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Diagnostic Procedures in Clinical Urology

General objective: Acquire the knowledge to understand:

  • The clinical setting in which diagnostic procedures are indicated.
  • The appropriate diagnostic maneuvers for definition of specifically named disease states, and the potential value, limitations and hazards of each diagnostic maneuver.
  • The physiologic basis for each diagnostic procedure.
  • The results of each study. Demonstrate proficiency in explaining the hazards, costs, risks and benefits to the patient.

Urinalysis

  • Know the items that may be examined during urinalysis and the disease oriented implication of any abnormality, such as specific gravity, proteinuria, glucosuria, hematuria, bacteriuria, pyuria, crystaluria, and casts.
  • Know the general disease states that may involve the urinary tract, the abnormalities of urinalysis that may accompany these disease states and the reasons for these abnormalities, such as inflammatory disease, malignant disease, calculus disease, diabetes mellitus, diabetes insipidus, and renal tubular acidosis.

Post void residual

  • Know how to measure a post-void residual with a catheter and with ultrasound. Understand the limitations or risks of both these methods.
  • Know the general disease states that may involve the urinary tract, the emptying disorders that may accompany these disease states and the reasons for these abnormalities, such as neurogenic disease, bladder outlet obstruction, and diabetes insipidus.

Semen analysis

  • Know the criteria that may be examined during semen analysis and the implications of any abnormality.

Urologic radiology

  • Know the forms of contrast imaging techniques available for diagnostic evaluation of the urinary tract, the indications for, limitations and hazards of each procedure.
    • IV excretory urography
    • Retrograde pyelography
    • Cystography
    • Retrograde urethrography
    • Antegrade percutaneous pyelogram
    • Ileal loop-o-gram
    • Voiding cystourethrography
    • CAT scan
    • MRI scan
    • Angiography and venocavography
    • Vasography
    • Cavernosography
  • Understand the methodology, indications and hazards of ultrasonography of the urinary tract and male genitalia.
  • Understand the principles, methodology, indications and hazards of radioisotope studies of the urinary tract and male genitalia, and be able to interpret the results of these studies.
    • Renal scans
    • Measurement of renal function
    • Localization of inflammatory lesions
    • Bone scans

Understand the indications for a urodynamic assessment

  • Cystometrogram
  • Urine flowmetry
  • Pelvic floor EMG
  • Voiding/pressure studies
  • Urethral pressure profile
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