Urology SURG 451Clinical session

Dr. Danny M. Rabah

Associate Professor

Chief of Urology, KKUH, KSU.

Colored urine

Urochrome gives urine its characteristic yellow color

Red Urine Color

Hematuria Myoglobinuria Hemoglobinuria

Purple urine bag syndrome

Occurs on patients with chronic indwelling urinary catheter .

The syndrome is often associated with a UTI,

Providencia bacteria, Escherichia coli, P. mirabilis or Klebsiella pneumoniae.

Orange Coloured Urine

Orange urine may be produced by phenazopyridine (Pyridium) or ethoxazene (Serenium) .

Pink Coloured Urine

Eating beetroot can produce urine that’s pink to deep-red in colour

(a condition known as beeturia)

Urate crystals in the urine.

BLUE / GREEN colored Urine

Food colourings

Increased carotene in the diet

Pseudomonas aeruginosa infection

Oxalate Poisoning Oxaluria Phenol poisoning

Pyuria

Surgical Incisions Classification of incisions

Vertical incision Midline incisions Paramedian incisions

Transverse and oblique incisions Kocher's subcostal Incision

Chevron (roof top Modification ) Mercedes Benz Modification

Mc Burney’s grid iron or muscle splitting incision. Pfannenstiel incision Maylard Transverse Muscle cutting Incision Transverse Muscle dividing incision Oblique Muscle cutting incision.

Thoracoabdominal incisions

Vertical Incisions

Midline incision:

1) Upper Midline Incision

2) Lower Midline Incision

3) Full Midline Incision

4) Paramedian incision

Transverse And Oblique Incisions

Kocher’s incision

Bilateral sub costal , Chevron , Thoracoabdominal (Kidney approach)

Thoracoabdominal Incision

Thoracoabdominal incision at the supra-tenthborder with patient in lateral decubitus position.

Oncology -Pathology

Renal cell carcinoma

Chevron (Roof Top) Modification

The Mercedes Benz Modification

McBurney Grid Iron

Pfannenstiel incision (smile incision)

Endo-urology Instruments

Papillary bladder lesion

Bladder Tumours

Broad-based papillary lesion

Depth of resection to detrusor muscle

TURBT video

Click above for video

SOC for AUR – The Foley

• 27 million inserted annually• Static design since 1930’s• Firmly entrenched as SOC

38

Significant Drawbacks High infection rate Passive vs active drainage Patient QOL

Foley Catheter insertion Male

Click above for video

Foley Catheter insertion Female

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Suprapubic catheterisation

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You can view a copy this presentation at: http://faculty.ksu.edu.sa/DannyRabah/defa

ult.aspx