Sunday, December 25, 2016

Testis Urethra male urethra marions decease

MARION’S DISEASE is obstruction to the neck of bladder with a thickning of the bladder neck and no enlargement of the prostate in a young man. Symptoms are identical with those of congenital valve.
      Cystoscopically; there is a hypertrophied inter-ureteric bar.
      Significant symptoms are present when function of legs is involved, patients have high pressure in the bladder with high residual urine incontinence (overflow) and urinary infection.

11.1.2 Neurogenic bladder is seen in cases of Spina bifida. Lesion of the central nervous system can also cause retention of urine is childhood and is of neurological origin.
Self cathetrisation or wearing external device to collect overflow may help

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Sunday, December 18, 2016

Testis Urethra male urethra

11. MALE URETHRA

11.1 Congenital Abnormalities
      The most common lesion in the distal urethra is meatal stenosis. The stream is poor and may predispose to infection ane enuresis (bed wetting) leading later to hydro-uretro-nephrosis and renal insufficiency due to back pressure.
Simple meatotomy provides relief.



11.1.1 CONGENITAL VALVES of the posterior urethra also obstruct the outflow of urine leading to chronic retention and hydroureter, infection and renal insufficiency. The most reliable method of confirming the diagnosis is voiding cysto-urethrography.
MARION’S DISEASE is obstruction to the neck of bladder with a thickning of the bladder neck and no enlargement of the prostate in a young man. Symptoms are identical with those of congenital valve.
      Cystoscopically; there is a hypertrophied inter-ureteric bar.

      Significant symptoms are present when function of legs is involved, patients have high pressure in the bladder with high residual urine incontinence (overflow) and urinary infection.

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All older posts are stored in archives for access and review.
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Monday, December 12, 2016

Testis Tumor Treatment

TREATMENT
      All testicular tumours need orchidectomy for diagnosis of cell type of tumour staging is achieved by the use of imaging technique
      -     stage I+II seminoma receive radiotherapy
      -     stage III receive in addition chemotherapy
      All non seminomas receive chemotherapy after orchidectomy. Tumour marker assay is used as guide to indicate tumour response to therapy.

Inguinal Orchidectomy Steps
-        An inguinal incision
-        Inguinal canal opened spermatic cord identified and clamped
-        The testis in the tunica is mobilized from parietal attachments and delivered in the inguinal wound
-        Open tunica vaginals and view the testis, if suspicious
-        Cord ligated and cut leaving a metal clip for further treatment

-        Testis sent for histology
Close wound

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Tuesday, December 6, 2016

Tumours testis choriocarcinoma symptoms markers

 Choriocarcinoma
      This accounts for only a small number of the germinal cell tumours, rapidly invading the venous system. Metastases are by blood and lymphatics, relatively unresponsive to chemotherapeutic measures.


10.4 Symptoms
      Pain in scrotum and heaviness are the commonest present ation and should be reported. A physical examination and ultrasound of the testis can reveal a testicular tumour. IVP and CT scan and bipedal lymphangiography can reveal the lymph gland enlargement of para-aortic glands

10.5 Tumour Markers
      In 90% of cases alpha feto-protien or human chorionic gonadotraphis can be detected in the serum and can help diagnosis. The other markers of help are in box.
      -     Placental lactogenic hormone
      -     Pregnancy specific antigens
      -     Placental alkaline phosphatase
      -     Carcinoembryonic antigen

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