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Urology
Urology Examinations & Procedures
| Question | Answer |
|---|---|
| urology involves an understanding of | the structure, physiology, and disease of the urinary system and the male reproductive system. |
| urologist | a provider specializing in treating diseases and disorders of these two systems. |
| nephrologist | provider who specializes in treating diseases and disorders of the kidneys. |
| Laboratory tests are important in the evaluation of urological health. | Blood tests and urine tests may provide indications that pathology is present. A complete analysis of the urine involves physical, chemical, and microscopic examination. |
| . To obtain accurate results, the medical assistant must ask the patient to collect a ______ ________ urine specimen | clean catch |
| A clean catch specimen means | that the patient has cleaned the vaginal or penile openings to rid the area of sloughing cells and microorganisms that may contaminate the urine sample |
| Blood tests are also performed to determine the health of the kidneys | Blood, urea, nitrogen (BUN), creatinine, uric acid, and blood protein levels are all tests that are used to evaluate renal function |
| Oliguria | scanty urination |
| Polyuria | passing large amounts of urine |
| Nocturia | to the need to urinate during normal hours of sleep or urinating frequently during the night |
| Urgency | to an immediate need to urinate |
| Incontinence | to an inability to retain urine |
| Dysuria | difficult or painful urination |
| The post-void residual (PVR) urine test measures | the amount of urine left in the bladder after urination. This is a common test medical assistants perform in a urology practice |
| The Post-void Residual Urine (PVR) Test | the test is used to help evaluate: Incontinence (accidental release of urine) in women and men. Urination problems. |
| Some laboratory analyses require a sterile urine specimen, which must be obtained by | catheterization. |
| catheterization. | This process involves inserting a sterile tube directly into the bladder through the urethra using a strict sterile technique. The medical assistant may assist the provider or may actually perform the procedure themselves. |
| Common Types of Catheters | straight catheters, and Foley catheters. |
| Straight catheters | are used for obtaining a single specimen and then discarded. They may also be utilized by the urologist for conditions, such as paralysis, that might cause urinary retention in the bladder. |
| Foley catheter | have a balloon that inflates to keep the catheter in place for an extended period of time. This type is useful for obtaining a 24-hour collection from a patient |
| Foley catheter use for | 24-hour collection from a pt who may not understand and follow the directions for obtaining specimen,used for pts during/after surgery/those on a meds that causes them to be incontinent, used for other urological difficulties that affect urine control. |
| Personal hygiene is a vital component | of caring for a patient with a urinary catheter. One of the greatest risks involved with urinary catheters is infection. |
| Ask for allergies | latex , iodine and tape |
| Cystoscopy | This procedure involves inserting a thin scope with a light into the urethra, which is then directed into the bladder. The physician can visualize and examine any abnormal pathology pathway that could include tumors, stones, infection, and bleeding |
| Provider Examination involves a | visual exam of the external genitalia of the pt. Lesions, drainage, rashes, and inflammatory signs should be noted. a male, the provider will carefully look at the skin of the penis, the prepuce or foreskin, and the glans. pubic hair examined for lice |
| Provider Examination involves the | penis, the scrotum should be inspected by the provider, including the skin, the posterior surface, and any swelling or excessive veins. Bulges might also be noted, indicating a hernia, either inguinal or femoral |
| Hernias are the | protrusion of a body part through a surrounding area into a body cavity, creating the observed bulge. The Figure to the left illustrates an inguinal type with a portion of the intestine protruding into the scrotal sac |
| Digital Rectal Exam | the provider will insert a gloved finger into the rectum and feel the prostate for enlargement, lumps, or any other abnormalities. |
| Trans-rectal Ultrasound (TRUS) | an ultrasound probe is inserted into the rectum to produce images to examine the prostate in men suspected of benign prostatic hyperplasia (enlargement of the prostate). The procedure is often used after the prostate is already determined to be enlarged. |
| Ultrasound procedures use | reflected sound waves to produce pictures of internal body parts. |
| if a high prostate-specific antigen (PSA), | a blood test to check prostate health, has been identified, and a biopsy is required, the TRUS may guide the location of the needle for the biopsy. |
| Other indications for TRUS are: | Estimation of prostate size ❖ Evaluation of lumps that are detected with a physical exam ❖ Evaluation of the vas deferens ❖ Evaluation of the seminal vesicles ❖ Evaluation of the ejaculatory duct |
| Potential Side Effects of TRUS Procedure: Urethral Bleeding | most men do pass a small amount of blood in their urine or leak blood from the penis after the procedure. This is an expected occurrence after the procedure. This should settle within 24-48 hours. |
| Potential Side Effects of TRUS Procedure: Rectal Bleeding | Most men do pass a small amount of blood in the first one or two bowel motions after the procedure. This is an unexpected occurrence after the procedure. This should settle within 24-48 hours. |
| Potential Side Effects of TRUS Procedure: UTI | Infection of the urine, prostate, or testicles can occur after the procedure and can cause symptoms of difficulty urinating, burning on urination, frequent urination, swollen testicles, or fevers. |
| Potential Side Effects of TRUS Procedure:Sepsis is a severe form of infection and is otherwise known as blood poisoning | The symptoms consist of fevers, chills, shaking, lethargy, warm skin, shortness of breath, rapid heartbeat, drowsiness, and a general feeling of being unwell. If this occurs, seek medical attention. |
| Potential Side Effects of TRUS Procedure: urinary retention | Occasionally patients will have difficulty passing urine after the procedure. This is called urinary retention. The symptoms consist of abdominal pain, poor flow of frequent urination. |
| Potential Side Effects of TRUS Procedure: pain | You may experience mild pelvic discomfort within 24 hours of the biopsy. |
| Potential Side Effects of TRUS Procedure: Erectile difficulties | Rarely patients have described difficulties in gaining erections after a prostate biopsy. |
| A biopsy | involves the surgical removal of tissue to determine if cancerous cells are present. Biopsies may be taken of any of the structures within the male reproductive system during TRUS procedures. |
| What is the purpose of an indwelling catheter? | Drain urine from the bladder Indwelling urinary catheters allow continuous drainage of urine from the bladder. |
| Which position is most appropriate for female catheter insertion? | Lithotomy position The lithotomy position provides optimal visualization of the urethral opening |
| What indicates correct catheter placement? | Urine begins to flow into tubing |
| Catheter Insertion | Clean the urethral opening and surrounding area using sterile antiseptic swabs. This step reduces microorganisms on the skin and helps prevent urinary tract infection. |
| Catheter Insertion | Apply sterile lubricant to the catheter tip to reduce friction during insertion. Proper lubrication helps minimize discomfort and prevents injury to the urethra. |
| Catheter Insertion | Gently insert the catheter into the urethra using sterile technique. Advance the catheter slowly until urine begins to flow. |
| Catheter Insertion | Watch for urine flowing through the catheter tubing. Urine flow confirms that the catheter has reached the bladder. advance the catheter slightly further after urine begins to flow to ensure the balloon is fully inside the bladder before inflation |
| Catheter Insertion | Once urine flow is observed, advance the balloon lightly further, make sure it's fully inside the bladder, then inflate the balloon with sterile water using the balloon port. The balloon secures the catheter in place inside the bladder. |
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