treatment of vesicoureteral reflux• spontaneous resolution in 60% of primary reflux
■ in lower grades (I-III), goal is to prevent infection or renal damage via medical treatment
• medical treatment: daily ABx prophylaxis
• surgical treatment: ureteral reimplantation ± ureteroplasty, or subureteral injection with bulking agents (Deflux® or Macroplastique®)
■ indications include failure of medical management, renal scarring (e.g. renal insufficiency, HTN), breakthrough UTIs, persistent ☆high grade (IV or V) reflux urologypediatrics卒試 HirotoShishido
penile fracture陰茎折症
① 性交中など陰茎の勃起時に強力な外力が加わって,☆陰茎海綿体白膜が断裂したもの.陰茎海綿体に損傷が及ぶこともある.
② 受傷時には断裂音を伴い,激痛が生じる.血腫のため対側に屈曲する.
③ 治療は,血腫除去と白膜断裂部の縫合を速やかに行う. urologysurgery国試過去3回 HirotoShishido
renal pelvic, ureteral cancer 好発部位、診断、治療、予後尿管癌は尿管の下1/3に好発し,再発が多いのが特徴である
which histological pattern of BPH does best respond to finasteride?predominant epithelial hyperplasia>> predominant stromal hyperplasia(collagen or smooth muscle predominance) reproductiveurologyUWorld HirotoShishido
vastectomy and viable spermpatient will have viable sperm in distal vas for 3 months and at least 20 ejaculations following vastectomy reproductiveurologyUWorld HirotoShishido
cystinuria
pathophysiologya defect in amino acid reabsorption in the ☆proximal tubule that leads to defective reabsorption of cystine, ornithine, lysine, and arginine(COLA)
the most common neurogenic cause of overflow incontinencediabetes mellitus(automatous bladder)
(pelvic nerve(sympathetic) is damaged) renalurology HirotoShishido
radiolucent kidney stoneradiolUcent(放射線透過性)
→Uric acid (5% of kidney stones)
(however, can be seen on noncontrast CT) urologyrenal HirotoShishido
center of urinationpontine strage center→stops micturation reflex
pontine micturation center(PMC)→allows micturation reflex
micturation center(S2,3)→micturation reflex(contraction of bladder,relaxation of sphincters) urology HirotoShishido