Penn Clinical Manual of Urology: Expert Consult - Online and Print

Introducing the Penn Clinical Manual of Urology. This one-volume reference presents the key clinical information you need to diagnose and treat urologic disorders quickly and effectively. Brief/, well-illustrated chapters combine an easy-to-read format with the comprehensive coverage you demand. This is a unique offering that deserves a place on every urologist's shelf. Find information quickly and easily with clearly presented algorithms, tables, and figures; an excellent resource for clinical questions and answers. Get the true high-quality information you expect in an easy access, quick reference format. Brush up or prepare for board review using the self-assessment questions at the end of each chapter sdarticle......Page 1 sdarticle_001......Page 2 sdarticle_002......Page 3 sdarticle_003......Page 4 Renal Anatomy......Page 12 Pelvic Anatomy......Page 16 General Considerations......Page 18 Laparoscopic Access......Page 19 Robotics......Page 21 Laparoscopic Renal Surgery......Page 22 Instrumentation......Page 23 Operative Steps......Page 24 Indications......Page 27 Operative Steps......Page 28 Postoperative Care......Page 29 Operative Steps......Page 30 Indications......Page 31 Operative Steps......Page 32 Instrumentation......Page 34 Indications......Page 35 Postoperative Care......Page 36 Operative Steps......Page 37 Indications......Page 38 Operative Steps......Page 39 Instrumentation......Page 43 Operative Steps......Page 44 Conclusions......Page 45 Suggested Readings......Page 46 Direct......Page 48 Asymptomatic......Page 49 Pain......Page 50 Alterations of Micturition......Page 52 Changes in the Gross Appearance of the Urine......Page 55 Abnormal Appearance and/or Function of the Male External Genitalia......Page 59 General Information......Page 61 Kidneys and Flanks......Page 62 Abdomen and Bladder......Page 63 Penis......Page 64 Scrotum and Scrotal Contents......Page 65 The Rectum and Prostate......Page 67 The Vaginal Examination......Page 72 Collection......Page 73 Dipstick Tests......Page 75 PSA Level......Page 77 Urethral Catheters......Page 78 Urethral Sounds and Filiforms and Followers......Page 79 Cystourethroscopy and Associated Techniques......Page 80 Ultrasound Evaluation of the Urinary Tract......Page 82 Percutaneous Suprapubic Cystostomy......Page 83 Summary......Page 84 Suggested Readings......Page 85 Indications......Page 86 Radiographic Iodinated Contrast Agents......Page 89 Technique of IVU......Page 93 Contraindications......Page 95 Indications......Page 101 Complications......Page 102 Technique......Page 103 Technique......Page 104 Indications......Page 106 Technique......Page 107 Purpose......Page 108 Indications......Page 109 Complications......Page 110 Loopogram and Pouchogram......Page 111 Indications......Page 112 Contraindications......Page 113 Indications for Renal Arteriography......Page 114 Indications for Gonadal Phlebography......Page 115 Indications......Page 116 Complications......Page 118 Indications......Page 119 Technique......Page 124 Indications......Page 125 Magnetic Resonance Imaging......Page 130 Percutaneous Nephrostomy......Page 131 Indications for PCN......Page 132 Preprocedural Evaluation Prior to PCN......Page 134 Contraindications to PCN......Page 135 Technique......Page 136 Results......Page 137 Complications......Page 138 Management of upper urinary tract calculi......Page 139 Stone size......Page 140 Staghorn stones......Page 141 Stone composition......Page 142 Contraindications......Page 143 Complications......Page 144 Other Procedures Performed Through a PCN Access Track......Page 145 Indications......Page 147 Technique......Page 149 Results......Page 150 Principles......Page 151 Indications......Page 152 Technique......Page 153 Complications......Page 154 Technique......Page 155 Results......Page 156 Percutaneous Drainage of Urinomas......Page 157 Results......Page 158 Contraindications......Page 159 Results......Page 160 Indications......Page 161 Results......Page 162 Cryoablation......Page 163 Suggested Readings......Page 164 Classification Schema......Page 165 Epidemiology......Page 167 Pathophysiology......Page 168 Diagnosis: Signs and Symptoms, Diagnostic Studies......Page 170 Therapy: General Considerations......Page 172 Uncomplicated Isolated Cystitis......Page 173 Recurrent Bacterial Cystitis......Page 174 Choice of Antibiotic......Page 176 Special Situations......Page 177 Clinical Presentation......Page 179 Complications......Page 181 Management......Page 183 Suggested Readings......Page 185 Other Risk Factors......Page 187 Pathogenesis......Page 188 Localization of Lower UTI......Page 189 Diagnosis......Page 190 Epidemiology......Page 191 Acute Bacterial Prostatitis-Category I Prostatitis......Page 192 Chronic Bacterial Prostatitis-Category II Prostatitis......Page 193 Chronic Nonbacterial Prostatitis-Category III/Chronic Pelvic Pain Syndrome (CPPS)......Page 194 Etiology......Page 196 Treatment......Page 197 Suggested Readings......Page 198 General Considerations......Page 199 Pathogenesis......Page 200 Clinical Features and Diagnosis......Page 201 Therapy......Page 202 Follow-up......Page 206 Etiology and Life Cycle......Page 207 Pathogenesis and Clinical Features......Page 208 Diagnosis......Page 209 General Considerations......Page 210 Pathogenesis and Clinical Features......Page 211 Therapy......Page 212 Hydatid Disease (Echinococcosis)......Page 214 General Considerations......Page 215 Primary Fungal Infections......Page 216 Opportunistic Fungal Infections......Page 217 Candidiasis (Opportunistic Fungal Pathogen)......Page 218 Pathogenesis......Page 220 Therapy......Page 221 Disclaimer......Page 222 Suggested Readings......Page 223 Painful Bladder Syndrome (Interstitial Cystitis)......Page 226 Definition......Page 227 Epidemiology......Page 229 Etiology......Page 230 Diagnosis......Page 233 Initial Management......Page 236 Oral Therapy......Page 237 Intravesical Therapy......Page 238 Hydrodistention......Page 239 Philosophy of Management......Page 240 Suggested Readings......Page 242 Composition of Renal Stones......Page 244 Physical and Biochemical Parameters......Page 245 Calcium Stones......Page 246 Struvite Stones (Triple Phosphate, Infected Stone)......Page 250 Clinical Manifestations of Nephrolithiasis......Page 251 Evaluation of Patients with Nephrolithiasis......Page 252 Physical Exam......Page 253 Radiologic Evaluation......Page 254 Treating Patients with Acute Renal Colic......Page 255 General Conservative Measures......Page 256 Specific Medical Therapy of Different Stone Types......Page 257 Extracorporeal Shock Wave Lithotripsy (ESWL)......Page 260 Percutaneous Nephrolithotomy (PCNL)......Page 263 Rigid and Flexible Ureteroscopy (URS)......Page 264 Factors Influencing Therapeutic Choice......Page 265 Suggested Readings......Page 266 Introduction......Page 267 Gross Hematuria......Page 268 Noncatheterized Patient......Page 269 Catheterized Patient......Page 270 Intrinsic Noncalculous Ureteric Obstruction......Page 271 Intrinsic......Page 272 Venous......Page 273 Torsion of Testis......Page 274 Torsion of Appendages......Page 275 Fractured Penis......Page 276 Postrenal Azotemia......Page 277 Urinary Tract Imaging......Page 278 Ischemic......Page 279 Etiology/Pathophysiology......Page 280 Treatment of Priapism......Page 281 Ischemic Priapism......Page 282 Phimosis......Page 283 Balanoposthitis......Page 284 Pathogenesis......Page 285 Zipper Injuries......Page 286 Postcircumcision Complications......Page 287 Suggested Readings......Page 288 Initial Evaluation......Page 290 Classification......Page 292 Management......Page 293 Operative Management......Page 294 Complications......Page 296 Initial Evaluation......Page 297 Management......Page 298 Mid Ureter......Page 299 Initial Evaluation......Page 300 Extraperitoneal Injuries......Page 301 Urethral InjurIes......Page 303 Initial Evaluation......Page 305 Posterior Urethra......Page 306 Postintervention Care......Page 307 Mechanisms......Page 308 Presentation......Page 309 Initial Evaluation......Page 310 Penile Trauma......Page 311 Penile Amputation......Page 312 Scrotal Trauma......Page 313 Mechanism......Page 314 Conclusions......Page 315 Suggested Readings......Page 316 Iatrogenic......Page 317 Infection......Page 318 Retrograde Urethrogram (RUG) and Voiding Cystourethrogram (VCUG)......Page 319 Treatment......Page 320 Open Reconstruction......Page 322 Procedure......Page 323 Substitution Urethroplasty......Page 324 Posterior Urethra......Page 325 Diagnosis......Page 326 Results......Page 327 Specific Conditions Causing Urethral Stricture......Page 328 Suggested Readings......Page 329 General Considerations......Page 331 Etiology......Page 332 Presentation......Page 333 Evaluation......Page 334 Therapy......Page 335 Etiology......Page 338 Therapy......Page 339 Presentation......Page 340 Presentation......Page 341 Therapy......Page 342 Presentation......Page 343 Urovascular Fistula......Page 344 Suggested Readings......Page 345 Introduction......Page 347 Bladder, Urethra, Smooth and Striated Sphincter......Page 348 Innervation and Receptor Function......Page 349 CNS Influences on Micturition......Page 358 What Determines Bladder Response During Filling?......Page 359 Why Does Voiding Ensue with a Normal Bladder Contraction?......Page 361 Why Does Urinary Continence Persist During Abdominal Pressure Increases?......Page 362 Overview of the Micturition Cycle: Simplification......Page 363 Bladder Overactivity......Page 365 Outlet Underactivity......Page 367 Outlet Overactivity or Obstruction......Page 369 History......Page 370 Physical and Neurologic Evaluation......Page 372 Radiologic Evaluation......Page 374 Endoscopic Evaluation......Page 375 Urodynamic/Video Urodynamic Evaluation......Page 376 General......Page 396 The Functional System......Page 397 International Continence Society Classification......Page 401 Lapides Classification......Page 404 Complete Spinal Cord Lesions From Spinal Cord Level T6 to S2......Page 406 Cerebrovascular Disease, CVA......Page 411 Parkinson's Disease......Page 413 Multiple System Atrophy......Page 415 Multiple Sclerosis......Page 416 Spinal Cord Injury......Page 417 Neurospinal Dysraphism......Page 421 Disk Disease; Cauda Equina Syndrome; Spinal Stenosis......Page 422 Radical Pelvic Surgery......Page 423 Diabetes Mellitus......Page 425 Bladder Neck Dysfunction......Page 426 Dysfunctional Voiding......Page 428 Postoperative Retention......Page 429 Urinary Incontinence......Page 430 Outlet-Related Incontinence in the Female......Page 433 Bladder-Related Incontinence in the Male......Page 435 Management of Incontinence......Page 436 Inhibiting Bladder Contractility/Decreasing Sensory Input/Increasing Bladder Capacity......Page 437 Increasing Outlet Resistance......Page 463 Circumventing the Problem......Page 473 Bladder Related (Increasing Intravesical Pressure or Facilitating Bladder Contractility)......Page 475 Outlet Related (Decreasing Outlet Resistance)......Page 478 Suggested Readings......Page 483 Definitions and Epidemiology......Page 485 Prostatic Size and Morphology Pertinent to BPH......Page 488 Etiologic Theories of BPH: Pathophysiology......Page 491 Hormones......Page 492 Static and Dynamic Components of Prostatic Obstruction......Page 493 Lower Urinary Tract Symptoms (LUTS)......Page 494 Urodynamics of BOO......Page 495 Uroflowmetry......Page 496 Cystometry and Pressure-Flow Studies......Page 498 Symptomatic Versus Urodynamic Improvement......Page 499 The Natural History of BPH and its Alteration......Page 500 Evaluation of LUTS Suspected to be Due to BPH......Page 501 Symptoms and Symptom Scores......Page 504 Indication for Treatment......Page 510 Assessing the Results of Treatment......Page 511 Alpha-Adrenergic Antagonists......Page 513 5-alpha Reductase Inhibitors......Page 514 Combined Therapy......Page 515 Prostatic Urethral Stents......Page 516 Transurethral Microwave Thermotherapy (TUMT)......Page 517 Laser Usage......Page 518 Interstitial Laser Coagulation (ILC)......Page 519 Holmium Laser Enucleation of the Prostate (HOLEP)......Page 520 Transurethral Resection of the Prostate (TURP)......Page 521 Transurethral Electrosurgical Incision of the Bladder Neck and Prostate (TUIBN-P)......Page 522 Open Prostatectomy......Page 523 Suggested Readings......Page 525 Incidence......Page 528 Epidemiology......Page 529 Etiology......Page 530 Pathology......Page 531 Grading and Staging System......Page 532 Natural History......Page 533 Diagnosis and Staging/PSA Screening......Page 535 Cancer Prevention......Page 538 Outcome Prognosis and Stratification......Page 539 Treatment of Localized Disease......Page 540 Treatment of Biochemical and Clinical Failure......Page 543 Treatment of Advanced Disease......Page 544 General Considerations......Page 545 Etiology......Page 546 Pathology......Page 547 CIS......Page 549 Signs and Symptoms......Page 550 Disease Screening and Tumor Markers......Page 551 Clinical Staging and Imaging......Page 553 Intravesical Chemotherapy Instillation......Page 554 Common Intravesical Chemotherapy Agents......Page 555 BCG Therapy......Page 556 Treatment of High-Grade Ta Disease and CIS......Page 557 Treatment of T1 Disease......Page 558 Radical Cystectomy......Page 559 Partial Cystectomy......Page 560 History......Page 561 Urolithiasis......Page 562 Electrolyte Abnormalities......Page 563 Drug Absorption......Page 564 Geometric Aspects......Page 565 Colon Conduit......Page 566 Ureterosigmoidostomy......Page 567 Cutaneous Continent Diversion......Page 568 Orthotopic Continent Diversion......Page 569 Neoadjuvant/Adjuvant Chemotherapy......Page 570 Prostate Cancer......Page 571 Bladder Cancer......Page 572 Epidemiology......Page 575 Renal Cell Carcinoma......Page 576 Oncocytoma......Page 577 Sarcoma......Page 578 Grading and Staging......Page 579 Diagnostic Studies......Page 581 Laparoscopic Radical Nephrectomy......Page 584 Nephron-Sparing Surgery......Page 585 Systemic Therapies......Page 586 Follow-up of RCC After Nephrectomy or Renal-Sparing Surgery......Page 587 Incidence......Page 588 Etiology and Natural History......Page 589 Diagnosis......Page 590 TCC of the Renal Pelvis......Page 591 Chemotherapy......Page 592 Pathology......Page 593 Urethral Diverticula......Page 594 Management......Page 595 Premalignant Lesions......Page 596 CIS and Other Malignant Lesions......Page 598 Etiology......Page 599 Diagnosis and Staging......Page 600 Primary Lesion......Page 601 Inguinal Lymph Nodes......Page 603 Surveillance......Page 605 The Pigmented Penile Lesion......Page 606 Epidemiology......Page 607 Seminoma......Page 608 Specialized Gonadal Stromal Tumors......Page 609 Clinical Presentation......Page 610 Diagnosis......Page 611 Seminoma......Page 614 Nonseminomatous Germ Cell Tumors......Page 615 Chemotherapy......Page 616 Leydig Cell Tumors......Page 617 Suggested Readings......Page 618 Physics......Page 620 Radiobiology......Page 621 Treatment Planning......Page 623 Clinical Radiation Oncology......Page 630 Renal Pelvic and Ureteral Carcinoma......Page 632 Bladder Carcinoma......Page 633 Prostate Cancer......Page 637 Testicular Cancer......Page 647 Penile Cancer......Page 650 Summary......Page 652 Suggested Readings......Page 653 Retroperitoneal Fibrosis......Page 655 Retroperitoneal Hemorrhage......Page 658 Pelvic Lipomatosis......Page 659 Primary Retroperitoneal Sarcoma......Page 660 Pathology......Page 661 Diagnosis......Page 662 Staging......Page 663 Outcomes......Page 664 Radiation and Chemotherapy for Retroperitoneal Sarcoma......Page 665 Suggested Readings......Page 666 Introduction......Page 667 Corporal Bodies......Page 670 Neurophysiology and Pharmacology of Erection......Page 671 Hemodynamics......Page 673 Ejaculation......Page 676 Erectile Dysfunction......Page 677 Vasculogenic......Page 678 Endocrine......Page 679 Psychogenic......Page 681 Iatrogenic/Drug Induced......Page 682 Sexual History......Page 683 Psychosocial History......Page 685 Physical Exam......Page 686 Vascular Evaluation......Page 687 Neurologic Evaluation......Page 688 Lifestyle Changes......Page 689 Oral Agents......Page 690 Intracavernous Injection Therapy......Page 693 History......Page 694 Prosthetic Surgery......Page 695 Hydraulic......Page 696 Vascular Procedures......Page 697 Premature Ejaculation......Page 698 Priapism......Page 701 Ejaculatory Incompetence......Page 705 Suggested Readings......Page 706 Embryology......Page 709 Reproductive Hormonal Axis......Page 711 Pituitary-Luteinizing Hormone (LH) and Follicle-Stimulating Hormone (FSH)......Page 712 Seminiferous Tubules-Spermatogenesis......Page 713 Feedback Mechanisms......Page 714 Testicular Transport......Page 715 Sperm Maturation......Page 716 Previous Marital History and Relationships......Page 717 Genitourinary History......Page 719 General Medical History......Page 720 Physical Examination......Page 722 Semen Analyses......Page 724 Other Laboratory Tests......Page 725 General Information......Page 728 Azoospermia......Page 729 Multiple Abnormal Parameters on the Semen Analysis......Page 732 Isolated Abnormal Parameter on Semen Analysis......Page 735 Empirical Treatment of Idiopathic Infertility......Page 738 Assisted Reproductive Technology......Page 740 Conclusion......Page 743 Suggested Readings......Page 744 Urethritis......Page 745 Diagnosis......Page 746 Follow-Up......Page 747 Chlamydia Trachomatis......Page 748 Recommended Regimens......Page 749 Condyloma Acuminata......Page 750 Physician-Administered......Page 752 Genital Ulcers......Page 753 Genital Herpes......Page 754 Episodic Therapy for Recurrent Genital Herpes......Page 755 Syphilis......Page 756 Secondary Syphilis......Page 757 Diagnosis......Page 758 Recommended Regimen for Adults......Page 759 Recommended Regimens......Page 760 Granuloma Inguinale......Page 761 Mollusca Contagiosum......Page 762 Bacterial Vaginosis (BV)......Page 763 Vulvovaginal Candidiasis......Page 764 Human Immunodeficiency Virus......Page 765 Epidemiology......Page 766 Malignancies......Page 767 Voiding Dysfunction......Page 768 Suggested Readings......Page 769 Arterial Supply......Page 770 Histologic Structure......Page 771 Adrenal Cortex Physiology......Page 772 Increased Adrenal Function......Page 774 Adrenal Neoplasia......Page 780 Imaging of Adrenal Masses......Page 783 Assessment of Function of Adrenal Masses......Page 785 Summary of Surgical Indications......Page 787 Suggested Readings......Page 789 Histocompatibility Considerations in Living Donor Selection......Page 790 Allograft Rejection......Page 791 Immunosuppression......Page 792 Calcineurin Inhibitors (Maintenance)......Page 793 Antimetabolites (Maintenance)......Page 794 Anti-B Cell Antibodies (Rejection, Desensitization)......Page 795 Deceased Donors......Page 796 Open Nephrectomy......Page 797 Evaluation of Recipients......Page 798 Recipient Operation......Page 799 Complications of Renal Transplantation......Page 800 Vascular Complications......Page 801 Opportunistic Infections......Page 802 Hyperparathyroidism......Page 803 Results of Renal Transplantation......Page 804 Suggested Readings......Page 805 Historical Overview......Page 806 Etiology......Page 807 Function of the Renin-Angiotensin System......Page 811 Mechanisms of RVH......Page 812 Clinical Presentation......Page 813 Radiologic Evaluation......Page 814 Differential Renal Function Studies......Page 817 Renal Vein Renin Assays......Page 818 General......Page 819 General......Page 820 Results......Page 821 General......Page 822 Surgical Procedures......Page 823 Results......Page 824 Recommendations......Page 825 Suggested Readings......Page 826 Disorders of Sexual Development......Page 827 CYP21 (21alpha-Hydroxylase) Deficiency......Page 830 CYP11B1 (11beta-Hydroxylase) Deficiency......Page 832 Testosterone Biosynthesis Enzyme Defects......Page 833 CYP17 Abnormality......Page 834 17beta-Hydroxysteroid Dehydrogenase Deficiency......Page 835 Androgen Insensitivity Syndrome......Page 836 Persistent Müllerian Duct Syndrome (Hernia Uteri Inguinale)......Page 838 46XY Gonadal Dysgenesis......Page 839 46XX Testicular DSD (Sex-Reversed Males)......Page 840 Complete Gonadal Dysgenesis......Page 841 Ovotesticular DSD (Formerly True Hermaphroditism)......Page 842 History and Physical Exam......Page 843 Patient Evaluation......Page 844 46XX DSD (CAH)......Page 845 Gonadal Dysgenesis......Page 846 Ovotesticular DSD......Page 847 46XY DSD......Page 848 Suggested Readings......Page 851 Pathology-Embryology......Page 853 Management of Wilms' Tumor......Page 855 Incidence......Page 860 Pathology......Page 861 Staging and Prognosis......Page 862 Treatment......Page 863 GU Rhabdomyosarcoma......Page 865 Pathology......Page 866 Staging......Page 867 Intergroup Rhabdomyosarcoma Studies......Page 868 Treatment......Page 869 Classification......Page 870 Management......Page 872 Prognosis......Page 874 Suggested Readings......Page 875 Anatomy and Physiology......Page 876 Neonate and Infant......Page 877 The Clinical Manifestations of Voiding Dysfunction......Page 878 History......Page 879 Questions a Consulting Physician Must Consider......Page 880 The Physical Examination......Page 881 Imaging......Page 882 Imaging That Is Less Frequently Indicated for Voiding Dysfunction......Page 883 Urodynamic Measurements......Page 884 Constipation......Page 885 Internal Sphincteric Dyssynergia......Page 887 Additional Background......Page 888 Anticholinergic Therapy in Pediatric Voiding Dysfunction......Page 889 Diabetes insipidus......Page 890 Suggested Readings......Page 891 Abnormalities of the Kidney Position and Number......Page 892 Cystic Abnormalities of the Kidney......Page 894 Collecting System Abnormalities......Page 896 Ureteral Anomalies......Page 898 Exstrophy/Epispadias-Spectrum of Anomalies......Page 902 Posterior Urethral Valves (Type I)......Page 904 Megalourethra......Page 905 Hypospadias......Page 906 Cryptorchidism......Page 910 Appendages......Page 914 Vaginal Atresia and Mayer-Rokitansky-Küster-Hauser Syndrome......Page 915 Suggested Readings......Page 917 Initial Evaluation......Page 918 Therapeutic Decisions......Page 921 Preoperative Patient Optimization......Page 923 Perioperative Problems......Page 924 Suggested Readings......Page 926 sdarticle_033......Page 927 Concise And Practical, The Penn Clinical Manual Of Urology Is An Indispensable Guide To The Daily Practice Of Urology. This One-volume Medical Reference Book Presents The Key Clinical Information You Need To Diagnose And Treat Urologic Disorders Quickly And Effectively, Featuring Brief, Well-illustrated Chapters And An Easy-to-read Format. Essential For Clinical Questions And Answers, The Penn Clinical Manual Of Urology Deserves A Place On The Bookshelf Of Not Only Every Urologist, But Every Provider Treating Urologic Problems. Find Information Quickly And Easily With A Format That Includes Clearly Presented Algorithms, Tables, And Figures. Effectively Review For The Boards Using The Self-assessment Questions At The End Of Each Chapter. Stay Abreast Of New Aua And Ici Incontinence Guidelines, And Access Up-to-date Information On The Latest Treatment Recommendations, Therapy For Castrate-resistant Prostate Cancer, And Active Surveillance For Prostate Cancer. Effectively Prepare For Board Examinations And Recertification. Understand And Apply Evaluation And Management Techniques For Male Subfertility And Androgen Deficiency. Focus On Hot Topics In Urology, Including Stress And Mixed Urinary Incontinence; Therapy For Prolapse; Overactive Bladder; And Renal Cell Carcinoma. Review Chapters On The Major Categories Of Urologic Diseases, And Integrate Radiology, Radiation Therapy, Nephrology, Pediatric Urology, Transplantation Surgery, And Vascular Surgery. Search The Entire Contents Online At Expert Consult!