Showing posts with label urology. Show all posts
Showing posts with label urology. Show all posts

Sunday, January 23, 2011

- TNM Staging of Renal cell carcinoma (illustrated).

TNM Staging of Renal cell carcinoma.
Primary tumor (T):-

T0: No evidence of primary tumor
T1: Tumor 7 cm or less in the largest dimension, Tumor is confined to the kidney (i.e no penetration through the capsule).

Sunday, December 12, 2010

- Renal trauma grading scale.

Basically we can divide renal trauma into five grades.
The grades I , II and III are classified as minor traumas, and the grades IV,V as major :-
  • Grade I: contusion or subcapsular hematoma, without parenchymal laceration.
  • Grade II: superficial cortical laceration less than 1 cm deep.
  • Grade III: deep cortical laceration extending more than 1 cm.
  • Grade IV:
    1. corticomedullary laceration with collecting system injury and urinary extravasation. 
    2.  vascular injury:- laceration or thrombosis of a segmental artery.
  • Grade V:
    1. Multiple deep lacerations.
    2. Thrombosis of the main renal artery.
    3. Avulsion of renal hilum which devascularizes kidney.

Monday, November 22, 2010

- Bladder Injury.

Bladder Injury
Aetiology:-
  1. Blunt trauma : 10% of pelvic fractures.
  2. Penetrating trauma :gunshots or stap wounds.
  3. Iatrogenic:-
    • Obestetric :- 0.3% with caeserean section.
    • Gynaecological e.g.during a vaginal or abdominal hysterectomy.
    • Urological e.g during cystescopy.
    • Orthopaedic e.g. pins and screws can commonly perforate the urinary bladder, particularly during internal fixation of pelvic fractures.
  4. Idiopathic:- due to presence of a previous scar.
Classification(Pathophysiology):-
  1. Extraperitoneal rupture bladder:
  2. Usually due to fracture pelvis,and Extravasation occur at the perivesical space and may extend up to the anterior abdominal wall,If the urogenital membrane is injuried.
  3. Intraperitoneal rupture bladder:(The most dangerous)
  4. Usually due to direct trauma when the bladder is full,associated with electrolyte disturbance and may passed unnoticed for along time.