Genitourinary Surgery Overview
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Questions and Answers

What is the primary function of the kidneys?

  • Filtering urea and liquid waste from blood (correct)
  • Regulating blood pressure
  • Secreting epinephrine
  • Storing urine until voiding
  • How are the adrenal glands primarily supplied with blood?

  • From the common iliac arteries
  • Through the superior vesical arteries
  • From the aorta and renal arteries (correct)
  • Via the renal vein and inferior phrenic arteries
  • What is the approximate length of the male urethra?

  • 25-30 cm
  • 10-15 cm
  • 20-25 cm (correct)
  • 15-20 cm
  • Which artery supplies blood to the prostate gland?

    <p>Pudendal artery</p> Signup and view all the answers

    During GU surgeries, which factor is NOT a perioperative nursing consideration?

    <p>Molecular structure of anesthetics</p> Signup and view all the answers

    What distinguishes the right kidney from the left kidney?

    <p>It is positioned lower due to liver placement</p> Signup and view all the answers

    What is the primary role of the bladder in the genitourinary system?

    <p>Serving as a reservoir for urine</p> Signup and view all the answers

    What is the correct diameter range of adult ureters?

    <p>4-5 mm</p> Signup and view all the answers

    What is the primary purpose of using normal saline during cystoscopy?

    <p>Providing irrigation during observational interventions</p> Signup and view all the answers

    Which type of laser is commonly used in laser lithotripsy procedures?

    <p>Holmium YAG Laser</p> Signup and view all the answers

    What is one of the key precautions for using lasers in surgical settings?

    <p>Basin of water must be present for fire safety</p> Signup and view all the answers

    Which irrigation fluid should be used with monopolar cautery where high absorption is anticipated?

    <p>Glycine</p> Signup and view all the answers

    What type of cystoscope is primarily used during endoscopic examination for most patients?

    <p>Rigid cystoscope</p> Signup and view all the answers

    Which procedure is classified as a closed GU surgery?

    <p>Pyelolithotomy</p> Signup and view all the answers

    In the context of urinary tract surgeries, what does TURP stand for?

    <p>Transurethral Resection of the Prostate</p> Signup and view all the answers

    What is the purpose of using a resectoscope in surgical interventions?

    <p>To remove tissue during transurethral procedures</p> Signup and view all the answers

    Which of the following statements about flexible cystoscopes is true?

    <p>They are used mainly when rigid scopes are insufficient.</p> Signup and view all the answers

    What is commonly required in the operating room for individuals involved in laser procedures?

    <p>Goggles or glasses for all present</p> Signup and view all the answers

    What is the primary solution used for preserving a kidney during transplant?

    <p>University of Wisconsin solution</p> Signup and view all the answers

    Which anatomical positioning is appropriate for the performing of ureteroneocystostomy?

    <p>Donor Ureter to Recipient Bladder</p> Signup and view all the answers

    What suturing material is commonly used for vascular anastomosis in kidney transplantation?

    <p>Prolene/Surgipro</p> Signup and view all the answers

    In the context of testicular torsion, which symptom primarily indicates the condition?

    <p>Unexplained scrotal pain</p> Signup and view all the answers

    During orchidopexy, which step is crucial for maintaining the testicle's position?

    <p>Suturing with an anchor stitch</p> Signup and view all the answers

    What symptom is commonly associated with bladder tumors?

    <p>Hematuria</p> Signup and view all the answers

    Which approach is used in a Simple Retropubic Prostatectomy?

    <p>Abdominal incision</p> Signup and view all the answers

    What is a potential complication that might require a cystogram during a procedure?

    <p>Bladder perforation</p> Signup and view all the answers

    During a Nerve Sparing Radical Retropubic Prostatectomy, what is the major concern for the surgeon?

    <p>Damage to important structures for erectile function</p> Signup and view all the answers

    In a Suprapubic Prostatectomy, how is access gained to the prostate gland?

    <p>Through the bladder</p> Signup and view all the answers

    What sutures are typically used in a Vesicourethral Anastomosis during radical prostatectomy?

    <p>3-0 Polysorb sutures</p> Signup and view all the answers

    What procedure is performed to assess the bladder for cancer and adjacent tissues?

    <p>TURBT</p> Signup and view all the answers

    Which surgical approach makes intraoperative bleeding more challenging to control?

    <p>Suprapubic Prostatectomy</p> Signup and view all the answers

    What is the main goal of performing a TUR procedure for bladder tumors?

    <p>To excise the tumor from the bladder wall</p> Signup and view all the answers

    What fluid is typically used for continuous bladder irrigation following a prostatectomy?

    <p>Normal Saline</p> Signup and view all the answers

    What is the primary purpose of the ileal conduit in radical cystectomy?

    <p>To divert urine flow</p> Signup and view all the answers

    Which surgical approach is most commonly used for nephrectomy?

    <p>Lateral positioning</p> Signup and view all the answers

    What distinguishes laparoscopic prostatectomy from open prostatectomy?

    <p>Laparoscopic dissection may occur only for nonmalignant cases</p> Signup and view all the answers

    Which statement correctly describes a radical cystectomy with pelvic lymphadenectomy?

    <p>It totals the removal of the bladder and associated structures</p> Signup and view all the answers

    During laparoscopic nephrectomy, what is one of the main advantages over open nephrectomy?

    <p>Shorter recovery time</p> Signup and view all the answers

    Which approach is used for open bladder surgery when addressing significant urological issues?

    <p>Open approach with supine positioning</p> Signup and view all the answers

    What is the purpose of the Verres needle in laparoscopic procedures?

    <p>To create the working space via insufflation</p> Signup and view all the answers

    What is a significant consideration during the kidney transplant procedure?

    <p>Donor kidneys are typically implanted in the iliac fossa</p> Signup and view all the answers

    Which statement is true about the surgical approach for bladder issues?

    <p>Transurethral approaches include diagnostic testing as well</p> Signup and view all the answers

    What is the common postoperative complication associated with an ileal conduit?

    <p>Loss of urinary control</p> Signup and view all the answers

    Study Notes

    Genitourinary Surgery Overview

    • Genitourinary (GU) anatomy includes critical components such as kidneys, adrenal glands, ureters, bladder, and reproductive organs.
    • Surgical interventions for GU surgeries encompass procedures like scrotal surgery, prostate surgery, and kidney surgery.

    Anatomy - Kidneys

    • Positioned retroperitoneally; essential for removing urea and liquid waste from blood.
    • Supplied by renal artery branching directly from the aorta; drainage occurs via the renal vein.
    • Recognized as highly vascular organs; the right kidney is smaller and lower due to liver location.

    Anatomy - Adrenal Glands

    • Endocrine glands located atop the kidneys.
    • Secretions include epinephrine (medulla) and various steroids and hormones (cortex), influenced by the pituitary gland.
    • Blood is supplied by arterial branches from the inferior phrenic artery and renal arteries.

    Anatomy - Ureters & Bladder

    • Ureters extend from renal pelvis to bladder base, measuring 25-30 cm long and 4-5 mm in diameter.
    • Function through peristalsis to propel urine to the bladder.
    • Bladder serves as the urine reservoir and is located extraperitoneally; supplied by superior and inferior vesical arteries, draining into the internal iliac vein.

    Urethra

    • Male urethra length: 20-25 cm; Female urethra length: 4 cm.

    Anatomy - Prostate Gland

    • Located at bladder neck, surrounding the urethra, with four glandular regions encapsulated by a capsule.
    • Blood supply from pudendal and inferior vesical arteries.

    Male Reproductive Organs

    • Paired organs include testes, epididymis, vas deferens, Cowper’s glands.
    • Singular organs include the penis and scrotum.

    Perioperative Nursing Considerations

    • Key factors in perioperative care include anesthesia management, patient positioning, surgical count, blood replacement protocols, and appropriate choice of irrigation fluids.

    Instrumentation and Equipment

    • Basic laparotomy sets with short/long instruments for prostate and kidney procedures, large abdominal retractors, Foley catheters, cystoscopes, and resectoscopes.
    • Lasers used include Holmium YAG and KTP Green Light; strict fire safety precautions are essential.

    Irrigation Fluids

    • Normal Saline: Used for observational interventions and compatible with lasers.
    • Sterile Water: Utilized with monopolar cautery when absorption is minimal.
    • Non-electrolytic mediums such as Sorbitol and Glycine are employed when absorption is expected.

    Surgical Interventions - Comparison

    • Closed GU Surgery examples: Cystoscopy, Ureteroscopy, Laser Lithotripsy, TURP (Transurethral Resection of Prostate), TURBT (Transurethral Resection of Bladder Tumor).
    • Open GU Surgery examples: Prostatectomy, Cystectomy, Nephrectomy, Kidney Transplant.

    Cystoscopy

    • A procedure for examining lower urinary tracts using rigid or flexible scopes.
    • Common indications include obstructive symptoms, with potential complications such as hypervolemia and hyponatremia.

    Prostate Surgery Techniques

    • Simple Retropubic Prostatectomy: Emphasizes good exposure and bleeding control through an abdominal incision.
    • Suprapubic Prostatectomy: Access to the prostate through a low abdominal incision, with difficulties in controlling bleeding.
    • Nerve Sparing Radical Prostatectomy: Aims to preserve erectile function by avoiding nerve damage.

    Bladder Surgery

    • Open radical cystectomy involves the removal of the bladder and adjacent structures.
    • Creation of an ileal conduit diverts urine flow post-surgery using a segment of the ileum.

    Kidney Surgery

    • Nephrectomy is commonly performed through lateral positioning, utilizing flank or thoracoabdominal approaches.
    • Laparoscopic nephrectomy offers shorter recovery times but typically involves longer surgical durations.

    Kidney Transplant

    • Indicated for patients with renal failure, involving the donor kidney's anastomosis to the recipient’s vasculature.
    • Commonly performed laparoscopically, often necessitating two ORs for living donor procedures.

    Orchidopexy

    • Surgical correction of undescended testicles, primarily in pediatric patients, ensuring proper anatomical positioning.

    Testicular Torsion

    • A surgical emergency characterized by twisted spermatic cords threatening blood supply; immediate intervention is essential.

    Conclusion

    • Understanding GU anatomy and surgical procedures' nuances is vital for effective perioperative care and patient management.

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    Description

    This quiz covers the essential aspects of genitourinary anatomy including the kidneys, adrenal glands, ureters, and bladder. It also highlights surgical interventions such as scrotal and prostate surgeries. Test your knowledge on this critical area of medical science.

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