UROLOGIUROLOGI

Prof. DR. Dr. H. Rifki Muslim SpB, SpUProf. DR. Dr. H. Rifki Muslim SpB, SpU

PENDAHULUANPENDAHULUANPenyakit Penyakit : - Tract. Urogenitalis: - Tract. Urogenitalis

- Tract. Urinarius - Tract. Urinarius

Anatomi + Fisiologi :Anatomi + Fisiologi :Ginjal Ginjal : - Retro peritoneal: - Retro peritoneal

- 150 gram- 150 gram

- Cortex - Cortex medulla medulla

- Nefron (p.d, glomerulus, tubulus)- Nefron (p.d, glomerulus, tubulus)

- Kaliks minor ( 8 – 12 )- Kaliks minor ( 8 – 12 )

mayor ( 2 – 3 )mayor ( 2 – 3 )

- Pedikel (dari post.) : - Pyelum – A - V- Pedikel (dari post.) : - Pyelum – A - V

Ureter Ureter : - 30 cm: - 30 cm - Penyempitan alamiah 3- Penyempitan alamiah 3 - - øø 3 – 5 mm 3 – 5 mm - Peristaltik- Peristaltik

BuliBuli : - Isi 350 – 450 ml: - Isi 350 – 450 ml - m. detrusor- m. detrusor - Segmen intravesical ureter 2 ½ - Segmen intravesical ureter 2 ½

cmcm

Ureter Ureter : - 30 cm: - 30 cm - Penyempitan alamiah 3- Penyempitan alamiah 3 - - øø 3 – 5 mm 3 – 5 mm - Peristaltik- Peristaltik

ProstatProstat : - Bentuk segi 3: - Bentuk segi 3 - 20 gram- 20 gram - Lobus 5 (ant, post, med, 2 lat)- Lobus 5 (ant, post, med, 2 lat)

TestisTestis : - 4 X 3 X 2,5 cm: - 4 X 3 X 2,5 cm - Sel sertoli + leydig (sperm.)- Sel sertoli + leydig (sperm.)

PenisPenis : - 2 corp cavernosa: - 2 corp cavernosa - 1 corp. spongiosa - 1 corp. spongiosa urethra urethra

UrethraUrethra : : - - øø 8 – 9 mm8 – 9 mmP. Post. 2 ½ cmP. Post. 2 ½ cm

- U. Post- U. Post P. Post. 2 ½ cmP. Post. 2 ½ cmP. Post. 2 ½ cmP. Post. 2 ½ cm

- U. Ant- U. Ant P. Post. 2 ½ cmP. Post. 2 ½ cm - Panjang 18 – 20 cm- Panjang 18 – 20 cm

- - øø 8 mm8 mm- Panjang lurus 4 cm- Panjang lurus 4 cm

GEJALAGEJALA

I.I. SistemikSistemik

II.II. SakitSakit

III.III. Gastro intestinalGastro intestinal

IV.IV. SeksualSeksual

V.V. Lain-lainLain-lain

VI.VI. MiksiMiksi

I.I. GEJALA SISTEMIKGEJALA SISTEMIK1.1. PanasPanas2.2. BB BB 3.3. AnoreksiaAnoreksia4.4. LemahLemah

II.II. GEJALA SAKITGEJALA SAKIT1.1. Lokal :Lokal :

• Ginjal Ginjal Pinggang sudut costovertebra Pinggang sudut costovertebra• VU VU supra pubik supra pubik• Testis Testis skrotum skrotum• Prostat Prostat perineum perineum

2.2. Dijalarkan Dijalarkan Kolik Kolik• 1/3 prox ureter : pinggang, epigastrium, testis1/3 prox ureter : pinggang, epigastrium, testis• 1/3 tengah 1/3 tengah : Mc. Burney ( Sin : Mc. Burney ( Sin • 1/3 distal 1/3 distal : Supra pubik, inguinal : Supra pubik, inguinal

scrotum, scrotum, paha medial paha medial

III.III. GEJALA GASTRO INTESTINALGEJALA GASTRO INTESTINAL1.1. NauseaNausea2.2. VomitusVomitus3.3. Kejang PerutKejang Perut4.4. Gejala “ Peptic – ulcer “Gejala “ Peptic – ulcer “5.5. “ “ Peritonismus “Peritonismus “

IV.IV. GEJALA SEXUALGEJALA SEXUAL1.1. Libido Libido 2.2. ImpotensiImpotensi3.3. Coitus sakitCoitus sakit4.4. HemospermaeHemospermae5.5. InfertilitasInfertilitas

V.V. GEJALA MIKSIGEJALA MIKSIDisuriaDisuria

1.1. PolakisuriaPolakisuria NocturiaNocturia2.2. PolyuriaPolyuria3.3. UrgencyUrgency4.4. Burning sensation (stranguria)Burning sensation (stranguria)5.5. DisuriaDisuria6.6. EnuresisEnuresis7.7. AnuriaAnuria8.8. OliguriaOliguria9.9. Retensio urineRetensio urine partialpartial

totaltotal10.10. Hesitancy (delayed urination)Hesitancy (delayed urination)11.11. StrainingStraining12.12. Kaliber kecilKaliber kecil13.13. Pancaran lemahPancaran lemah14.14. Terminal dribblingTerminal dribbling

15.15. Sense of residual urineSense of residual urine16.16. Kencing tiba-tiba berhentiKencing tiba-tiba berhenti17.17. Pancaran terbelahPancaran terbelah18.18. InkontinensiaInkontinensia : - True Inc: - True Inc

- Stress inc- Stress inc - Over flow / Paradoxal inc- Over flow / Paradoxal inc - False inc- False inc - Urgency inc- Urgency inc

19.19. PneumaturiaPneumaturia20.20. FecaluriaFecaluria21.21. Claudy urineClaudy urine22.22. PyuriaPyuria23.23. HematuriaHematuria

- Waktu (initial, total, terminal)- Waktu (initial, total, terminal)- Sakit (Painless, Painfull)- Sakit (Painless, Painfull)- Warna- Warna

24.24. ChyluriaChyluria