Menu Expand
Practical Urology for the General Surgeon, An issue of Surgical Clinics of North America, E-Book

Practical Urology for the General Surgeon, An issue of Surgical Clinics of North America, E-Book

Lisa T. Beaule | Moritz H. Hansen

(2016)

Additional Information

Book Details

Abstract

This issue of Surgical Clinics of North America, guest edited by Drs. Lisa T. Beaule and Moritz H. Hansen, is devoted to Practical Urology for the General Surgeon. They have assembled expert authors to review the following topics: Surgical Management of Acute Urologic Emergencies; Surgical Management of Urologic Trauma and Iatrogenic Injuries; Diagnosis and Management of Voiding Dysfunction; Surgical Management of Urinary Retention; Surgical Management of Female Voiding Dysfunction; Surgical Management of Male Voiding Dysfunction; Diagnosis and Management of Hematuria; Diagnosis and Management of Nephrolithiasis; Surgery of Urologic Implants; Surgical Pediatric Urology; Use of Bowel in Urologic Reconstructive Surgery; Diagnosis and Surgical Management of Uro-enteric Fistulae; Diagnosis and Surgical Management of Pelvic, Inguinal, and Testicular Pain; Robotic Surgery of the Kidney, Bladder and Prostate, and more!


Table of Contents

Section Title Page Action Price
Front Cover Cover
Practical Urology\rfor the General Surgeon i
Copyright ii
Contributors iii
CONSULTING EDITOR iii
EDITORS iii
AUTHORS iii
Contents vii
Foreword vii
Preface vii
Urologic Emergencies vii
Surgical Management of Urologic Trauma and Iatrogenic Injuries vii
Diagnosis and Management of Lower Urinary Tract Dysfunction vii
Urinary Retention in Surgical Patients vii
Surgical Management of Female Voiding Dysfunction viii
Surgical Management of Male Voiding Dysfunction viii
Diagnosis and Management of Hematuria viii
Diagnosis and Management of Nephrolithiasis ix
Genitourinary Prosthetics: A Primer for the Non-urologic Surgeon ix
Pediatric Urology for the General Surgeon ix
The Use of Bowel in Urologic Reconstructive Surgery ix
Diagnosis and Surgical Management of Uroenteric Fistula x
Diagnosis and Surgical Management of Male Pelvic, Inguinal, and Testicular Pain x
Robotic Surgery of the Kidney, Bladder, and Prostate x
SURGICAL CLINICS\rOF NORTH AMERICA xi
FORTHCOMING ISSUES xi
August 2016 xi
October 2016 xi
December 2016 xi
RECENT ISSUES xi
April 2016 xi
February 2016 xi
December 2015 xi
October 2015 xi
Foreword xiii
Preface xv
Urologic Emergencies 407
Key points 407
ACUTE URINARY RETENTION 407
Overview 407
Causes/Pathophysiology 407
Diagnosis 408
Treatment 409
Urethral catheter placement technique 409
FOURNIER GANGRENE 411
Overview 411
Causes/Pathophysiology 411
Diagnosis 412
Treatment 412
ISCHEMIC PRIAPISM 414
Overview 414
Causes/pathophysiology 414
Diagnosis 415
Treatment 415
OBSTRUCTIVE PYONEPHROSIS 417
Introduction 417
Causes/Pathophysiology 417
Diagnosis 417
Urinalysis interpretation 418
Treatment 418
PARAPHIMOSIS 419
Introduction 419
Pathophysiology 419
Diagnosis 419
Treatment 419
TESTICULAR TORSION 420
Introduction 420
Pathophysiology 420
Diagnosis 422
Treatment 423
REFERENCES 423
Surgical Management of Urologic Trauma and Iatrogenic Injuries 425
Key points 425
INTRODUCTION 425
RENAL INJURY 426
Initial Evaluation 426
Management 427
Nonoperative 427
Operative 428
Operative Technique 428
Complications 429
INJURY TO THE URETER 429
Initial Evaluation 429
Management 430
Surgical Exploration 430
BLADDER INJURY 430
Initial Evaluation 430
Management 431
Nonoperative 431
Operative 431
URETHRAL INJURIES 432
Initial Evaluation 432
Management 433
Pelvic fracture urethral injury 433
Anterior urethra injury 433
PENILE INJURY 433
Initial Evaluation 433
Management 434
PENILE AMPUTATION 434
SCROTAL AND TESTICULAR INJURY 435
Initial Evaluation 435
Management 435
REFERENCES 436
Diagnosis and Management of Lower Urinary Tract Dysfunction 441
Key points 441
INTRODUCTION 441
NORMAL BLADDER PHYSIOLOGY 441
LOWER URINARY TRACT PATHOPHYSIOLOGY 443
LOWER URINARY TRACT DYSFUNCTION: PATIENT EVALUATION 443
URODYNAMICS 444
Noninvasive Uroflowmetry 444
Multichannel Urodynamics 445
Electromyogram 446
Video Urodynamics 446
Recommendations on Use 446
Urodynamics required 448
Urodynamics helpful 448
Urodynamics unnecessary 448
MEDICAL AND BEHAVIORAL MANAGEMENT OF LOWER URINARY TRACT DYSFUNCTION 448
Failure to Empty Due to Bladder 448
Failure to Empty Due to Outlet 449
Failure to Store Due to Bladder 449
Failure to Store Due to Bladder Outlet 450
SUMMARY 450
REFERENCES 450
Urinary Retention in Surgical Patients 453
Key points 453
URINARY RETENTION 453
Definitions 454
Epidemiology 454
Pathophysiology 454
Normal bladder function 454
Cause of retention 455
Obstruction: either mechanical or dynamic 455
Disruption of the innervation: sensory and motor pathways 455
Overdistention: myogenic failure 456
Risk Factors 456
Age 456
Sex 456
Medications 456
Anesthesia 456
Benign prostatic hyperplasia 457
Surgery related 458
Women and children 459
Others 459
Diagnosis 460
Associated signs and symptoms 460
Postvoid residual: how much is too much? 460
Complications of Retention 461
Treatment 461
Conservative 461
Surgical intervention: overview 463
REFERENCES 464
Surgical Management of Female Voiding Dysfunction 469
Key points 469
INTRODUCTION 469
STRESS URINARY INCONTINENCE 470
Urethral Hypermobility 470
Intrinsic Sphincteric Deficiency 470
STRESS URINARY INCONTINENCE PROCEDURES 470
Bulking Agents 470
Coaptite 471
Macroplastique 471
Technique 471
Considerations 471
Open or Laparoscopic Surgical Intervention for Stress Urinary Incontinence 471
Retropubic suspension 472
Marshall Marchetti Krantz procedure 472
Burch colposuspension 472
Needle suspensions 472
Four-corner bladder neck (needle) suspension 472
Anterior vaginal wall suspension 473
Pereyra 473
Raz-modified Pereyra 473
Stamey 473
Gittes 473
Vaginal repair 473
Kelly-type plication 473
Slings 473
Retropubic midurethral mesh slings 475
Transobturator midurethral mesh sling 475
Single incision mesh sling 475
Pubovaginal sling 475
Readjustable sling 475
PELVIC ORGAN PROLAPSE: NATIVE TISSUE AND MESH 476
Vaginal Vault Suspension 477
Vaginal approach 477
Sacrospinous ligament suspension 477
Iliococcygeus suspension 477
Vaginal uterosacral ligament suspension 477
Mesh 477
Abdominal approach 478
Abdominal sacrocolpopexy 478
Cystocele Repair 478
Kelly Kennedy plication 478
Site-specific graft augment 479
Lateral paravaginal repair (relatively historic) 480
Anterior vaginal wall suspension 480
Mesh kits 481
Rectocele Repair 482
Posterior colporrhaphy 482
Site-specific defect repair 483
Site-specific graft augment 483
Levator myorrhaphy 484
High midline levator myorrphaphy 484
Mesh kits 485
URGE URINARY INCONTINENCE 485
Onabotulinumtoxin A to Bladder Detrusor 485
Interstim Sacral Neuromodulation 486
Augmentation Cystoplasty 486
OBSTRUCTION 486
Urethral Diverticulum 486
Urethral Stricture 487
Onabotulinumtoxin A to Sphincter or Bladder Neck 487
Incision of Bladder Neck 487
Levator Dysfunction 487
SUMMARY 487
ACKNOWLEDGMENTS 487
REFERENCES 487
Surgical Management of Male Voiding Dysfunction 491
Key points 491
INTRODUCTION 491
ETIOLOGY AND EPIDEMIOLOGY OF BENIGN PROSTATIC HYPERPLASIA AND LOWER URINARY TRACT SYMPTOMS 492
MANAGEMENT OF BENIGN PROSTATIC HYPERPLASIA AND LOWER URINARY TRACT SYMPTOMS 492
PREOPERATIVE EVALUATION 493
OFFICE-BASED PROCEDURES 493
Transurethral Microwave Therapy 493
Transurethral Needle Ablation 494
SURGICAL PROCEDURES 494
Monopolar Transurethral Resection of the Prostate 494
Bipolar Transurethral Resection of the Prostate 495
Laser Therapy for Benign Prostatic Hyperplasia 496
Holmium laser physics 496
Holmium laser ablation of the prostate 496
Holmium laser enucleation of the prostate 497
Photoselective Vaporization of the Prostate Physics 498
Photoselective Vaporization of the Prostate Procedure 498
OPEN SIMPLE PROSTATECTOMY 498
ROBOTIC SIMPLE PROSTATECTOMY 499
COMPLICATIONS OF BENIGN PROSTATIC HYPERPLASIA SURGERY 499
SUMMARY 499
SUPPLEMENTARY DATA 500
REFERENCES 500
Diagnosis and Management of Hematuria 503
Key points 503
INTRODUCTION 503
RELEVANT ANATOMY AND PATHOPHYSIOLOGY 504
Kidney and Ureter 504
Bladder 505
Prostate 506
Urethra 506
CLINICAL PRESENTATION AND EXAMINATION 506
Urinary Tract Infection 507
Urologic Malignancy 508
Hemorrhagic Cystitis 508
Trauma 508
Prostatic Enlargement 508
Ureteroarterial Fistula 508
DIAGNOSTIC PROCEDURES AND DIAGNOSIS 508
INTERVENTIONS AND TREATMENT 510
Urinary Tract Infections 510
Urolithiasis 510
Urologic Malignancy 511
Clot Retention 511
Prostatic Hematuria 512
Hemorrhagic Cystitis 512
Urotrauma 512
Ureteroarterial Fistulae 512
SUMMARY 513
REFERENCES 513
Diagnosis and Management of Nephrolithiasis 517
Key points 517
INTRODUCTION 517
Prevalence 517
Extent and Cost 518
Morbidity and Prognosis 518
Risk Factors 518
Relevance to the General Surgeon 518
RELEVANT ANATOMY AND PATHOPHYSIOLOGY 518
Anatomy 518
Pathophysiology 519
Pathophysiology of General Surgery Conditions Resulting in Stone Formation 520
Examples of disorders with increased risk of stone formation 520
Inflammatory bowel diseases 521
Chronic pancreatitis 521
Bariatric surgery 521
Hyperparathyroidism 521
PATHOPHYSIOLOGY OF RENAL COLIC AND STONE PASSAGE 521
CLINICAL PRESENTATION AND EXAMINATION 522
Symptoms 522
Physical Examination 522
General 522
Vital signs 522
Abdominal and flank examination 522
Laboratory Work 523
Imaging 523
Noncontrast computed tomography 523
Retroperitoneal ultrasound scan 523
Plain radiograph of abdomen and pelvis 523
Intravenous pyelogram 523
Nuclear functional renal scan 524
MANAGEMENT AND AVAILABLE PROCEDURES 524
Observation 524
Medical Expulsive Therapy 524
AVAILABLE SURGICAL PROCEDURES 524
PROCEDURE TECHNIQUE 525
Shock Wave Lithotripsy 525
Ureteroscopy 525
Percutaneous Nephrolithotomy 526
Open or Laparoscopic Surgery for Stone Disease 527
SELECTION OF PROCEDURE 528
REFERENCES 529
Genitourinary Prosthetics 533
Key points 533
INTRODUCTION 533
TYPES OF GENITOURINARY PROSTHESIS 534
Testicular Prosthesis 534
Semirigid Penile Prostheses 535
Inflatable Penile Prostheses 535
Artificial Urinary Sphincter 536
PERIOPERATIVE CONSIDERATIONS FOR GENITOURINARY PROSTHESES 538
Antibiotic Coverage for Nonurologic Surgery 538
Urethral Catheterization with an Artificial Urinary Sphincter or Penile Prosthesis 538
Management of Traumatic Urethral Catheterization 539
GENERAL SURGICAL CONSIDERATIONS 539
Inguinal Hernias 539
Small Bowel Obstruction 539
Vascular Complications 540
Managing Iatrogenic Injuries to the Device During Nonurologic Surgery 540
SUMMARY 540
REFERENCES 541
Pediatric Urology for the General Surgeon 545
Key points 545
INTRODUCTION 545
HERNIA/HYDROCELE 545
Background 545
Diagnosis 546
Management 547
Surgery 547
CRYPTORCHIDISM 548
Background 548
Diagnosis 548
Treatment 549
CIRCUMCISION 549
Background 549
Circumcision Benefits 550
Neonatal Circumcision 551
Postnewborn Circumcision 552
Risk-Benefit Assessment 553
GENITOURINARY TRAUMA 553
Introduction 553
Renal Trauma 554
Ureteral Trauma 556
Bladder and Urethral Injury 557
Penile Trauma 558
Scrotal/Testicular Trauma 559
Vaginal Trauma 559
REFERENCES 560
The Use of Bowel in Urologic Reconstructive Surgery 567
Key points 567
URINARY DIVERSION 567
URETEROSIGMOIDOSTOMY 568
CONDUIT URINARY DIVERSIONS 568
ILEAL CONDUIT 568
JEJUNAL CONDUIT 570
COLON CONDUITS 570
TRANSVERSE COLON CONDUIT 571
SIGMOID COLON CONDUIT 571
CONTINENT URINARY DIVERSION 571
BLADDER SUBSTITUTION (COMMONLY REFERRED TO AS A NEOBLADDER) 572
BLADDER AUGMENTATION/CYSTOPLASTY 575
APPENDICOVESICOSTOMY 576
ILEAL URETERAL SUBSTITUTION 578
METABOLIC COMPLICATIONS 579
Electrolyte Abnormalities 579
Stomach 579
Jejunum 580
Ileum and colon 580
Nutritional Disturbances 580
Infection 580
Abnormal Drug Metabolism 581
Bone Disease 581
REFERENCES 581
Diagnosis and Surgical Management of Uroenteric Fistula 583
Key points 583
INTRODUCTION 583
VESICOENTERIC FISTULAE 584
Causes 584
Incidence 584
Presentation 585
Diagnosis 585
Management 586
PROSTATORECTAL AND URETHRORECTAL 587
Causes 587
Incidence 587
Presentation 588
Diagnosis 588
Management 588
URETEROENTERAL 589
Causes 589
Incidence 589
Diagnosis and Surgical Management of Male Pelvic, Inguinal, and Testicular Pain 593
Key points 593
INTRODUCTION 593
CHRONIC PAIN PATHOPHYSIOLOGY 594
PROSTATIC PAIN 594
CATEGORY I: ACUTE BACTERIAL PROSTATITIS 594
Clinical Presentation 594
Diagnosis 595
Treatment 595
Medical 595
Surgical 596
CATEGORY II CHRONIC BACTERIAL PROSTATITIS 596
Clinical Presentation 596
Diagnosis 596
Treatment 597
CATEGORY III: CHRONIC NONBACTERIAL PROSTATITIS/CHRONIC PELVIC PAIN SYNDROME 597
Clinical Presentation 597
Diagnosis 598
Treatment 599
CATEGORY IV: ASYMPTOMATIC INFLAMMATORY PROSTATITIS 601
INGUINODYNIA 601
DIAGNOSIS 601
MEDICAL TREATMENT OF POSTOPERATIVE INGUINODYNIA 602
INTERVENTIONAL TREATMENT OF POSTOPERATIVE INGUINODYNIA 602
SURGICAL NEURECTOMY FOR TREATMENT OF POSTOPERATIVE INGUINODYNIA 603
CHRONIC ORCHALGIA 604
SPERMATIC CORD BLOCK 604
SURGICAL TREATMENT OF CHRONIC SCROTAL PAIN 605
REFERENCES 608
Robotic Surgery of the Kidney, Bladder, and Prostate 615
Key points 615
INTRODUCTION 615
A BRIEF HISTORY OF SURGICAL ROBOTICS 618
THE DA VINCI SURGICAL SYSTEM 618
ROBOTIC SURGERY OF THE KIDNEY AND URETER 619
Partial Nephrectomy 619
Radical Nephrectomy 621
Pyeloplasty 622
ROBOTIC SURGERY OF THE BLADDER 623
Radical Cystectomy 623
ROBOTIC SURGERY OF THE PROSTATE 625
Radical Prostatectomy 625
Simple Prostatectomy 628
SUMMARY 630
REFERENCES 630
Index 637