Dr mohammad alshahwani
*بسم الله الرحمن الرحيم
Dr mohammad alshahwani
* URINARY SYMTOMS&INVESTIGATIONS dr.mohamed fawzi alshahwaniLECTURE ONE
Dr mohammad alshahwani
* URINARY SYSTEMUS is extra peritoneal system composed of two kidneys located in the upper abdomen protected by thoracic cage, each weighs about 150 g. Each kidney supplied by main renal artery from aorta, divided into 5 segmental branches and drained by renal vein to the inferior vena cava.
Dr mohammad alshahwani
* URINARY BLADDERMuscular organ located in the pelvis, acts as urine reservoir during resting time and discarding urine via urethra during the process of urination by the action of detruser muscles contraction. Normal capacity about 350-400 cc
Dr mohammad alshahwani
*Dr mohammad alshahwani
* urethra
Dr mohammad alshahwani
* URINARY SYMTOMSHAEMATURIA PAIN ALTERED BLADDER FUNCTION INCONTINENCE Nocturnal enuresis ASSOCIATED SYMTOMS
Dr mohammad alshahwani
* HAEMATURIAMACROSCOPICAL MICROSCOPICAL TERMINAL TOTAL EARLY INTERMITANT PERSISTANT
Dr mohammad alshahwani
* painRenal pain Ureteric colic Bladder pain Perineal pain Urethral pain
Dr mohammad alshahwani
* Incontinence involuntary loss of urineContinuous incontinence . Stress incontinence . Urge incontinence. Overflow urinary incontinence
Dr mohammad alshahwani
* Associated symptoms&sign
GIT Autonomic Organ relationship Peritoneal irritation Mass or swelling Failure to thrive Uremia
Dr mohammad alshahwani
* INVESTIGATION urine examinationDIPSTIC…RBC,,,protein,,,nitrite,,,,screenigGUECYTOLOGICALBACTERIOLOGICALBIOCHEMICAL HAEMOGLOBIN;MYIGLOBIN;BILIRUBIN;GLUCOSE;ELECTROLYTE protein 24h urine for calcium; uric acid; oxalate,protein
Dr mohammad alshahwani
* INVESTIGATIONRenal function test MORE THAN 70%OF RENAL FUNCTION MUST BE LOST BEFOR RENAL FAILURE BECOME EVIDENT BLOOD UREA& SERUM CRIATININ Isotope study (EDTA),(DMSA)
Dr mohammad alshahwani
* INVESTIGATION radiologicalKUB BONES SOFT TISSUE STONES IVU RETROGRADE URETERPYELOGRAPHY ANTEGRADE PYELGRAPGY CYSTOGRAPHY (MCUG) URETHROGRAPHY
Dr mohammad alshahwani
* INVESTIGATIONULTRASONOGRAPHY Color Doppler uls TRANSRECTAL ULTRASONOGRAPHY CT SCAN TUMOR SIZE;SITE;INVATION LYMPH NODE INVATION OF THE RENAL VEIN&VENA CAVA STAGING&FOLLOW UP OF TESTICULAR TUMOR MRI
Dr mohammad alshahwani
* INVESTIGATIONRADIOISOTOP SCANNING FUNCTION OF INDIVIDUAL RENAL UNIT DTPA LABELLED WITH TECHNETIUM-99 ISOTOP BONE SCANING FOR STAGING KIDNEY&PROSTATE CANCER Urodynamic study ENDOSOPY
Dr mohammad alshahwani
* URINARY TRACT IMAGING KUB (kidneys, ureters, and bladder)A plain radiograph of the abdomen and pelvis includes the area above both adrenal glands and extends to 2 cm below the symphysis pubis \ \
Dr mohammad alshahwani
* / KUB: site, skin, sex, stones, psoas shadow, skeleton, and soft tissue shadow.Dr mohammad alshahwani
* 3-IVU: No., size, site, function of the kidneys, anatomy of the collecting system, hydronephrosis, and filling defects. C.I.: allergy and renal failure.Dr mohammad alshahwani
*Dr mohammad alshahwani
*Dr mohammad alshahwani
*Dr mohammad alshahwani
* RETROGRADE URETERPYELOGRAPHY invasive
Dr mohammad alshahwani
* CYSTOURETHROGRAPYHContrast-enhanced imaging of the lower urinary tract provides valuable information on the function and anatomy of the bladder and urethra
Voiding Cystourethrography
Dr mohammad alshahwani
* ANGIOGRAPHYCurrently, CT, MRI, and ultrasonography have supplanted angiography for most diagnostic indications, providing equivalent and at times greater information with markedly decreased morbidity and risk.
Dr mohammad alshahwani
* NUCLEAR IMAGING\. Technetium Tc 99m Diethylenetriaminepenta-acetic Acid 99mTc-DTPA Technetium Tc 99m Mercaptoacetyltriglycine 99mTc-MAG3 Technetium Tc 99m Dimercaptosuccinic Acid 99mTc-DMSA It gives the split function of each kidney
Dr mohammad alshahwani
*Dr mohammad alshahwani
*Dr mohammad alshahwani
* Color doppler ult
Dr mohammad alshahwani
* MAGNETIC RESONANCE IMAGING\
Dr mohammad alshahwani
* COMPUTED TOMOGRAPHYNon Contrasted Oral Contrast Agents Intravenous Contrast Agents
CT can accurately characterize the nature of tissue in the lesion. CT is useful in the preoperative evaluation and staging of tumors. CT has replaced IV urography as the primary modality for the assessment of suspected renal injuries and their complications For the evaluation of patients with acute flank pain, unenhanced spiral CT is more sensitive in detecting calculi than EXU
Dr mohammad alshahwani
* Endoscope…invasive Urethroscope, cystoscope ureteroscope and renoscope.Dr mohammad alshahwani
*Dr mohammad alshahwani
*Dr mohammad alshahwani
*
Dr mohammad alshahwani
* nephroscopy:
Dr mohammad alshahwani
* :Urodynamic studies: To study the function of the vesico-urethral unit. Include cystometry, flow rate and EMG of pelvic floor.