Urological emergencies notes...

urology

causes of enterocutaneous fistula

FRIEND

Foreign body

Radiation

Infection/Inflammation

Epithelialization

Neoplasm

Distal obstruction

7 Urologic Emergencies (means take action now!)

1. Torsion - testicle twists- acute severe pain. 4-6 hour window before tissue death

diagnosis is US, tx can try and detorse (open book) turn each testicle laterally, will still need to operate orchiopexy

2. Priapism - either low flow or high flow. Low flow is emergency, drain it w/needle, tx w/phenylephrine,

low flow associated w/leukemias, multiple myeloma, sickle cell, can also try PDE5 inhibitors

high flow let go

3. Paraphimoses - 4-6 hour window before tissue death in glans, squeeze on glans and it goes back in (most times), still no? dorsal foreskin gets cut

4. Ureteral obstruction w/fever - no flow past stone soon to be urosepsis, patient w/diabetes even worse

5. Acute urinary retention - etiiology clot or bph, fix w/catheter

6. Ureteral damage - most often iatrogenic from not pushing the catheter all the way in, when balloon expands trauma to prostate PUSH THE CATHETER ALL THE WAY IN

7. Fornier's gangrene - infxn of perineum increased in diabetics, immunosuppression, chronic etoh, normal polymicrobial, requires empiric Abx and debridement bad news

bad news