UROLOGY

Zhang Xue-pei MD
Anatomy
Symptoms
Frequency, Nocturia and
Urgency

• Increased bladder residual urine

• Decreased bladder capacity
• Urinary tract inflamed
odynuria (pain in urination)

• Always with the voiding.

• Acute inflammation of bladder, urethra
and prostate.

• Often associated with urinary frequency

and urgency
Enuresis

• Before 3 years : physiology

• Infection. Distal urethra stenosis,

posterior urethra valve, neurogenic

bladder
Difficult Urination

• Hesitancy, loss of force and decreased of caliber

of the stream, terminal dribling

• Due to lower urinary tract obstruction

• Such as BPH, Pca, urethra stricture, urethra stone
et al.
 Acute and Chronic Urinary
Retention

• Boo (bladder outlet obstruction)

• Such as BPH, Pca, urethra stricture,
urethra stone et al.

• Neurogenic bladder
Incontinence

• True incontinence: constant urine

leakage due to ectopic ureter orifice,
injury to the sphincter of the urethra
and neurogenic bladder
• Stress incontinence: in multiparous
women loss the muscle support to the
bladder neck and urethra
• Urge incontinence : due to overactive
bladder ---infection; Upper motor
neuron lesions; It is often seen in
anxious , tense women even without
infection
• False incontinence: bladder pressure
equals the urethra resistance then
the constant dribbling occures
Bloody Urine

• Hematuria associated with flank pain

radiates to lower anterior abdominal
quadrant , also to scrotum testis and
vulva---ureter stone. Due to spasm of
ureter muscle .
• Painless hematuria throughout the
urination ----urinary tract tumor.
Physical Examination

• Kidney
Non-invasive Examination
Ultrasound

• The most common use in urology

• Cheap, get quick result, noninvasive
• Valuable in renal cyst disease, renal
tumors, stones, urinary tract obstruction
• The accuracy of the result depended on
the experience of the operators
• It is always as a screening methods.
KUB+IVP

• What is KUB?
• What is IVP?
• Shape
• Function
• Common used as ultrasound
Retrograde pyelography

• Use the cystoscope to insert the

catheter into the ureter then inject
contrast medium.
• Invasive operation
• Used when IVP can not show the lesions
clearly or renal function is severely
damaged
Voiding cystourethrograms

• To invest the LUT

• Machinical or dynamic disease
Computed tomography
Scanning(CT)
• Transverse section of the body
• Applied to any urinary tract tumors,
adrenal tumors, renal injury

• More accurate than ultrasound

Magnetic Resonance
Imaging (MRI)
• Applied in kidney, retroperitoneum
lesions, bladder and prostate

• More expensive than CT

• Less common use than CT
Catheter
Invasive Examination
Cystoscope

• Can see the urethra and bladder

• Simultaneously biopsy or treatment of the
lesions
• Most accuracy examination of the
diseases
• Invasive can cause hematuria and
retrograde infection
Ureteroscope

• To invest ureter and pelvic

• When the noninvasive examination
can not make a defined dignosis

• Can also do the treatment

Laparoscopy

• It is a revolution to the traditional surgery

• Minimal invasive
• Short hospital time
• Economic
• Most open operation can be done by lap