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Urology IntroductionUrology Introduction
Basuki B Purnomo
Department Of Urology
Medical School Brawijaya University/Saiful Anwar Hospital
Malang
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UrologyUrology
y The speciality that focuses on the urinary
tract of males and females and on the
reproductive system of males
y Urologist is medical professional
specializing- in the field of urology who
are trained to diagnose, treat and manage
of urologic disorders.
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Organs that involve in urOrgans that involve in urinaryinary
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History of UrologyHistory of Urology
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The image below shows the surgeon about to operate with hisassistants and of course no anaesthetic.
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The image below shows the type of instruments used.
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Clinical processClinical process
History taking
Physical examination
Laboratory-imaging-others examination
Histopathology Examination
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History taking:History taking:
CHIEF COMPLAINTCHIEF COMPLAINT
y Presenting the symptom(s) felt by the patient and not a diagnosis
y Urinary histories or symptoms
PainPain
Kidney or ureteral painVesical painProstatic painTesticular pain
Symptoms related to act of urinationSymptoms related to act of urination(LUTS)(LUTS)
Irritative symptoms
Frequency Nocturia DysuriaObstructive symptoms Hesitancy Decrease force of urination Intermittency Post void dribblingIncontinenceEnuresis
Change in appearance of urine:Change in appearance of urine:
Hematuria (bloody urine)PyuriaCloudy urineOrange brown: conjugated bilirubin, rhubab, concentrated normal
urine (very low fluid intake)
Symptoms sugestive of chronic renalSymptoms sugestive of chronic renalfailurefailure
OliguriaPolyuriaAnorexia, vomiting, hiccup, insomniaItch, bruising, oedema
Urethral or vaginal discharge
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SymptomSymptom(s)(s)
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Physical Examination:Physical Examination:
Digital rectal examinationDigital rectal examination
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Laboratory test:Laboratory test:
UrinalysisUrinalysis
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Laboratory test:Laboratory test:
Urine / blood / pus cultureUrine / blood / pus culture
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Imaging:Imaging:
Kidney UltrasoundKidney Ultrasound
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Imaging:Imaging:
BladderBladder UltrasoUltrasoundund
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Imaging:Imaging:
Trans Rectal Ultrasound (TRUS)Trans Rectal Ultrasound (TRUS)
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Imaging:Imaging:
Kidney Ureter Bladder & UrethrographyKidney Ureter Bladder & Urethrography
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Imaging:Imaging:
IntravenousIntravenous UrographyUrography (IVU)(IVU)
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Imaging:Imaging:
Reflux StudyReflux Study
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Imaging:Imaging:
Magnetic Resonance Imaging (MRI)Magnetic Resonance Imaging (MRI)
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UROFLOWMETRYUROFLOWMETRY
Male 70 years old with LUTS
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Disease of the Urinary TractDisease of the Urinary Tract
Kidney
Lower urinary tract
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Type of DiseasesType of Diseases
y Congenital / Hereditary
y Acquired:
Inflammation (Infection)
Trauma
Oncology
Degenerative
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ACQUIREDACQUIRED
y Acute / Chronic Kidney Disease
y Renal Hypertension
y Diabetic nephropathy
y Nephrotic syndrome
y Glomerulonephritis
y Renal stone disease
y Genitourinary trauma
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Congenital anomaly of the kidney:Congenital anomaly of the kidney:
Anomalies of Structure (Simple Cyst)Anomalies of Structure (Simple Cyst)
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Congenital anomaly of the Kidney:Congenital anomaly of the Kidney:
Anomalies in numberAnomalies in number
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Congenital anomaly of the kidney:Congenital anomaly of the kidney:
Anomalies of Structure (polycystic kidney)Anomalies of Structure (polycystic kidney)
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Congenital anomaly of the Renal Pelvic:Congenital anomaly of the Renal Pelvic:
PielouretericPieloureteric Junction ObstructionJunction Obstruction
UPJ stenosisAberrant vessel obstruct UPJ
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Congenital anomaly of Urethra:Congenital anomaly of Urethra:
HypospadiasHypospadias
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Trauma (kidney trauma)Trauma (kidney trauma)
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Carcinoma of the TesticleCarcinoma of the Testicle
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Penile CarcinomaPenile Carcinoma
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Carcinoma of the BladderCarcinoma of the Bladder
((CystoscopicCystoscopic view)view)
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Treatment:Treatment:
HemodialysisHemodialysis
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Treatment:Treatment:CAPD (CAPD (continuoscontinuos ambulatory peritoneal dialysis)ambulatory peritoneal dialysis)
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Operative Treatment:Operative Treatment:
Open operationOpen operation
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Operative treatment:Operative treatment:Transurethral Resection of the Prostate (TURP)Transurethral Resection of the Prostate (TURP)
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Operative Treatment:Operative Treatment:
PercutaneousPercutaneous NephrolithotripsyNephrolithotripsy (PCNL)(PCNL)
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Operative Treatment:Operative Treatment:
Laparoscopic OperationLaparoscopic Operation
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