Surgical Approach to UTIs | Surgery Lectures | Medical Online Learning | V-Learning

Welcome to this General Surgery lecture on urinary tract infections. In this presentation, we will delve into the complexities of these infections and their implications on the urinary system. Our discussion will cover the key topics related to the Anatomy of the urinary system and its significance in understanding infection pathways.

▬ 📌 Surgical Approach to UTIs
The urinary system plays a vital role in the body by filtering waste products and excess substances, maintaining electrolyte balance, and regulating blood pressure. It comprises the kidneys, ureters, bladder, and urethra.

▬ 📌 Obstructive vs Irritative Symptoms
Urinary tract infections (UTIs) can present with obstructive or irritative symptoms. Obstructive symptoms include difficulty in passing urine, hesitancy, or weak urine stream, often resulting from blockage or narrowing of the urinary tract.

Irritative symptoms involve increased frequency and urgency, nocturia, and dysuria, typically caused by inflammation or infection of the urinary tract.

▬ 📌 Acute Pyelonephritis
Acute pyelonephritis is a common bacterial infection that results in inflammation of the renal parenchyma, calyces, and pelvis. It often stems from an ascending UTI and can lead to kidney damage if left untreated. Symptoms include fever, flank pain, nausea, and vomiting.

Diagnosis involves urine culture, blood tests, and imaging studies.
Treatment includes antibiotics, hydration, and pain management. Complications may include sepsis, renal scarring, or abscess formation.

▬ 📌 Vesico-Ureteric Reflux
Vesicoureteral reflux (VUR) is a condition where urine flows backward from the bladder into the ureters and kidneys. Causes may include congenital defects, urinary tract obstruction, or bladder dysfunction. VUR is classified into five grades based on severity. Management options include antibiotic prophylaxis, endoscopic treatment, or surgical intervention, depending on the grade and associated complications.

▬ 📌 Emphysematous Pyelonephritis
Emphysematous pyelonephritis is a severe, necrotizing infection characterized by gas formation within or around the kidneys. It typically occurs in diabetic patients and those with compromised immune systems.

👉 Symptoms may include fever, flank pain, and septic shock.
Diagnosis is confirmed through imaging studies. Management includes aggressive antibiotic therapy, drainage of abscesses, and, in severe cases, nephrectomy.

▬ 📌 Xanthogranulomatous Pyelonephritis
Xanthogranulomatous pyelonephritis is a rare, chronic granulomatous inflammation of the kidney, often resulting from long-term urinary tract obstruction or recurrent infections. It predominantly affects females and can occur at any age.

Symptoms may include fever, weight loss, and flank pain.
Diagnosis is based on imaging studies and histopathological examination. Treatment typically involves antibiotics and nephrectomy.

▬ 📌 Abscess of the Urinary Tract
Urinary tract abscesses are collections of pus that develop within various parts of the urinary system due to bacterial infections. Types of abscesses include renal cortical abscesses, corticomedullary abscesses, and peri-anal abscesses, which can occur following surgical intervention. Symptoms may include fever, pain, and urinary disturbances. Diagnosis is based on imaging studies and laboratory tests. Treatment involves antibiotics and drainage or surgical removal of the abscess.

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