Conteudo Anecoico Na Bexiga

Conteudo Anecoico Na Bexiga – Clinical Case – Vaccination Fabricio Leite de Carvalho PhD USP Professor of Urology. Faculty of Medical Sciences, MG University Hospital.

Presentation on theme: “Clinical Case – Wading Dysfunction Fabricio Leit de Carvalho PhD in Urology USP Adjunct Professor Faculty of Medical Sciences MG University Hospital.” – Presentation Text:

Conteudo Anecoico Na Bexiga

Conteudo Anecoico Na Bexiga

1 Clinical case – Vaccination failure Fabricio Leite de Carvalho PhD USP Professor in Urology. Hospital Hospital MG University of Medical Sciences Belo Horizonte MG1 Faculty of Medical Sciences

Noções De Ultrassonografia

2 Case 1 JOL, 23 years old, female QP: urinary incontinence HDA: urgency and disappearance, frequency, nocturia 3x Feeling very uncomfortable symptoms denies loss of effort Denies emptying bladder symptoms AP: Nulliparous. History of any joint disease/surgery excludes drug use Physical examination: No dystopias, no cough or valsalva 2.

3 Case 1 Normal urine: ndn Urine culture: no bacterial growth Urinary tract ultrasonography: kidney abnormal Urine with normal thick walls: 250 ml Voiding balance: zero Voiding diary (3 days) Average 1 Volume: 50 ml Maximum volume: 200 ml Day frequency: 8 x Night frequency: 2x 1-2 loss events/day (urgent) 3

5 Behavior 1. Behavior Therapy 2. Pelvic Floor Rehabilitation Exercise 3. Electrostimulation 4. Drug Therapy What is the first choice? Beta 3 Agonist Anticholinergic Tricyclic Antidepressants 5

6 Treatment Behavioral therapy + pelvic floor rehabilitation Physiotherapy for 2 months Antimuscarinic treatment: Solinfecin 5 and 10 mg Oxybutynin 5 mg 12/12 hours 6 Failure

Ultrassonografia Do Sistema Urinário E Reprodutor

11 Next Steps 1. Other antimuscarinics 2. Relationship with antimuscarinics 3. Tricyclics 1. Isolation 2. Relationship with antimuscarinics 4. Beta 3 agonists 5. Third line of treatment? Botulinum toxin NMS 11

12 Case 2 EB, 80 years old, male QP: recurrent UTI and urinary incontinence HMA: 5x nocturia, frequency, poor flow, sensation of incomplete voiding. Onset of LUTS 5 years ago (mild) but getting worse. IPS: 20 QoL: SVD required for 5 episodes of urinary retention, voided volume up to 1 liter (currently using SVD) Average 4 UTI events/year 12

13 Case 2 AP: Non-insulin-dependent diabetes EF: Clear urine, painless TR: Prostate 3-4x enlarged to palpable, fibroblastic without nodes Urine culture: E coli MS PSA: 3, 5 13

Conteudo Anecoico Na Bexiga

14 Procedures 1.UTU Ultrasound 2.Pelvic Ultrasound 3.Urethrocystoscopy 4.Urodynamic Study How to do this in patients using SVD 14

Pdf) Protocolo Alternativo Na Utilização Do Estrógeno De Curta Duração No Tratamento Da Incontinência Urinária Em Cadela

15 Case 2 Ultrasonography Urethral and pelvic organs: kidney abnormal Prostate 118 g pre-void volume: 400 ml Waste: 250 ml bladder thick walls 15

21 TURP 80 g Resection of AP material: prostatic hyperplasia, no signs of neoplasia ↓ no improvement in urinary symptoms. Continue: Urinary, poor flow, incomplete urination, frequent UTIs Most: Urinary retention required SVD 21

22 Post-operative examination cystoscopy: absence of urethral stricture or bladder neck sclerosis ↓ ↓ CIL! 22

23 Case 3 BDC, 71 years old, male QP: Urinary incontinence after retropubic RP 3 years ago HDA: Loss of strength No loss of 3 pads during the day in the supine position and voiding urinary urgency at sleep Bladder full empty, normal voiding AP: SAH COPD 23

Qual O Tamanho Normal Da Próstata?

24 Case 3 Abdominal Physical Examination: Abnormal Reproductive Organ and Perineum: Mild Absence Nerve Absence TR: Free Glandular Field Laboratory Examination Urine I= Normal. Urine Culture: Negative PSA: Undetectable Glucose and Creatinine: Normal 24

25 habits? 1.Voiding Diary 2.Ultrasonography 3.Urethrocystography/Urethrocystoscopy 4.Urodynamic Study – How to assess the severity of IUPPR? – 25

26 cases 3 void diary 2-3 hours per urine. Nocturia 1x Urine volume: 150 to 300 ml Diuresis 24 hours = 1500 ml Ultrasonography Kidney normal Post-bladder residual: 10 ml Urethrocystoscopy: Normal, no obstruction 26

Conteudo Anecoico Na Bexiga

32 Post-operative follow-up initially showed significant improvement: 1 pad/day (safe), mostly dry scars with vigorous physical activity only after 6 months with no external symptoms; 1 pad/day after 1 year: worse than 3 pads/day

Laudo Us Aparelho Urinário

38 Procedure 1.Injection 2.Transobturator Sling (again) Remove the anterior sling.

39 Case 4 NOS, 55 years old, female QP: Recurrent UTI HDA: After OTT surgery in 2014, she had more UTIs than before Bladder emptying symptoms G3PC2A1 Menopausal LMP: 04/25/2015 Uses nortriptyline 25 mg/day and tibolone (hot flush). He denied dyspareunia 39

40 Case 4 Female examination: no dystopias, membrane hypotrophy +/4+, no discharge signs of mesh extrusion Cytology: no atypias 01/06/2016 Previous urine culture: all showed E coli multi s. Current urine culture: E coli resistant to ampicillin, ciprofloxacin and sulfamethoxazole 40

42 Case 4 Ultrasound of the ureter: kidney with abnormal anchoic contents, NL thickness: 400 ml Post-void volume: Neglected Urethrocystoscopy: Absence of ureteral erosion or infusion FB 42

Cisto Renal (simples, Complexo, Cortical, Bosniak)

48 Case 5 ATF, 31 years old, female QP: Urinary incontinence HDA: Urgent and absent, Urinary episodes Urinary incontinence, urinary frequency and loss of effort Both conditions are very There are many and I am not sure which one is the most as she is suffering from symptoms He denies bladder emptying symptoms AP: G1P1A0. History of any joint disease/surgery precludes drug use Physical examination: no dystopias, with cough and micturition 48

49 Case 5 Frequent urination: ndn Urine culture: no bacterial growth Urinary tract ultrasonography: kidney abnormal Absence of residual bladder with 300 ml full Voiding diary (3 days) average urine volume: 150 ml . Maximum Volume: 250 ml Average Daily Frequency: 10 x Total Volume: 1500 ml Average Night Volume: 3x Total Volume: 450 ml +/- 4-5 events per day (emergency) 49

54 Ritual 1. Drug therapy Beta 3 agonist anticholinergics 2. Behavior therapy 3. Pelvic floor rehabilitation Physiotherapy 4. Electrostimulation 5. Surgical treatment SUI sling 54

Conteudo Anecoico Na Bexiga

55 Antimuscarinic therapy Solifenacin 5 mg Solifenacin 10 mg New urodynamics or TT SUI Physical surgery 55 Rapid improvement in failure but SUI remains

Nota De RepÚdio

57 4th month follow-up PO No complaints about loss of potency but no complaints about voiding: Worsening storage symptoms: again urgency and urge to continence, this time even using solifenacin 10 mg “Doctor, no more loss.” can urinate. Jim, but incontinence worse than before surgery! Urinary frequency: nl Urine culture: negative 57

59 Case 5 Ultrasound of the bladder with thick walls Absence of internal lesions or FB Pre-void volume: 250 ml Post-void residual: Absence Urethracystoscopy of the urethra Absence of urethral erosion Absence of F59

63 Ritual 1. Insist on the second line of TT: 1.try another antimuscarin 2.Beta 3 agonist 3.Association 2.Start with the third line of TT: 1.Electrical stimulation 63

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Minha Retirada De útero

To operate this website, we access user data and share it with processors. To use this website, you must agree to our privacy policy, including our cookies policy. A cyst (pronounced cyst in Portuguese) is basically a fluid or fluid-filled sac surrounded by a membrane, forming a kind of bag or bag. Simply put, a cyst is a fluid-filled blister.

Kidney cysts are similar to cysts in other parts of the body, such as ovarian cysts, breast cysts, or synovial cysts. In fact, cysts can appear anywhere in the body, from the brain to the skin.

In most cases, cysts are benign lesions, do not cause symptoms and do not require treatment. Removal of the lymph nodes is usually required when one of the following conditions is met:

Conteudo Anecoico Na Bexiga

The presence of kidney cysts is a very common diagnosis, especially in the elderly. The prevalence of kidney cysts in the population varies by study, but is estimated to be between 30 and 50% of people over the age of 50. A kidney cyst is like a white hair, it does not cause any problems, and the person gets older.

Boletim Teste By Associação De Ginecologia E Obstretrícia Do Rio De Janeiro

In most cases, a completely asymptomatic cyst of the disease is performed unexpectedly with an abdominal ultrasound or CT scan requested for another reason.

Before we continue, watch this short video about kidney stones, which summarizes the information in this article.

Kidney cysts are not a form of cancer and do not carry the risk of developing cancer. A cyst is a cyst, cancer is cancer, but there are types of cancer that can look like cysts. Therefore, every time a kidney cyst is seen on ultrasound, it is important for the radiologist to inform us that the lesion is really a cyst or a very hard lesion that can suggest a characteristic malignant tumor.

To help with this classification, kidney fibers are divided into simple cysts and hard cysts. We call a simple cyst that is filled with fluid only and has a very normal round shape like the picture above. It is called a cyst

Diagnóstico Por Imagem

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