Urological Surgery
Core concepts
Know the evaluation and management of urinary tract obstruction, stones, hematuria, and urologic emergencies. Understand when obstruction with infection requires urgent decompression. Prostate disease spans benign hyperplasia and cancer, with distinct diagnostic pathways.
Key topics
- Obstructing stone with fever: urgent decompression with stent or nephrostomy, then definitive stone treatment.
- Testicular torsion: time-critical surgical exploration.
- Hematuria: risk stratification and cystoscopy for unexplained cases.
- Trauma: urethral injury versus bladder injury patterns.
Traps
- Treating an infected obstructed kidney with antibiotics alone.
- Delaying exploration in testicular torsion.
- Missing the difference between upper and lower tract bleeding sources.
- Overlooking renal function in bilateral obstruction.
Worked example
A patient with flank pain, fever, and hydronephrosis on imaging: infected obstructed kidney - decompress urgently, then treat the stone. Rule of thumb: pus under pressure needs drainage, not just antibiotics.
Study strategy
Pair each emergency with its time window. Build a differential for hematuria and know when imaging and cystoscopy are indicated.