Urology Emergencies
Urinary Retention
Testicular Torsion
Epidemiology
Babies and adolescents
Clinical Features
Ddx
Management
Fournier's Gangrene
Definition
Necrotising fasciitis of perineum
Epidemiology
M>>F
Middle age with co-morbidities
Clinical Features
Management
Paraphimosis
Definition
Ischaemic stricture following phimosis or failure to replace foreskin
Management
Priapism
Usually low flow
Low flow more dangerous
Risk Factors
Management
Source
Dr Kathryn Gilliams 2014
- UTI
- BPH
Testicular Torsion
Epidemiology
Babies and adolescents
Clinical Features
- Pain, n+v
- High riding testicle, swollen, tender
- Absent cremaster reflex
Ddx
- Torsion of testicular appendix (blue dot sign, hard palpable nodule, less severe pain)
- Epidydimoorchitis (present cremaster reflex, low hanging testicle on affected side)
Management
- Urgent surgical exploration
Fournier's Gangrene
Definition
Necrotising fasciitis of perineum
Epidemiology
M>>F
Middle age with co-morbidities
Clinical Features
- Disproportionate pain
- Cellulitic skin
- May not have visible source (infected hair follicle, scratch)
Management
- Urgent imaging (gas in fascia planes) then surgical
Paraphimosis
Definition
Ischaemic stricture following phimosis or failure to replace foreskin
Management
- Manual reduction with analgesia
- Needle puncture =/- sugar
- Urology to do dorsal slit +/- circumcision
Priapism
Usually low flow
Low flow more dangerous
Risk Factors
- Low flow: intrapenile injections
- High flow: trauma
Management
- Hydration, analgesia
- Direct aspiration
Source
Dr Kathryn Gilliams 2014