ppt urologi

8/10/2019 ppt urologi

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R A T I H M A S I T A D E V Y

UROLOGI


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OLIGOURIA & ANURIA

If the patient concentrates urine in a normal fashion,oliguria (for tha person) is present at urine volumesunder 400 mL/day, or approximately 6 mL/kg body

weight. If the kidney concentration is impaired andthe patient can achieve a specific gravity of only1.010, oliguria is present at urine volumes under10001500 mL/day.

There is no urine output at all (anuria)in acute renalfailure.

Campbell-Walsh Urology.10th ed 2012, Alan J. Wein ; editors, Louis R. Kavoussi. Printed in the United States of America


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IRITATIVE

SYMPTOMS

OBSTRUCTIVESYMPTOMS

Frequency

Nocturia Dysuria

Urgency

Weak stream

Hesitancy Intermittency

Postvoid dribbling

Straining Residual urine

LOWER URINARY TRACT SYMPTOMS



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KIDNEY BALLOTEMENT

The best way to palpate the kidneys is with the patient in the supineposition. The kidney is lifted from behind with one hand in thecostovertebral angle .On deep inspiration, the examiner's hand isadvanced firmly into the anterior abdomen just below the costalmargin. At the point of maximal inspiration, the kidney may be feltas it moves downward with the diaphragm. With each inspiration,

the examiner's hand may be advanced deeper into the abdomen. The most successful method of renal palpation is carried out with

the patient lying in the supine position on a hard surface .Thekidney is lifted by one hand in the costovertebral angle (CVA). Ondeep inspiration, the kidney moves downward; the other hand ispushed firmly and deeply beneath the costal margin in an effort to

trap the kidney. When successful, the anterior hand can palpate thesize, shape, and consistencyof the organ as it slips back into itsnormal position. Alternatively, the kidney may be palpated with theexaminer standing behind the seated patient.


Tanagho, Emil A, McAninch, Jack W. 2008. Smiths GENERAL UROLOGY Seventeenth Edition. The McGraw-Hill Companies,Inc. All rights reserved. Manufactured in the United States of America


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DIGITAL RECTAL EXAMINATION

DRE should be performed at the endof the physical examination. It is done

best with the patient standing andbent over the examining table or withthe patient in the knee-chest position.In the standing position, the patient

should stand with his thighs close tothe examining table. The feet should

be about 18 inches apart, with theknees flexed slightly. The patientshouldbend at the waist 90 degreesuntil his chest is resting on hisforearms. The physician should give

the patient adequate time to get in theproper position and relax as much aspossible. The physician should place aglove on the examining hand andshould lubricate the index fingerthoroughly.


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