clinical Guide to Urologic Emergencies

A Clinical Guide to Urologic Emergencies
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A Clinical Guide to Urologic Emergencies A Clinical Guide to Urologic Emergencies An ageing population and a predicted shortfall in the number of urologists means that, increasingly, the management of complex urological problems will fall to hospital emergency departments and the surgeries of primary care physicians. With many doctors and medical students now having less exposure to urology, there is a real and urgent need for accessible and practical guidance in managing urologic emergencies. A Clinical Guide to Urologic Emergencies offers practical guidance to the best practices in diagnosis, treatment and management of patients with urgent urological conditions. Designed to be an extremely useful tool to consult in the clinical setting, it will be a vital source of information and guidance for all clinicians, irrespective of their level of urologic knowledge.Edited by an outstanding international editor team, this book is particularly aimed at physicians, advanced practice providers, and urology and emergency medicine trainees managing patients in diverse healthcare settings across the globe. A Clinical Guide to Urologic Emergencies is accompanied by a website featuring video content at www.wiley.com/go/wessells/urologic

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Группа авторов. A Clinical Guide to Urologic Emergencies

Table of Contents

List of Tables

List of Illustrations

Guide

Pages

A Clinical Guide to Urologic Emergencies

Dedication

List of Contributors

Preface. A Clinical Guide to Urologic Emergencies

References

List of Abbreviations

About the Companion Website

1 Blunt Renal Injuries

Epidemiology, Etiology, Pathophysiology. Epidemiology and Etiology

Pathophysiology

Diagnosis. Workup

Radiographic Evaluation

Management. Non‐operative Management

Indications for Intervention

Non‐operative Versus Operative Management

Predictors of Failure of Non‐Operative Management in Blunt Renal Trauma

Management of Renal Trauma in Children

Operative Technique

Issues in Operative Technique for Blunt Trauma

Complications and Follow‐Up

Secondary Hemorrhage

Urinary Extravasation and Perinephric Abscess

Renal Insufficiency

Hypertension

Other Complications

Mortality

Conclusions

References

2 Penetrating Renal Trauma: A Civilian and Military Perspective

Introduction

Civilian Versus Military Trauma

Pathophysiology of Penetrating Trauma

Anatomy

Evaluation

Imaging

Management. Non‐Operative

Operative

Complications

Conclusion

References

3 Renal Infections

Introduction

Acute Pyelonephritis

Epidemiology

Clinical Presentation

Laboratory Findings

Microbiology and Pathophysiology

Imaging

Treatment

Emphysematous Pyelonephritis

Pathogens and Pathogenesis

Clinical Presentation

Diagnosis

Treatment

Xanthogranulomatous Pyelonephritis

Clinical Presentation

Imaging

Diagnosis and Treatment

Chronic Pyelonephritis

Clinical Presentation

Radiologic Findings

Management

Renal Abscess

Epidemiology

Clinical Presentation

Microbiology

Laboratory Diagnosis

Imaging

Management

Tuberculosis of the Kidney

Clinical Presentation

Laboratory Findings

Imaging

Treatment

Conclusions

References

4 Acute Kidney Stone Management

Introduction

History and Physical

Additional Relevant History

Physical Exam

Diagnostic Evaluation. Laboratory

Imaging

Management of Symptoms

Trial of Stone Passage/Medical Expulsion Therapy

Medical Dissolution Therapy

Acute Procedural Intervention. Indications

Upper Urinary Tract Decompression

Stone Treatment

Prognosis

Special Considerations. Pregnant Patients

Pediatric Patients

Conclusion

References

5 Traumatic Adrenal Hemorrhage

Introduction

Relevant Anatomy

Etiology. Blunt Trauma

Penetrating Trauma

Staging

Presentation

Imaging

Management

Complications of Adrenal Trauma

Conclusion

References

6 External Ureteral Trauma

Introduction

Anatomical Considerations

Mechanisms of Injury

Concomitant Injuries

Diagnosis

Diagnostic Imaging

Intra‐operative Diagnosis

Delayed Diagnosis

Diagnostic Endoscopy and Urography

Management

Ureteral Contusions

Surgical Principles

Damage Control Surgery

Delayed Management of Injuries

Complications

Conclusions

References

7 Iatrogenic Ureteral Injury

Introduction

Etiology

Management

Timing of Repair

Surgical Technique

Complete Ureteral Loss

Outcomes and Complications

Conclusions

References

8 Bladder Injuries

Introduction

Etiology

Clinical Symptoms and Imaging Diagnoses

Treatment of Bladder Injuries

Long‐term Consequences

Complications

Conclusion

References

9 Traumatic Urethral Injuries

Introduction

Initial Management of Suspected Trauma to the Lower Urinary Tract

Urethral Trauma

Urethral Anatomy. Male Urethra

Female Urethra

Urethral Trauma Classification

Trauma to the Posterior Urethra

Fractures of the Bony Pelvis

Management in the Acute Phase

Delayed Management

Trauma to the Anterior Urethra

Management in the Acute Phase

Delayed Management

Conclusions

References

10 Acute Management of Urethral Stricture

Introduction

Etiology of Urethral Stricture

Patient History and Physical Examination

Evaluation of Urethral Stricture

Voiding Symptoms and Uroflowmetry

Urethrography

Ultrasound Urethrography

Urethro‐Cystoscopy

MRI

Emergency Management of Urinary Retention and Unexpected Urethral Stricture

Elective Management of Urethral Stricture

Transurethral Procedures. DVIU and Dilation

Urethral Stents

Urethroplasty

EPA

Substitution Urethroplasty

Post‐operative Follow‐Up. Post Transurethral Procedures

Post Urethroplasty

Conclusion

References

11 Prostatitis and Prostatic Abscess

Introduction

Classification

Presentation

Management

Diagnostic Imaging

Prostatic Abscess

Conclusions

References

12 Fournier's Gangrene

Introduction

Epidemiology

Etiology

Bacteriology

Clinical Symptoms and Imaging

Treatment

Conclusions

References

13 Traumatic Penile Injuries

Introduction

Pathophysiology of Traumatic Penile Injury. Blunt Penile Injury (Penile Fracture)

Penetrating Penile Injury. Gunshot Wounds

Stab Wounds/Amputation

Avulsion/Bites

Burns

Initial Evaluation. Penile Fracture

Penetrating Injury

Amputation

Management. Penile Fracture

Penetrating GSW and Stab Wounds

Amputation

Abrasions/Lacerations/Avulsion

Bites

Burns

Conclusions

References

14 Priapism

Introduction

Epidemiology

Pathophysiology and Causes. Ischemic

Non‐ischemic

Stuttering

Evaluation and Diagnostic Workup

Treatment

Effects of Priapism on Erectile Function

Summary

References

15 Traumatic Scrotal and Testicular Injuries

Introduction

General Evaluation

Imaging

Management. Acute Management

Scrotal Skin Injuries and Scrotal Reconstruction

Hematocele

Intratesticular Hematoma

Testicular Rupture

Testicular Dislocation and Testicular Torsion

Penetrating Scrotal Injury

Combat‐Related Scrotal Injuries

Considerations. Infection

Future Fertility

Endocrine

Psychological Impact

Conclusions

References

16 Testicular Torsion

Introduction

Epidemiology

Pathophysiology

Presentation

Diagnostic Evaluation

Management

Outcomes

Conclusions and Future Directions

References

17 Epididymitis and Orchitis

Introduction

Anatomy and Physiology

Epidemiology

Pathophysiology

Infectious Epididymitis

Non‐infectious Epididymitis

Chronic Epididymitis

Diagnosis

Treatment

Recommended Antibiotic Regimens

Additional Considerations

Treatment of Sexual Partners

Allergies, Intolerance, and Adverse Reactions

Patients with HIV

Follow‐up

Management of Chronic Epididymitis

Complications

Conclusion

References

18 Urologic Neonatal Emergencies

Introduction

Posterior Urethral Valves (PUV)

Antenatal Diagnosis and Management

Pre‐Operative Management in the Neonatal Unit

Imaging Diagnosis

Surgical Management

Post‐Operative Management and Long‐Term Outcomes

Management of Valve Bladder Syndrome

Epispadias, Bladder and Cloacal Exstrophy

Antenatal Diagnosis

Initial Management in Neonate Unit

General Principles for Surgical Repair

Post‐Operative Considerations

Neonatal Testicular Torsion

Disorders of Sex Development

Female Genital Masses

Paraurethral Cysts

Ureterocele Prolapse

Urethral Prolapse

Urethral Polyps

Sarcoma Botryoides

Imperforated Hymen

Conclusions

References

19 Urologic Emergency Care in the COVID‐19 Pandemic Era

Immediate Responses of Urology Departments

Surgical Triage

Telemedicine

Consequences of COVID‐19 on Urologic Care

Conclusions

References

Index. a

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d

e

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Edited by

Hunter Wessells, MD, FACS

.....

Dana A. Weiss The Children's Hospital of Philadelphia, Philadelphia, PA, USA

Hunter Wessells Department of Urology, University of Washington School of Medicine, Seattle, WA, USA

.....

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