INTERSTITIAL CYSTITIS INTERSTITIAL CYSTITIS (HUNNER’S ULCER, ELUSIVE ULCER) Inflammation of bladder mucosa is cystitis. The characteristic linear bleeding ulcer is caused by splitting of mucosa when the bladder is distended under anaesthesia Severe fibrosis along with inflammation of urinary bladder due to pancystitis results in small thimble bladder. Ulceration of the mucosa occurs in fundus […]
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ACUTE PROSTATITIS ACUTE PROSTATITIS Inflammation of prostate can be Acute or Chronic. ETIOLOGY- MC organism- E. Coli > staphylococcus aureus > staphylococcus albus Instrumentation Ascending and descending infection from below and above into infected urine into prostatic ducts Haematogenous CLINICAL FEATURES- High grade fever, chills and rigors Retention of urine Perineal heaviness, pain on defaecation
CARCINOMA OF PROSTATE CARCINOMA OF PROSTATE Carcinoma of prostate is the MC malignant tumour in men over 65 years. MC cause of bone secondaries Carcinoma of prostate occurs in peripheral zone in prostatic gland proper (commonly in posterior lobe) RISK FACTORS- Advancing age + increase fat intake Genetic alterations is hypermethylation of glutathione transferase (GSTP-1)
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EPISPADIAS EPISPADIAS Urethra opens in the dorsum (upper aspect) of the penis in males. In females, there is fissure in the wall of the urethra which opens above clitoris (uncommon) MC site in abdominopenile junction Associated with- a) Dorsal chordee b) Ectopia vesicae c) Urinary incontinence d) Separated pubic bone CLINICAL FEATURES- Males- glandular epispadias
PHIMOSIS PHIMOSIS Inability to retract the preprucial skin over the glans. ETIOLOGY- Congenital (MC) Balanitis (inflammation of the glans) & Balanoposthitis (inflammation of glans, prepuce and sac). Both are common in diabetics Chancre Carcinoma of penis CLINICAL FEATURES- Difficuluty in micturition In children, ballooning of prepuce Edema, erythema, tenderness of prepuce TREATMENT- Circumcision (especially recurrent
PARAPHIMOSIS PARAPHIMOSIS Inability to place back the retracted prepucial skin over the glans. The retracted skin acts like a tight ring constricting proximal to the corona and prepuceal skin resulting in venous congestion. Congestion results n glans swelling, oedematous with severe pain and tenderness. Glans will undergo necrosis or gangrenous change. ETIOLOGY Catherization After sexual
PEYRONIE’S DISEASE PEYRONIE’S DISEASE (PENILE FIBROMATOSIS/ INDURATION- PENIS PLASTICA) It is a development of fibrous tissue plaque on the covering of corpus cavernosum involving tunica albuginea which may later calcify or ossify. Palmar fibromatosis + plantar fibromatosis + penile fibromatosis = superficial fibromatosis ETIOLOGY Associated with- a) Dupuytren’s contracture (plamar fibromatosis) b) Retroperitoneal fibrosis c)
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CIRCUMCISION CIRCUMCISION INDICATIONS- Religious (jews and muslims) Phimosis Paraphimosis Balanitis & balanoposthitis Early carcinoma of prepuce or glans penis STD Recurrent UTI PROCEDURE- In children, it is done under GA In adults, it is done under LA. COMPLICATIONS- Reactionary haemorrhage Infection Stricture urethra near external meatus in children Chordee Exam Important INDICATIONS- Religious (jews and
CARCINOMA OF PENIS CARCINOMA OF PENIS MC type – SCC ETIOLOGY- Premalignant lesions- Genital warts- Bushke- Lowenstein tumour is a giant penile condyloma (verrucous carcinoma of penis) Erythroplasia of Queyrat or Paget’s disease of penis- precancerous lesion Leukoplakia of glans Bowen’s disease- small eczematous plaque Chronic balanoposthitis, phimosis (50%), Balanitis xerotica obliterans Condyloma auminata (HPV)
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PRIAPISM PRIAPISM Painful, persistent erection, not normally associated with sexual excitement. Erection may be atleast for 24 hours May occur due to Cantharide poisoning TYPES- High flow priapism- secondary to penile or perneal trauma Low flow flow priapism- painful, more common CLINICAL FEATURES- Children 5 to 10 years – MC due to sickle cell disease,
