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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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