Genitourinary Emergencies

Chapter 33 Genitourinary Emergencies



This chapter discusses common genitourinary emergencies seen the emergency department. Problems of the urinary tract are covered, as well as problems unique to males and dialysis patients. See Chapter 47, Gynecologic Emergencies, for more information related to specific female genitourinary emergencies.



Problems of the Urinary Tract



Acute Uncomplicated Pyelonephritis


Pyelonephritis is an inflammation of the kidneys that involves the tubules, glomeruli, and renal pelvis. It is more commonly seen in women. The usual cause is a bacterial infection with gram-negative bacilli such as Escherichia coli. Risk factors for the development of pyelonephritis include anatomical or functional genitourinary abnormalities and a new sexual partner in women.






Gross Hematuria


Hematuria is a symptom of nephrological and urological diseases; gross hematuria is enough blood present in the urine to cause a noticeable color change. Blood may appear in the urine as a result of the following:



Bleeding at the start of urination suggests a problem in the region of the anterior urethra. If blood is visualized at the end of the urinary stream, suspect bleeding from the posterior urethra or prostate. If bleeding is noted throughout urination, the most likely cause is a bladder or upper urinary tract source.


Important considerations for the patient with gross hematuria include the following:







Renal Calculi


The pain of renal colic typically radiates from the flank to the ipsilateral lower quadrant, the groin, and (occasionally) the leg. Men may also describe pain that radiates to the testicle on the affected side, while women may report pain in the labia on the affected side. This pain results from ureteral distension caused by the passage of renal calculi. The size of the stone or clot does not necessarily relate to pain severity. Important patient historical information includes the following:








Aug 9, 2016 | Posted by in EMERGENCY MEDICINE | Comments Off on Genitourinary Emergencies

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