Blandy's Urology E-Book

• Herausgeber: John Wiley & Sons
• Kategorie: Fachliteratur
• Sprache: Englisch

Seitenzahl: 2049

Veröffentlichungsjahr: 2019

Beschreibung

Blandy's Urology, 3rd edition is set to become a classic in its field, the latest edition of one of the most well-loved general urology textbooks for urologists and surgeons alike, successfully combining both general urology and urologic surgery.  Its key strength is the unique ‘Blandy way’ of describing urological diseases and their management, consisting of:

• clear, straightforward, uncomplicated descriptions of disease/conditions, including hundreds of clinical photos
• an abundance of outstanding drawn surgical diagrams to illustrate best technique in the operating theatre
• a focus on the most commonly seen problems in the clinic
• organization of each topic under anatomical headings

Especially loved by urology and surgery trainees for its straightforward approach to the speciality and as a preparation for speciality urology exams, consultants and specialists also value it as a handy refresher tool. 

Leseprobe

Table of Contents

Cover

Preface

List of Contributors

Part I:

1 Armaments in Urology

1.1 Principles of Urological Technology

1.1.1 Optics in Urology

1.1.2 Surgical Energy

1.1.3 Dangers

1.1.4 Urological Diathermy

1.1.5 Lasers in Urology

1.1.6 Catheters

1.1.7 Stents

1.1.8 Guidewires

References

1.2 Wound Healing in the Urinary Tract

1.2.1 Introduction

1.2.2 Wound‐Healing Process

1.2.3 Vascular Response

1.2.4 Cellular Response

1.2.5 Urinary Tract Healing

1.2.6 Different Methods of Making Surgical Incisions

1.2.7 Von Brunn's Nests and Metaplasia

1.2.8 Squamous Metaplasia

1.2.9 Heterotopic Ossification

1.2.10 Regeneration of Smooth Muscle in the Urinary Tract

1.2.11 Particular Effects of Urine

1.2.12 Suture Materials, Splints, Meshes, and Films

References

1.3 Simulation in Urology

1.3.1 Introduction

1.3.2 History of Simulation in Medicine

1.3.3 Simulation Modalities

1.3.4 Simulation in Urology

1.3.5 Endourology Simulation

1.3.6 Laparoscopy Simulation

1.3.7 Robotic Surgery Simulation

1.3.8 Nontechnical Skills Simulation

1.3.9 Simulation Training Curriculums

1.3.10 Assessment of Trainees

1.3.11 Future of Simulation

References

2 Principles of Medical Statistics

2.1 Introduction

2.2 Descriptive Statistics

2.3 Confidence Intervals

2.4 Significance Tests

2.5 Relationships between Variables

2.6 Diagnostic Tests

2.7 Study Design

2.8 Number Needed to Treat

2.9 Systematic Reviews and Meta‐Analysis

References

3 Embryology for the Urologist

3.1 Historical Consideration

3.2 Introduction

3.3 Embryology of the Kidneys and Ureters

3.4 Embryology of the Bladder

3.5 Embryology of the Indifferent Genital System

3.6 Embryology of the Male Genital System

3.7 Embryology of the Prostate

3.8 Embryology of the Penis and Urethra

3.9 Neuter State

3.10 Embryology of the Female Genital System

3.11 Embryology of the Adrenal Gland

References

4 Principles of Urologic Oncology

4.1 The Scope of Urologic Oncology

4.2 Carcinogenesis

4.3 Molecular Biology of Cancer Growth

4.4 Tumour‐Promoting Inflammation

4.5 Reprogramming Energy Metabolism

4.6 Evading Immune Destruction

4.7 The Tumour Microenvironment

4.8 The Rate of Cancer Growth

4.9 Principles of Treatment

4.10 Oncologic Surgery

References

Part II:

5 Kidney and Ureter Anatomy

5.1 Comparative Anatomy

5.2 Renal Fasciae

5.3 Macroscopic Appearances

5.4 Arterial Supply

5.5 Renal Veins

5.6 Common Vascular and Anatomic Variations

5.7 Lymphatics

5.8 Innervation of the Kidney

References

6 Kidney and Ureter Physiology

6.1 Glomerular Filtration Rate

6.2 Renal Tubules

6.3 Hormonal Function of the Kidney

6.4 Special Disorders of Renal Tubules

6.5 Acid–Base Metabolism

6.6 Obstructive Uropathy

6.7 Ureteric Physiology

6.8 Whitaker Test

References

7 Renal Failure

7.1 Acute Kidney Injury

7.2 Chronic Kidney Disease

7.3 Dialysis

References

8 Renal Transplant

8.1 The Patients and the Kidneys

8.2 Technique of Removal of Donor Kidneys

8.3 Immunology of Organ Transplantation

8.4 Graft Rejection

8.5 Immunosuppression

References

9 Kidney and Ureter

9.1 Introduction

9.2 Congenital Abnormalities of the Kidney

9.3 Congenital Abnormalities of the PUJ

References

10 Hydronephrosis

10.1 Definition

10.2 Incidence

10.3 Pathophysiology

10.4 Diagnostic Imaging

10.5 Complications of Hydronephrosis

10.6 Management (General Principles)

10.7 Perinatal Hydronephrosis

10.8 Pelviureteric Junction Obstruction

10.9 Retrocaval Ureter

10.10 Duplication Anomalies, Ectopic Ureter, and Ureteroceles

10.11 VUR

10.12 Megaureter

10.13 Ureteral Strictures

References

11 Kidney and Ureter Trauma

11.1 Kidney Injuries

11.2 Ureteral Injuries

References

12 Kidney and Ureter Inflammation

12.1 Medical Inflammatory Conditions of the Kidney

12.2 Acute Surgical Inflammatory Conditions of the Kidney

12.3 Chronic Surgical Inflammatory Conditions of the Kidney

12.4 Other Inflammatory Conditions of the Kidney

12.5 Inflammatory Conditions of the Ureters

References

13 Kidney and Ureter Neoplasm

13.1 Kidney Neoplasms

13.2 Benign Renal Masses

13.3 Ureter and Renal Pelvis Neoplasms

References

14 Kidney and Ureter Calculi

14.1 Epidemiology

14.2 Pathophysiology

14.3 Formation of Calculi in the Kidney

14.4 Common Types of Urinary Stones

14.5 Clinical Features

14.6 Complications of Stones

14.7 Investigations

14.8 Investigations for Metabolic Stone Disease

14.9 Medical Management of Stones

14.10 Surgery for Stones

References

15 Kidney and Ureter Vascular Disorders

15.1 Congenital Anomalies of the Renal Vessels

15.2 Renal Artery Disorders

15.3 Disorders of the Renal Veins

References

16 The Adrenal Glands

16.1 Principles of Endocrine Surgery

16.2 Anatomy

16.3 Physiology

16.4 Pathology

16.5 Pathology of the Adrenal Medulla

16.6 Congenital Disorders of the Adrenals

16.7 Trauma

16.8 Inflammation

References

Part III:

17 Bladder and Urethra Structure and Function

17.1 Anatomy

17.2 Physiology

References

18 Bladder Congenital Anomalies

18.1 Embryology [1, 2]

18.2 Exstrophy‐Epispadias Complex

18.3 Urachal Anomalies

18.4 Bladder Diverticula

18.5 Disorders of Development of the Sacrum

18.6 UTI in Children [91, 92]

References

19 Bladder Trauma

19.1 Bladder Injuries

References

20 Bladder Inflammation

20.1 Introduction and Definitions

20.2 Acute Cystitis or Lower UTI

20.3 Chronic Interstitial Cystitis and Bladder Pain Syndrome

20.4 Tuberculosis

20.5 Parasitic Infections

20.6 Amoebiasis

20.7 Worm Infestations

20.8 Catfish

References

21 Bladder Neoplasm

21.1 Bladder Neoplasm

21.2 Field Biopsies

21.3 Pathology

21.4 Malignant Tumours of the Bladder

21.5 Grading of Transitional Cell Carcinoma

21.6 Staging of Bladder Tumours

21.7 Risk Stratification after Transurethral Resection of Bladder Tumour

21.8 Treatment of Transitional Cell Carcinoma

21.9 Muscle‐Invasive Bladder Cancer

21.10 Recurrence and Follow‐up of MIBC

21.11 Management of Locally Advanced MIBC (T3b/T4) and Metastatic Disease (N1 or M1)

21.12 Bladder Cancer Variants

References

22 Urinary Diversion

22.1 Urinary Diversions

22.2 Bladder Urinary Diversion

22.3 Functional Follow‐Up

22.4 Quality of Life Urinary Diversion after Cystectomy

References

23 Bladder Disorder of Function

23.1 Introduction

23.2 Investigating Bladder Function

23.3 Disorders of Function

23.4 Urethral Disorders

References

24 Fistulae and Sinuses

24.1 Principles and Definitions

24.2 Pathophysiology

24.3 General Complications

24.4 Organ‐Specific Fistulae

References

Part IV:

25 Prostate Structure and Function

25.1 Comparative Anatomy

25.2 Maturation of the Prostate

25.3 Anatomy of the Prostate

25.4 Prostate Physiology

References

26 Prostate Inflammation

26.1 Classification of Prostatitis

26.2 Investigations

26.3 Imaging

26.4 Serum Prostate Specific Antigen

26.5 Histology

26.6 Treatment Options

26.7 Upoint Phenotypic Classification of CP/CPPS

26.8 Surgical Options

26.9 Heat Therapies

26.10 Prostate Tuberculosis

26.11 Summary

References

27 Prostate Benign Prostatic Hyperplasia

27.1 Nomenclature

27.2 Aetiology

27.3 Pathology of BPH

27.4 Complications of BPH

27.5 Epidemiology and Natural History of BPH

27.6 Investigations

27.7 Management

27.8 Surgical Management

References

28 Prostate Neoplasm

28.1 Epidemiology

28.2 Aetiology

28.3 Clinical Features

28.4 Prognosis

28.5 Investigations

28.6 Pathology, Histopathology, and Molecular Pathology

28.7 Management, Treatments, and Patient Selection

28.8 Androgen‐Deprivation Therapy

28.9 Castration‐Resistant Prostate Cancer

28.10 The Role of TURP for Voiding Symptoms Associated with PCa

28.11 Controversies, Cutting‐Edge Developments, and Hot Topics

References

Part V:

29 Penis and Urethra Structure and Penis

29.1 Anatomy and Physiology

29.2 The Penis

29.3 The Scrotum

29.4 The Urethra

29.5 Erection

29.6 Function of the Scrotum

References

30 Penis and Urethra and Prostate Congenital Anomalies

30.1 Foreskin

30.2 Hypospadias

30.3 Primary Epispadias

30.4 Posterior Urethral Valves

30.5 Prostatic Utricle

30.6 Syringocele

30.7 Anterior Urethral Valves

30.8 Urethral Duplication

30.9 Urethral Anomalies in Anorectal Malformations

30.10 Interesting Terminologies

References

31 Penis and Urethra Trauma

31.1 Penis and Scrotum

31.2 Urethral Trauma

References

32 Penis and Urethra Inflammation

32.1 Urethral Inflammation

32.2 Penile Inflammation

32.3 Other Urethro‐Peno‐Scrotal Pathologies

32.4 Stricture Disease of the Urethra

32.5 Pelvic Fracture Urethral Injury

References

33 Penis and Urethra Neoplasm

33.1 Penile Neoplasm

33.2 Lymph Node Disease

33.3 Urethral Neoplasm

References

34 Penis and Urethra Disorders of Function

34.1 Erectile Dysfunction

34.2 Premature Ejaculation

34.3 Retrograde Ejaculation

34.4 Anejaculation

34.5 Priapism

34.6 Peyronie Disease

34.7 Late Onset Hypogonadism

References

Part VI:

35 Testes Structure and Function

35.1 Comparative Anatomy

35.2 Topographical Anatomy

35.3 Blood Supply and Lymphatic Drainage

35.4 Epididymis

35.5 Vas Deferens

35.6 Seminal Vesicle

35.7 Verumontanum

35.8 Spermatic Cord

35.9 Testicular Physiology

References

36 Testes Congenital and Childhood Anomalies

36.1 Congenital Anomalies of the Testis

36.2 Inguinoscrotal Masses

36.3 The Acute Scrotum

References

37 Testes Trauma and Inflammation

37.1 Testicular Trauma

37.2 Inflammatory Diseases of the Testicle

37.3 Chronic Inflammation

37.4 Treatment

References

38 Testes Benign Swelling

38.1 Hydrocele

38.2 Epididymal Cyst

38.3 Benign Testicular Cyst

38.4 Testicular Torsion

38.5 Polyorchidism

38.6 Varicocele

38.7 Orchialgia

38.8 Nux Amatoris

References

39 Testes Neoplasm

39.1 History

39.2 Incidence

39.3 Basic Embryology

39.4 Aetiology and Risk Factors

39.5 Clinical Features

39.6 Diagnosis

39.7 Staging

39.8 Method of Spread

39.9 Prognosis

39.10 Treatment

39.11 Nongerm Cell Tumours

39.12 Tumours Containing Both Germ Cell and Sex Cord or Gonadal Stromal Elements: Gonadoblastoma

39.13 Other Tumours of the Testis

39.14 Tumours of the Paratesticular Structures

References

40 Male Infertility

40.1 Incidence

40.2 Definitions

40.3 History and Examination

40.4 Aetiology

40.5 Investigations for Male Infertility

40.6 Testis Biopsy

40.7 Treatment of Male Infertility

40.8 Assisted Conception Techniques

40.9 Varicocele Repair

40.10 Medical Treatment of Male Infertility

References

41 Vasectomy and Seminal Vesicle Disorders

41.1 Seminal Vesicles

41.2 Vasectomy

References

Index

End User License Agreement

List of Tables

Chapter 1a

Table 1.1.1 Lasers used in urology.

Table 1.1.2 Colour coding for different catheter sizes.

Chapter 1b

Table 1.2.1 Suture types, material, and absorption time.

Table 1.2.2 Mesh types, characteristics, and material.

Chapter 1c

Table 1.3.1 Endourology simulators and there validation.

Table 1.3.2 Laparoscopy simulators and there validation.

Table 1.3.3 Robotic simulators and their validation.

Table 1.3.4 Operating theatre team NOTECHS assessment tool.

Table 1.3.5 Definitions of terms related to competence, training and assessme...

Chapter 2

Table 2.1 Summary statistics: Definitions.

Table 2.2 Results post surgery.

Table 2.3 Diagnostic tests.

Table 2.4 Estimates of risk.

Chapter 3

Table 3.1 Table of developmental timings.

Chapter 4

Table 4.1 Cycle action of common chemotherapeutics.

Table 4.2 Mechanisms of action of commonly used chemotherapy drugs.

Table 4.3 Karnofsky performance scale.

Chapter 7

Table 7.1 AKIN grading of acute kidney injury (AKI).

Table 7.2 Prerenal causes of acute kidney injury (AKI).

Table 7.3 Causes of intrinsic acute kidney injury (AKI).

Table 7.4 Causes of obstructive acute kidney injury (AKI).

Chapter 8

Table 8.1 Approximate risk of recurrence of renal disease in the transplanted...

Table 8.2 Organ donation rates in different countries (per million inhabitant...

Table 8.3 Recommended minimum recurrence‐free survival (years) after curative...

Table 8.4 Contraindications for organ donation.

Table 8.5 Diagnostic criteria for brain death.

Table 8.6 Possible causes and differential diagnosis of delayed graft functio...

Table 8.7 Common maintenance immunosuppressive combination regimens.

Chapter 9

Table 9.1 The SFU‐Grading System for Hydronephrosis takes into account three ...

Chapter 10

Table 10.1 Causes of obstructive nephropathy.

Table 10.2 Phases of ureteric obstruction.

Table 10.3 Causes of antenatal hyronephrosis (ANH).

Table 10.4 Normal values for urinary tract dilation classification system.

Table 10.5 Causes of extrinsic and intrinsic pelviureteric junction obstructi...

Table 10.6 Presenting symptoms of pelviureteric junction (PUJ) obstruction.

Table 10.7 International reflux classification and suggested management of ve...

Chapter 11

Table 11.1 CT‐based grading system of renal injury by AAST.

Table 11.2 Ureteral injury with various procedures.

Table 11.3 Classification of ureteral injury.

Table 11.4 Principles of ureteral repair.

Chapter 12

Table 12.1 Summary of glomerulonephritides.

Table 12.2 Causes of acute and chronic tubulointerstitial renal disease [1]....

Table 12.3 Risk factors for pyelonephritis in adults.

Table 12.4 Definitions of used terms for infection [2, 3].

Table 12.5 Classification of EPN based in CT findings [12, 14].

Table 12.6 Risk factors for XPN.

Table 12.7 Manifestations of genitourinary TB infection and common routes of ...

Table 12.8 Principles of ureteric anastomosis.

Table 12.9 High‐risk groups for the development of renal malakoplakia.

Chapter 13

Table 13.1 Pathology of renal masses.

Table 13.2 Renal cell carcinoma subtype histological classification.

Table 13.3 Clinical features of renal cell carcinoma.

Table 13.4 TNM classification of renal cancer.

Table 13.5 Fuhrman (nuclear) grading system.

Table 13.6 Prognostic stratification for survival of patients with metastatic...

Table 13.7 Prognostic stratification for survival of patients with metastatic...

Table 13.8 Based on European Association of Urology recommendation for renal ...

Table 13.9 Staging and risk stratification for Wilms tumour.

Table 13.10 Postoperative treatment of Wilms tumour based on stage and histol...

Table 13.11 Pathological prediction of survival.

Table 13.12 Bosniak classification of renal cysts.

Table 13.13 Risk factors for developing upper urinary tract cancer.

Table 13.14 TNM classification of upper urinary tract cancer.

Table 13.15 European Association of Urology recommended guidelines for upper ...

Chapter 14

Table 14.1 Types of stones.

Table 14.2 Sensitivity, specificity, and radiation exposure of different imag...

Table 14.3 Approximate computed tomography‐attenuation values (Hounsfield Uni...

Table 14.4 Risk of stone to require intervention, or cause pain, or increase ...

Table 14.5 Dissolution therapy of various stones.

Chapter 16

Table 16.1 Classification of pathology of the adrenal gland.

Table 16.2 Differential diagnosis of an adrenal mass on imaging.

Table 16.3 Adjuvant therapy according to World Health Organisation stage in adre...

Chapter 18

Table 18.1 Presenting symptoms and signs in infants and children with UTI [91].

Table 18.2 The interpretation of urine dip test

for children three years or older

...

Table 18.3 Guidance on the interpretation of microscopy results [91].

Table 18.4 Recommended investigations and timing [91].

Chapter 20

Table 20.1 Risk factors for developing bacterial cystitis.

Table 20.2 Classification of bacteria causing urinary tract infection.

Table 20.3 Recommended antimicrobial therapy in uncomplicated cystitis in premen...

Table 20.4 Classification, pathophysiology, investigations, and management of re...

Table 20.5 Antibiotics to avoid in pregnancy by trimester.

Table 20.6 Drugs and chemicals identified to cause haemorrhagic cystitis [24, 25...

Chapter 21

Table 21.1 Benign lesions of the bladder.

Table 21.2 Classification of urothelial (transitional cell) neoplasms including ...

Table 21.3 Characteristics of different grades of urothelial cancer.

Table 21.4 TNM staging of bladder cancer.

Table 21.5 Variables and assigned scores in European Organisation for the Resear...

Table 21.6 Risks of recurrence and progression.

Table 21.7 Risk stratification of bladder cancer and recommended treatment optio...

Table 21.8 Summary of mode of action of intravesical Bacillus Calmette‐Guerin (B...

Table 21.9 Induction intravesical Bacillus Calmette‐Guerin (BCG).

Table 21.10 Maintenance schedule of intravesical Bacillus Calmette‐Guerin (BCG).

Table 21.11 Follow‐up of non‐invasive–muscle bladder cancer (NMIBC).

Table 21.12 Intravesical chemotherapies and their characteristics.

Table 21.13 Recommended follow‐up for bladder cancer after radical treatment (cy...

Chapter 22

Table 22.1 Ideal characteristics of a urinary reservoir.

Table 22.2 Issues affecting urinary diversion selection.

Table 22.3 Primary indications and metabolic consequences for use of bowel segme...

Table 22.4 Absolute and relative contraindications for continent cutaneous or or...

Table 22.5 Early versus late complications of continent urinary diversions.

Table 22.6 Comparison of complications: ileal conduits versus continent diversio...

Chapter 23

Table 23.1 Storage symptom definitions.

Table 23.3 Postmicturition symptom definition.

Table 23.4 Symptom syndrome definition.

Table 23.5 Objective measurements.

Table 23.6 Distribution of muscarinic receptors which are affected by treating o...

Table 23.7 The classification of painful bladder syndrome by the

European society

...

Chapter 25

Table 25.1 Each prostate lobe corresponds to part(s) of an anatomical zone.

Table 25.2 Age‐specific reference range guide.

Chapter 26

Table 26.1 Definitions of four distinct categories of prostatitis.

Table 26.2 Four‐glass urine collection method and interpretation of cultures, as...

Chapter 27

Table 27.1 (a) One‐year mortality rates after acute urinary retention (b) One...

Table 27.2 Natural history of benign prostatic hyperplasia to cause acute uri...

Table 27.3 Prostate‐specific antigen counselling guidelines.

Chapter 28

Table 28.1 Age‐specific reference ranges used to trigger referral for prostat...

Table 28.2 Predicted value for prostate cancer based on digital rectal examin...

Table 28.3 TNM staging.

Table 28.4 Translating from the Gleason scoring system to new Gleason grades ...

Table 28.5 Risk stratification for men with localised prostate cancer. (Pleas...

Table 28.6 Definitions of Active Surveillance and Watchful Waiting.

Table 28.7 Example protocol of active surveillance adapted from NICE guidelin...

Table 28.8 Side effects of ADT and their prevalence.

Table 28.9 Timeline of clinical trials of therapy in advanced prostate cancer...

Table 28.10 Wilson & Junger WHO criteria for disease screening [233].

Table 28.11 Serum and urine biomarkers in prostate cancer and their descripti...

Chapter 32

Table 32.1 Grading system for pelvic fracture urethral injury.

Chapter 33

Table 33.1 Squamous cell carcinoma histological subtypes.

Table 33.2 TNM classification of penile cancer.

Table 33.3 Treatment options for penile cancers.

Table 33.4 Penile cancer risk group stratification.

Table 33.5 Treatment modalities for lymph nodes.

Table 33.6 Follow‐up regime for penile cancer.

Table 33.7 TNM classification of urethral cancer.

Chapter 34

Table 34.1 IIEF‐5 scoring: The IIEF‐5 score is the sum of the ordinal respons...

Table 34.2 Key characteristics of PDE 5 Inhibitors.

Table 34.3 Causes of anejaculation.

Table 34.4 Testosterone replacement preparations.

Chapter 36

Table 36.1 Differential diagnosis of an acute scrotum.

Chapter 38

Table 38.1 Differential diagnosis for testicular torsion.

Table 38.2 Varicocele grading system.

Chapter 39

Table 39.1 Table of the common onco‐foetal proteins detected in the serum of ...

Table 39.2 The World Health Organisation histopathological classification of ...

Table 39.3 The international TNM staging for testicular neoplasm.

Table 39.4 Stage grouping for testicular cancer.

Table 39.5 The Royal Marsden staging system.

Table 39.6 Prognostic‐based staging system for metastatic germ cell cancer. ...

Table 39.7 European Association of Urology recommended follow up regimes.

Table 39.8 Tumours of the paratesticular structures.

Chapter 40

Table 40.1 Clinical examination.

Table 40.2 Lower reference limits for semen analysis WHO 2010.

Table 40.3 Grading of sperm motility.

Table 40.4 Interpretation of male reproductive hormonal profile.

Table 40.5 The Johnsen Score of testicular biopsy.

Table 40.6 Treatment options for varicocele repair.

Chapter 41

Table 41.1 Patency and pregnancy rate with time.

List of Illustrations

Chapter 1a

Figure 1.1.1 Diagram of conventional cystoscope. The glass lenses are held in...

Figure 1.1.2 Rod‐lens telescope, with ‘lenses’ of air, separated by ‘spaces’ ...

Figure 1.1.3 (a) Comparison between the angle of view offered by the convetio...

Figure 1.1.4 (a) A flexible cystoscope looking back at itself the ‘J manoeuvr...

Figure 1.1.5 (a) Typical diathermy waveforms. (b) Cutting current: a continuo...

Figure 1.1.6 Monopolar diathermy generators are ground referenced by earthing...

Figure 1.1.7 (a) Photon emission with electron transition. (b) Photons are em...

Figure 1.1.8 Laser construction. The active laser medium is contained between...

Figure 1.1.9 (a) Side open, (b) Whistle tip, (c) Coude tip, (d) Mallecot, (e)...

Figure 1.1.10 The five stages of biofilm development. Stage 1, initial attach...

Figure 1.1.11 (a and b) Urease‐producing bacteria hydrolysis of urea. 2NH

3

 + ...

Chapter 1b

Figure 1.2.1 (a–d) A nest of cells may become buried under the healing urothe...

Figure 1.2.2 To avoid stenosis, all anastomoses in the urinary tract are desi...

Chapter 1c

Figure 1.3.1 Virtual reality robotic simulators. (a) SEP, (b) RoSS, (c) ProMI...

Figure 1.3.2 Image of simulated operating theatre.

Chapter 2

Figure 2.1 Distribution of blood loss.

Figure 2.2 Distribution of operating times.

Figure 2.3 Flow chart I: the process for selecting the appropriate summary stat...

Figure 2.4 Flowchart II: the process for selecting the appropriate statistical ...

Figure 2.5 Flowchart III: the process for selecting the appropriate statistical...

Figure 2.6 Flowchart IV: the process for selecting the appropriate statistical ...

Figure 2.7 Flowchart V: the process for selecting the appropriate statistical a...

Figure 2.8 Prostate‐specific antigen (PSA) and prostate total volume.

Figure 2.9 Regression line for prostate‐specific antigen (PSA) and prostate tot...

Chapter 3

Figure 3.1 The basic unit of the kidney is the pyramid, with a flower bunched a...

Figure 3.2 Locations of pronephros (fourth week), mesonephros (fourth to eighth...

Figure 3.3 The mesonephros runs along the length of the foetus on the lateral s...

Figure 3.4 The mesonephros can be identified in the four‐week‐old human embryo.

Figure 3.5 (a) The caudal part of the mesonephros becomes the metanephros. It r...

Figure 3.6 The ureteric bud develops as an outgrowth of the mesonephric duct cl...

Figure 3.7 The ureteric bud splits repeatedly until about 15 generations of duc...

Figure 3.8 As the ureteric bud approaches the metanephros, it branches repeated...

Figure 3.9 The metanephric tissue caps covering each collecting tubule form ren...

Figure 3.10 The urorectal septum grows down between the future bladder and rect...

Figure 3.11 The cloacal membrane disappears and the phallic tubercles meet in t...

Figure 3.12 (a) A second (müllerian) duct forms on the lateral side of the meso...

Figure 3.13 Migration of the germ cells from the yolk sac to the genital ridge.

Figure 3.14 Complete duplex system on the left. The Wiegert‐Meyer rule states t...

Figure 3.15 The ureter from the upper half‐kidney may open into the vagina belo...

Figure 3.16 If the kidney remains in the pelvis, it stays ‘rotated’.

Figure 3.17 If the lower end of the metanephros fuse together, they remain ‘rot...

Figure 3.18 Crossed renal ectopia.

Figure 3.19 The foetal hindgut bends round and the urogenital septum descends t...

Figure 3.20 The urorectal septum descends at four to six weeks to separate the ...

Figure 3.21 As the urogenital septum reaches the perineum, the cloacal membrane...

Figure 3.22 The male anterior urethra is not initially tubular, but rather a fl...

Figure 3.23 The male anterior urethra folds in sideways and closes along the mi...

Figure 3.24 The skin rolls in on either side to form the urethra.

Figure 3.25 The lower ends of the mesonephric ducts (due to become the vasa eff...

Figure 3.26 The urogenital septum brings down the wolffian ducts, which will be...

Figure 3.27 Cloacal folds form in the third week and will become genital folds....

Figure 3.28 The germ cells pass from the yolk sac across the coelom to the gona...

Figure 3.29 Sertoli cells secrete müllerian duct inhibiting factor. About a wee...

Figure 3.30 Male hormone dependence.

Figure 3.31 The müllerian duct‐inhibiting factor from Sertoli cells cause the m...

Figure 3.32 Upon arrival of germ cells, primitive sex cords form in the then‐in...

Figure 3.33 (a–d) Testosterone from the Leydig cells cause the phallus to grow ...

Figure 3.34 In males, the wolffian duct becomes the vas deferens, epididymis, a...

Figure 3.35 Testicular descent happens in two phases: (1) dependent on AMH and ...

Figure 3.36 Normal migration of the testicle.

Figure 3.37 The maldescended testis may be off its normal course of descent (ec...

Figure 3.38 Varieties of hydrocele and hernia.

Figure 3.39 Various types of hernia and hydrocele. (a) Common hydrocele, (b) en...

Figure 3.40 The prostate begins to form in the mesenchyme of the urogenital sep...

Figure 3.41 The Y chromosome produces the HY gene, which turns germ cells eithe...

Figure 3.42 When the cloacal membrane dissolves, the bladder opens behind the g...

Figure 3.43 Under the influence of dihydrotestosterone, the genital tubercle el...

Figure 3.44 A cord extends through the solid glans and then becomes canalised t...

Figure 3.45 The scrotum is formed by the in‐rolling of the two genital tubercle...

Figure 3.46 Derivatives of the paramesonephric duct in females: fallopian tubes...

Figure 3.47 Female external genital development: the genital tubercle develops ...

Figure 3.48 Migration of neuroectodermal cells from neural crest.

Figure 3.49 The cortex arises in the mesoderm of the ‘intermediate cell mass’, ...

Chapter 4

Figure 4.1 Mitotic cycle.

Figure 4.2 (a–c) In prophase, parts of chromosomes may stick to each other or b...

Figure 4.3 Alterations of cell cycle control mechanisms in cancer cells. Highly...

Figure 4.4 Important proteins in cell cycle control (red) are commonly overexpr...

Figure 4.5 Diffusion of oxygen and nutrients can only supply a tumour <2 mm in ...

Figure 4.6 The Gompertz curve: cell division slows down as the tumour enlarges.

Figure 4.7 Theoretical weight of tumours of different doubling times (one day t...

Figure 4.8 Using multiple ports of entry, crossfire builds up the dose of radia...

Figure 4.9 With higher energy radiation, there is less absorption at the skin l...

Chapter 5

Figure 5.1 Anterior relations the kidneys (a) on the left the duodenum and colo...

Figure 5.2 Posterior relations of the kidneys.

Figure 5.3 The fasciae surrounding the kidney. Note that Gerota fascia is tough...

Figure 5.4 Diagrammatic section through the kidney.

Figure 5.5 (a and b) Segmental arterial supply of the kidney.

Figure 5.6 Branches of the segmental arteries within the kidney. The renal papi...

Figure 5.7 The renal veins communicate freely with each other. Not shown are th...

Figure 5.8 The nephron.

Figure 5.9 The juxtaglomerular body.

Figure 5.10 The basement membrane lies between the endothelium of the glomerula...

Figure 5.11 The basement membrane supported by foot processes of the epithelial...

Figure 5.12 The normal valvular arrangement of collecting tubules in the renal ...

Figure 5.13 Congenitally deformed papillae, or compound papillae, may permit in...

Figure 5.14 The sinus fat allows free movement for the contraction and expansio...

Figure 5.15 Main ureteral relations.

Figure 5.16 (a) Ureters running through the cardinal ligament. (b) Uterine prol...

Figure 5.17 Ureteral blood supply.

Figure 5.18 The antireflux ureterovesical valve.

Chapter 6

Figure 6.1 Filtration in the glomerular arteriole.

Figure 6.2 The countercurrent hypothesis for the formation of hyperosmotic ur...

Figure 6.3 Diagram showing the mechanisms involved in regulating acid–base ba...

Figure 6.4 In diuresis, the ureter dilates (a), the peristaltic contractions ...

Figure 6.5 Whitaker test. Saline or water is infused into the renal pelvis th...

Chapter 7

Figure 7.1 Classification and prognosis of chronic kidney disease (CKD).

Figure 7.2 A catheter is placed in the pelvis and 2 l quantities of dialysate...

Figure 7.3 Principle of haemodialysis: blood flows over a thin semi‐permeable...

Chapter 8

Figure 8.1 The bowel is mobilised completely and placed on the chest.

Figure 8.2 (a and b) The superior mesenteric and (c) coeliac arteries are div...

Figure 8.3 Perfusion of the kidneys through a Foley catheter in the aorta.

Figure 8.4 The aorta and vena cava are removed en bloc with the kidneys and u...

Figure 8.5 (a and b) The aorta and vena cava are slit open in the midline, ca...

Figure 8.6 Living donor nephrectomy. On the left side beware of a circumaorti...

Figure 8.7 The donor kidney is irrigated with ice‐cold preserving fluid until...

Figure 8.8 Extraperitoneal exposure of the common and internal iliac vessels....

Figure 8.9 (a) Preparation of the external iliac artery for end to side anast...

Figure 8.10 Preparation of the internal iliac artery.

Figure 8.11 End‐to‐end anastomosis of the internal iliac artery to the donor ...

Figure 8.12 Where there is more than one renal artery, both should be left on...

Figure 8.13 The vascular anastomoses are completed, and the submucosal tunnel...

Figure 8.14 (a and b) A wide elliptical anastomosis is made between the urete...

Figure 8.15 Inheritance of class I and II human leucocyte antigens (HLAs).

Figure 8.16 Diagram of chromosome 6.

Figure 8.17 The immune response. Antigens from the transplant are taken up by...

Chapter 9

Figure 9.1 Absence of one nephrogenic ridge results in absence of all wolffia...

Figure 9.2 Dysplasia: a tiny, often cystic nubbin of tissue is found at the u...

Figure 9.3 In congenital multicystic disease, without amniotic fluid, the foe...

Figure 9.4 DMSA (posterior view) of a three‐month‐old girl with asymptomatic,...

Figure 9.5 When there is a herniation of the diaphragm, the kidney may be see...

Figure 9.6 (a) It was once believed that cysts were the result of failure of ...

Figure 9.7 (a–d) Treatment of a renal cyst. A small window is removed from th...

Figure 9.9 It is only necessary to remove a small window from the wall of the...

Figure 9.10 Medullary sponge kidney.

Figure 9.11 Ultrasound showing calyceal dilatation on a two‐month‐old girl wi...

Figure 9.12 Cystoscopic findings in agenesis: there is no ureter on one side....

Figure 9.14 An aberrant ureter may end in a blind‐ended pouch.

Figure 9.15 Diagram of a duplex kidney in which the ureters divide about half...

Figure 9.16 When there is complete duplication, the ureter from the upper hal...

Figure 9.17 Diagram of see‐saw reflux: the urine from the lower moiety of the...

Figure 9.18 The ureter from the upper half‐kidney may open into the vagina be...

Figure 9.19 (a and b) A ureterocele may prolapse through the urethra and caus...

Figure 9.20 A ureterocele may cause (a) obstruction and (b) the formation of ...

Figure 9.21 Diagram of retrocaval ureter.

Figure 9.22 (a–d) Operation for a retrocaval ureter: there is no need to remo...

Chapter 10

Figure 10.1 (a) MAG3 curves. (b) As the dilated renal pelvis bulges out betwe...

Figure 10.2 Prenatal diagnosis, risk stratification, and management of hydron...

Figure 10.3 Postnatal diagnosis, risk stratification, and management of hydro...

Figure 10.4 Usually the obstructing segment is only a few millimetres long; o...

Figure 10.5 Coronal and axial computed tomography imaging to demonstrate a di...

Figure 10.6 MAG 3 Renogram showing reduced clearance of radio‐isotope form ri...

Figure 10.7 (a and b) A sling is placed around the lower pole segmental vesse...

Figure 10.8 Dismembered pyeloplasty. A U‐shaped flap is formed from the redun...

Figure 10.9 The renal pelvis is distended.

Figure 10.10 (a–d) A long elliptical anastomosis is formed between the flap o...

Figure 10.11 (a–f) When there is a long narrow segment of ureter, Culp's spir...

Figure 10.12 Computed tomography (CT) axial and coronal images showing left d...

Figure 10.14 MAG3 renogram showing split function of left kidney with the obs...

Figure 10.15 Ultrasound scan showing a ureterocoele.

Figure 10.16 Voiding cystourethrogram show reflux up a lower moiety duplex.

Figure 10.17 Coronal computed tomography image with contrast showing delayed ...

Chapter 11

Figure 11.1 Closed renal injury: the kidney is compressed between the 12th ri...

Figure 11.2 Gunshot injury with multiple pellets in various organs including ...

Figure 11.3 Classification of renal injury depending on degree of injury.

Figure 11.8 Grade 5 injury (renal pedicle injury), no blood supply to upper a...

Figure 11.9 Grade 4 injury with multiple segmental artery bleeds being emboli...

Figure 11.10 Exploration for renal injury. The colon is reflected. The renal ...

Figure 11.11 Angiography may reveal a bleeding arterial branch which can be p...

Figure 11.12 (a) Urinary extravasation after renal trauma (b) urinoma develop...

Figure 11.13 Ureteric injuries with contrast extravasation, (a) Grade 2 (obta...

Figure 11.14 Distal ureteral injury with urine extravasation.

Figure 11.15 If a guidewire can be made to pass the site of the injury a doub...

Figure 11.16 The ureter is followed down to the site of the injury.

Figure 11.17 The ureter is divided above the site of the injury: it always re...

Figure 11.18 The ⋂ − shaped Boari flap is raised and a submucosal tunnel form...

Figure 11.19 The ureter is drawn through the submucosal tunnel, spatulated, a...

Figure 11.20 The Boari flap is closed.

Figure 11.21 Psoas hitch. The bladder is mobilised and incised at right angle...

Figure 11.22 The bladder is sutured to the tendon of psoas minor, when presen...

Figure 11.23 The principle of uretero‐ureterostomy.

Figure 11.24 A long gap in the ureter may be bridged with an ileal conduit.

Chapter 12

Figure 12.1 Effects of tissue damage.

Figure 12.2 Transverse and coronal computed tomography scan showing sever pye...

Figure 12.3 Perinephric abscess with significant renal destruction.

Figure 12.4 (a–d) Transverse and coronal computed tomography (CT) images show...

Figure 12.5 Recommendations for treating emphysematous pyelonephritis (EPN). ...

Figure 12.6 The pathogenesis of renal tuberculosis: (a) haematogenous infecti...

Figure 12.7 Healing of the tuberculosis in the ureter leads to a stricture.

Figure 12.8 (a–c) Tuberculosis of left kidney.

Figure 12.9 Kidney‐ureter‐bladder (KUB) X‐ray of kidney tuberculosis.

Figure 12.10 A tuberculosis stricture of the upper end of the ureter may be r...

Figure 12.11 A tuberculosis stricture of the lower end of the ureter may be r...

Figure 12.12 A long length of stenosed ureter may be replaced with ileum.

Figure 12.13 After the appendix has been mobilised on the mesoappendix a.

Figure 12.14 Life cycle of

Echinococcus granulosus

.

Figure 12.15 (a) Combined lymphangiogram (left) and retrograde urogram (right...

Figure 12.16 The life cycle of

Wuchereria bancrofti

.

Figure 12.17 Intravenous urogram (IVU), computed tomography (CT) scan, magnet...

Figure 12.18 (a–c) Retroperitoneal fibrosis: the ureters are compressed and d...

Figure 12.19 The colon is mobilised on each side and reflected medially.

Figure 12.20 The fibrous tissue is incised to release the ureter.

Figure 12.21 After ureterolysis, each ureter is wrapped in omentum.

Chapter 13

Figure 13.1 Ultrasounds of different‐sized renal cell carcinomas (RCCs).

Figure 13.2 Computed tomography (CT) scans of different staging of renal canc...

Figure 13.3 Angiogram showing (a and b) tumour circulation followed by emboli...

Figure 13.4 Computed tomography (CT) showing (a and b) tumour recurrence near...

Figure 13.5 Magnetic resonance image (MRI) showing (a) right renal simple cys...

Figure 13.6 Tumour invading the inferior vena cava: (a–c) computed tomography...

Figure 13.7 Staging of adenocarcinoma of the kidney (see text for further det...

Figure 13.8 (a) On the right side the colon and (b) duodenum are mobilised me...

Figure 13.9 The right renal artery may be ligated in continuity where it lies...

Figure 13.10 (a and b) With large tumours the left renal artery may be found ...

Figure 13.11 A large lumbar vein often enters the back of the left renal vein...

Figure 13.12 Tenth rib thoracoabdominal approach to the kidney. (a) The anter...

Figure 13.13 Partial nephrectomy. (a) After clamping the renal artery, a clea...

Figure 13.14 When there is a tumour in the right renal vein and vena cava, af...

Figure 13.15 (a) The vena cava is opened, (b) the tumour is extracted, and th...

Figure 13.16 (a) When tumour has blocked the

inferior vena cava

(

IVC

), there ...

Figure 13.17 When the vena cava is invaded by tumour from the left renal vein...

Figure 13.18 Staging of nephroblastoma of the kidney (see text for explanatio...

Figure 13.19 (a and b) Nephrectomy for Wilms tumour: the renal vein on the si...

Figure 13.20 A large column of Bertin may mimic a renal cell cancer.

Figure 13.24 Ureteroscopy with retrograde urography showing a filling defect ...

Figure 13.25 TNM staging of transitional cell carcinoma of the upper urinary ...

Figure 13.26 (a) The bladder is opened obliquely. (b) An ellipse of bladder i...

Figure 13.27 Semple manoeuvre. The ureter is resected down to fat with the re...

Figure 13.28 After mobilising the kidney, the ureter is followed down between...

Chapter 14

Figure 14.1 Effects of increasing ion concentration in the urine.

Figure 14.2 Most calculi originate in the kidney as Carr's concretions in the...

Figure 14.3 Hyperoxaluria from disease or loss of the terminal ileum.

Figure 14.4 (a) Noncontrast computed tomography (

NCCT

) showing dilatation of ...

Figure 14.5 (a) Left: Intravenous pyelography (IVP) showing an enlarged ‘whit...

Figure 14.6 (a and b) Coronal and sagittal views of a stag horn calculi in an...

Figure 14.7 Noncontrast computed tomography (NCCT) (left) and kidneys, ureter...

Figure 14.8 Three‐dimensional computed tomography (3DCT) showing stone burden...

Figure 14.9 Ultra‐low‐dose noncontrast computed tomography (NCCT) in a 36‐mon...

Figure 14.10 infected obstructed system with a 2.5‐cm renal pelvic stone su...

Figure 14.11 Treatment algorithm for renal calculi.

Figure 14.12 Treatment algorithm for ureteric calculi.

Figure 14.13 Lithotripter used at Tenon Hospital, Paris (LITHOSKOP

®

, Sie...

Figure 14.15 The principle of piezo‐electric lithotripsy: a battery of piezoc...

Figure 14.16 Rigid or flexible fibre‐optic ureteroscopes may be passed right ...

Figure 14.17 Different ureterorenoscope available on the market: digital (URF...

Figure 14.18 The ‘semi‐flexible’ URF‐V2 and URF‐P6 (Olympus) versus the flexi...

Figure 14.19 Ultrasonic lithotripsy: a toothed cylinder is made to oscillate ...

Figure 14.20 Electrohydraulic lithotripsy: concentric or parallel electrodes ...

Figure 14.21 The Swiss lithoclast: on the principle of the jackhammer probes ...

Figure 14.22 Different ureteral access sheath available on the market and the...

Figure 14.23 If a double‐J stent is left in the ureter, it becomes dilated an...

Figure 14.24 Percutaneous nephrolithotomy. Tubes of increasing diameter are i...

Figure 14.25 Positioning for combined intrarenal surgery, Galdakao modified V...

Figure 14.26 Access in percutaneous surgery, prone position.

Figure 14.27 Fluoroscopy during combined intrarenal surgery illustrates worki...

Figure 14.28 (a) Ultrasound showing a bladder stone; (b and c) corresponding ...

Figure 14.29 Computed tomography (CT) scan of a calyceal diverticulum contain...

Chapter 15

Figure 15.1 Underlying arrangement of renal artery branches: four anterior and ...

Figure 15.2 Urogram showing upper calix indented by upper pole segmental artery...

Figure 15.3 Ureteroscopy or percutaneous nephroscopy may reveal a tiny aneurysm...

Figure 15.4 A small traumatic arteriovenous aneurysm may be embolised at angiog...

Figure 15.5 Atheroma and arteriolosclerosis.

Figure 15.6 Fibromuscular dysplasia and hyperplasia.

Figure 15.7 Tracing of X‐rays taken 15 years apart at the age of 66 (left) and ...

Figure 15.8 Pyelogram showing ring of calcification in the wall of the aneurysm...

Figure 15.9 (a, b, and c) Computed tomography (CT) angiogram. (d) CT urogram: s...

Figure 15.10 This patient had a sudden onset of hypertension, haematuria, and p...

Figure 15.11 The renin‐angiotensin cascade.

Figure 15.12 Angioplasty: the stenosed renal artery is dilated with a balloon.

Chapter 16

Figure 16.1 Surgical relations of the adrenal glands.

Figure 16.2 The sandwich structure of the adrenal: zona glomerulosa (aldosteron...

Figure 16.3 Hormonal control of the layers of the adrenal: the zona glomerulosa...

Figure 16.4 Patient with Cushing syndrome with typical ‘lemon‐on‐stick’ body ha...

Figure 16.5 Caricature showing the principal clinical features of Cushing syndr...

Figure 16.6 Unenhanced computed tomography (CT) scan showing primary cortical t...

Figure 16.7 Principal features of Conn syndrome.

Figure 16.8 Selective adrenal venous sampling demonstrating the catheters in ea...

Figure 16.9 Acne and hirsutism in a 24‐year‐old woman with a benign androgen‐se...

Figure 16.10 Coronal section of enhanced computed tomography (CT) scan. A left ...

Figure 16.11 Enhanced computed tomography (CT) scan of myelolipoma of the right...

Figure 16.12 Fluorodeoxyglucose (FDG) sagittal, coronal, and cross‐sectional fu...

Figure 16.13 Enhanced computed tomography (CT) scan showing huge mass occupying...

Figure 16.14 Enhanced computed tomography (CT), magnetic resonance image (MRI),...

Figure 16.15 Positron emission tomography‐computed tomography (PET‐CT) showing ...

Figure 16.16 Exposure of the right adrenal in pheochromocytoma. The liver is re...

Figure 16.17 Exposure of the left adrenal for pheochromocytoma. After taking do...

Chapter 17

Figure 17.1 (a) Sagittal section through the male pelvis showing main anatomica...

Figure 17.2 (a) Sagittal section through the female pelvis showing main anatomi...

Figure 17.3 Arrangement of the smooth muscles fibres of the bladder, they swoop...

Figure 17.4 A special sheath of smooth muscle surrounds the lower end of the ur...

Figure 17.5 The action of Bell's muscle is to draw the ureter down towards the ...

Figure 17.6 The efferent and afferent nerves of the bladder.

Figure 17.7 The male bladder neck: there is an adrenergic internal sphincter wh...

Figure 17.8 The female bladder neck: the bladder neck is not usually closed at ...

Figure 17.9 Arterial supply of the bladder.

Figure 17.10 Muscarinic and adrenergic pathways to muscular contraction.

Figure 17.11 Muscarinic and adrenergic pathways to muscular relaxation.

Chapter 18

Figure 18.1 In exstrophy, the cloacal membrane extends right up to the umbilica...

Figure 18.2 Diagram of the principal features of exstrophy.

Figure 18.4 Female bladder exstrophy.

Figure 18.5 Diagram of the findings in superior vesical fissure.

Figure 18.6 Jeffs' method of closure of exstrophy. First stage – performed in t...

Figure 18.7 Jeffs' method for exstrophy. Second stage – performed at about thre...

Figure 18.8 Diagram of the findings in epispadias.

Figure 18.9 (a) and (b) Isolated Male epispadias.

Figure 18.10 Diagram of the findings in cloacal exstrophy.

Figure 18.11 (a) and (b) Cloacal exstrophy.

Figure 18.12 Complications of a persistent urachus. (a) It may cause a urinary ...

Figure 18.13 (a) and (b) Patent urachus.

Figure 18.14 (a) and (b) Bladder diverticulum before and after bladder emptying...

Chapter 19

Figure 19.1 The common cause of ruptured bladder is a combination of drunkennes...

Figure 19.2 (a) The bladder may be pierced by a fragment of bone. (b) The bladd...

Figure 19.3 Computed tomography (CT) cystogram of a patient with multitrauma sh...

Figure 19.4 It is a wise precaution to perform bilateral ureterograms even when...

Figure 19.5 (a) Extraperitoneal bladder perforation, and (b–d) intraperitoneal ...

Chapter 20

Figure 20.1 Diagram of a bacterium showing pili. These enable a bacillus to adh...

Figure 20.2 Pathogenesis of urinary tract infection in Children.

Figure 20.3 The cystoscopic appearances of cystitis follicularis.

Figure 20.4 Radiograph showing gas is seen in the bladder wall in keeping with ...

Figure 20.5 Parasite species and geographical distribution.

Figure 20.6 Life cycle of

Schistosoma haematobium

.

Figure 20.7 (a and b) Pair of adult schistosome worms (miracidea and cercaria) ...

Figure 20.8 Eggs of

Schistosoma haematobium

.

Figure 20.9 Calcification of the bladder and ureters.

Figure 20.10 Cystoscopy appearance of schistosoma nodules in the bladder.

Figure 20.11 Computed tomography (CT) showing ureteric and bladder calcificatio...

Chapter 21

Figure 21.1 Showing difference between white light cystoscopy (WLC) and blue li...

Figure 21.2 (a and b) A small papillary tumour can be removed with a divot of u...

Figure 21.3 To reach the stalk of a larger tumour the overhanging bush must be ...

Figure 21.4 After removing the bush, the stalk is resected and sent separately ...

Figure 21.5 (a and b) A moderate sized bladder tumour on computed tomography (C...

Figure 21.6 Very large bladder tumour occupying the majority of the bladder.

Figure 21.7 A large leiomyoma presenting with obstructive uropathy.

Figure 21.8 Urachal adenocarcinoma arising from the dome of the bladder along t...

Figure 21.9 Staging of bladder cancer.

Figure 21.10 A diagram of circuit of bladder thermos‐chemotherapy.

Figure 21.11 (a and b) The peritoneum is mobilised on either side to reveal the...

Figure 21.12 The lymph nodes are dissected from the iliac vessels.

Figure 21.13 The common and internal iliac vessels are cleaned.

Figure 21.14 The sleeve around the obturator nerve must be slit open to dissect...

Figure 21.15 The dorsal veins are defined and divided.

Figure 21.16 To spare the neurovascular bundle to the penis, (a) the fascia is ...

Figure 21.17 The bladder is pulled up, and the plane between the layers of fasc...

Figure 21.18 Urethrectomy. A midline incision is made in the perineum.

Figure 21.19 (a) The urethra is progressively dissected off the corpora caverno...

Figure 21.20 The dorsal arteries and vein (a), and the bulbar arteries (b) are ...

Figure 21.21 The rectum is pushed down with two fingers to display the rectopro...

Figure 21.22 A carcinoma of the urachus forms a mass outside the bladder much l...

Figure 21.23 The incision for carcinoma of the urachus includes the umbilicus.

Figure 21.24 Most of the bladder, urachus, and the wedge of tissue extending to...

Figure 21.25 Only a narrow rim of bladder is left around the trigone. The urete...

Figure 21.26 Carcinoma in a diverticulum. The wall is always so thin that invas...

Figure 21.27 Carcinoma in a diverticulum. (a) The bladder is opened well clear ...

Chapter 22

Figure 22.1 (a–c) Suprapubic cystostomy.

Figure 22.2 Formal open cystostomy. After (a) separating the recti, the periton...

Figure 22.3 Ureterostomy when the ureter is dilated.

Figure 22.4 Double‐Z plasty for ureterostomy with an undilated ureter.

Figure 22.5 (a) The mesentery is viewed with transmitted light. (b and c) The m...

Figure 22.6 (a–d) The ends of the ileum are anastomosed together.

Figure 22.7 (a) The ends of the ureters are spatulated and sewn together and an...

Figure 22.8 Merricks–Gilchrist ileocaecal reservoir.

Figure 22.9 A simple length of ileum, colon, or ileum and colon were added onto...

Figure 22.10 Clam cystoplasty. (a) The bladder is opened in the coronal plane a...

Figure 22.11 Kock's pouch. (a) A 45‐cm length of ileum is isolated, and (b) the...

Figure 22.12 (a–f) The Mainz pouch. A 30‐cm length of ileum and caecum are isol...

Figure 22.13 Camey operation. The ureters are anastomosed through a long submuc...

Figure 22.14 Leadbetter technique of ureterosigmoidostomy. (a) The ureter is br...

Figure 22.15 The Mansoura diversion. (a) The sigmoid is intussuscepted to form ...

Chapter 23

Figure 23.1 Various urodynamic traces. (a) Normal trace, (b) detrusor overactiv...

Figure 23.2 Normal uroflow measurement.

Figure 23.3 The flattened curve of infravesical obstruction (a) with prostatic ...

Figure 23.4 Obstructed voiding caused by failure of sphincter relaxation; note ...

Figure 23.5 Cystometry. Intra‐abdominal pressure is measured in the rectum and ...

Figure 23.6 Filling cystometrogram. (a) Normal: spikes of intra‐abdominal press...

Figure 23.7 Filling cystometrogram: poorly compliant detrusor.

Figure 23.8 Tracing of cystogram showing ‘beaking’.

Figure 23.9 The hypothesis of aetiologic bladder pain syndrome cascade [3].

Figure 23.10 Micturating cystourethrogram showing the uretheral diverticulum.

Figure 23.11 Magnetic resonance imaging (MRI) scans (T1 and T2 weighted) showin...

Figure 23.12 Suprapubic catheter inserted into bowel, note the distance from th...

Chapter 24

Figure 24.1 Causes for persistence of a fistula or sinus. (a) Obstruction to a ...

Chapter 25

Figure 25.1 The fundamental ‘blueprint’ of the primate prostate. There are two ...

Figure 25.2 The cranial prostate is fitted into the caudal prostate like an egg...

Figure 25.3 The gap in the front of the prostate in man is filled by a fibromus...

Figure 25.4 The prostatic ducts grow (a) back, out, and round from either side ...

Figure 25.5 Diagram of structure of normal adult prostate. There is a stroma ma...

Figure 25.6 (a) Around the age of 40 nodules of hyperplastic acini and muscle b...

Figure 25.7 Sagittal section through the prostate showing anatomical relations.

Figure 25.8 Diagrammatic cross‐sections through the prostate at two levels show...

Figure 25.9 Anatomy of the normal human prostate. (a) Sagittal section through ...

Figure 25.10 (a) The main arterial supply to the prostate from the inferior ves...

Figure 25.11 The three components of the sphincter of the prostate. The bladder...

Figure 25.12 At urethrectomy or urethroplasty the ring of the levator ani can b...

Figure 25.13 Schematic view of the prostate showing the situation of the supram...

Figure 25.14 (a) During micturition all the sphincters are open. (b) On complet...

Chapter 26

Figure 26.1 Contrast‐enhanced magnetic resonance imaging (MRI) showing multiple...

Figure 26.2 UPOINT phenotypic classification of CP/CPPS the ‘Snowflake Hypothes...

Figure 26.3 Normal transurethral representation of prostatic cavity (a). Endosc...

Chapter 27

Figure 27.1 Hald's rings. BPH, benign prostatic hyperplasia; BOO, bladder outfl...

Figure 27.2 (a) Regulation of cell growth and (b) growth factors affecting the ...

Figure 27.3 Diagram of McNeal's prostate zonal anatomy.

Figure 27.4 Diagram showing the radiographic appearances of the normal and the ...

Figure 27.5 (a) Diagram showing changes in the detrusor secondary to outflow ob...

Figure 27.6 Diagram of the progress of a diverticulum.

Figure 27.7 Flow rate (a) normal (b) in benign enlargement of the prostate.

Figure 27.8 Infiltrating local anaesthesia to find the bladder. A disposable su...

Figure 27.9 Acute urinary retention management algorithm. BOO, bladder outflow ...

Figure 27.10 Flow chart of chronic retention management. HPCR, high‐pressure ch...

Figure 27.11 Bladder neck incision. A 6 o'clock incision avoids damage to the p...

Figure 27.12 The objective of transurethral resection of prostate (TURP) (a) is...

Figure 27.13 (a) The verumontanum; (b–d) the middle lobe is resected until the ...

Figure 27.14 (a) A trench is made between the bladder neck and adenoma at 1 o'c...

Figure 27.15 Any little bits of adenoma that have been left are resected especi...

Figure 27.16 Appearance after supramembranous intramural sphincter has been cut...

Figure 27.17 (a) Freyer transvesical prostatectomy. The salient lobes of the pr...

Figure 27.18 After the adenoma has been enucleated sutures at each quadrant hel...

Figure 27.19 The fascia is incised on either side of the dorsal veins which are...

Figure 27.20 The capsule of the prostate is incised with the diathermy to expos...

Figure 27.21 The plane between capsule and adenoma is developed with scissors.

Figure 27.22 First on one side, then the other, the plane between adenoma and c...

Figure 27.23 Both lateral lobes are now delivered out of the prostatic shell.

Figure 27.24 The middle lobe is dissected from the bladder neck.

Figure 27.25 Badenoch's sutures are placed at each corner to secure the main ar...

Figure 27.26 Haemostasis is completed by sutures at the bladder neck.

Figure 27.27 Bleeding from inside the prostatic capsule can be located by evert...

Chapter 28

Figure 28.1 Prostate cancer, average number of new cases per year and age‐speci...

Figure 28.2 Imaging algorithm in patients with elevated prostate‐specific antig...

Figure 28.3 Cancer of the prostate may be more (hyperechoic), less (hypoechoic)...

Figure 28.4 Most invasive cancer arise in the outer zone of the prostate which ...

Figure 28.5 Diagrams representing tumour, node, metastasis (TNM) staging system...

Figure 28.6 (a) MRI of pelvis with normal anatomy axial T2W image showing norma...

Figure 28.7 Histopathology of prostatic adenocarcinoma. (a) PIN, (b) foamy PIN,...

Figure 28.8 Histopathology of prostatic small cell neuroendocrine Carcinoma. (a...

Figure 28.9 Gleason's grading pattern.

Figure 28.10 Immunostains. (a) H&E prostatic adenocarcinoma, (b) AMACR, (c) CK ...

Figure 28.11 Schematic algorithm of the management of prostate cancer. +/‐, wit...

Figure 28.12 Pelvic fascia is incised on either side of the dorsal veins which ...

Figure 28.13 The neurovascular bundles are displaced laterally and posteriorly.

Figure 28.14 The urethra is opened just cephalad to the membranous urethra and ...

Figure 28.15 The catheter pulls up the prostate, and the rectourethralis muscle...

Figure 28.16 The inferior vesical vessels are ligated.

Figure 28.17 The bladder is opened at the bladder neck. The prostate is now slu...

Figure 28.18 The bladder is dissected away from the prostate, displaying the se...

Figure 28.19 The vascular leach of seminal vesicles is divided well medial to t...

Figure 28.20 After narrowing the bladder neck, a precise mucosa‐to‐mucosa anast...

Figure 28.21 The sleeve of nodes is teased off the internal iliac vessels. Haem...

Figure 28.22 The pituitary secretes luteinizing hormone‐releasing hormone (LHRH...

Figure 28.23 Subcapsular orchidectomy.

Figure 28.24 The aim of transurethral resection of prostate (TURP) in prostate ...

Figure 28.25 Diagram showing the different routes of prostatic biopsy and the e...

Chapter 29

Figure 29.1 The three components of the penis.

Figure 29.2 Bony attachments of the urethra: the corpora cavernosa are fixed to...

Figure 29.3 Transverse section through the penis.

Figure 29.4 Arterial supply to the penis.

Figure 29.5 Blood supply to the penis (a) arterial, (b) venous.

Figure 29.6 Venous drainage of the penis.

Figure 29.7 Attachments of the fasciae of Colles and Scarpa which (a) limit the...

Figure 29.8 Cutaneous nerves of the scrotum.

Figure 29.9 Topographical anatomy of the male urethra.

Figure 29.10 The level at which squamous epithelium extends up the lining of th...

Figure 29.11 Surrounding the corpus spongiosum of the female urethra is a sleev...

Figure 29.12 The lumen of the female urethra is crescentic in shape. The bladde...

Figure 29.13 The efferent veins from the corpora cavernosa are closed by being ...

Chapter 30

Figure 30.1 Smegmal cyst.

Figure 30.2 Preputioplasty. Only the tight band need be incised. Afterwards the...

Figure 30.3 The hazards of diathermy in the penis are avoided by using the bipo...

Figure 30.4 Technique of circumcision.

Figure 30.5 Balanitis xerotica obliterans.

Figure 30.6 Congenital megaprepuce.

Figure 30.7 Congenital megaprepuce (filled with urine).

Figure 30.8 Degrees of hypospadias.

Figure 30.10 (a, b, and c) Proximal hypospadias with chordee.

Figure 30.11 Outcome of the foreskin graft for proximal hypospadias.

Figure 30.12 Postoperative outcome of single‐stage hypospadias repair.

Figure 30.13 Meatal advancement and glansplasty (MAGPI) operation.

Figure 30.14 (a) Two‐stage hypospadias repair. First, the chordee is corrected ...

Figure 30.15 At second stage, a full‐thickness skin tube is outlined and the sk...

Figure 30.16 The urethral plate marked for tubularisation at the second‐stage o...

Figure 30.17 Modified circumcision for minor forms of hypospadias.

Figure 30.18 Postoperative subcoronal urethral fistula.

Figure 30.19 (a) Subcoronal primary epispadias. (b) Penopubic epispadias.

Figure 30.20 Primary epispadias in female child.

Figure 30.21 Outcome of isolated distal epispadias surgery.

Figure 30.22 Posterior urethral valves.

Figure 30.23 Bilateral dilated ureter behind the bladder.

Figure 30.24 (a) Cystogram showing dilated posterior urethra and trabeculated b...

Figure 30.25 Large prostatic utricle behind the bladder BLD, bladder.

Figure 30.26 An abscess of Cowper’s gland presents as tender swelling in the pe...

Figure 30.27 Ruptured syringocele.

Figure 30.28 Anterior urethral valve – a double‐barrelled urethra.

Figure 30.29 The anterior leaf of the ‘valve’ may be incised endoscopically, bu...

Figure 30.30 Duplication of the urethra.

Figure 30.31 (a) Rectovesicle fistula. (b) Rectourethral fistula in imperforate...

Figure 30.32 Females subject to masculinization. Mechanisms causing an excess o...

Figure 30.33 Mechanism causing under‐masculinization in males.

Figure 30.34 Bilateral impalpable testes.

Figure 30.35 (a and b) Severe hypospadias with undescended testis on right.

Figure 30.36 (a and b) Prune belly syndrome with megalourethra.

Figure 30.37 Aphallia.

Chapter 31

Figure 31.1 Fracture of the penis. (a) The penile skin is pulled back, (b) the ...

Figure 31.2 The symphysis is forced backwards carrying the prostate with it, st...

Figure 31.4 Diagram of type II injury: the right hemipelvis is forced upwards, ...

Figure 31.5 Severe crushing injuries may lacerate urethra and rectum, avulse th...

Figure 31.6 (a) A fall‐astride injury forces the urethra up against the edge of...

Figure 31.7 The urethra and its corpus spongiosum are splinted by the corpora c...

Figure 31.8 If the urethral injury heals with a stricture it is a short one.

Figure 31.9 To prevent sloughing both fascial compartments of the scrotum must ...

Figure 31.10 If the urethral lumen is completely blocked, the bulbar urethra is...

Figure 31.11 The symphysis springs back but not quite completely and the prosta...

Figure 31.12 The urethra takes an S‐shaped bend whose two leaves can be incised...

Figure 31.13 Ischaemic necrosis caused by the pressure of a catheter leads to a...

Figure 31.14 Common sites for catheter strictures are at the penoscrotal juncti...

Figure 31.15 (a) A linear incision in the urethra heals without stenosis. (b) I...

Figure 31.16 Strictures following surgery often extend the whole length of the ...

Chapter 32

Figure 32.1 Lichen sclerosus.

Figure 32.2 Zoon balanitis.

Figure 32.3 Lichen planus.

Figure 32.4 Normal urethrogram.

Figure 32.5 (a) Acute gonococcal inflammation of the paraurethral glands bursts...

Figure 32.6 Paraurethral glands are most numerous in the terminal centimetre an...

Figure 32.7 Inflammatory stricture tends to creep up the urethra as infected ur...

Figure 32.8 In the extravasation of urine, it is important to make sure that bo...

Figure 32.9 An infected paraurethral gland upstream of a stricture may cause an...

Figure 32.10 Urethral stricture flow pattern, a ‘flat box‐shaped’ curve.

Figure 32.11 Short penile urethral stricture.

Figure 32.12 Bulbar urethral stricture longer than 2 cm.

Figure 32.13 Panurethral stricutre.

Figure 32.14 The technique of using multiple filiforms.

Figure 32.15 Filiform bougies, with flexible or rigid followers.

Figure 32.16 Clutton sounds.

Figure 32.17 S‐curve dilators.

Figure 32.18 Internal urethrotomy. The knife or laser must cut right through al...

Figure 32.19 Excision and end‐to‐end anastomosis. The mobilised urethral ends a...

Figure 32.20 For a stenosis some way down from the meatus a dartos‐pedicled pat...

Figure 32.21 For longer penile strictures a pedicled graft from the shaft of th...

Figure 32.22 A pouch may form upstream or downstream of a restenosis.

Figure 32.23 A pouch is apt to form in a skin urethroplasty in the presence of ...

Figure 32.24 Mature dorsal inlay of buccal graft mobilised and tubularised.

Figure 32.25 The bulbar urethra is mobilised.

Figure 32.26 The upper end of the prostatic urethra is found by cutting down on...

Figure 32.27 (a) The corpora cavernosa are separated in the midline to (b) reve...

Figure 32.28 (a) The periosteum of the symphysis is incised with diathermy and ...

Figure 32.29 (a) Removing the arch of bone reveals the inner layer of periosteu...

Chapter 33

Figure 33.1 Pearly penile papules.

Figure 33.2 Annual incidence rate (world standardised) by European region or co...

Figure 33.3 Cutaneous horn of the penis.

Figure 33.4 Squamous cell carcinoma of the glans with prepuce covering.

Figure 33.5 Squamous cell carcinoma glans and distal penis.

Figure 33.6 Sagittal magnetic resonance imaging (MRI) after intracavernosal alp...

Figure 33.7 Sagittal magnetic resonance imaging (MRI) showing invasion of the c...

Figure 33.8 Depth of cancer invasion tumour, node, metastasis (TNM) classificat...

Figure 33.9 (a–g) Pictures showing stages of a glansectomy and split skin graft...

Figure 33.10 (a–d) Pictures showing the stages of a total penectomy and fashion...

Figure 33.11 The stages for dynamic sentinel lymph node biposies. DSNB, dynamic...

Figure 33.12 The contents of the femoral triangle are dissected cleanly.

Figure 33.13 To protect the femoral vessels, the sartorius is detached from its...

Figure 33.14 Radical and modified inguinal lymph node dissection margins.

Chapter 34

Figure 34.1 Strain gauges fitted around the penis record nocturnal tumescence.

Figure 34.2 Paper strips can be used to denote expansion of the penis during sl...

Figure 34.3 A continuous record is made of expansion and elongation of the peni...

Figure 34.4 The pressure in the corpora is recorded during erection while fluid...

Figure 34.5 Using radio‐opaque fluid, leakage of contrast medium during erectio...

Figure 34.6 Mechanism of action of PDE5 inhibitors. NOS enzyme cleaves L‐argini...

Figure 34.7 Mechanism of action of PGE1 stimulates adenylate cyclase which resu...

Figure 34.8 Insertion of semi‐rigid prosthesis into corpora cavernosa.

Figure 34.9 ‘DuraPhase’ penile prosthesis (Euro Surgical Ltd).

Figure 34.10 ‘Dynaflex’ flexible penile prosthesis (Pfizer American Medical Sys...

Figure 34.11 The mechanism of ejaculation.

Figure 34.12 Incision to permit blood to flow from the corpora cavernosa into t...

Figure 34.13 Trucut needle used to make a fistula between the corpora.

Figure 34.14 Anastomosis between corpus spongiosum and cavernosum.

Figure 34.15 Anastomosis between the saphenous vein and corpus cavernosum.

Figure 34.16 Peyronie disease.

Figure 34.17 Polaroid photographs taken by a patient of his bent erections in P...

Figure 34.18 Nesbit's operation for Peyronie disease. A series of ellipses are ...

Figure 34.19 (a) Plication operation for Peyronie disease. Having made an artif...

Figure 34.20 Algorithm for diagnosis and treatment of late onset hypogonadism. ...

Chapter 35

Figure 35.1 The testicle in varying stages of descent in different mammals: in ...

Figure 35.2 Diagram of the anatomy of the testicle (a) lateral and (b) cross se...

Figure 35.3 Spermatogenesis.

Figure 35.4 Blood supply to the testis.

Figure 35.5 The veins of the testicle and the coverings of the cord.

Figure 35.6 Anatomy of the epididymis.

Figure 35.7 Surgical anatomy of the vas deferens.

Figure 35.8 The seminal vesicle develops as a diverticulum of the ejaculatory d...

Figure 35.9 Structure of the verumontanum. Note the presence of erectile tissue...

Figure 35.10 Hypothalamic‐pituitary‐gonadal axis. FSH, follicle‐stimulating hor...

Chapter 36

Figure 36.1 Right nonpalpable undescended testis.

Figure 36.2 Types of maldescent of testis on normal course of descent.

Figure 36.3 Intra‐abdominal left testis.

Figure 36.4 Bilateral undescended testis (palpable in groin).

Figure 36.5 Palpable left undescended testis. Note the bulge in groin.

Figure 36.6 Crease incision for orchiopexy.

Figure 36.7 The cremaster is split along its fibres revealing the processus vag...

Figure 36.8 (a) The sac is dissected off the cord. (b) The sac is retracted, an...

Figure 36.9 The testicle is mobilised and brought down to the scrotum, taking c...

Figure 36.10 (a) A pocket is made for the testicle by dissecting between the da...

Figure 36.11 Laparoscopic division of the testicular artery as the first stage ...

Figure 36.12 (a) If one complete genitourinary ridge fails to develop there is ...

Figure 36.13 Types of abnormal junctions between the gonad and the wolffian duc...

Figure 36.14 Left scrotal swelling (i.e. hernia/hydrocele).

Figure 36.15 Incarcerated inguinal hernia.

Figure 36.16 Right scrotal swelling.

Figure 36.17 Testicular tumour. Note the inguinal approach.

Figure 36.18 Left varicocele.

Figure 36.19 Acute scrotum acknowledgement.

Figure 36.20 Extravaginal perinatal torsion of testis.

Figure 36.21 Torsion in undescended testis.

Figure 36.22 Blue dot sign of torsion of testicular appendages.

Chapter 37

Figure 37.1 To prevent testicular atrophy occurring from pressure by the haemat...

Figure 37.2 Epididymectomy: a little branch of the testicular artery supplies t...

Figure 37.3 Epididymectomy: the epididymis is removed, sparing the main testicu...

Chapter 38

Figure 38.1 Various types of hernia and hydrocele. (a) Common hydrocele, (b) en...

Figure 38.2 Ultrasound of a hydrocele.

Figure 38.3 Ultrasound of complex hydrocele showing multiple large septate mass...

Figure 38.4 Jaboulay's ‘bottle’ operation for hydrocele.

Figure 38.5 Lord's plication for hydrocele.

Figure 38.6 Radical cure of hydrocele. The surplus tunica vaginalis testis is e...

Figure 38.7 Cysts of epididymis are diverticula of the vasa efferentia testis.

Figure 38.8 Ultrasound of epididymal cyst.

Figure 38.9 Neonatal extravaginal torsion of the testis.

Figure 38.10 Intravaginal torsion of the testis.

Figure 38.11 Doppler ultrasound showing lack of blood flow in the testicle.

Figure 38.12 Torsion of the appendix testis.

Figure 38.13 Ultrasound of third testicle.

Figure 38.14 Venous drainage of the testis.

Figure 38.15 Varicocele visible through scrotum.

Figure 38.16 Doppler ultrasound showing a varices.

Figure 38.17 Laparoscopic clipping of testicular veins for varicocele.

Figure 38.18 High ligation of testicular veins through the inguinal approach.

Figure 38.19 Low ligation of testicular veins at the external ring.

Chapter 39

Figure 39.1 It is difficult to feel a lump in the testicle when it is surrounde...

Figure 39.2 Ultrasound images of the testicle (a) large solid lesion representi...

Figure 39.3 Computed tomography (CT) scans (a‐e) showing large para‐aortic lymp...

Figure 39.4 Magnetic resonance imaging (MRI) scans showing large para‐aortic ly...

Figure 39.5 Orchiectomy for testicular tumour. A clamp is placed on the cord be...

Figure 39.6 The cord is transfixed and ligated above the clamp.

Figure 39.7 Cellular origin of germ cell tumours.

Figure 39.8 T staging of tumour of the testis.

Figure 39.9 Spread of testis tumours. (a) By lymphatics to the ipsilateral para...

Chapter 40

Figure 40.1 Scrotal ultrasound showing intratesticular neoplasia.

Figure 40.2 Scrotal ultrasound showing intratesticular neoplasia (arrow); dou...

Figure 40.3 Transrectal ultrasound image showing a midline prostatic cyst cau...

Figure 40.4 Transrectal ultrasound‐guided seminal vesiculography showing a di...

Figure 40.5 Testis biopsy a few tubules are snipped off and immersed in Bouin...

Figure 40.6 Transurethral resection of the ejaculatory ducts using a resectos...

Figure 40.7 Epididymo‐vasostomy.

Figure 40.8 Microdissection TESE: image showing the seminiferous tubules unde...

Chapter 41

Figure 41.1 Some congenital anomalies of the seminal vesicles.

Figure 41.2 Diagram of an example of a congenital anomaly of the wolffian syste...