Day: May 22, 2024

Acute prostatitis This is acute inflammation of the prostate, which usually occurs in infection   Causes Young adults – Chlamydia trachomatis, Neisseria gonorrhoeae Older Adults – E. coli   Symptoms Dysuria, urinary frequency, and suprapubic pain Can cause urinary retention leading to pain and haematospermia Systemic symptoms, e.g., fevers   Key tests DRE gives tender prostate and secretions reveal bacteria   Management Antibiotics e.g. levofloxacin (Quinolone) or Trimethoprim   Benign prostatic hyperplasia (BPH) This refers to hyperplasia of the prostate which occurs with age and is common. It does not increase the risk of cancer, as it is the central

Epididymo-orchitis This is inflammation of the epididymis (and the testes)   Causes Bacteria, e.g., chlamydia, gonorrhea, E. coli Viruses, e.g., mumps (in teenage males) Drugs e.g., amiodarone Symptoms Acute onset tender swelling (confined to epididymis) Dysuria, sweats, fever   Management Treat the underlying cause, e.g., antibiotics if due to an STI   Testicular torsion This refers to twisting of the spermatic cord, usually in adolescents It can cut off the blood supply to the testes resulting in ischaemia   Symptoms Acute onset testicular pain Absence of the cremasteric reflex Abdominal pain, nausea and vomiting Prehn’s sign seen (where raising the

Polycystic kidney disease This is a genetic condition which leads to the development of multiple cysts on the kidneys. It exists as both autosomal dominant and recessive forms:   Autosomal dominant This occurs due to a mutation in the genes PKD1 (Chr 16), or PKD2 (Chr 4) Symptoms Clinically silent initially but gives symptoms in early adulthood  Hypertension (due to renin release), hematuria, cyst infection and kidney failure   Associations Liver cysts (most common extra-renal manifestation) Berry aneurysms in the brain Cardiovascular abnormalities (mitral valve prolapse, valve issues, aortic dissection)   Key tests Abdominal ultrasound is used to detect cysts

Renal Cell Carcinoma (RCC) This refers to a malignant proliferation of kidney cells. It can be sporadic which is associated with increased age, but it is also seen in young children (genetic causes). The most common form is a clear cell carcinoma as the cells look clear on histology   Symptoms Triad of painless hematuria, loin mass and lumbar pain Systemic symptoms e.g., weight loss, fever Paraneoplastic syndromes – due to hormone release, e.g., ACTH, renin, PrPTH Can cause a left-sided varicocele as the tumour may compress the left renal vein   Key tests Ultrasound and CT scan show a

Renal Stones (Nephrolithiasis) This is the presence of a stone which can get lodged somewhere in the urinary tract. It usually in one of the 3 natural points of constriction – pelviureteric junction (PUJ), pelvic brim or vesicoureteric junction (VUJ). There are different types of stones Types of Kidney Stones Risk Factors Dehydration – this increases ion concentration of the urine Recurrent UTIs and foreign bodies which stagnate flow, e.g., stents/catheters Diet – may cause hypercalcaemia and certain foods also increase oxalate levels Underlying metabolic conditions (e.g., hyperparathyroidism)   Symptoms Writhing (colicky) pain which travels from “loin” to groin with