A surgical team is establishing triage protocols for patients presenting to the emergency department with acute genitourinary symptoms. Match each patient scenario with the most appropriate immediate diagnostic or therapeutic intervention.
- An adolescent male experiencing abrupt, severe unilateral scrotal pain accompanied by an absent cremasteric reflexUrgent bilateral scrotal exploration
- An adult male passenger in a high-speed collision presenting with a pelvic fracture, blood at the urethral meatus, and a high-riding prostateRetrograde urethrography
- An elderly male with a history of prostatic enlargement presenting with severe suprapubic pain and anuria for 10 hoursUrethral Foley catheterization
- An adult male presenting with a painful, fully rigid erection lasting 6 hours independently of sexual stimulationIntracavernosal aspiration and sympathomimetic injection
Cevap
The correct matches align testicular torsion with urgent scrotal exploration, urethral injury with retrograde urethrography, acute urinary retention with Foley catheterization, and ischemic priapism with intracavernosal aspiration and injection.
Each scenario represents a classic, highly-tested urologic emergency. Testicular torsion requires immediate surgical exploration to prevent ischemic necrosis. Posterior urethral injuries demand a retrograde urethrogram to evaluate urethral continuity before any catheter placement. Acute urinary retention is managed by immediate bladder decompression via Foley catheterization. Finally, ischemic priapism requires urgent corporal blood aspiration and injection of an alpha-agonist to induce detumescence.
Adım Adım Çözüm
Anahtar Kavram
Initial triage and management of core urologic emergencies