Subjects

WINTER SEMESTER

Study objectives – Practical course #1

At the conclusion of this activity, participants will be able to:

-Define the following terms and to use them in the correct context: anuria, aseptic (abacterial) pyuria, bacteriuria, biliuria, cystalgia, dysuria, enuresis diurna, enuresis nocturna, fecaluria, pneumaturia, haematuria, haematopsermia, urinary incontinence, ischuria, nephralgia, nycturia (nocturia), oliguria, orchialgia, polakisuria, polyuria, prostatalgia, prostatodynia, proteinuria, pyuria, renal colic, urinary hesitancy, urinary retention, split urine stream (spraying of the urine stream), sexual dysfunction, significant bacteriuria, lower urinary tract symptoms (LUTS), urethralgia, urethral bleeding, urgency, urge urinary incontinence, urosepsis

-Explain the difference between anuria and urinary retention

-Compare microscopic haematuria with macroscopic haematuria

-List lower urinary tract symptoms

-Describe renal colic and its symptoms

-Give examples of conditions manifested by haematuria

-Explain the difference between haematuria and urethral bleeding.

Study objectives – Practical course #2

At the conclusion of this activity, participants will be able to:

-Define the following terms and to use them in the correct context: urinary catheter, catheterisation, suprapubic catheter (epicystostomy), one way catheter (single-lumen/single channel), two-way catheter (double-lumen/two channels), three-way catheter (triple lumen/three channels), continuous bladder irrigation, latex catheter, silicone catheter, Nelaton tip catheter (straight tip), Tiemann tip catheter (Coudé tip), Charrière (French) scale

-Draw and to describe Nelaton (straight) tip and Tiemann (Coudé) tip catheters

-Explain the differences between one way, two way and three way catheters

-List possible uses of urinary catheters

-Describe suprapubic catheter placement

-Catheterise male and female patient simulator (manikin)

Study objectives – Practical course #3

At the conclusion of this activity, participants will be able to:

-Define the following terms and to use them in the correct context: nephrectomy, nephrotomy, pyelotomy, calicotomy, pyeloplasty, ureterocalicostomy, ureterolithotomy, cystectomy, diverticulectomy, circumcision, frenuloplasty, glansectomy, penile amputation, emasculation, prostatectomy, urethrocystoscopy, ureterorenoscopy, nephroscopy, transurethral resection

-Describe differences between open access, endoscopic and laparoscopic access surgery

-Explain the underlying principle, purpose and working of a cystoscope. Describe the basic components of a cystoscope.

-Differentiate between rigid and flexible cystoscopes and list possible uses of cystoscope

-Describe proper patient positioning for kidney surgery (lateral decubitus position / kidney position)

-Explain the differences between total penile amputation and emasculation, and their consequences

Study objectives – Practical course #4

At the conclusion of this activity, participants will be able to:

-Define the following terms and to use them in the correct context: changing surgical wound dressing (bandage), desinfection, antisepsis, wound dressing materials and equipement, patient medical history (case history, anamnesis), family history, past medication history, obstetric/gynecological history, drug abuse, alergies, chief complaint and history of the present illness, blood drawing, vein cannulation

-List the instruments used for surgical wound care

-Change a wound dressing

-Draw peripheral venous blood

-Perform and analyse physical exam results

-Take medical history, define specific aspects of urological history taking

-Define and formulate patient chief complaint and the history of the present illness

Study objectives – Practical course #5

At the conclusion of this activity, participants will be able to:

-Define the following terms and to use them in the correct context: operating Room department, operating room, surgery, surgical field, desinfection, antisepsis, sterilisation, open access surgery, endoscopic access surgery, laparoscopic access surgery, radiation exposure, skiascopy, radiation exposure protection

-Define basic principles of asepsis, sterilisation, desinfection, antisepsis

-Demonstrate proper surgical hand preparation

-Use surgical mask and scrubs

-Assist with simple surgical operations

Study objectives – Practical course #6

At the conclusion of this activity, participants will be able to:

-Define the following terms and to use them in the correct context: out patient department (ward), endoscopy unit, specialized outpatient clinic, follow-up visit, ultrasound, transrectal sonography, urinalysis, urine culture, urine sediment, urology symptoms, incontinence products, complex examination, focused examination, follow up examination, digital rectal exam

-Replace urinary catheter under supervision

-Perform digital rectal exam

-Examine the external genitalia

-Perform a physical exam, describe any peculiarities, localise surgical scars

-Explain the underlying principle and working of an ultrasound, list its benefits

-Successfully sonographically visualise the urinary bladder and kidneys

Study objectives – Practical course #7

At the conclusion of this activity, participants will be able to:

-Define the following terms and to use them in the correct context: medical simulator, laparoscopy, endoscopy, cystoscopy, ureterorenoscopy, urethroscopy, LASER, indwelling stent, urinary catheter, endoscope, cystoscope, resectoscope, grasper, scissors, needle driver (needle holder), Péan forceps

-Describe digital rectal examination results, differentiate between prostate cancer and benign prostatic hyperplasia during a physical exam

-Insert a cystoscope and ureteroscope inside the medical simulator bladder and ureter

-Carry out a cystoscopy using the medical simulator and describe the results of the endoscopic exam

-Hold and to use the basic laparoscopic instruments correctly

SUMMER SEMESTER

Study objectives – Practical course #1

At the conclusion of this activity, participants will be able to:

-Define the following terms and to use them in the correct context: surgical knot, suture material types, surgical suture, needle, needle driver, Péan forceps, clamps, forceps, scissors, natural and synthetic sutures, absorbable and nonabsorbable sutures, monofilament and braided sutures

-Tie a surgical knot

-Describe the difference between interrupted and continuous stitch

-List suture types

-Close a surgical wound using different stitch types (medical simulator)

-Explain and to extract a surgical stitch (medical simulator)

Study objectives – Practical course #2

At the conclusion of this activity, participants will be able to:

-Define the following terms and to use them in the correct context: open acces surgery, endoscopy, cystoscopy, ureterorenoscpy, nephroscopy, flexible cystoscopy, rigid cystoscopy, laparoscopy, radical prostatectomy, nephrectomy, kidney resection, pyeloplasty, transurethral resection of bladder tumor (TURBT), transurethral resection of the prostate, circumcision, robotic surgery

-Describe the diffrences between open access surgery, endoscopic access surgery and laparoscopic access surgery

-List basic bladder and prostate procedure

-Explain the underlying principles of laparoscopy, its purpose

-List surgical management approaches to urolithiasis (nephrolithiasis and ureterolithiasis)

-Explain the differences between radical and simple nephrectomy and list indications for these treatment methods

-List urine derivation types after radical cystectomy

LECTURES – SUMMER SEMESTER

1. General urology, information sources in urology, evidence based medicine (EBM), renal failure, genitourinary tract abnormalities, intersex, transexualism

At the conclusion of this activity, participants will be able to:

-Define the following terms and to use them in the correct context: general urology, information sources in urology, evidence based medicine (EBM), renal failure, genitourinary tract abnormalities, intersex, transexualism

-Provide urology Specialty Description, explain the differences between general urology and urological sub-specialities

-List urological subspecialities

-Describe the urology care structure in the Czech republic

-Define Evidence based medicine (EBM)

-List several information sources

-List the basic physical and imaging studies used in urology, to list specialized diagnostic test in urology

-Describe basic abnormalities of the urogenital tract. Name principles of urogenital tract examination and specific tests. List possible treatment methods of vesicoureteral reflux, congenital hydronephrosis, cryptorchidism, phimosis.

-Define disorders of sex developement (DSDs), list DSD categories, explain causes of intersex

2.Urinary tract infections and urolithiasis

At the conclusion of this activity, participants will be able to:

-Define the following terms and to use them in the correct context: urinary tract infection (UTI), cystitis, pyelonephritis, upper and lower urinary tract infection, renal (kidney) abscess, specific infections of the genitourinary tract, tuberculosis, schistosomiasis, urolithiasis, nephrolithiasis, calicolithiasis, pyelolithiasis, ureterolithiasis, cystolithiasis, urethrolithiasis, prostatolithiasis, nephralgia, renal colic, stone dissolution

-Describe the differences between uper and lower urinary tract infections, basic symptoms, basic treatments, types of antibiotics used in treatment of UTI

-List the most common urinary tract pathogens, describe routes of invasion

-Describe clinical presentation of tuberculosis in urology, diagnostic workup, therapy

-Describe urinary schistosomiasis

-List urolithiasis examples, imaging studies used (difference between X-ray findings), list urolithiasis risk factors

-Describe renal colic, treatment

-List urolithiasis diagnosic workup studies (ultrasound, X-ray (nephogram), CT, stone analysis (infrared spectroscopy), metabolic evaluation in stone formers

-Urolithiasis treatment types – extracorporeal lithotrypsy (ESWL), percutaneous nephrolithotomy (PCNL), ureterorenoscopy, nephrolithotomy, pyelolithotomy, percutaneous nephrostomy, cystolithotrypsy

3. Urooncology I – penile cancer, testis cancer, renal cystic disease, kidney tumors, andrenal tumors, diseases of the retroperitoneum

At the conclusion of this activity, participants will be able to:

-Define the following terms and to use them in the correct context: carcinoma, primary cancer, lymph node disease, generalized (metastatic) cancer, TNM classifcation, cancer etiology, risk factors, incidence, mortality, precancerous lesion

-List penile cancer risk factors, precancerous lesion risk factors

-Give a presentation on basic surgery types in penile cancer treatment, explain resurfacing, glansectomy, pertial penile amputation, total penile amputation, emasculation, ilioinguinal lymphadenectomy

-Discuss testicular cancer Incidence, mortality and risk factors

-Analyse the impact of testis self-examination, analyse testicular cancer treatment results

-List testis tumor subtypes

-Discuss testicular cancer diagnostic workup and treatment methods, explain the principle of radical orchiectomy (in comparison with simple orchiectomy – why not using transscrotal approach)

-Give a talk on renal cancer incidence, incidence in the Czech republic

-Discuss kidney cancer clinical manifestation, paraneoplastic syndrome, metastatic renal cancer symptoms

-Explain diagnostic evaluation in kidney cancer, imaging studies, PET/CT, MRI

-Clinical presentation, diagnosis and treatment of Wilms tumor

-Discuss treatment principles in the management of localised and metastatic kidney cancer, cytoreductive nephrectomy, metastasectomy

-Define cystic kidney disease, differences in the management of Bosniak I – IV cysts

-Discuss adrenal tumor types, surgical approaches (open access, laparoscopic, retroperitoneoscopy)

4. Urooncology II – bladder cancer, upper urinary tract urothelial cancer, prostate cancer

At the conclusion of this activity, participants will be able to:

-Define the following terms and to use them in the correct context: urothelial tumor, macroscopic and microscopic haematuria, bladder haemotamponade, urine cytology, prostate cancer, localised and metastatic prostate cancer, prostate biopsy, prostatic spefic antigen, Gleason score, ratiotherapy, hormonal threapy, castration resistant prostate cancer, radical prostatectomy

-Present etiology and incidence of bladder cancer, define non-muscle invasive and muscle invasive bladder cancer

-List bladder cancer symptoms, name basic diagnostic methods in bladder cancer management

-Define fluorescent cystoscopy

-Describe how to carry out transurethral resection of bladder tumor, bimanual palpation, panendoscopy

-Identify the extend of radical cystectomy in a male and female patient

-Discuss urine derivation after cystectomy, compare continent and incontinent derivation, ortotopic and heterotopic derivation types

-List etiology, symptoms, diagnostic methods and therapy of upper tract urothelial cancer. Explain the term: nephroureterectomy

-Evaluate prostate cancer growth rate, explain hormonal dependence of prostate cancer and the basic prostate cancer characteristics

-Recall prostate cancer incidence in the Czech republic and in the world, compare prostate cancer incidence and mortality curves

-List prostate cancer symptoms including subvesical obstruction and name symptoms of metastatic disease

-Discuss prostate cancer diagnostic workup: screening, PSA elevation, transrectal sonograph, prostate biopsy, prostate cancer staging

-Define prostate cancer classification, Gleason score, grade group, prostate cancer differential diagnostic

-Describe the treatment of localised prostate cancer – radical prostatectomy, post-surgical urinary incontinence, erectile dysfunction, radiotherapy, multimodal treatment

-Explain the underlying principle of hormonal treatment and therapy of metastatic castration resistant prostate cancer

5. Lower urinary tract dysfunction, urinary incontinence

At the conclusion of this activity, participants will be able to:

-Define the following terms and to use them in the correct context: dysfunction, neurogenic bladder, autonomous and somatic innervation, primary micturition center, micturition reflex coordination, frontal micturition center, detrusor muscle, urinary sphincter, urodynamics, spinal trauma, urinary incontience, stress and urge urinary incontinence, paradoxical (overflow) incontinence

-Decribe and draw a scheme of basic micturition reflex anatomy and physiology, explain urinary tract innervation, name micturition centers and their functions

-List examinations used for the diagnosis of lower urinary tract dysfunction and urinary incontinence, explain Madersbacher classification system

-Explain the underlying principle of urodynamic examination – uroflowmetry, cystometry, pressure-flow (PQ) studies, ICS normogram

-Name treatment principles used in the management of neurogenic bladder, hypoactive detrusor, sphincter hyperactivity, detrusor-sphincter dyssynergia, hypoactive sphincter, hyperactive detrusor

-Discuss urological management of the patient with traumatic spinal cord injury

-List urinary incontinence incidence, diagnosis and management

-define, classify stress urinary incontinence types, list treatment methods (conservative and surgical therapy – colposuspension, slings)

-Define urge urinary incontinence, discuss its clinical presentation and evaluate urodynamic test results, list urge urinary incontinence management types

-Explain reflex incontience, paradoxical (overflow) incontience

6. BPH, prostatitis, benign conditions of the male external genitalia, uretrhitis, urethral stricture disease

At the conclusion of this activity, participants will be able to:

-Define the following terms and to use them in the correct context: benign prostatic hyperplasia (BPH), pharmacotherapy, treansurethral resection of the prostate, photoselective vaporisation of prostate, holmium laser enucleation (anatomical endoscopic enucleation of the prostate), open simple prostatectomy (suprapubic / transvesical), prostatatis, balanitis, balanopostitis, phimosis, hydrocele, varicocele, spermatocele, testicular torsion, penile fracture, urethral stricture

-Define BPH, discuss etiology and histopathology

-Compare storage and voiding symptoms and give examples of each

-Discuss BPH complications

-List BPH diagnostic workup methods – medical history taking, IPSS questionnaire

-Name and explain indication for BPH treatment and discuss management types of BPH: watchful waiting, pharmacologic treatment, surgery (transurethral resection of the prostate, photoselective vaporisation of the prostate, holmium laser enucleation of the prostate, open (suprapubic) prostatectomy

-Explain the differences between acute prostatitis and chronic prostatitis, discuss diagnostic exams and treatments

-Name some benign conditions of the male external genitalia

-Describe clinical manifestation of balanitis and balanopostitis, discuss treatment methods

-Describe phimosis and paraphimosis, give examples of management of these conditions

-Describe clinical presentation of adult and pediatric hydrocele, give examples of diagnostic exams, discuss treatment

-Discuss the risk a varicocele has on the developement of the testicle, discuss its possible consequences in regard to fertility, discuss treatment

-Describe clinical presentation of testicular torsion, discuss diagnostic workup and treatment

-Describe penile fracture, discuss etiology, diagnostics and treatment

-Compare urethral stricture causes, discuss examinations tests used in urethral stricture disease diagnostic, describe treatment types – dilation, optical urethrotomy, uretroplasty

7. Andrology, traumatology, urologic emergencies

At the conclusion of this activity, participants will be able to:

-Define the following terms and to use them in the correct context: andrology, erection, erectile dysfunction, infertility, spermiogram, priapism, aging man´s health, Induratio penis plastica (Peyronie´s disease), premature ejaculation, urogenital trauma, kidney laceration, bladder rupture, urethral rupture, ureteral trauma, ureteral reimplantation, external genital trauma, Fournier gangrene

-Specify main themes of andrology – male fertility, infetility, erectile dysfunction, aging male

-Define erectile dysfunction, its etiology, prevalence, to discuss treatment, to explain and discuss erection phases

-Name causes of infertility, discuss treatment options, define and compare normal and abnormal spermiogram

-Define priapism, compare low-flow (venous/ischemic) and high-flow (arterial/non-ischemic) priapism, give examples of treatment, analyse late complications of priapism

-Discuss aging man´s health, give examples of physiologic changes of this nosological entity

-Describe Peyronie´s disease (Induratio penis plastica)

-Give a list of causes of premature ejaculation and to discuss its treatment

-List examples of urological trauma, classify kidney trauma using AAST classification, list renal trauma management, explain mechanisms of bladder, urethral and ureteral injury, discuss treatment

-Recognize emergencies in urology, discuss urinary retention, bladder hemotamponade and renal colic management

-Give a description of Fournier gangrene clinical presentation, name bacterial types involved in this condition, list causes and risk factors, discuss basic management principles, evaluate patient prognosis

Last update: Mičolová Lucie, Ing. (29.09.2020)