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Endoscopy and Radiology for Lower Urinary Tract Dysfunction Hann-Chorng Kuo Department of Urology Buddhist Tzu Chi General Hospital.

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Presentation on theme: "Endoscopy and Radiology for Lower Urinary Tract Dysfunction Hann-Chorng Kuo Department of Urology Buddhist Tzu Chi General Hospital."— Presentation transcript:

1 Endoscopy and Radiology for Lower Urinary Tract Dysfunction Hann-Chorng Kuo Department of Urology Buddhist Tzu Chi General Hospital

2 Lower Urinary Tract Urinary bladder Ureteral orifices Trigone Bladder neck Prostate and prostatic urethra Urethral sphincter Urethra (posterior, bulbous, anterior)

3 Bladder wall in Cystoscopy Smooth bladder wall Trabeculated bladder wall Diverticulum Pseudodiverticulum Bladder tumor External compression

4 Smooth Bladder Wall

5 Trabeculation of Bladder Wall

6 Bladder Tumor

7 Bladder mucosa Normal mucosa and vasculature Hyperemia Ischemia Hemorrhagic cystitis Cystitis cystica Pseudomembranous trigonitis Granulomatous cystitis

8 Normal Mucosal Vasculature

9 Hyperemia and Inflammation

10 Hemorrhagic cystitis

11 Cystitis Cystica

12 Pseudomembranous Trigonitis

13 Granulomatous Cystitis

14 Tuberculosis Cystitis

15 Prostatic enlargement Benign prostatic enlargement Prostatic cancer

16 Bladder Neck Obstruction

17 Urethral Stricture Bladder neck contracture Membranous urethral stricture Anterior urethral stricture Anterior urethral valve Meatal stenosis

18 Urethral Stricture

19 Ureteral Orifice Normal cone shape Horseshoe shape Stadium shape Golf hole shape Short submucosal ureteral tunnel

20 Ureteral Orifice

21 Chronic Inflammation of Female Bladder Neck

22 Female Urethral Incompetence Bladder neck incompetence Urethral incompetence

23 Interstitial Cystitis

24 Painful Bladder Syndrome

25 Bladder Stone

26 Bladder musculature

27 Uroradiology in Lower Urinary Tract Dysfunction Intravenous pyelography (IVP) Retrograde pyelography Cystography Voiding cystourethrography Retrograde urethrography Beaded chain cystourethrograph Magnetic resonance image (MRI)

28 Intravenous pyelography in Benign Prostatic Hyperplasia

29 Inravenous Pyelography in High Grade Cystocele

30 Retrograde Pyelography in Ureteral stricture

31 Voiding Cystourethrography Bladder neck dysfunction Prostatic obstruction Urethral stricture Anterior urethral valve Vesicoureteral reflux Bladder diverticulum

32 Cystography on Straining

33 Urethral Incompetence

34 Bladder Base Indentation Prostate Enlargement

35 Voiding Cystourethrography Prostatic Obstruction

36 Voiding Cystourethrography in DESD and after Sphincterotomy

37 Voiding Cystourethrography Anterior urethral valve

38 Voiding Cystourethrography Dysfunctional voiding

39 Voiding Cystourethrography Urethral meatal stricture

40 Transrectal sonography Prostatic configuration Urethral stricture Bladder neck incompetence Bladder base hypermobility Intravesical pathology

41 Prostate Configuration Prostatic urethra Transition zone of prostate Seminal vesicle Ejaculatory duct Peripheral zone of prostate Bladder neck

42 Transrectal sonography of the Prostate, Seminal vesicle, Urethra

43 Prostatic Enlargement

44 Transition Zone Index (TZI) Transition zone vol/ total prostate vol A TZI of 0.5 indicates highly suspicious prostatic obstruction TZI correlates poorly with total prostatic volume

45 Measurement of TZI

46 Female Urethral Structure

47 Female Urethra in SUI

48 Hypermobility of Bladder Base

49 Beaded-Chain Cystourethrography

50 MRI of Cystocele

51 MRI of Large Cystocele & Enterocele

52 MRI of Rectocele

53 MRI of Uterine Prolapse


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