A Clinical Guide to Urologic Emergencies E-Book
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- Sprache: Englisch
A Clinical Guide to Urologic Emergencies
A Clinical Guide to Urologic Emergencies
An ageing population and a predicted shortfall in the number of urologists means that, increasingly, the management of complex urological problems will fall to hospital emergency departments and the surgeries of primary care physicians. With many doctors and medical students now having less exposure to urology, there is a real and urgent need for accessible and practical guidance in managing urologic emergencies.
A Clinical Guide to Urologic Emergencies offers practical guidance to the best practices in diagnosis, treatment and management of patients with urgent urological conditions. Designed to be an extremely useful tool to consult in the clinical setting, it will be a vital source of information and guidance for all clinicians, irrespective of their level of urologic knowledge.
Edited by an outstanding international editor team, this book is particularly aimed at physicians, advanced practice providers, and urology and emergency medicine trainees managing patients in diverse healthcare settings across the globe.
A Clinical Guide to Urologic Emergencies is accompanied by a website featuring video content at www.wiley.com/go/wessells/urologic
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Veröffentlichungsjahr: 2021
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Table of Contents
Cover
Title Page
Copyright Page
Dedication Page
List of Contributors
Preface
A Clinical Guide to Urologic Emergencies
References
List of Abbreviations
About the Companion Website
Section I: Upper Urinary Tract
1 Blunt Renal Injuries
Epidemiology, Etiology, Pathophysiology
Diagnosis
Management
Complications and Follow‐Up
Conclusions
References
2 Penetrating Renal Trauma
Introduction
Anatomy
Evaluation
Management
Conclusion
References
3 Renal Infections
Introduction
Acute Pyelonephritis
Emphysematous Pyelonephritis
Xanthogranulomatous Pyelonephritis
Chronic Pyelonephritis
Renal Abscess
Conclusions
References
4 Acute Kidney Stone Management
Introduction
History and Physical
Management of Symptoms
Medical Dissolution Therapy
Acute Procedural Intervention
Prognosis
Special Considerations
Conclusion
References
5 Traumatic Adrenal Hemorrhage
Introduction
Relevant Anatomy
Etiology
Staging
Presentation
Imaging
Management
Complications of Adrenal Trauma
Conclusion
References
6 External Ureteral Trauma
Introduction
Anatomical Considerations
Mechanisms of Injury
Concomitant Injuries
Diagnosis
Management
Complications
Conclusions
References
7 Iatrogenic Ureteral Injury
Introduction
Etiology
Management
Timing of Repair
Surgical Technique
Outcomes and Complications
Conclusions
References
Section II: Lower Urinary Tract
8 Bladder Injuries
Introduction
Long‐term Consequences
Complications
Conclusion
References
9 Traumatic Urethral Injuries
Introduction
Initial Management of Suspected Trauma to the Lower Urinary Tract
Urethral Trauma
Management in the Acute Phase
Delayed Management
Conclusions
References
10 Acute Management of Urethral Stricture
Introduction
Etiology of Urethral Stricture
Patient History and Physical Examination
Evaluation of Urethral Stricture
Emergency Management of Urinary Retention and Unexpected Urethral Stricture
Elective Management of Urethral Stricture
Post‐operative Follow‐Up
Conclusion
References
11 Prostatitis and Prostatic Abscess
Introduction
Classification
Presentation
Management
Diagnostic Imaging
Prostatic Abscess
Conclusions
References
Section III: External Genitalia
12 Fournier's Gangrene
Introduction
Epidemiology
Etiology
Bacteriology
Clinical Symptoms and Imaging
Treatment
Conclusions
References
13 Traumatic Penile Injuries
Introduction
Pathophysiology of Traumatic Penile Injury
Conclusions
References
14 Priapism
Introduction
Epidemiology
Pathophysiology and Causes
Evaluation and Diagnostic Workup
Treatment
Effects of Priapism on Erectile Function
Summary
References
15 Traumatic Scrotal and Testicular Injuries
Introduction
General Evaluation
Imaging
Management
Combat‐Related Scrotal Injuries
Considerations
Conclusions
References
16 Testicular Torsion
Introduction
Epidemiology
Pathophysiology
Presentation
Diagnostic Evaluation
Management
Outcomes
Conclusions and Future Directions
References
17 Epididymitis and Orchitis
Introduction
Anatomy and Physiology
Epidemiology
Pathophysiology
Infectious Epididymitis
Non‐infectious Epididymitis
Chronic Epididymitis
Diagnosis
Treatment
Complications
Conclusion
References
Section IV: Pediatric
18 Urologic Neonatal Emergencies
Introduction
Posterior Urethral Valves (PUV)
Epispadias, Bladder and Cloacal Exstrophy
Neonatal Testicular Torsion
Disorders of Sex Development
Female Genital Masses
Conclusions
References
Section V: COVID‐19
19 Urologic Emergency Care in the COVID‐19 Pandemic Era
Immediate Responses of Urology Departments
Surgical Triage
Telemedicine
Consequences of COVID‐19 on Urologic Care
Conclusions
References
Index
End User License Agreement
List of Tables
Chapter 1
Table 1.1 Demographics of renal trauma.
Table 1.2 2018 American Association for the Surgery of Trauma (AAST) organ in...
Table 1.3 Long‐term follow‐up recommendations.
Chapter 2
Table 2.1 AAST Renal injury classification, revised in 2018.
Chapter 3
Table 3.1 Factors associated with complicated UTI (pyelonephritis).
Table 3.2 Pathogens associated with complicated and uncomplicated UTI.
Table 3.3 Pathogens causing acute pyelonephritis [2].
Table 3.4 CT findings in acute pyelonephritis.
Table 3.5 Classification of emphysematous pyelonephritis.
Table 3.6 Factors associated with mortality in emphysematous pyelonephritis.
Table 3.7 Staging of Xanthogranulomatous pyelonephritis [56, 67].
Chapter 4
Table 4.1 Differential diagnosis of renal colic.
Table 4.2 Comparison of imaging modalities for renal colic.
Table 4.3 Indications for urgent decompression, via ureteral stenting or plac...
Table 4.4 Estimated spontaneous passage rate and time‐to‐passage, by stone wi...
Chapter 5
Table 5.1 The American Association for the Surgery of Trauma (AAST) organ inj...
Chapter 6
Table 6.1 AAST organ injury scale: ureter.
Table 6.2 Ureteral trauma: patterns and mechanism of injury.
Chapter 7
Table 7.1 Outcomes of ureteral reconstruction for injury
a
Chapter 9
Table 9.1 Classification of urethral injuries.
Table 9.2 Mechanisms of anterior urethra injury.
Chapter 11
Table 11.1 Empirical antibiotic choices for acute prostatitis.
Chapter 12
Table 12.1 Fournier's Gangrene Severity Index (FGSI).
Chapter 13
Table 13.1 American Association for the Surgery of Trauma (AAST Penis Injury ...
Chapter 14
Table 14.1 Blood gas findings in priapism.
Table 14.2 Etiology of ischemic priapism.
Table 14.3 Clinical findings in priapism.
Table 14.4 Treatment options for stuttering priapism.
Chapter 15
Table 15.1 AAST scrotal injury scale [16].
Table 15.2 AAST testicular injury scale [16].
Chapter 16
Table 16.1 Differential diagnosis of the acute scrotum.
Table 16.2 European Association of Urology summary of evidence and recommenda...
Table 16.3 Relationship between time, testis salvage, and testis atrophy.
a
Chapter 18
Table 18.1 Predictive amniotic fluid variables.
Chapter 19
Table 19.1 Urgent and emergent urological patients, mean (standard deviation)...
List of Illustrations
Chapter 1
Figure 1.1 American Association for the Surgery of Trauma (AAST) Organ Injur...
Figure 1.2 CT images of renal injuries including: (a) axial view of a left s...
Figure 1.3 Nomogram predicting bleeding interventions after high‐grade renal...
Figure 1.4 Surgical approach to renal vessels and hilum. (a) Relationship be...
Figure 1.5 Surgical management of vascular injuries. (a) Schematic showing i...
Chapter 2
Figure 2.1 The kidneys and their association with adjacent organs.
Figure 2.2 Proposed Proposed treatment algorithm. CT, computed tomography; H...
Figure 2.3 Twenty‐one‐year‐old male who sustained a GSW to the abdomen. He h...
Figure 2.4 Twenty‐five‐year‐old female who sustained multiple stab wounds wi...
Figure 2.5 Renorrhaphy. (a) Deep midrenal laceration into pelvis. Basic reco...
Figure 2.6 Forty‐four‐year‐old male who sustained a GSW with a grade III lef...
Chapter 3
Figure 3.1 Striated nephrogram in right kidney in acute pyelonephritis.
Figure 3.2 Emphysematous pyelonephritis of right kidney.
Figure 3.3 Emphysematous pyelonephritis with nephrostomy tube
in situ
.
Figure 3.4 Xanthogranulomatous pyelonephritis.
Figure 3.5 Left renal abscess (arrowhead).
Chapter 4
Figure 4.1 Suggested algorithm for diagnostic imaging for acute renal colic....
Figure 4.2 CT KUB demonstrating two ureteral stones (arrows) within the left...
Figure 4.3 Renal ultrasound shows a proximal ureteral stone (yellow cross ma...
Figure 4.4 Plain film abdominal x‐ray demonstrates a large radiopaque left p...
Figure 4.5 Plain film abdominal x‐ray demonstrates a right ureteral stent in...
Chapter 5
Figure 5.1 Vascular arrangement in the tail (A) and head/body (B) of the adr...
Figure 5.2 Contrast enhanced axial abdominal CT image demonstrating right ad...
Figure 5.3 Contrast enhanced axial abdominal CT image of a two‐year‐old pati...
Chapter 6
Figure 6.1 Right proximal ureteral injury after GSW. Note contrast extravasa...
Figure 6.2 Delayed nephrogram and hydronephrosis associated with right urete...
Figure 6.3 Missed distal ureteral injury detection and management. (a) Parti...
Figure 6.4 Antegrade nephrostogram after prior ureteral ligation due to majo...
Figure 6.5 Augmented anastomotic buccal ureteroplasty. (a) Viable ureteral e...
Chapter 7
Figure 7.1 Pre‐operative MRI of the prostate demonstrating a small cystic le...
Figure 7.2 Algorithm for the evaluation and management of iatrogenic uretera...
Figure 7.3 (a) Nephrostogram showing complete obstruction of the left ureter...
Figure 7.4 Uretero‐ureterostomy. Spatulated, tension‐free, mucosa‐to‐mucosa ...
Figure 7.5 Uretero‐ureterostomy. When the repair is performed intra‐abdomina...
Figure 7.6 Uretero‐calicostomy. The fully mobilized distal spatulated ureter...
Figure 7.7 Modified psoas hitch procedure. The fully mobilized bladder dome ...
Chapter 8
Figure 8.1. CT and fluoroscopic imaging of bladder rupture including: (a) co...
Chapter 9
Figure 9.1 Initial management in a stable patient with suspected lower urina...
Figure 9.2 Retrograde urethrography: (a) Patient positioning. (b) Cone‐tip s...
Figure 9.3 Thirty degree cranial tilt of x‐ray beam.
Figure 9.4 Partial and complete urethral injury: appearance on retrograde ur...
Figure 9.5 Anatomy of the male urethra.
Figure 9.6 Schematic anatomy of male and female urinary sphincter complex.
Figure 9.7 Anatomical relationships of the posterior urethra.
Figure 9.8 Bony pelvis anatomy.
Figure 9.9 Initial options for management of urethral trauma.
Figure 9.10 Initial management of urethral trauma.
Chapter 10
Figure 10.1 (a) RUG immediately after catheter removal in patient after fail...
Figure 10.2 A flow chart of emergent urethral stricture management.
Figure 10.3 A flow chart of elective urethral stricture management.
Figure 10.4 Surgical steps in urethroplasty according to stricture location....
Figure 10.5 RUG showing pan‐anterior urethral stricture secondary to lichen ...
Chapter 11
Figure 11.1 Axial image from contrast enhanced pelvic CT scan demonstrating ...
Figure 11.2 Axial (a) and saggital (b) image from contrast enhanced pelvic C...
Figure 11.3 Endoscopic images of transurethral drainage of the prostatic abs...
Chapter 12
Figure 12.1 The spreading infectious process may arise from local skin, urin...
Figure 12.2 Photograph of patient with violet/black color scrotal skin indic...
Figure 12.3 CT demonstrating gas in scrotum and posterior tracking into peri...
Figure 12.4 CT demonstrating gas in the scrotal wall consistent with subcuta...
Figure 12.5 Appearance of genitalia after surgical debridement for Fournier’...
Figure 12.6 Vacuum assisted closure device applied to large scrotal wound. F...
Chapter 13
Figure 13.1 Penile fracture: (a) Ecchymosis and eggplant deformity. (b) Ultr...
Figure 13.2 Penile amputation reattachment with urethra anastomosis complete...
Figure 13.3 Penile amputation reattachment tunica albuginea anastomosis comp...
Chapter 14
Figure 14.1
Penile ultrasonography
of patients with priapism. (a) Color dupl...
Figure 14.2 Algorithm for the management of priapism.
Figure 14.3 Conceptual basis for distal shunts for ischemic priapism. Note t...
Figure 14.4 Percutaneous cavernosal spongiosal shunts. Top: Winter shunt wit...
Figure 14.5 Al‐Ghorab distal shunt in which a transverse incision in the gla...
Figure 14.6 Proximal shunt (Quackel’s). Note the shunts are bilateral in thi...
Chapter 15
Figure 15.1 Ultrasonography demonstrating irregular hypoechoic regions with ...
Figure 15.2 Ultrasonography demonstrating a 1‐cm intratesticular hematoma....
Figure 15.3 Axial CT scan demonstrating dislocated right testis lying within...
Figure 15.4 Extensive debridement following skin and soft tissue injury incl...
Figure 15.5 Severe IED‐related perineal trauma resulting in complete loss of...
Figure 15.6 Bilateral testicular injury with extensive hematoma and loss of ...
Chapter 16
Figure 16.1 Bell clapper deformity with a horizontal testis lie.
Figure 16.2 Color Doppler ultrasound of a patient with testicular torsion of...
Figure 16.3 Ultrasound of a patient with prolonged torsion, showing heteroge...
Figure 16.4 A torsed spermatic cord found on early surgical intervention....
Figure 16.5 A cyanotic testis with hemorrhagic change to the epididymis foun...
Chapter 17
Figure 17.1 Ultrasonographic findings of acute epididymitis showing increase...
Chapter 18
Figure 18.1 Prenatal maternal ultrasound of a fetus with PUV. (a) Bladder pr...
Figure 18.2 Neonate with PUV and ascites that extends into the scrotum.
Figure 18.3 (a) Double J stent in place in a patient with PUV with the proxi...
Figure 18.4 Classic findings of voiding cystourethrogram. Arrow highlights t...
Figure 18.5 (a) Cold knife valve ablation. (b) Verum montanum and utricle or...
Figure 18.6 Blocksom vesicostomy on a neonate with posterior urethral valves...
Figure 18.7 Radiologic image of a retrograde pyelogram on a patient with Y‐S...
Figure 18.8 (a) Epispadias demonstrating dorsal urethral plate, (b) bladder ...
Figure 18.9 Left‐side Neonatal testicular torsion. Patient is explored and c...
Figure 18.10 Paraurethral cyst secondary to Skene’s glands obstruction.
Figure 18.11 Prolapsed ureterocele causing urinary retention on a 12‐hour ne...
Figure 18.12 Prolapsed ureterocele with some mucosal congestion and urinary ...
Figure 18.13 Prolapsed urethral mucosa. Beefy‐red friable to touch.
Figure 18.14 Urethral polyp. Pedunculated lesion that extends beyond the int...
Figure 18.15 Imperforated hymen. Bulging whitish mass with and intact urethr...
Chapter 19
Figure 19.1 COVID‐19 case rates in Washington State, March–October 2020. Ins...
Figure 19.2 Diagram of physical layout and criteria for specialty consultati...
Figure 19.3 Clinical activity including outpatient and surgical cases as mea...
Figure 19.4 Outpatient visit volumes by type within UW Medicine Department o...
Guide
Cover Page
Title Page
Copyright Page
Dedication Page
List of Contributors
Preface
List of Abbreviations
About the Companion Website
Table of Contents
Begin Reading
Index
Wiley End User License Agreement
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A Clinical Guide to Urologic Emergencies
Edited by
Hunter Wessells, MD, FACS
Professor and Nelson Chair of Urology
Department of Urology
University of Washington School of Medicine
Seattle, WA, USA
Shigeo Horie, MD, PhD
Professor and Chairman
Department of Urology
Juntendo University Graduate School of Medicine
Tokyo, Japan
Reynaldo G. Gómez, MD, FACS
Chief of Urology
Hospital del Trabajador
Santiago, Chile
This edition first published 2021© 2021 John Wiley & Sons Ltd
All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, except as permitted by law. Advice on how to obtain permission to reuse material from this title is available at http://www.wiley.com/go/permissions.
The right of Hunter Wessells, Reynaldo G Gómez, Shigeo Horie to be identified as the authors of the editorial material in this work has been asserted in accordance with law.
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Library of Congress Cataloging‐in‐Publication Data
Names: Wessells, Hunter, editor. | Horie, Shigeo, 1960– editor. | Gómez, Reynaldo Guillermo, editor. Title: A clinical guide to urologic emergencies / edited by Hunter Wessells, Shigeo Horie, Reynaldo Guillermo Gómez. Description: Hoboken, NJ : Wiley‐Blackwell, [2021] | Includes bibliographical references and index. Identifiers: LCCN 2020040342 (print) | LCCN 2020040343 (ebook) | ISBN 9781119021476 (cloth) | ISBN 9781119021483 (Adobe PDF) | ISBN 9781119021490 (epub) Subjects: MESH: Male Urogenital Diseases | Urogenital System–injuries | Emergencies Classification: LCC RC874.8 (print) | LCC RC874.8 (ebook) | NLM WJ 140 | DDC 616.6/025–dc23 LC record available at https://lccn.loc.gov/2020040342LC ebook record available at https://lccn.loc.gov/2020040343
Cover Design: WileyCover Images: X‐ray and ultrasound images © Hunter Wessells, Image of the kidneys and their association with adjacent organs © Daniel Burke, University of Washington
Dedication
To all those who served in the COVID‐19 pandemic and to those we lost.
To the patients, students, residents, fellows and colleagues at UW Medicine and Harborview who contributed to the knowledge in this volume, as well as my family for their unwavering support. H.W.
To my patients, colleagues, and students past, present and future. To my family for their support. To my mentors of emergency medicine, Drs. Mii, Toyooka and Morita for enlightening and inspiring me. S.H.
To my parents for the effort they put into my education, my masters for guiding my curiosity, my patients for their trust, my hospital’s staff support along over 35 years and my family for their patience and for inspiring my work. R.G.G.
List of Contributors
Justin S. AhnDepartment of Urology, UCSF School of Medicine, San Francisco, CA, USA
Nayib FakihDivision of Urology, Hospital Universitario San Ignacio, Pontificia Universidad Javeriana, Bogota, Colombia
Nicolas FernandezDivision of Pediatric Urology, Seattle Children's Hospital, University of Washington, Seattle, WA, USA
Bradley D. FiglerDepartment of Urology, University of North Carolina‐Chapel Hill, Chapel Hill, NC, USA
Ariel FredrickLahey Hospital and Medical Center, Lahey Institute of Urology at Portsmouth and Rochester, Portsmouth and Rochester, NH, USA
Dr. Juan FulláClinica Las Condes, Las Condes, Chile
Reynaldo G. GómezUrology Service, Hospital del Trabajador, Santiago, Chile
Marios HadjipavlouGuy's Hospital, London, UK
Lindsay A. HampsonDepartment of Urology, UCSF School of Medicine, San Francisco, CA, USA
Jonathan D. HarperDepartment of Urology, University of Washington School of Medicine, Seattle, WA, USA
Sarah K. HoltDepartment of Urology, University of Washington School of Medicine, Seattle, WA, USA
Shigeo HorieDepartment of Urology, Juntendo University Graduate School of Medicine, Tokyo, Japan
Akio HoriguchiDepartment of Urology, National Defense Medical College, Tokorozawa, Japan
Steven J. HudakUT Southwestern Medical Center, Dallas, TX, USA
Kazuyoshi IijimaDepartment of Urology, Nagano Municipal Hospital, Nagano, Japan
Akash A. KapadiaDepartment of Urology, University of Washington School of Medicine, Seattle, WA, USA
Haruaki KatoDepartment of Urology, Nagano Municipal Hospital, Nagano, Japan
Kosuke KitamuraDepartment of Urology, Juntendo University Graduate School of Medicine, Tokyo, Japan
Rajeev KumarAll India Institute of Medical Sciences, New Delhi, India
Rachel McKenzieDepartment of Urology, University of Washington School of Medicine, Seattle, WA, USA
Joseph MenoDepartment of Urology, University of Washington School of Medicine, Seattle, WA, USA
Nnenaya MmonuDepartment of Urology, UCSF School of Medicine, San Francisco, CA, USA
Yosuke NakajimaKawasaki Municipal Ida Hospital, Kawasaki, Japan
Brusabhanu NayakAll India Institute of Medical Sciences, New Delhi, India
Tomohiko OguchiDepartment of Urology, Nagano Municipal Hospital, Nagano, Japan
Kevin OstrowskiDepartment of Urology, University of Washington School of Medicine, Seattle, WA, USA
Rishi R. SekarDepartment of Urology, University of Washington School of Medicine, Seattle, WA, USA
Davendra SharmaSt George's Hospital, London, UK
Alexander J. SkokanHarborview Medical Center, University of Washington School of Medicine, Seattle, WA, USA
Nitin SrivastavaAll India Institute of Medical Sciences, New Delhi, India
Hong TruongDepartment of Urology, Thomas Jefferson University Hospital, Philadelphia, PA, USA
Alex J. VanniCenter for Reconstructive Urologic Surgery, Lahey Hospital and Medical Center, Burlington, MA, USA
Laura G. VelardeUrology Service, Hospital del Trabajador, Santiago, Chile
Humberto G. VillarrealLoma Linda University Medical Center, Loma Linda, CA, USA
Thomas J. WalshDepartment of Urology, University of Washington School of Medicine, Seattle, WA, USA
Dana A. WeissThe Children's Hospital of Philadelphia, Philadelphia, PA, USA
Hunter WessellsDepartment of Urology, University of Washington School of Medicine, Seattle, WA, USA
Jonathan WingateMadigan Army Medical Center, Tacoma, WA, USA
Seiji YanoDepartment of Urology, Nagano Municipal Hospital, Nagano, Japan
Norman ZambranoClinica Las Condes, Las Condes, Chile
Preface
A Clinical Guide to Urologic Emergencies
The burden of urological disease worldwide is driven by a range of common conditions, some of which impair health acutely and others through chronic pathophysiological processes. Urological emergencies, when untreated, can lead to death, permanent disability, and lifelong reductions in quality of life. History is replete with examples including urinary stone disease in ancient Egypt and descriptions of combat wounds by Ambrose Pare in the Renaissance; this book will highlight common indications for acute urological intervention as well the emergence of unforeseen mechanisms of injury such as necrotizing genital skin infections associated with the introduction of novel sodium‐glucose cotransporter 2 (SGLT2) inhibitors for diabetes and the contemporary battlefield injuries of such immense complexity as to require the re‐engineering of military care.
Variation in population demographics, access to care, workforce capacity, and technology have a profound effect on how a given segment of the population will experience illness. The Global Burden of Disease, a tool to quantify health loss from hundreds of diseases, injuries, and risk factors, demonstrates that the determinants of health vary greatly by geography, whether continent‐, country‐, or county‐level. These disparities have been brought into sharper focus by the pandemic of COVID‐19, which exerts a disproportionate impact on individuals from minority populations in the United States and worldwide. These same at‐risk populations also shoulder an excess burden of disease due to war, cyclic violence, road traffic injuries, and diseases for which access to emergency care is essential.
Population growth worldwide, changing epidemiology of disease, and human migration and displacement will exacerbate emergency urological needs across the lifespan and across the spectrum of global wealth. For healthcare providers in high income countries (HIC), motor vehicle collisions, obstructing urinary calculi, urinary tract infections (UTI), and the cumulative burden of urological diseases associated with aging and comorbid chronic disease such as diabetes and cardiovascular disease will drive urgent and emergent healthcare utilization. Urological surgery to improve health in low and middle‐income countries (LMIC) has a critical focus on the broader impact of road traffic accidents, urethral stricture, advanced benign prostatic obstruction and genitourinary infections. The Lancet Commission on Global Surgery achieved consensus that HIC actors should work in equal partnership with LMIC actors and should situate efforts to improve the delivery of surgical care within the broader health systems strengthening agenda.
The editors have collaborated to present a global perspective, encompassing a diversity of healthcare environments, patient populations, and authors to ensure that the content of this book will be relevant to the widest range of healthcare providers. Acknowledging that not all urological care can or should be delivered by urologists, we provide detailed information for first‐line providers in urgent care, emergency, and office‐based settings. Where indicated we call out alternative laboratory testing, imaging, and treatments for situations in which resources preclude the use of technology intensive and costly choices. Similarly, the publisher has aimed to provide a low‐cost textbook with digital imprint to ensure wide accessibility.
We organized the content by organ systems, allowing the reader to go from “top to bottom” of the genitourinary system, or cut to the chase and find a specific chapter as a point of reference. An important feature incorporates perspectives on traumatic injuries from the civilian and military environments. Unfortunately, war and road traffic will place increasing burdens on civilian populations and healthcare systems. Thus, the inclusion of military and civilian perspectives allows for innovation, cross pollination, and preparedness. The burden of congenital anomalies cannot be eradicated and will require surgical and non‐surgical interventions across decades of a person’s life; early treatment can have enormous benefit and thus we include a chapter on neonatal emergencies.
Completing this book in the midst of a global pandemic, it is important to recognize that diagnosis and treatment of many urological conditions will be deferred because of limited access to routine care, surgery, and even emergency services. The frequency of extreme weather events, resource scarcity, and other factors will likely lead to other severe disease outbreaks that will further limit access to care and drive greater pressure on emergency urological services. Thus, it is instructive to estimate the burden of the COVID‐19 toll of deferred urological problems, which will come to the fore as pressure eases on ICU and Emergency Departments worldwide. We have added a special chapter on the topic.
References
http://www.healthdata.org/gbd/about
Ng‐Kamstra JS, Greenberg SLM, Abdullah F, et al. Global Surgery 2030: a roadmap for high income country actors. BMJ Glob Health. 2016; 1(1): e000011.
https://www.brookings.edu/research/the‐climate‐crisis‐migration‐and‐refugees/
List of Abbreviations
Abbreviation
Expansion
AAST
American Association for the Surgery of Trauma
ACCI
Age
Adjusted Charlson Comorbidity Index
ACTH
adrenocorticotropic hormone
AFB
acid fast bacilli
ATLS
Advance Trauma and Life Support
AUA
American Urological Association
AUA‐SI
American Urological Association Symptom Index
AVF
arteriovenous fistula
BCG
bacillus Calmette Guérin (vaccine)
BI
blast injury
BRI
blunt renal injury
Ca
calcium
CAH
congenital adrenal hyperplasia
CBC
complete blood count
CDC
Centers for Disease Control and Prevention
CDUS
color Doppler ultrasound
CKD
chronic kidney disease
Cl
chloride
CMV
cytomegalovirus
CNS
central nervous system
COPUM
congenital obstructing posterior urethral membranes
CT
computed tomography
DHT
dihydrotestosterone
DMSA
dimercaptosuccinic acid
DSD
disorders of sex development
DVIU
direct vision internal urethrotomy
EAU
European Association of Urology
ED
erectile dysfunction
EP
extraperitoneal
EPA
excision and primary anastomosis
EPN
emphysematous pyelonephritis
ESRD
end‐stage renal disease
ERMS
embryonal rhabdomyosarcoma
FG
Fournier's gangrene
FGSI
Fournier's Gangrene Severity Index
FSH
follicle stimulating hormone
GSW
gunshot wound
GU
genitourinary
GUTB
genitourinary tuberculosis
HbS
hemoglobin S
HCT
hematocrit
HIC
high income countries
HIV
Human Immunodeficiency Virus
ICU
intensive care unit
IDSA
Infectious Disease Society of America
IED
improvised explosive devices
IgA
Immunoglobulin A
IIEF
International Index of Erectile Function
IM
intramuscular
INR
international normalized ratio
IP
intraperitoneal
IR
interventional radiology
IRSG
Intergroup Rhabdomyosarcoma Study Group
ISS
Injury Severity Score
IVC
inferior vena cava
IVU
intravenous urogram/urography
LH
luteinizing hormone
LMIC
low‐ and middle‐income countries
LS
lichen sclerosus
MEDC
more economically developed countries
MET
medical expulsive therapy
MiGUTS
Multi‐institutional Genito‐Urinary Trauma Study
MRI
magnetic resonance imaging
Na
sodium
NIE
noninfectious epididymitis
NOM
non‐operative, management
NPWT
negative‐pressure wound therapy
NSAID
nonsteroidal anti‐inflammatories
NSTI
necrotizing soft tissue infection
NTDB
National Trauma Data Bank
NTT
neonatal testicular torsion
OEIS
omphalocele, exstrophy of the bladder, imperforate anus, and spinal abnormalities complex
OIS
Organ Injury Scaling
ORIF
open reduction internal fixation
Osm
osmolarity
PCD
percutaneous drainage
PCN
percutaneous nephrostomy
PCO
2
partial pressure of carbon dioxide
PCR
polymerase chain reaction
PDDU
penile duplex doppler ultrasonography
PDE‐5
phosphodiesterase‐5
PDS
polydioxanone suture
PFUI
pelvic fracture urethral injury
PO
2
partial pressure of oxygen
PRI
penetrating renal injury
PROM
patient reported outcome measurement
PSV
peak systolic velocity
PT
prothrombin time
PTT
partial thromboplastin time
PUV
posterior rethral valves
PVR
post void residual
ROC
receiver operator characteristic
RUG
retrograde urethrogram
SCD
sickle cell disease
SD
standard deviation
SIU
Societe Internationale d’Urologie
STI
sexually transmitted infections
T1
T1 weighted image
T2
T2 weighted image
TUR
transurethral resection
TWIST score
Testicular Workup for Ischemia and Suspected Torsion
UA
urinalysis
UFGSI
Uludag Fournier's Gangrene Severity Index
UPEC
uropathogenic
E. coli
UPJ
ureteropelvic junction
US
ultrasound
USG
ultrasonography
US‐PVR
ultrasonographic post void residual
UTI
urinary tract infection
VAC
vacuum‐assisted closure
VCUG
voiding cystourethrography
VUR
vesicoureteral reflux
WHO
World Health Organization
XGP
xanthogranulomatous pyelonephritis
XR
x‐ray
About the Companion Website
This title is accompanied by a website:
www.wiley.com/go/wessells/urologic
The website contains key videos related to the following chapters in the book:
Chapter 2. CT scan of penetrating renal injury
Chapter 4. Ureteroscopic stone treatment (laser lithotripsy and basket extraction)
Chapter 6. Robotic ureteral reconstruction with buccal mucosa graft
Chapter 9. Urethral elongation after pelvic fracture urethral injury
Chapter 9. Urethral disruption after pelvic fracture urethral injury
Chapter 9. Endoscopic urethral realignment after pelvic fracture urethral injury
Chapter 10. Excision and primary anastomosis of bulbar urethral stricture
Chapter 11. Transurethral drainage of prostatic abscess
