By Hashim Hashim M.D., FEBU, FRCS (Urol) (auth.), Hashim Hashim, John Reynard, Nigel C. Cowan, Dan Wood, Noel Armenakas (eds.)
Urological Emergencies in scientific perform, moment Edition, is a well-researched notebook that gives a finished precis of urological emergencies and their administration, in a kind that's concise, proper to the objective viewers and on hand. whereas the outline of every emergency is accomplished, the emphasis is at the useful method of the stipulations that are prone to be encountered.
Since the 1st version, there were new instructions released by means of the ecu organization of Urology that are included within the re-creation of this ebook. in addition this variation incorporates a bankruptcy on pediatric urological emergencies.
For the health care provider or nurse anticipated to supply the preliminary evaluation and administration of a with which she or he has had very constrained adventure, Urological Emergencies in scientific perform, moment Edition will supply a useful resource of data and suggestion.
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Additional info for Urological Emergencies In Clinical Practice
Thus, if you see a patient with a history suggestive of ureteric colic and their pain started 3–4 days ago, they may well have no blood detectable in their urine even though they do have a stone. The relatively poor specificity of dipstick or microscopic hematuria for detecting ureteric stones reflects the multiple other pathologies that can mimic the pain of a ureteric calculus combined with the fact that blood is detectable in a proportion of patients without demonstrable urinary tract pathology; in fact, no abnormality is found in approximately 70 % of patients with microscopic hematuria, despite full investigation with cystoscopy, renal ultrasound, and intravenous urography (IVU) (Khadra et al.
2) and where required CT urography (CTU). The CT-KUB has the following advantages over IVU: 1. It has greater specificity (95 %) and sensitivity (97 %) for diagnosing ureteric stones than has IVU (Smith et al. 1996). The CT-KUB can identify other non-stone causes of flank pain such as leaking aortic aneurysms (Fig. 3). 2. There is no need for contrast administration. This avoids the chance of a contrast reaction. The risk of fatal anaphylaxis following the administration of low-osmolality contrast media for IVU is on the order of 1 in 100,000 (Caro et al.
By draining the hydronephrosis and hydroureter, it allows the ureteric wall to coapt and thus encourages a return to normal peristaltic function. 36 J. Reynard Medical Expulsive Therapy for Stones (MET) There is a growing body of evidence supporting the efficacy of MET with the smooth muscle-relaxing alpha-1 adrenergic adrenoceptor blockers, such as tamsulosin. The evidence suggests that they probably increase spontaneous stone passage rates, reduce stone passage time, and reduce the frequency of episodes of ureteric colic (Dellabella 2003; Parsons et al.