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Atallah A. Shaaban<br />
43<br />
<strong>Basic</strong> <strong>Urology</strong>: History Taking<br />
Genital: T.B. thickening and beading of vas.<br />
DRE: Bladder mass, BPH, prostate cancer.<br />
P.V.: Bladder mass.<br />
C) Investigations:<br />
Laboratory:<br />
Blood: CBC, liver function tests, creatinine, blood glucose.<br />
Attention to platelets, prothrombin, clotting and coagulation<br />
time.<br />
Urine analysis and culture: microscopic hematuria with pyuria<br />
(UTI), crystals (stones), …<br />
Radiologic:<br />
Ultrasound: renal masses, stones, polycystic kidneys, bladder<br />
mass….<br />
KUB: Radio-opaque stones.<br />
Non-contrast CT: stone disease.<br />
CT with contrast: kidney, ureteric, bladder and prostate cancer<br />
evaluation.<br />
Endoscopy:<br />
Ureteroscopy: Stones, tumors of ureter.<br />
Cystoscopy: diagnostic and therapeutic in bladder cancer.<br />
A) Emergency<br />
Treatment<br />
Blood transfusion if necessary.<br />
Clot retention is an emergency condition.<br />
Clots are evacuated and triway 22 F urethral catheter is inserted<br />
with continuous irrigation.<br />
Cystoscopy and coagulation of the bleeding source e.g. bladder<br />
tumor, post- TURBT or TURP.<br />
Arterial embolization is performed in significant hematuria after<br />
PCNL or kidney trauma.<br />
Open surgery may be necessary if other measures fail.<br />
B) Treat the cause
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