⛔ Normal urine out put for adult/ day:

20-30 ml/hr or 0.5ml/kg/hr

⭕️ Undescended testis :

Def = arrest in normal pathway of descent , more in Rt side

Etiology = H3S = ¹ ⏬ HCG
                              ² short gabernaculm
                           ³ short spermatic cord
                  ⁴ strictures of inguinal canal

Cp = empty scrotum

Inx = Hormonal assay , US , Ct , laparoscopy

Ttt = orchedopexy & according to the age, or hormonal ttt.

Comp = 3T 2S 2I = ¹ torsion testis
                                 ² tumer
                                ³ truma
                                ⁴ sterility
                               ⁵ psychiatry
                              ⁶ infection
                           ⁷ indiret inguinal hernia

⭕️ Ectopic testis :

¹ Def = arrest testis outside normal pathway

² Ectopic site = superficial inguinal pouch commenst site

³ Ttt = orchedopexy or orchedoctomy no hormonal ttt

⭕️ Retractile testis :

Def = occure in young children due to exaggerated creamastric reflex

Note : cremastric ms not well developed in first 3 months so no retractile testis under 3 months

Type : ¹ low retractile = by melking test stay there
² high retractile = milking test dosen't stay

Ttt = orchedopexy

⭕️ Hydrocele :

Def = collection of serous fluid inside tunics vaginalis

Type : ¹ congenital / due to persistent of tunica vaginalis , reducible,  testis palpable

² aquired / idiopathic  , irreducible,  testis impalpaple

CP = scrotal swelling ,  +ve transllumination test , +ve fluctuation test 

Inx = scrotal US

Ttt = Jaboly operation = نفتح ونربط للخلف
Or Lords operation = نفتح ونربط ع الجناب

Complications =  ¹ pyocele
                              ² hematocele
                    ³ herniation through dartos
                    ⁴ buried penis

⭕️ varicocele :

Def = elongation or dilatation of pumpiniform plexus of veins

Site = unilateral lt side 95%

Type = ¹ primary ( reflux )
            ² secondary ( obstructive )

CP = dragging sensation or aching pain

Inx = doppler or duplex us

Ttt = ¹ secondary treat underlying cause

² Primary __ do varicelectomy by ( open , laparoscopic )
or sclerotherapy

Open ___ do  high ligation = ligation of testicular veins
or low ligation = ligation of pumpiniform plexus

Laparoscopic ___ do ligation of testicular veins

If reccurent do embolization

Complications = ¹ subfitility
        ² 2nd hydrocele & thromboplebitis

⭕️ Torsion testis :

Def = twisting of testis and epididymis around axis of spinal cord,  it's surgical emergency & more in Rt side

CP = sudden sever pain

D.d = ¹ torsion testis
          ² epidymo orchitis
نفرق عن طريق prehis signs
نرفع scrotum فوق ، لو الألم زاد يعني testis
ولو نقص يعني epidymo orchitis

Inx = urgent doppler & douplex

Ttt =  urgent exploration of scrotum
Do detorsion & orchedopexy

⭕️ penis disorder :

¹ hypospadias = opening of external urethral meatus on ventral side of penis , ttt early surgical correction before 2yr , CI circumcision

² epispadias = on dorsum

³ phimosis = foreskin can't be retracted over glans penis

⁴ para phimosis = inability to reduce fore skin , ttt by circumcision

⁵ circumcision = remove foreskin

Indication : Religion , social , phimosis , para phimosis

CI in : hypospadias,  bleeding disorder,
Unstable or sick infant

Complications : MC bleeding then infection

⁶ priapism = prolonged unwanted erection lasting > 4 hr

⭕️ testicular tumers :

2 type :

¹ Teratoma = هذا يمثل طلبة الطب 😁

العمر ديمه في العشرينات من 20 _ 30 سنة
سريع في كل شي 🥲

و Radio resistance مقاوم لكل الظروف✔️🌚

دمهم حامي ابسط كلمة عراكات طول 🙂 = blood metastasis
Poor prognosis.

Tumer marker = B-HCG , LDH, alpha FP🚨 (MCQ).

ttt: excission + chemo only

² seminoma = هذا يمثل فترة مابعد التخرج

العمر بعد 30 سنة 🌚

بطيء هلبا يعني ماعندا شي امتي ماينوض ويدير حاجته عادي لاعنده شيت ماقراشي لاعنده هم يخمم فيه 🙅🏻‍♀

ويكون radiosensetive يعني ابسط كلمة يفتح منها نقاش ويكسد عليها 🫢🫣

Lymphatic spread
Good prognosis

Tumer marker B-HCG, LDH

ttt: Excision + Radio + chemo.

🚨Most commen تجميعة

🍃Mc cancer in infant neuro blastoma.
🍃Commen benign cyst kidney is simple cyst.
🍃Commen benign mass kidney  is adenoma.
🍃Commen maligenint primary   kidney in adult is Rcc.
🍃Commen maligenint primary kidney in children is willems.

🍃Mc presention of Rcc is  total pian Less hematourea.
🍃Mc presention of wilms is mass.
🍃Mc presention of Urinary bladder cancer is pianless, hematourea.
🍃Mc presention of testicular cancer is palpable pianless solid mass in testis.

⭕️ D.d of scrotal swelling :

🔻Painless
¹ hydrocele
² varicocele
³ indirect inguinal hernia

🔻Painful
¹ torsion testis
² epidymo orchitis
³ strangulation indirect inguinal hernia

⭕️ D.d of empty scrotum :

¹ undescended testis
² retractile testis
³ ectopic testis
⁴ agenesis
⁵ orchidectomy

Prostate zones anatomy

Trigone is the commenest site of CA.

Bladder cancer

حَسْبِيَ اللَّهُ لَا إِلَهَ إِلَّا هُوَ، عَلَيْهِ تَوَكَّلْتُ
وَهُوَ رَبُّ الْعَرْشِ الْعَظِيمِ.

من قالها حين يصبح وحين يمسي ٧مرات
كفاه الله ما أهمه من أمر الدنيا والآخرة.💙