The Royal Marsden. MDT case study. Mr Alan Thompson Consultant Urological Surgeon The Royal Marsden
|
|
- Gregory Rogers
- 5 years ago
- Views:
Transcription
1 MDT case study Mr Alan Thompson Consultant Urological Surgeon The Royal Marsden
2 2 The Royal Marsden Case history 56 year old lady from Bangladesh with 5 children Rarely seen her GP over the last 10 years Complains of increasing urinary frequency, nocturia and malaise Slight weight loss 1Kg On statins and antihypertensives but otherwise well
3 Q1. What are you thinking? 1. I need more information 2. I need to examine her and do some tests 3. This sounds serious 4. You are just getting old! 29% 68% 3% 0% I need more information I need to examine her an... This sounds serious You are just getting old!
4 Q 2. What are the possible diagnoses for this patient? 1. Diabetes 2. Renal stone disease 3. Lifestyle fluid intake / 5 children 4. UTI 5. Interstitial cystistis 6. Tuberculosis 7. STD 8. All of the above 3% 4% 1% 8% 3% Diabetes Renal stone disease Lifestyle fluid intake / 5... UTI Interstitial cystistis Tuberculosis 80% 1% 0% STD All of the above
5 5 The Royal Marsden The following history and investigations were obtained No history of recent travel No history of exposure to TB There may be some associated night sweats but she is a poor historian Abdominal examination is unremarkable Urine dip test negative for glucose Urine positive for nitrites, protein and haem
6 Q3. What is the possible diagnosis for this patient now? 1. Diabetes 2. Renal stone disease 3. Lifestyle fluid intake / 5 children 4. UTI 5. Interstitial cystistis 6. Tuberculosis 7. STD 8. All of the above 1% 7% 0% 62% 8% Diabetes Renal stone disease Lifestyle fluid intake / 5... UTI Interstitial cystistis Tuberculosis 20% 3% 0% STD All of the above
7 Q 4. What would you do next? 1. Send off MSU and wait for the results 2. Treat empirically 3. Send MSU, treat empirically and reassess after MSU back 4. Refer to Urologist 5. Refer on two week rule Send off MSU and wait fo... Treat empirically Send MSU, treat empirica... 79% 8% 12% 1% 0% Refer to Urologist Refer on two week rule
8 Q 5. 5 weeks later she returns with the same symptoms. What is the likely diagnosis? 1. Diabetes 2. Renal stone disease 3. Lifestyle fluid intake / 5 children 4. Recurrent UTI s 5. Interstitial cystistis 6. Tuberculosis 7. All of the above Diabetes Renal stone disease 1% 4% 1% Lifestyle fluid intake / 5... Recurrent UTI s Interstitial cystistis 55% 28% 6% 4% Tuberculosis All of the above
9 9 The Royal Marsden What actually happened GP performed sent off MSU on this occasion and treated with appropriate antibiotic Symptoms recurred after 3 months Symptoms recurred again after 4 months Referred to Urologist
10 10 The Royal Marsden Discussion point What is a recurrent UTI? Episode of UTI after a documented UTI with successful resolution of an earlier episode + occurring 2x in last 6 months or 3x in last 12 months. Subclassified into: Persistent infection UTI caused by the same organisms. Poss focus of infection e.g. stone/tcc/diverticulum/fistula Reinfection UTI caused by different organisms. Usually indicates susceptibility to UTI Post menopause/sexual intercourse/poor hygiene/genetic 95% recurrent UTI s in a female are due to re-infection
11 11 The Royal Marsden In the urology clinic History rec UTI?/pyelonephritis/STD/complicated infection MSU results checked is there a non-infective process e.g. stones, interstitial cystitis, cis (carcinoma in situ) PMH including constipation, childhood UTI, neurological illness, diabetes Pregnant? On OCP Family history UTI s associated with ABO blood group antigen non-secretors, Lewis non-secretor or P blood group secretors - Examination Including vaginal to ascertain oestrogenisation, genital prolapse, urethral diverticulum
12 12 The Royal Marsden Investigations MSU Cytology If sterile pyuria AFB CT urogram or KUB/USS residual Possibly flexible cystoscopy
13 Q 6. She has been found to have recurrent UTI s. What are your favoured treatment strategies? 1. Lifestyle changes 2. Lactobacilli topically 3. Oestrogen pessaries/cream 4. Antimicrobial therapy Low dose long-term 5. Antimicrobial therapy Post coitus 6. Antimicrobial therapy Intermittent selfstart 11% 0% Lifestyle changes Lactobacilli topically 54% 24% 3% Oestrogen pessaries/cream Antimicrobial therapy... Antimicrobial therapy... Antimicrobial therapy I... 8%
14 14 The Royal Marsden Case history 65 year old man from Bangladesh wife known to you Rarely seen his GP over the last 10 years Epigastric discomfort, pain occasionally intense but vague Slight weight loss 2.5 Kg over 2 months On statins and antihypertensives but otherwise well
15 What are you thinking? 1. I need more information 2. I need to examine him and do some tests 3. This sounds serious 4. You are just getting old! 15% 68% 17% 0% I need more information I need to examine him... This sounds serious You are just getting old!
16 Examination and investigation Examination reveals slight tenderness in right upper quadrant You arrange an USS This reveals gall stones but also a large right renal cyst What next?
17 Q 2. What next? 1. Dietary advice and reassure? 2. Refer to Upper GI surgeon and ignore cyst? 3. Refer to Urologist and ignore gall stones? 4. Refer to both? 3% Dietary advice and re-ass... Refer to Upper GI surgeo... Refer to Urologist and ig... 57% 24% 16% Refer to both?
18 18 The Royal Marsden Differential diagnosis of the cystic renal lesions Simple renal cysts Cystic renal-cell carcinoma Autosomal dominant polycystic kidney disease Multicystic dysplastic kidney disease Multilocular cyst VHL syndrome
19 19 The Royal Marsden In Urological clinic History etc Confirmation of normal renal function CT urogram pre and post contrast Bosniak cyst classification I-IV I benign and smooth with no enhancement/septae II thin septae + minimal Ca. No enhancement III Irregular/mod Ca/thick septae/enhancement IV Solid enhancing elements
20 Bosniak and clinical management Type I benign and require no follow-up Type II 10 to 20% risk malignant transformation (IIF) Type III 40-50% chance malignancy therefore operate Type IV - > 90% malignant therefore operate
21 Q 3. Above patient presented with haematuria and CT revealed a fatty lesion in the kidney. Diagnosis? 1. Renal cell carcinoma 2. Lipoma 3. Cyst 4. AML - Angiomyolipoma 31% 13% 1% 54% Renal cell carcinoma Lipoma Cyst AML - Angiomyolipoma
22 22 The Royal Marsden Angiomyolipoma - AML 80% sporadic. Female : Male ratio is 4:1 (rest tuberous sclerosis) Middle aged 80% right sided 5 % growth rate per year 4cm diameter or recurrent bleeding is indication for intervention (selective embolisation or partial neph) Tuberous sclerosis bilateral, smaller and younger 20% growth per year
Bladder Cancer in Primary Care. Dr Penny Kehagioglou Consultant Clinical Oncologist
Bladder Cancer in Primary Care Dr Penny Kehagioglou Consultant Clinical Oncologist Objectives Patient presentation in primary care Investigating bladder cancer Management of bladder cancer Differential
More informationH(a)ematuria. FX Keeley Consultant Urologist Bristol Urological Institute
H(a)ematuria FX Keeley Consultant Urologist Bristol Urological Institute From Philadelphia to Bristol, England Southmead Hospital, 1916 Southmead Hospital, 2013 Southmead Hospital, 2014 H(a)ematuria Blood
More informationUroradiology For Medical Students
Uroradiology For Medical Students Lesson 8 Computerized Tomography 2 American Urological Association Objectives In this lesson you will: Gain more experience reading CT images Learn how computer generated
More informationThe Royal Marsden. Prostate case study. Presented by Mr Alan Thompson Consultant Urological Surgeon
Prostate case study Presented by Mr Alan Thompson Consultant Urological Surgeon 2 Part one Initial presentation A 62 year old male solicitor attends your GP surgery. He has rarely seen you over the last
More informationRenal Cystic Disease. Dr H Bierman
Renal Cystic Disease Dr H Bierman Objectives Be able to diagnose renal cystic disease Genetic / non-genetic Be able to describe patterns of various renal cystic disease on routine imaging studies Be able
More informationNewcastle upon Tyne, Gateshead and Northumbria Urology guidelines
Newcastle upon Tyne, Gateshead and Northumbria Urology guidelines INTRODUCTION This document is an update of the NORTH OF TYNE AND GATESHEAD GUIDELINES FOR MANAGEMENT OF COMMON UROLOGICAL CONDITIONS IN
More informationHaematuria and Modern Bladder Cancer Treatment
Haematuria and Modern Bladder Cancer Treatment Mr Nikhil Vasdev MBBS MRCS MCh(Urol) FRCS(Urol) RCSEng/BAUS Robotic Fellowship Accredited and Trained Consultant Urological and Robotic Surgeon Hertfordshire
More informationAn Undergraduate Syllabus for Urology. Produced on behalf of the British Association of Urological Surgeons. March 2012
An Undergraduate Syllabus for Urology Produced on behalf of the British Association of Urological Surgeons March 2012 Authors H Hashim, P Jones, KJ O Flynn, I Pearce, J Royle, M Shaw, AM Sinclair Correspondence
More informationEMPIRICAL TREATMENT OF SELECT INFECTIONS ADULT GUIDELINES. Refer to VIHA Algorithm for the empiric treatment of Urinary Tract Infection
URINARY TRACT Refer to VIHA Algorithm for the empiric treatment of Urinary Tract Infection and Asymptomatic Bacteriuria on the VIHA Intranet: https://intranet.viha.ca/departments/pharmacy/clinical_pharmacy/pages/infec
More informationGuidelines for the management of urinary tract infections in children 0-17 years
Guidelines for the management of urinary tract infections in children 0-17 years Guideline to be used where appropriate in conjunction with the Ashford and St Peter s sepsis guideline (Dr Ruth Mew 2016)
More informationLower Urinary Tract Infection (UTI) in Males
Lower Urinary Tract Infection (UTI) in Males Clinical presentation For patients in care homes see UTI in adults where IV Antibiotics in the community may be appropriate (under development) History and
More informationCase studies: LUTS. Case 1 history. Case 1 - questions. Case 1 - outcome. Case 2 - history. Case 1 learning point 14/07/2015 DR JON REES
Case 1 history Case studies: LUTS DR JON REES A 49 year old male comes to see you he has had gradual deterioration of his flow over the last few years- he saw a colleague of yours 6 weeks ago who recorded
More informationRenal tumors of adults
Renal tumors of adults Urinary Tract Tumors 2%-3% of all cancers in adults. The most common malignant tumor of the kidney is renal cell carcinoma. Tumors of the lower urinary tract are twice as common
More informationREFERRAL GUIDELINES: UROLOGY
All patients referred to specialist clinics are assigned to a priority category based on their clinical need and related psychosocial factors. The examples given are indicative only and the clinician reviewing
More informationCase studies. Stephen Mark Rob Walker
Case studies Stephen Mark Rob Walker Case 1 31 yr old woman with 3 rd UTI. E coli Frequency and dysuria Asymptomatic after treatment Recurrent UTI Lower tract symptoms Coliforms Asymptomatic after treatment
More informationUrogynaecology. Colm McAlinden
Urogynaecology Colm McAlinden Definitions Urinary incontinence compliant of any involuntary leakage of urine with many different causes Two main types: Stress Urge Definitions Nocturia: More than a single
More informationLower Urinary Tract Symptoms (LUTS) and Nurse-Led Clinics. Sean Diver Urology Advanced Nurse Practitioner candidate Letterkenny University Hospital
Lower Urinary Tract Symptoms (LUTS) and Nurse-Led Clinics Sean Diver Urology Advanced Nurse Practitioner candidate Letterkenny University Hospital 01/02/2018 Lower Urinary Tract Symptoms LUTS - one of
More informationManagement of suspected bacterial urinary tract infections in older people. based on SIGN 88. Jane Lawson Infection Prevention and Control Nurse
Management of suspected bacterial urinary tract infections in older people based on SIGN 88 Jane Lawson Infection Prevention and Control Nurse Bacterial urinary tract infection (UTI s) UTI s are common
More informationDiagnosis and Management of UTI s in Care Home Settings. To Dip or Not to Dip?
Diagnosis and Management of UTI s in Care Home Settings To Dip or Not to Dip? 1 Key Summary Points: Treat the patient NOT the urine In people 65 years, asymptomatic bacteriuria is common. Treating does
More informationNICE guideline on Suspected cancer: recognition and referral (2015) Education package for GPs and Nurse Practitioners Case scenarios
NICE guideline on Suspected cancer: recognition and referral (2015) Education package for GPs and Nurse Practitioners Case scenarios How to use the case scenarios The case scenarios can be used in a training
More informationUTI IN ELDERLY. Zeinab Naderpour
UTI IN ELDERLY Zeinab Naderpour Urinary tract infection (UTI) is the most frequent bacterial infection in elderly populations. While urinary infection in the elderly person is usually asymptomatic, symptomatic
More informationAUCKLAND REGIONAL UROLOGY GUIDELINES AND REFERRAL RECOMMENDATIONS
AUCKLAND REGIONAL UROLOGY GUIDELINES AND REFERRAL RECOMMENDATIONS This document outlines the urological conditions currently funded at Auckland District Health Board (ADHB), Counties Manukau District Health
More informationDr Anna Lawrence. Mr Simon Van Rij
Mr Simon Van Rij Urologist OneSixOne Urology Auckland Dr Anna Lawrence Urologist Auckland Surgical Centre Auckland 8:30-9:25 WS #94: Management of Common Urologic Problems in General Practice 9:35-10:30
More informationMODULE 5: HEMATURIA LEARNING OBJECTIVES DEFINITION. KEY WORDS: Hematuria, Cystoscopy, Urine Cytology, UTI, bladder cancer
MODULE 5: HEMATURIA KEY WORDS: Hematuria, Cystoscopy, Urine Cytology, UTI, bladder cancer LEARNING OBJECTIVES At the end of this clerkship, the learner will be able to: 1. Define microscopic hematuria.
More information6 UROLOGICAL CANCERS. 6.1 Key Points
6 UROLOGICAL CANCERS 6.1 Key Points Prostate Cancer Commonest cancer in males in Scotland Approximately 99% of cases occur in men aged > 50 years About 40% of cases present in men aged < 70 years when
More informationUrological Tumours 1 Kidney tumours 2 Bladder tumours
Urological Tumours 1 Kidney tumours 2 Bladder tumours Tim Bracey SpR Histopathology Derriford Hospital Kidney tumours What are we going to talk about?! Anatomy of urinary tract! Types of kidney tumours!
More informationTrans Urethral Resection of Bladder Tumour
Trans Urethral Resection of Bladder Tumour Department of Urology 2 Patient Information Contents Where is the bladder and what does it do? 3 What is non invasive cancer of the bladder? 4 How is bladder
More informationGuidelines for the Management of Bladder Cancer West Midlands Expert Advisory Group for Urological Cancer
Guidelines for the Management of Bladder Cancer West Midlands Expert Advisory Group for Urological Cancer West Midlands Clinical Networks and Clinical Senate Coversheet for Network Expert Advisory Group
More informationPercutaneous (Keyhole) Removal of Kidney Stone(s)
Who can I contact if I have a problem when I get home? If you experience any problems related to your surgery or admission once you have been discharged home. Please feel free to contact 4A, 4B or 4C ward
More informationContents. TSC and kidneys. P3 Introduction P4 Monitoring P5 Renal (kidney) AMLs P7 Renal (kidney) cysts P8 Information and support
TSC and kidneys Contents TSC and kidneys P3 Introduction P4 Monitoring P5 Renal (kidney) AMLs P7 Renal (kidney) cysts P8 Information and support P2 Introduction Tuberous sclerosis complex (TSC) is a rare
More informationLUTS A plea for a holistic approach. HUBERT GALLAGHER, MCh; FRCSI, FRCSI(Urol) Head of Urology Beacon Hospital
LUTS A plea for a holistic approach. HUBERT GALLAGHER, MCh; FRCSI, FRCSI(Urol) Head of Urology Beacon Hospital LUTS- Classification Men LUTS can be divided into: Storage Voiding Frequency Nocturia Urgency
More informationCystoscopy and urethroscopy
Page 1 of 5 Cystoscopy and urethroscopy Introduction This leaflet is provided to give you information about undergoing cystoscopy and/or urethroscopy. What is a cystoscopy? A cystoscopy is a procedure
More informationCase Presentation: Mr. S
Case Presentation: Mr. S History Seen as inpatient in May, but has significant prior history and is a poor historian 53 y.o. Male no PMH, has been out of contact with medicine for years aside from hernia
More informationUrology Case Study Workbook - Questions
Urology Case Study Workbook - Questions Developed in Partnership with the CME tutors for the CME Network Facilitated by an educational grant by GlaxoSmithKline Date of Preparation. September 5th 2011 IE/DUTT/0025/11
More informationMANAGING BENIGN PROSTATIC HYPERTROPHY IN PRIMARY CARE DR GEORGE G MATHEW CONSULTANT FAMILY PHYSICIAN FELLOW IN SEXUAL & REPRODUCTIVE HEALTH
MANAGING BENIGN PROSTATIC HYPERTROPHY IN PRIMARY CARE DR GEORGE G MATHEW CONSULTANT FAMILY PHYSICIAN FELLOW IN SEXUAL & REPRODUCTIVE HEALTH INTRODUCTION (1) Part of male sexual reproductive organ Size
More informationURINARY TRACT INFECTIONS
URINARY TRACT INFECTIONS Learning Objectives Identify signs and symptoms that may indicate presence of UTI (both complicated and uncomplicated) List common causative organisms and risk factors for UTIs
More informationUrology. Flexible Cystoscopy
Urology Flexible Cystoscopy The Urology service offers a comprehensive range of adult urologic care to patients, including advanced diagnostic, medical and surgical care for men and women. Our team of
More informationPAINFUL URINATION CAUSES & NATURAL REMEDY. Dr. Bestman Anyatonwu
LIBRACIN NATURAL MEDICINE IND. LTD PAINFUL URINATION CAUSES & NATURAL REMEDY Dr. Bestman Anyatonwu MEANING Painful urination is a broad term that describes discomfort during urination. This pain may originate
More informationProstate Artery Embolisation (PAE)
Service: Imaging Prostate Artery Embolisation (PAE) Exceptional healthcare, personally delivered Ask 3 Questions The team delivering your healthcare want to encourage you to become as involved as possible
More informationExcretory urography (EU) or IVP US CT & radionuclide imaging
Excretory urography (EU) or IVP US CT & radionuclide imaging MRI arteriography studies requiring catherization or direct puncture of collecting system EU & to a lesser extent CT provide both functional
More informationUniversity Medical Center Brackenridge Specialty Clinics. Urology Clinic Worksheet
Urology Clinic Worksheet Distal Stone Thank you for the consult. Please make sure patient is staying well hydrated by drinking at least 2 liters of water/fluids per day, pain is controlled with ibuprofen
More informationAsyntomatic bacteriuria, Urinary Tract Infection
Asyntomatic bacteriuria, Urinary Tract Infection C. Infectious Diseases Society of America Guidelines for the Diagnosis and Treatment of Asyntomatic Bacteriuria in Adults (2005) Pyuria accompanying asymptomatic
More informationThe Urinary System. Maintenance Systems Unit 5
The Urinary System Maintenance Systems Unit 5 Basic Functions of the Urinary System Regulates the composition and volume of the blood by removing and restoring selected amounts of water and solutes. Eliminates
More informationLower Urinary Tract Symptoms K Kuruvilla Zachariah Associate Specialist
Lower Urinary Tract Symptoms K Kuruvilla Zachariah Associate Specialist Lower Urinary Tract Symptoms Storage Symptoms Frequency, urgency, incontinence, Nocturia Voiding Symptoms Hesitancy, poor flow, intermittency,
More informationTitle Protocol for the Management of Urinary Tract Infections for Adult Females and Children in MIUs and WICs
Document Control Title Protocol for the Management of Urinary Tract Infections for Adult Females and Children in MIUs and WICs Author Author s job title Professional Lead, Minor Injuries Unit Directorate,
More informationGynaecology Cancer Red Flags. Dr Dina Bisson Consultant Obstetrician and Gynaecologist Southmead Hospital North Bristol NHS Trust 27 April 2017
Gynaecology Cancer Red Flags Dr Dina Bisson Consultant Obstetrician and Gynaecologist Southmead Hospital North Bristol NHS Trust 27 April 2017 Gynaecological Cancers Endometrial Cancer Ovarian Cancer Cervical
More informationUWE Bristol. UTI in Children. Angie Green Visiting Lecturer March 2011
UWE Bristol UTI in Children Angie Green Visiting Lecturer March 2011 Approx 2% children will develop acute febrile UTI Up to 10% girls will develop any kind of UTI Progressive scarring in children with
More informationUrine bench. John Ferguson Sept 2013
Urine bench John Ferguson Sept 2013 Overview Specimen collection- separate presentation Urinalysis: protein, blood, white cells, nitrite Microscopy- crystals and casts- separate presentations quantitative
More informationTrans urethral resection of prostate (TURP)
Trans urethral resection of prostate (TURP) Information for patients Urology PROUD TO MAKE A DIFFERENCE SHEFFIELD TEACHING HOSPITALS NHS FOUNDATION TRUST What is the prostate? Only men have a prostate
More informationRECURRENT URINARY TRACT INFECTIONS: WHAT AN INTERNIST
RECURRENT URINARY TRACT INFECTIONS: WHAT AN INTERNIST MUST KNOW PROF. MD. ENAMUL KARIM Professor of Medicine Green Life Medical College INTRODUCTION Urinary tract infection (UTI) is one of the commonest
More informationEverolimus (Votubia) for angiomyolipoma associated with tuberous sclerosis complex or sporadic lymphangioleiomyomatosis first line or post surgery
Everolimus (Votubia) for angiomyolipoma associated with tuberous sclerosis complex or sporadic lymphangioleiomyomatosis first line or post surgery April 2011 This technology summary is based on information
More informationUpdate on Haematuria and Bladder Cancer
Update on Haematuria and Bladder Cancer Hugh Mostafid FRCS(urol) FEBU Consultant Urologist, Royal Surrey County Hospital and Honorary Senior Lecturer, University of Surrey Guildford None Declarations Recent
More informationDiagnosis and testing in primary care for urological cancers
The Royal Marsden Diagnosis and testing in primary care for urological cancers Alan Thompson Consultant Urological Surgeon 2 The Royal Marsden GP Education Day 7 th July 2017 3 The Royal Marsden GP Education
More informationPersonal data. Age : 63 Gender : male
Personal data Age : 63 Gender : male Chief complain No specific symptom or discomfort A hepatic mass, found by abdominal sonography of routine health exam on 88-12-08 Past history 1984-3-3 Old CVA with
More informationOveractive Bladder: Diagnosis and Approaches to Treatment
Overactive Bladder: Diagnosis and Approaches to Treatment A Hidden Condition* Many Many patients self-manage by voiding frequently, reducing fluid intake, and wearing pads Nearly Nearly two-thirds thirds
More information15. Prevention of UTI and lifestyle modifications
15. Prevention of UTI and lifestyle modifications Key questions: Does improving poor voiding habits help prevent UTI recurrence? Does improving constipation help prevent UTI recurrence? Does increasing
More informationCase 2 Dwayne A. Williams CASE 2
CASE 2 A 40- year- old male with no past medical history presents with bilateral flank pain and dark colored urine for 5 days. During family history taking, he states his father died from kidney failure
More informationYou have been booked for a. Flexible Cystoscopy. Under Local Anaesthetic
You have been booked for a Flexible Cystoscopy Under Local Anaesthetic 1 WHAT IS A FLEXIBLE CYSTOSCOPY A flexible cystoscopy is a test to examine the uretha (waterpipe) and bladder using a thin, lighted
More information3.1 Investigations for Patients Presenting with Haematuria Table 1
3.1 Investigations for Patients Presenting with Haematuria Table 1 Patients at risk of bacterial endocarditis should be given antibiotic prophylaxis as per local guidelines. Patients with heart valve replacements
More informationTrans Urethral Resection of Prostate (TURP)
Trans Urethral Resection of Prostate (TURP) Patient Information Author ID: SF Leaflet Number: Urol 010 Version: 6 Name of Leaflet: Trans Urethral Resection of Prostate (TURP) Date Produced: March 2018
More informationIntravesical immunotherapy (known as BCG therapy): procedure-specific information
PATIENT INFORMATION Intravesical immunotherapy (known as BCG therapy): procedure-specific information What is the evidence base for this information? This leaflet includes advice from consensus panels,
More informationHaematuria and Bladder Cancer
Haematuria and Bladder Cancer Dr Pardeep Kumar Consultant Urological Surgeon Haematuria 3 Haematuria Macroscopic vs Microscopic Painful vs Painless Concurrent abdo pain/urinary symptoms Previous testing?
More informationACUTE KIDNEY INJURY A PRIMER FOR PRIMARY CARE PHYSICIANS. Myriam Farah, MD, FRCPC
ACUTE KIDNEY INJURY A PRIMER FOR PRIMARY CARE PHYSICIANS Myriam Farah, MD, FRCPC Clinical Assistant Professor Division of Nephrology, University of British Columbia November 2016 1. How to recognize acute
More informationDiagnostic approach and microorganism resistance pattern in UTI Yeva Rosana, Anis Karuniawati, Yulia Rosa, Budiman Bela
Diagnostic approach and microorganism resistance pattern in UTI Yeva Rosana, Anis Karuniawati, Yulia Rosa, Budiman Bela Microbiology Department Medical Faculty, University of Indonesia Urinary Tract Infection
More informationThe diagnostic value of abdominal ultrasound, urine cytology and prostate-specific antigen testing in the lower urinary tract symptoms clinic
ORIGINAL PAPER The diagnostic value of abdominal ultrasound, urine cytology and prostate-specific antigen testing in the lower urinary tract symptoms clinic N. S. Patel, 1 C. Blick, 1 P. V. S. Kumar, 2
More informationFlexible Cystoscopy. Patient Information
Flexible Cystoscopy Patient Information 05/11/2012 Mehul Pankaj Raithatha 3 rd Year Medical Student Barts and the London - School of Medicine and Dentistry INTRODUCTION The urinary bladder is the organ
More informationPercutaneous removal of kidney stone(s): procedurespecific information
PATIENT INFORMATION Percutaneous removal of kidney stone(s): procedurespecific information What is the evidence base for this information? This leaflet includes advice from consensus panels, the British
More informationBladder Cancer Canada November 21st, Bladder Cancer 2018: A brighter light at the end of the cystoscope
Bladder Cancer Canada November 21st, 2018 Bladder Cancer 2018: A brighter light at the end of the cystoscope Chris Morash MD FRCSC Associate Professor, University of Ottawa Head, Urological Oncology Bladder
More informationCystoscopy and insertion of a ureteric stent
Cystoscopy and insertion of a ureteric stent Urology Department Patient Information Leaflet Introduction This leaflet is for people who have been recommended to have a procedure called cystoscopy and insertion
More informationSpecific complaint and conclusion Failure by the Practice to diagnose the complainant wife s cancer (not upheld)
Scottish Parliament Region: Central Scotland Case 200501217: General Medical Practice in Forth Valley Summary of Investigation Category Health: Family health services, clinical treatment Overview The complainant
More informationBladder Cancer Knowing the Risks and Warning Signs. Part II: Warning Signs
Bladder Cancer Knowing the Risks and Warning Signs Part II: Warning Signs May 8, 2018 Presented by: is the Director of Urologic Oncology at MedStar Washington Hospital Center and an Assistant Professor
More informationHaematuria Clinic. Information for patients Urology PROUD TO MAKE A DIFFERENCE SHEFFIELD TEACHING HOSPITALS NHS FOUNDATION TRUST
Haematuria Clinic Information for patients Urology PROUD TO MAKE A DIFFERENCE SHEFFIELD TEACHING HOSPITALS NHS FOUNDATION TRUST The Haematuria Clinic You have been referred to the Haematuria Clinic as
More informationPediatric Retroperitoneal Masses Radiologic-Pathologic Correlation
Acta Radiológica Portuguesa, Vol.XVIII, nº 70, pág. 61-70, Abr.-Jun., 2006 Pediatric Retroperitoneal Masses Radiologic-Pathologic Correlation Marilyn J. Siegel Mallinckrodt Institute of Radiology, Washington
More informationCystoscopy and hydrostatic bladder distension
Cystoscopy and hydrostatic bladder distension Urology Department Patient Information Leaflet Introduction This leaflet is for people who have been recommended to have a procedure called cystoscopy and
More informationIndex. Note: Page numbers of article titles are in boldface type.
Magn Reson Imaging Clin N Am 12 (2004) 587 591 Index Note: Page numbers of article titles are in boldface type. A Adenoma(s), adrenal, gadolinium-enhanced MR imaging in, 533 534 hyperfunctioning versus
More informationBladder Cancer Guidelines
Bladder Cancer Guidelines Agreed by Urology CSG: October 2011 Review Date: September 2013 Bladder Cancer 1. Referral Guidelines The following patients should be considered as potentially having bladder
More informationBLADDER CANCER: PATIENT INFORMATION
BLADDER CANCER: PATIENT INFORMATION The bladder is the balloon like organ located in the pelvis that stores and empties urine. Urine is produced by the kidneys, is conducted to the bladder by the ureters,
More informationIncontinence in neurological disease
nice bulletin Incontinence in neurological disease NICE provided the content for this booklet which is independent of any company or product advertised NICE Bulletin - Incontinence in neurological disease.indd
More informationUrinary tract infections, renal malformations and scarring
Urinary tract infections, renal malformations and scarring Yaacov Frishberg, MD Division of Pediatric Nephrology Shaare Zedek Medical Center Jerusalem, ISRAEL UTI - definitions UTI = growth of bacteria
More informationProstate surgery. What is the prostate? What is a TURP? Why is a TURP operation necessary? Deciding to have a TURP operation.
What is the prostate? The prostate is a gland about the size of a walnut that is only present in men. It is located just below the bladder and surrounds the urethra, the tube through which urine flows
More informationChildren s Services Medical Guideline
See also: NICE Guidelines These local guidelines are in conjunction with NICE UTI Algorithms Renal scarring and subsequent nephropathy are important causes of later hypertension and renal failure. Early
More informationThe Incidental Renal lesion
The Incidental Renal lesion BACKGROUND Increase in abdominal CT/US in last 15 years Resulted in detection of many (small) renal lesions 50% > 50yrs has at least 1 lesion majority simple cysts Renal lesions
More informationMEDitorial March Bladder Cancer
MEDitorial March 2010 Bladder Cancer Last month, my article addressed the issue of blood in the urine ( hematuria ). A concerning cause of hematuria is bladder cancer, a variably malignant tumor starting
More informationPrepared by: Dr Katherine Brown Fir Lea House Whitecross Newquay Cornwall TR8 4LW. Date: 17/10/2016
EXPERT MEDICAL REPORT FOR THE COURT ON BREACH OF DUTY Prepared by: Dr Katherine Brown Fir Lea House Whitecross Newquay Cornwall TR8 4LW Date: 17/10/2016 -------------------------------------------------------------------
More informationTubulointerstitial Renal Disease. Anna Vinnikova, MD Division of Nephrology
Tubulointerstitial Renal Disease Anna Vinnikova, MD Division of Nephrology Part I: Cystic Renal Disease www.pathguy.com Simple cysts Simple cysts May be multiple Usually 1 5cm, may be bigger Translucent,
More informationDefinition/Epidemiology Approach to premenopausal and postmenopausal women A couple tricky cases DISCLOSURES. No financial relationships to disclose.
DISCLOSURES RECURRENT URINARY TRACT INFECTIONS No financial relationships to disclose. Anna C. Kirby, MD, MAS Acting Assistant Professor University of Washington Division of Urogynecology Department of
More informationBilateral Renal Angiomyolipomas with Invasion of the Renal Vein: A Case Report
Case Study TheScientificWorldJOURNAL (2008) 8, 145 148 TSW Urology ISSN 1537-744X; DOI 10.1100/tsw.2008.29 Bilateral Renal Angiomyolipomas with Invasion of the Renal Vein: A Case Report C. Blick, N. Ravindranath,
More informationHistory of Present Illness Please answer the following questions
Last Name First Name Date of Birth: / / What is the main reason for your visit today? Social Security Number: History of Present Illness Please answer the following questions Bladder Cancer Urinary Tract
More informationTransperineal ultrasound-guided biopsy of the prostate gland
PLEASE PRINT WHOLE FORM DOUBLE SIDED ON YELLOW PAPER Patient Information to be retained by patient biopsy of the prostate gland affix patient label What is a transperineal (TP) ultrasound-guided prostate
More informationThe Management of Female Urinary Incontinence. Part 1: Aetiology and Investigations
The Management of Female Urinary Incontinence Part 1: Aetiology and Investigations Dr Oseka Onuma Gynaecologist and Pelvic Reconstructive Surgeon 4 Robe Terrace Medindie SA 5081 Urinary incontinence has
More informationCaveat sonologist Mistakes to avoid in Kidney Ultrasound
Caveat sonologist Mistakes to avoid in Kidney Ultrasound Simon Freeman Derriford Hospital, Plymouth simonfreeman@nhs.net Bear trap 1 Report: There is a 4cm solid mass arising from the left kidney likely
More informationClinical guideline Published: 22 August 2007 nice.org.uk/guidance/cg54
Urinary tract infection in under 16s: diagnosis and management Clinical guideline Published: 22 August 2007 nice.org.uk/guidance/cg54 NICE 2017. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and-conditions#notice-ofrights).
More informationHMM 4401 Genito-urinary tract diseases
HMM 4401 Genito-urinary tract diseases Urine production Core elements: Glomerulus, proximal and distal convoluted tube, loop of Henle, collecting tubules, ureters, bladder, sphincter, uretra, and out
More informationCase Based Urology Learning Program
Case Based Urology Learning Program Resident s Corner: UROLOGY Case Number 18 CBULP 2011 041 Case Based Urology Learning Program Editor: Associate Editors: Manager: Case Contributors: Steven C. Campbell,
More informationESSIC 2008 Annual Meeting Rome
Bladder Pain Syndrome Developing a History Protocol Normal Bladder Function Depends on Suzy, Arul, Andrei, Arvind Integrity of the macroscopic and microscopic anatomy of the bladder Central nervous system
More informationTrans Urethral Resection of Bladder Tumour (TURBT) Department of Urology Information for Patients
Trans Urethral Resection of Bladder Tumour (TURBT) Department of Urology Information for Patients i Why do I need a trans urethral resection of bladder tumour Your recent cystoscopy has shown a growth
More informationImaging Ejaculatory Disorders and Hematospermia
ATHENS 4-6 October 2018 European Society of Urogenital Radiology Imaging Ejaculatory Disorders and Hematospermia Parvati Ramchandani, MD Professor, Radiology and Surgery University of Pennsylvania Medical
More informationDisease Management. Incontinence Care. Chan Sau Kuen Continence Nurse Consultant United Christian Hospital 14/11/09
Disease Management in Incontinence Care Chan Sau Kuen Continence Nurse Consultant United Christian Hospital 14/11/09 What is incontinence? Definition of Incontinence - Is the compliant of any involuntary
More informationHow To Approach Renal Masses? - Differential Diagnosis On Image
How To Approach Renal Masses? - Differential Diagnosis On Image Poster No.: C-1646 Congress: ECR 2015 Type: Educational Exhibit Authors: A. E. A. G. Costa, A. Gomes, A. Duarte, I. Távora; Lisbon/PT Keywords:
More informationChapter 47 1/8/2018. Urinary System Disorders. Urinary Tract Infections. Treatment
Chapter 47 Urinary System Disorders Urinary Tract Infections Urinary tract infections (UTIs) are common Infection in one area can involve the entire system Microbes enter through the urethra. Catheterization,
More information