Contents

1 Urologic Emergencies: Overview

2 The Clinical Approach to the Acutely Ill Patient

S. Buse, R. Santucci, M. Hohenfellner 2

2.1 Diagnosis 2

2.2 History 3

2.3 Physical Examination 3

2.4 Laboratory Testing 4

2.5 Imaging 4

References 6

3 New Developments in Anesthesia

3.1 Perioperative Cardiac Complications 8

3.2 Deep Vein Thrombosis and Pulmonary Embolism 15

3.4 Sepsis 18

3.5 Intensive Care Procedures 20

3.6 Intraoperative- and Postoperative Procedures 25

3.7 Perioperative Management of Jehovah's Witnesses 27

References 30

4 Anaphylaxis

P. Bader, D. Frohneberg 32

4.1 Definition 32

4.2 Immunological Mechanism 32

4.3 Clinical Presentation and Differential Diagnosis 33

4.4 Diagnostic Tests and Risk Factors 34

4.5 Prevention and Treatment of Anaphylactic Reactions 35

4.6 The Role of Skin and Provocation Tests 36

4.7 Immediate and Nonimmediate Reactions to Contrast Media 37

4.8 Reactions to Perioperative Drugs 40

4.9 Latex Allergy: Diagnosis and Management 42

References 43

5 Urosepsis

5.1 Definition 45

5.2 Epidemiology of Sepsis 45

5.3 Etiology of Urosepsis 45

5.4 Pathophysiology 45

5.5 Classification System 46

5.6 Risk Factors for Urosepsis 47

5.7 Clinical Symptoms 47

5.8 Diagnostic Procedures 47

5.9 Microbiology 48

5.10 Further Diagnostic Procedures 48

5.11 Therapy 48

References 49

6 Fournier's Gangrene

6.1 Definition and Historical Perspective 50

6.2 Etiology 50

6.3 Anatomy 52

6.4 Microbiology 53

6.5 Pathogenesis 54

6.6 Clinical Presentation 55

6.7 Special Investigations 55

6.8 Management 55

6.9 Complications 59

6.10 Prognosis 59

References 59

7 Urologic Emergencies in Pregnant Women: Special Considerations

J.F. HERmiEU, L. BoccoN-GibOD 61

7.1 Introduction 61

7.2 Anatomical and Physiological Modifications During Pregnancy 61

7.3 Diagnostic Procedures in the Pregnant Patient 62

7.4 Treatment 64

7.5 Particular Treatments of Certain Urological Emergencies in Pregnant Women 67

7.6 Conclusion 70

References 70

8 Urologic Emergencies in Children: Special Considerations

8.1 Introduction 73

8.2 Adrenal 73

8.3 Kidney 75

8.4 Bladder 84

8.5 External Genitalia 89

References 97

9 Autonomic Dysreflexia and Emergencies in Neurogenic Bladder

9.1 Autonomic Dysreflexia 101

9.2 Neurogenic Bladder and Spinal Shock 103

References 103

10 Failure of Urinary Drainage: Upper Urinary

M.T. Gettjman, J.W. SEgURA 104

10.1 Introduction 104

10.2 Presenting Signs and Symptoms 104

10.3 Diagnostic Evaluation 105

10.4 Acute Urologic Management 111

10.5 Delayed Definitive Interventions 116

10.6 Conclusion 116

References 116

11 Failure of Urinary Drainage: Lower Tract

J.M. Patterson, C.R. Chapple 118

11.1 Introduction 118

11.2 The Male Patient 118

11.3 The Female Patient 129

References 130

12 Scrotal Emergencies

V. Master 132

12.1 Introduction 132

12.2 Testis 133

12.3 Paratesticular Emergencies 136

12.4 Spermatocele 137

12.5 Varicocele 138

12.6 Trauma 139

12.7 Paratesticular Masses 139

12.8 Scrotal Wall Problems 139

12.9 Miscellaneous 141

12.10 Summary of Diagnostic Workup 141

References 141

13 Oncologic Emergencies

13.1 Introduction 142

13.2 Spontaneous Perinephric Hemorrhage 142

13.3 Hypercalcemia of Malignancy 144

13.4 Complications of Bacille Calmette-Guerin Therapy 146

13.5 Malignant Spinal Cord Compression 148

13.6 Neutropenia 151

13.7 Intractable Bladder Hemorrhage 154

13.8 Ureteral Obstruction 159

13.9 Bladder Outlet Obstruction 162

13.10 Respiratory Complications 165

References 166

14 Urologic Paraneoplastic Syndromes

14.1 Renal Cell Carcinoma 172

14.2 Prostate Cancer 176

14.3 Bladder Cancer 179

14.4 Testicular Cancer 179

14.5 Penile Cancer 180

14.6 Conclusion 180

References 180

15 Trauma

15.1 Urologic Trauma: General Considerations

15.1.1 Iatrogenic Injury 183

15.1.2 External Trauma 184

References 184

15.2 Modern Trauma: New Mechanisms of Injury Due to Terrorist Attacks

15.2.1 Introduction 185

15.2.2 Mechanisms of Explosive Injury 186

15.2.3 Characteristics of Terrorist-Related Blast Injuries 186

15.2.4 Characteristics of Terrorist-Related Gunshot Injuries 187

15.2.5 Medical Management of Terrorist-Related Injuries 187

15.2.6 Urological Aspects of Terrorist-Related Injuries 188

15.2.7 Summary 190

References 190

15.3 Mass Casualties: Urologic Aspects of Triage and Definitive Management

15.3.1 Mass Casualties 192

15.3.2 Mechanisms of Injury and Specific Urological Injuries in Mass Casualty Events 194

15.3.3 The Urologic Approach in Mass Casualty Events 195

References 200

15.4 Renal Trauma

E. Serafetinides 201

15.4.1 Anatomy 201

15.4.2 Iatrogenic Vascular Injuries 202

15.4.3 Renal Transplantation 202

15.4.4 Percutaneous Renal Procedures 203

15.4.5 Renal Injuries 205

15.4.6 Foreign Bodies 217

15.4.7 Spontaneous Retroperitoneal Haemorrhage 217

References 218

15.5 Trauma of the Ureter

J. Pfitzenmaier, Ch. Gilfrich, A. Haferkamp, M. Hohenfellner 233

15.5.1 Anatomy 233

15.5.2 Clinical Diagnosis 234

15.5.3 Radiographic Diagnosis 234

15.5.4 Intraoperative Diagnosis 234

15.5.5 External Trauma 235

15.5.6 Iatrogenic/Intraoperative Trauma 235

15.5.7 Techniques of Trauma Repair 237

15.5.8 Ureteroureterostomy and Primary Closure 238

15.5.9 Ureterocalycostomy and Pyeloplasty 239

15.5.10 Transureteroureterostomy and Transureteropyelostomy 239

15.5.11 Psoas Hitch 239

15.5.12 BoariFlap 241

15.5.13 Intestinal Replacement of the Ureter 241

15.5.14 Autotransplantation of the Kidney 243

15.5.15 Nephrectomy 243

15.5.16 Stricture Repair 243

15.5.17 Future 244

References 244

15.6 Bladder Trauma

15.6.1 Introduction 246

15.6.2 Etiology and Incidence 246

15.6.3 Classification 249

15.6.4 Risk Factors 252

15.6.5 Diagnosis 252

15.6.6 Treatment 255

15.6.7 Damage Control 256

References 257

15.7 Genital Trauma

15.7.1 Introduction 260

15.7.2 Pathophysiology of Trauma to External Genitalia 261

15.7.3 Diagnosis and Management of Genital Trauma 264

15.7.4 Blunt Trauma of the Male Genitalia 264

15.7.5 Treatment of External Genital Trauma 265

References 267

15.8 Management of Penile Amputation

G.H. Jordan 270

15.8.1 Introduction 270

15.8.2 History of Penile Replantation 271

15.8.3 Anatomy of the Penis 271

15.8.4 Penile Replantation 272

15.8.5 Summary 274

References 274

15.9 Urethral Trauma

15.9.1 Anatomical and Etiological Considerations 276

15.9.2 Diagnosis: Initial Emergency Assessment 282

15.9.3 Management 284

15.9.4 Recommendations for Treatment: Algorithms 293

References 295

16 Priapism

16.1 Introduction 301

16.2 Classification 302

16.3 Etiology 302

16.4 Evaluation 303

16.5 Management 304

16.6 Surgical Treatment of Ischemic Priapism 305

16.7 Postoperative Care 308

16.8 Treatment of Nonischemic Priapism 308

16.9 Recurrent (Stuttering) Priapism 309

16.10 Mechanical Priapism 310

16.11 Conclusion 310

Appendix 310

References 311

17 Intraoperative Complications

17.1 Management of Intraoperative Complications in Open Procedures

17.1.1 Introduction 313

17.1.2 Vascular Complications 314

17.1.3 Intestinal Complications 319

17.1.4 Solid Organ Injury 323

17.1.5 Conclusion 326

References 326

17.2 Complications in Endoscopic Procedures

F. Wimpissinger, W. Stackl 327

17.2.1 Complications of Percutaneous Nephrolithotomy 327

17.2.2 Complications of Ureterorenoscopy 331

References 334

17.3 TUR-Related Complications

N. Zantl, R. Hartung 335

17.3.1 Intraoperative Complications During TURP 336

17.3.2 Postoperative Emergencies After TURP 343

17.3.3 Intraoperative and Early Postoperative Complications During TURB 344 References 347

17.4 Complications in Laparoscopic Surgery

17.4.1 Introduction 349

17.4.2 Intraoperative Complications 349

17.4.3 Postoperative Complications 359

References 361

18 Postoperative Complications

18.1 Acute Postoperative Complications

18.1.1 Postoperative Bleeding 364

18.1.2 Chest Pain and Dyspnea 373

18.1.3 Acute Abdomen 377

18.1.4 Postoperative Fever 378

18.1.5 Abdominal Wound Dehiscence 403

18.1.6 Chylous Ascites 410

18.1.7 Deep Venous Thrombosis 414

18.1.8 Lymphoceles 416

References 421

18.2 Preventing and Managing Infectious Emergencies of Urologic Surgery

18.2.1 Introduction 430

18.2.2 Surgical Site Infections 430

18.2.3 Urinary Tract Infections Complicating Urological Procedures 437

References 441

18.3 Emergencies in Continent Bladder Replacement

M. Schumacher, F.C. Burkhard, U.E. Studer 444

18.3.1 Introduction 444

18.3.2 Continent Urinary Diversion 444

18.3.3 Diversion-Related Emergencies 444

18.3.4 Emergencies Not Related to Diversion 448

18.3.5 Conclusions 449

References 450

18.4 Emergencies Following Renal Transplantation

M.A. Ghoneim, A.A. Shokeir 451

18.4.1 Introduction 451

18.4.2 The Living Donor: Surgical Emergencies 451

18.4.3 Recipients: Surgical and Nonsurgical Emergencies 452

References 464

18.5 Open Salvage Surgery

C. WoTKOwicz, M.A. Jacobs, J.A. Libertino 466

18.5.1 Introduction 466

18.5.2 Indications 466

18.5.3 Infectious Peritonitis 468

18.5.4 Posto Operative Bleeding 476

18.5.5 Stomal Complications 478

18.5.6 Bowel Obstruction 479

18.5.7 Dehiscence 480

18.5.8 Abdominal Compartment Syndrome 481

18.5.9 Cutaneous Ureterostomy 482

18.5.10Conclusions 483

References 483

19 Surgical Techniques: Endoscopic and Percutaneous Procedures

19.1 Lower Urinary Tract 486

19.2 Upper Urinary Tract 491

20 Interventional Radiology in Emergencies in Urology

20.1 Transcatheter Embolization 496

20.2 Transcatheter Lysis and Thrombectomy in Renal Artery Occlusion 501

20.3 PTA and Stenting 502

20.4 Percutaneous Drainage 505

20.5 Percutaneous Nephrostomy 509

20.6 Failure of Transplant Kidney 511

References 512

21 Selected Case Reports and Personal Experience 517

21.1 Percutaneous Approach for Difficult Stones

21.2 The Relaxing Incision for Priapism

C.F. Donatucci 521

21.3 Priapism Redux

21.4 Iatrogenic Pathology, Undiversion, Contralateral Renal Autotransplantation

J.M. Gil-Vernet 523

21.5 Deferred Emergency Surgery of Total Rupture of the Posterior Urethra

J.M. Gil-Vernet 526

21.6 Surgery of Complicated Horseshoe Kidney

J.M. Gil-Vernet 530

21.7 Cold Fire

Ch.F. Heyns 534

21.8 Lost in the Kidney

M. Hohenfellner 536

21.9 A Rare Accident

R. Hohenfellner 537

21.10 Appendectomy

R. Hohenfellner 539

21.11 Posterior Sagittal Approach in Pediatric Urology

F. Ikoma 541

21.12 Postoperative Urinary Retention After Hypospadias Repair

F. Ikoma 548

21.13 Hairs in the Urethra of a Hypospadias Patient

F. Ikoma 549

21.14 A Tale of Two Brothers

21.15 Unfortunate Honeymoon Under the Palm Trees

J.A. MartInez-PiNeiro 552

21.16 Intravenous Uroperitoneogram

J.A. Mart Inez-PiNeiro 554

21.17 Coitus Interruptus

J.A. Mart Inez-PiNeiro 555

21.18 Exploding Bladder

21.19 Education by Humiliation

21.20 Vena Caval Injury

C.A. Olsson 558

21.21 False Sepsis and Advanced TCC

C.A. Olsson 559

21.22 Laparoscopic Vascular Emergency

V. Pansadoro 560

21.23 Percutaneous Nephrolithotomy

E. Perez-Castro E 561

21.24 Bladder Tumor

E. Perez-Castro E 562

21.25 Frenulum

E. Perez-Castro E 563

21.26 Penile Fracture Associated with Urethral Rupture and Its Complex Repair

S.V. Perovic 564

21.27 Low-Flow Priapism in Children

S.V. Perovic 566

21.28 Tragic Complications of Missed Urethral Injury

E. Pontes 568

21.29 Keep Looking

21.30 What Goes in Must Come Out

21.31 Metabolic Dangers of the Neobladder

M. Schumacher, U.E. Studer 571

21.32 Torsion After Minor Insult

E. Serafetinides 572

21.33 Fleas and Lice at the Same Time

E. Serafetinides 573

21.34 Continent Urinary Diversion for the Treatment of Urinary Fistulae Through a Sacral Scar in a Paraplegic Patient

F. Trigo-Rocha 574

21.35 Entrapped Foley Catheter After Radical Prostatectomy

21.36 Unexpected Inferior Vena Caval Thrombus

E.D. Vaughan, Jr 577

21.37 The Lord of the Rings - Fournier's Gangrene as a Consequence of Strangulating Testicular Rings

Overall Reference List 583

Subject Index 649

10 Ways To Fight Off Cancer

10 Ways To Fight Off Cancer

Learning About 10 Ways Fight Off Cancer Can Have Amazing Benefits For Your Life The Best Tips On How To Keep This Killer At Bay Discovering that you or a loved one has cancer can be utterly terrifying. All the same, once you comprehend the causes of cancer and learn how to reverse those causes, you or your loved one may have more than a fighting chance of beating out cancer.

Get My Free Ebook


Post a comment