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Genitourinary Emergencies

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Presentation on theme: "Genitourinary Emergencies"— Presentation transcript:

1 Genitourinary Emergencies
Chemeketa Community College Paramedic Program

2 Penile Fracture Usually when erect Hear a “crack” or “tear”
Abrupt pain , swelling Ecchymosis, deviation, immediate flaccidity Urethral tear warrants immediate surgery

3 Priapism Prolonged, painful erection Ischemia, fibrosis Causes
Sickle cell disease Drugs ED Hypertension Depression Anticoagulants Urologist

4 Urinary Catheterization
Used to drain bladder Prevent urinary incontinence Short and long term Complications Trauma Put in and taken out Urethral injury UTI Sepsis



7 UTI Women more often than men Increase in bacteria
Fecal matter Bubble baths Tampons Catheter Chlamydia most common cause for men

8 PID Usually sexually transmitted infection Vagina to fallopian tubes
Mild to severe crampy pain Changes in menstration Sometimes hard to diagnose cause Typically chlamydia

9 Thrush Itching Soreness and irritation Vaginal discharge
Pain/discomfort during intercourse Pain/discomfort during urination


11 Acute Scrotal Pain Trauma Epididymitis Torsion Orchitis Fournier’s
Hernia Renal colic Abscess Varicocele Neoplasm

12 Testicular Trauma Painful Need I say more

13 Epididymitis Most common complaint of scrotal pain
Differentiated from testicular torsion Inflammatory reaction to certain pathogens Chlamydia trachomatis responsible for 2/3 of the cases

14 Testicular Cancer Misdiagnosed as Epididymitis Intractable pain N/V

15 Prostatitis Most misdiagnosed disorder Dysuria Frequency Urgency
Back or perineal pain Fever Chills Dehydration

16 Testicular Torsion True surgical emergency
Most common in adolescent males Severe unilateral scrotal pain Possible swelling Arterial ischemia causing infarction of the testicle Rapid recognition and treatment Ultrasound?

17 Acute Orchitis Approximately 20% of prepubertal patients with mumps develop orchitis Testicular pain and swelling Associated with epididymitis Testicular atrophy occurs in 60%

18 Fournier Gangrene (Necrotizing Fasciitis)
Immune compromised Diabetes mellitus Morbid obesity Cirrhosis Vascular disease of the pelvis Malignancies Pain and itching of the scrotal skin Progressive, rapidly spreading, inflammatory infection located in the deep fascia, with secondary necrosis of the subcutaneous tissues Mortality as high as 75%


20 Appearance of patient's pubic region after initial debridement, with scrotum and suprapubic fat pad excised, testes preserved within tunica vaginalis, and penile skin and subcutaneous tissue debrided 'Aho T et al. (2006) Fournier's gangrene Nat Clin Pract Urol 3: 54–57 doi: /ncpuro353


22 Necrotizing Fasciitis
Causes Trauma Surgery Idiopathic Mean age years Begins with erythema that quickly spreads Dusky or purplish skin discoloration Morbidity and mortality is 70-80%

23 Strangulated Hernia Painful enlargement of previous hernia N/V
Even if reduced N/V Bowel obstruction symptoms Sepsis


25 Urethral Bleeding? D/Dx

26 Urethral Bleeding Trauma Catheter Chancre Meatitis Cancer Foreign Body
Saddle, Crotch, Perineal area Catheter Chancre Meatitis Cancer Bladder Urethra Foreign Body Calculus Kidney Schistosomiasis

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