Important knowledge

⚡️ In acute renal failure dialysis should done while the kid. In recovery phase

⚡️acute tubular necrosis{ATN} is the most common cause of acute renal failure.

⚡️We should loss at least 80-90% of renal function to produce increase in urea & keratin level in blood (RFT) because one third of kidney (1/3) in enough for human

Complication of bladder injury

Classic triad of bladder rupture 1. Gross hematuria. 2. Suprapubic pain and tenderness (with sometimes bruising). 3. Difficulty or inability in passing urine.

Name of surgery Anderson-Hynes ( pyeloplasty)

Findings -Balooning of renal pelvis -atrophied renal paranchima -collapsed proximal ureter Diagnosis Pelvi-ureteric junction obstruction

Most common in left side -Varicocele - Duplication of Renal Pelvis - Ureteropelvic Junction (UPJ) (PUJ) Obstruction Most common in Rigt side - chriptochridism - Testicular malignancy - inguinal hernia - hydronephrosis & pylonephritis in pregnency

⚡️Ureteropelvic Junction (UPJ) (PUJ) Obstruction is the most common ranal congenital anomaly

Cobra head sign ( ureterocele )

⚡️The most common renal fusion anomaly is Horseshoe Kidney

⚡️ جماعة ال DM نتيجة ال Neuropathy يصير عدهم paralysis بال internal urinary sphincter (neck of bladder) وهذا يؤدي الى retrograde ejaculation وبالتالي infertility

Urethrogram Bulbur urethral stricture caused by gonorrhea (STD)

Gonorrhia discharge (yellow to green mucopurulant discharge)

pubo-prostatic ligment that tear with complete urethral tear lead to floating of prostate & bladder by D.R.E

⚡️Most common site of urethral injury in membranous urethra due to pelvic fracture or itrogenic by cystoscopy

Clinical features of urethral injury (very important) 1-drops of blood on the external meatus. 2-perineal heamatoma. 3-retention of urine.

Types of hypospadias

🔰Hypospadias ▪︎Is The most common congenital malformation of the urethra. ▪︎Urethra opens into the undersurface of the penis, scrotum, or perineum (Ventral Or Posterior Surface Of the Penis) ▪︎Result from incomplete development of the urethra ▪︎Hypospadias is combination of three anomalies: 1. an abnormal opening of the urethral meatus 2. curvature (chordee) of the penis 3. the prepuce is poorly developed (hooded prepuce) ▪︎Hypospadias is classified dependent on the position of the meatus 1.Distal hypospadias (most common) (Glanular – Coronal) 2.Mid penile 3.Penoscrotal (most severe) ▪︎Surgery Indications for hypospadias (At 1y Before 2y) 1.Cosmetic 2.Interfere With Semination 3.Interfere With Intercourse ▪︎Surgery Will 1.Correct The curvature of peins 2.Re sitting urethral meatus (creating new urethra) 🔰Epispadias ▪︎Rare ▪︎the opening Of the Urethra is on the Dorsum Of the Penis (Anterior Surface) ▪︎Usually coexists with bladder exstrophy. •Hypo للاسفل Ventral HV •Epi للاعلى Dorsum ED