A 50 years old male has hematuria and abdominal pain the cause can be all except
(C) (BPH) (1331-33 Bailey & Love 26th)BENIGH PROSTATIC HYPERTROPHY:Primary symptom of bph arise because of difficulty in voiding urine due to obstruct ion of urethra by the prostate. They consist of hesitancy, poor urinary flow, and a sensation of incomplete emptyingNon specific symptoms -include urinary frequency urgency of micturation and incontinace nocturiaSome patients presents suddenly with acute urinary retension and urge in continnece nocturiaSome patients presents suddenly with acute urinary retension when they are unable to micturate and develop a pain ful distended bladder - precipitated by excessive alchol in take , constipation and prostatic infection.Urothelial cell carcinoma of the bladder * Strongly associated with smoking and chemical exposure in western societies (Male- female 3;1)* Strongly associated with schistosoma- haematobium infection (Bilharzial bladder cancer) in regions where the parasite is endemic* Painless gross haematuria is the most common symptoms and is indicative of bladder carcinoma until proven otherwise* Pain in the pelvis usually heralds extravesical spread discomfort associated with urination, pain in the loin or pyelonephritis may indicate ureteric obstruction and hydronephrosis, late manifestation in nerve involvement causing pain that is referred to the suprapubic regions groins perineum anus and into the thighs.Relation of hematuria to micturitionSite of bleeding* Blood appears at the beginning of act* Blood appears towards the end of the act* Blood is intimaterly mixed throughout the processUrethraVesicalPrerenal, renal, vesical* Commonest cause of periumbilical pain after 30 min of TRUP done under spinal anaesthesia with Bupivaccaine - Perforation of Bladder *** The verumontanum is the single most imprtent anatomical, land mark in (TURP. The verumontanumlies immediately proximal to the external sphincter muscle and serve as the distal landmark for prostate resection to prevent injury to External sphincter (contracture)* Bladder neck stenosis is the single most common side of obstruction after the TURP* Earliest symptom of renal tuberculosis- urinary frequency* Earliest- diagnosis can be made by - IVP* Sterile pyuria is a charactcrictic feature of renal tuberculosis* Most common renal vascular anomaly is the presence of supernumerary renal arteries *** Meteorism- is distension of the abdomen or intestine by gas. This is seen in Renal injury **
Renal stone
Renal cell cancer
BPH
Urothelial carcinoma
Kidney & Ureturs