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Procedures for Kidney StonesMedical intervention is necessary when kidney stones or renal calculi are too large to pass spontaneously (typically greater than 5 millimeters) when stones are accompanied by symptomatic infection (such as fever or pyelonephritis), when they impair kidney function, or when they cause persistent symptoms like severe pain, nausea, or urinary retention. Additionally, patients with only one kidney or those who cannot be treated with medical management also require...
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Renal calculi, commonly termed kidney stones, are crystalline solid masses that form in the kidneys but can occur at any point within the urinary system, encompassing the kidneys, ureters, bladder, and urethra.The pathophysiology of renal stones involves several key factors: supersaturation of the urine with stone-forming constituents, changes in urine pH, a decrease in urine volume, and the presence of substances that promote or inhibit stone formation.Supersaturation of Urine: This is the...
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Urinary Tract Infection III: Diagnostic Studies and Interprofessional Care01:30

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A healthcare provider can diagnose a urinary tract infection (UTI) through several methods:Medical History and Symptoms: The provider will take a detailed medical history and ask about symptoms such as frequent urination, burning sensation during urination, and lower abdominal pain.Urinalysis: A clean-catch urine sample is collected in a sterile container and tested for the presence of bacteria, white blood cells (leukocytes), nitrites, blood, and protein. The presence of leukocytes and...
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Meaning of Cystoscopic Examination:Cystoscopy is an essential diagnostic tool in urology that is used to assess the structure and function of the genitourinary system. It provides a direct view of the urethra, bladder, and, in some cases, the ureteral openings. This procedure helps detect structural abnormalities, infections, cancers, and blockages in the urinary tract. There are two types of cystoscopy:Flexible cystoscopy is commonly performed in outpatient settings due to its less invasive...
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[Hypospadias : Insights and challenges].

I Rübben1, R Stein2

  • 1Klinik und Poliklinik für Urologie, Kinderurologie und Uroonkologie, Universitätsklinikum Essen, Hufelandstr. 55, 45122, Essen, Deutschland. iris.ruebben@uk-essen.de.

Der Urologe. Ausg. A
|September 13, 2017
PubMed
Summary
This summary is machine-generated.

Hypospadias, a common birth defect, may be linked to environmental factors like endocrine disrupting chemicals (EDCs). Surgical correction is indicated, but complication risks increase with follow-up time, emphasizing the need for experienced centers.

Keywords:
AndrogenEmbryologyForeskinHypospadiasPenisUrethra

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Area of Science:

  • Pediatric Urology
  • Congenital Malformations
  • Environmental Health

Background:

  • Hypospadias is a frequent congenital childhood malformation affecting urethral development.
  • An increasing incidence has been observed, particularly in the US, with potential links to genetic and environmental factors.
  • Endocrine disrupting chemicals (EDCs) and assisted reproductive technologies are implicated as potential triggers.

Purpose of the Study:

  • To review the current understanding of hypospadias etiology, focusing on environmental influences.
  • To discuss the indications, surgical correction, and associated complications of hypospadias.
  • To highlight the importance of experienced surgical centers and long-term follow-up for managing hypospadias.

Main Methods:

  • Literature review of studies on hypospadias incidence, causes, and management.
  • Analysis of animal models demonstrating causal relationships between prenatal exposures and hypospadias.
  • Examination of data regarding surgical outcomes and complication rates based on follow-up duration and center experience.

Main Results:

  • Animal studies confirm that prenatal exposure to hormones and antiandrogens (e.g., phthalates, fungicides) can cause hypospadias.
  • Boys conceived via in vitro fertilization (IVF) show a higher likelihood of hypospadias.
  • Surgical complication rates are associated with longer follow-up periods and suggest benefits from high-volume centers.

Conclusions:

  • The etiology of hypospadias is multifactorial, with significant contributions from environmental factors like EDCs.
  • Surgical correction requires careful discussion of risks and benefits, with outcomes influenced by surgeon expertise and follow-up duration.
  • Long-term, competent follow-up into adulthood is crucial for patients with hypospadias.