Foreword . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ix
Noel A. Armenakas
1 Presenting Symptoms of Urological
Emergencies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Hashim Hashim and John Reynard
Flank Pain . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Haematuria . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
Oliguria, Anuria, and Inability to Pass Urine . . . . . . 4
Suprapubic Pain . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
Scrotal Pain and Swelling . . . . . . . . . . . . . . . . . . . . 5
Priapism . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
Back Pain and Urological Symptoms . . . . . . . . . . . 6
2 Lower Urinary Tract Emergencies . . . . . . . . . . . . . . 9
John Reynard
Acute Urinary Retention . . . . . . . . . . . . . . . . . . . . . 9
Is It Acute or Chronic Retention? . . . . . . . . . . . . . . 12
What to Do Next for the Man with Acute
Retention . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14
Retention in Patients with a Catheterisable
Stoma . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
3 Nontraumatic Renal Emergencies . . . . . . . . . . . . . . 17
John Reynard
Acute Flank Pain—‘Ureteric’ or ‘Renal’ Colic . . . . . . 17
Acute Pyelonephritis . . . . . . . . . . . . . . . . . . . . . . . . 32
Pyonephrosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36
Perinephric Abscess . . . . . . . . . . . . . . . . . . . . . . . . 37
Emphysematous Pyelonephritis . . . . . . . . . . . . . . . 38
Acute Pyelonephritis, Pyonephrosis, Perinephric
Abscess, and Emphysematous Pyelonephritis—
Making the Diagnosis . . . . . . . . . . . . . . . . . . . . . 41
Xanthogranulomatous Pyelonephritis . . . . . . . . . . . 42
4 Other Infective Urological Emergencies . . . . . . . . . 45
Hashim Hashim and John Reynard

Urinary Septicaemia . . . . . . . . . . . . . . . . . . . . . . . . 45
Pyelonephritis and Pyonephrosis . . . . . . . . . . . . . . . 48
Prostatic Infections and Prostatic Abscess . . . . . . . . 48
Fournier’s Gangrene . . . . . . . . . . . . . . . . . . . . . . . . 49
Epididymo-Orchitis . . . . . . . . . . . . . . . . . . . . . . . . . 51
Periurethral Abscess . . . . . . . . . . . . . . . . . . . . . . . . 53
5 Traumatic Urological Emergencies . . . . . . . . . . . . . 54
John Reynard
Renal Injuries . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 54
Ureteric Injuries . . . . . . . . . . . . . . . . . . . . . . . . . . . 63
Pelvic Fractures and Injuries to the
Urinary System . . . . . . . . . . . . . . . . . . . . . . . . . . 83
Bladder Injuries . . . . . . . . . . . . . . . . . . . . . . . . . . . 97
Posterior Urethral Injuries . . . . . . . . . . . . . . . . . . . 109
Anterior Urethral Injuries . . . . . . . . . . . . . . . . . . . . 109
Testicular Injuries . . . . . . . . . . . . . . . . . . . . . . . . . . 113
Penile Injuries . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 115
Penile Fracture . . . . . . . . . . . . . . . . . . . . . . . . . . . . 118
6 Scrotal and Genital Emergencies . . . . . . . . . . . . . . 125
John Reynard and Hashim Hashim
Torsion of the Testis and Testicular Appendages . . . 125
Priapism . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 132
Paraphimosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 135
Foreign Bodies in the Urethra and Attached to
the Penis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 137
7 Postoperative Emergencies After Urological
Surgery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 141
Hashim Hashim and John Reynard
Shock Due to Blood Loss . . . . . . . . . . . . . . . . . . . . 141
Anaphylaxis After Administration of Intravenous
Contrast or Antibiotics . . . . . . . . . . . . . . . . . . . . . 142
Scrotal Swelling After Scrotal Surgery . . . . . . . . . . 144
Wound Dehiscence Leading to Burst Abdomen . . . . 145
Postcircumcision Bleeding . . . . . . . . . . . . . . . . . . . 146
Blocked Catheter Post–Transurethral Resection of
the Prostate (TURP) and Clot Retention . . . . . . . 146
Extraperitoneal Perforation During TURP . . . . . . . . 147
The Transurethral Resection (TUR) Syndrome . . . . 147
Displaced Catheter Post–Radical Prostatectomy . . . 148
vi CONTENTS

Compartment Syndrome of the Lower Limb
Associated with the Lithotomy Position . . . . . . . . 148
8 Ureteric Colic in Pregnancy . . . . . . . . . . . . . . . . . . 151
John Reynard
The Hydronephrosis of Pregnancy . . . . . . . . . . . . . 151
Presentation of Stones in Pregnancy . . . . . . . . . . . . 152
What Imaging Study Should Be Used to Establish
the Diagnosis of a Ureteric Stone in Pregnancy . . 152
Management of Ureteric Stones in Pregnant
Women . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 156
9 Management of Urological Neoplastic Conditions
Presenting as Emergencies . . . . . . . . . . . . . . . . . 160
John Reynard and Hashim Hashim
Testicular Cancer . . . . . . . . . . . . . . . . . . . . . . . . . . 160
Malignant Ureteric Obstruction . . . . . . . . . . . . . . . . 160
Spinal Cord Compression in Patients with
Urological Disease . . . . . . . . . . . . . . . . . . . . . . . . 163
10 Common Emergency Urological Procedures . . . . . . 167
John Reynard and Nigel Cowan
Urethral Catheterisation . . . . . . . . . . . . . . . . . . . . . 167
Suprapubic Catheterisation . . . . . . . . . . . . . . . . . . . 168
Bladder Washout for Blocked Catheter . . . . . . . . . . 170
Blocked Catheters Following Bladder
Augmentation or Neobladder . . . . . . . . . . . . . . . . 170
JJ Stent Insertion . . . . . . . . . . . . . . . . . . . . . . . . . . 171
Percutaneous Nephrostomy Insertion . . . . . . . . . . . 176
Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 183

 

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