Urinary tract infection (UTI)
UTIs are common infections in women but rare in men because of the longer urethra. Recurrent or untreated infection can cause considerable morbidity, including renal disease and end-stage renal failure. A UTI is of particular significance in children because of the need for early diagnosis of abnormal urinary tracts.
What to learn
Common causative organisms and risk factors for infection.
Symptoms, signs and diagnosis.
Complications of UTIs.
Management and further investigation (especially in children).
Benign prostatic hypertrophy (BPH)
This commonly occurs in men over the age of 60 years. The etiology is not known, but BPH is characterized by hyperplasia of the glandular and connective tissue in the prostate, resulting in compression of the urethra and bladder outflow obstruction.
What to learn
Symptoms and signs of bladder outflow obstruction, or 'prostatism'.
Prostate cancer
Carcinoma of the prostate is the fourth most common cause of death from malignancy in men in the UK, accounting for 7% of cancers in men. By the age of 80 years, 80% of men have malignant cells within the prostate, although most remain dormant.
What to learn
Clinical features and diagnosis.
Treatment with hormone analogues, radiotherapy, and surgery.
Renal and vesical calculi
About 2% of the UK population have a urinary tract stone at any given time. Most stones are composed of calcium oxalate and phosphate, but mixed infective stones are also common. It is commonly a recurrent problem; 50% of patients will have formed a further stone within 10 years.
What to learn
Etiology and risk factors for the various types of stone.
Symptoms, signs, and diagnostic tests.
Conservative and surgical management of renal and vesical calculi.
Renal failure
This term refers to the failure of renal excretory function due to depression of the glomerular filtration rate. It is often associated with failure of other renal functions: acid-base balance; regulation of salt, water, and blood pressure; secretion of erythropoietin; and activation of vitamin D.
What to learn
Definitions of renal failure: prerenal, renal, and postrenal; acute versus chronic renal failure.
Causes of renal failure, which can be grouped into failure of renal perfusion, disease of the renal vasculature, glomerulonephritis, and tubulointerstitial disease.
Symptoms, signs, and diagnostic tests.
Management of end-stage renal failure: Continuous Ambulatory Peritoneal Dialysis (CAPD), hemodialysis, transplant, and ancillary treatment (e.g. erythropoietin, calcium supplementation).
