Description
Jaypee Brothers Medical Publishers (P) Ltd Management Of Urological Problems In General Practice 2Nd Edition by KAMAT
Contents
CLINICAL CONSIDERATIONS
1. “I cannot pass urine”
Acute Retention of Urine 1
Common pitfalls 1, Can acute retention be prevented? 2, Must a patient wait for treatment until he develops
acute retention? 4, Is there any harm in delaying
treatment? 6, Near normal sized gland: Does the patient
need treatment? 8, Medical (nonoperative) treatment of
enlarged prostate 10, Can enlargement of prostate be
prevented? 13, Acute retention: What to do? 13,
Catheterization 14, Pitfalls in catheterization 15, When
you fail to pass the catheter 17, Leaking of urine around the
catheter 19, Choice of surgery: Open prostatectomy vs
TUR-P 19, Recurrence of symptoms following TUR-P 22,
BPH and sexual function 23, Acute retention in
females 23, Acute retention in children 24, Cancer of the
prostate 25.
2. “I pass excess urine”
Frequency of Urination 27
Rule out UTI (Urinary Tract Infection) 27, Rule out
diabetes and congestive heart failure 27, Rule out residual
urine 28, Frequency-urgency syndrome: The overactive
bladder (OAB) 30.
3. “I have pain and burning during urination/I have pus in my
urine”
Clinical Aspects of Urinary Tract Infections 34
Important principles and pitfalls 34, UTI in children
(Males and Females) 35, UTI in children: A menace to the
kidneys 36, UTI and females 39, Diagnostic difficulty:
Collection of proper urine sample 39, Principles of treatment of UTI in females 40, UTI in pregnancy 42, Choice
of antibiotics 42, Silent UTI in pregnancy 43, Conditions
Contd...
xii Management of Urological Problems in General Practice
that mimic UTI 43, UTI and adult males 43, Prostatitis
(acute and chronic): Genital/pelvic pain syndrome 45, UTI
and diabetes mellitus 46, UTI and use of alkalizers 47,
“I have pus in my urine” 47.
4. “I have blood in my urine”
Hematuria 49
Believe the patient 49, Sudden, spontaneous, gross hematuria and clot retention 50, Drug-induced hematuria 50,
Pain and hematuria 51, Exercise and hematuria 51,
Hematuria following trauma 51, Hematuria and normal
IVP 52, Drugs to stop hematuria 52, Blood in the semen
(Hematospermia) 52.
5. “I have severe pain in my abdomen”
Renal (Ureteric) Colic 53
Making the initial diagnosis 53, What to do? Management
of acute colic 55, Should diuresis be induced in acute
ureteric obstruction due to stone? 55, Investigations: X-ray
KUB/Ultrasound/IVP 56, Choosing a treatment modality
for stone removal 57, Ureteric stones 58, Kidney
stones 60, Bladder stones 63, Alkalizers and prevention
of recurrent stone formation 63.
6. “I have pain in my scrotum”
Painful Scrotal Swelling: 64
Testicular Torsion vs Epididymo-orchitis
Diagnostic clues 65, Pain in a ‘normal’ testis: Stone in the
ureter? 66.
7. “My scrotum is enlarged”
Painless Scrotal Swelling: 67
Hydrocele and Hernia vs Testicular Tumor
Timing of operation (in infants and children) 69,
Varicocele 70.
8. “My child does not have testes
Undescended Testes 71
Diagnostic pitfall: All absent testes are not undescended
testes 71, Why is the treatment necessary? 73, Ideal
time for treatment 74, Medical treatment 74.
Contd...
Contents xiii
9. “My child screams while passing urine”
Phimosis 75
Phimosis in the older age group 75, Paraphimosis 76.
10. “My child passes urine in bed”
Bed-wetting (Nocturnal Enuresis) 77
Investigations 77, Treatment 78.
11. “I cannot hold urine/I leak urine in my clothes
Incontinence of Urine 79
The elderly male 79, The multiparous female 80,
Incontinence common in both sexes and all age groups 81,
Miscellaneous cases 82.
12. “I have sexual weakness”
“I don’t have children”
Impotence and Infertility 84
Impotence 84, Pitfalls 85, Investigations 85, Guidelines
for treatment 85, Infertility 87, Common pitfalls 87,
What is normal semen 88, What to do and what not to
do 88, In vitro fertilization (ICSI—Intracytoplasmic
Sperm Injection) 89, Sperm processing and intrauterine
insemination (IUI) 89, Insemination by donor semen 89.
13. HIV and AIDS 90
What are HIV and AIDS? 90, How does HIV infection
occur 91, How HIV is not transmitted? 93, How does
infection with HIV lead to AIDS? 93, How does a person
with AIDS die? 94, Risk of transmission of HIV from the
patient to the doctor 94, Universal precautions for health
workers 94, What are universal precautions? 95, Procedure in the event of contamination with infected blood 96.
14. Some Harmless Urological Conditions 97
Simple renal cysts 97, Anatomical anomalies of kidneys 98,
Silent stone 99, Prostatic calculi 100, Sebaceous cysts of
the scrotum 100.
Contd...
xiv Management of Urological Problems in General Practice
INVESTIGATIONS AND PROCEDURES
15. Common Urological Investigations 101
Urine examination 101, Timing and method of urine
collection 101, Special situations: Tuberculosis and
malignancy 103, Blood urea and serum creatinine 103,
PSA 104, Ultrasound examination 105, X-ray KUB and
IVP 106, Uroflometry 106.
16. Common Urological Operations 109
Cystoscopy 109, Optical urethrotomy for stricture of
urethra 112, Transurethral resection of prostate
(TUR-P) 113, Some other new methods for treatment of
enlarged prostate 115, Other uses of TUR 116, TUR of
bladder tumors 117, Operations for urinary
stones 118, D-J stenting 121.
Index 123