Handbook> Selectives > Surgery > Urology

Surgery Subspecialties

Urology

Course Content

Number: (Oasis - S78b) 3103

Rotation Supervisor: Dr. Ryan Smith

Available: all Rotations

Duration: 2 weeks

Report to: Clinic Resident or Chief Resident

Time to Report: 6:00am

Place to Report: 5 West, call Urology Resident On-Call (PIC#1586) with questions.

Typical Day: 6:00 am - 6:00 pm

Suggested Preparatory Reading: review of pertinent genitourinary anatomy

Number of students per rotation: 2

Course Description: The student will learn pathophysiology, evaluation, and treatment for diseases of the urinary tract, male genital tract, retroperitoneal space and adrenal glands. The selective allows students to have a broad exposure to urology, both office and operative. Students are expected to attend weekly conferences: a 5 pm Monday x-ray, M&M, pediatric, and journal club; a 7:45 am Wednesday basic science; and a 9 am Wednesday oncology conference. Students will round with the team on inpatients and participate in the outpatient evaluation and preoperative, intraoperative, and postoperative management of patients with urologic disorders. Students are evaluated based on performance in the clinic by direct observation of history and physical examination skills, and by discussions in the clinic, operating room and on rounds. There is no night or weekend call.

Goals:

  • learn to perform a history, physical examination and office evaluation of patients with common urologic diseases under the direction of resident and attending staff: urologic oncology (renal tumors, transitional cell carcinoma, prostate cancer, testicular cancer and adrenal tumors); stone disease; incontinence and bladder dysfunction; urinary tract infections; bladder outlet obstruction and lower urinary tract symptoms; erectile dysfunction and male infertility
  • learn and observe common diagnostic techniques used in the urology clinic: urinalysis, flow rate, urodynamics and cystoscopy
  • learn the indications for and reading of common uroradiographic evaluation: plain films, IVP, nuclear medicine, ultrasonography and CT
  • learn the fundamentals of pharmacologic treatment of common urologic conditions
  • observe common urologic surgical procedures: radical nephrectomy, radical cystectomy with urinary diversion, radical prostatectomy, ESWL, ureteroscopy, TURP and TURB

Learning Objectives:

  1. Acute Scrotum - The student will provide a differential diagnosis of conditions that produce acute scrotal pain and/or swelling, select appropriate imaging studies for confirming the diagnosis of acute scrotum, and determine which acute scrotal conditions require emergent surgery versus elective surgery or medical treatment.
  2. Urinary Stone Disease - Given a patient with urinary stone disease in the clinic setting, the student will identify the appropriate imaging study for diagnosis, explain the indications for urgent intervention, and discuss medical therapies and surgical techniques for managing urinary stones that fail to pass with observation.
    1. When presented with a patient with acute flank pain in the emergency setting, the student will provide a differential diagnosis and explain the appropriate laboratory and imaging studies necessary to make the diagnosis.
    2. The student will describe the five most common chemical compositions of urinary stones.
  3. Urinary Incontinence - Given a patient with urinary incontinence, the student will take a history, identify the symptoms and signs of various types of incontinence (stress, urge, overflow, mixed, total), and describe medical and surgical treatment options for management of stress and urge incontinence.
  4. Hematuria - When presented with a patient with hematuria, the student will take a relevant history, describe common glomerular and non-glomerular causes of hematuria, and identify imaging studies used in the workup of hematuria.
  5. Prostate Disease - The student will identify the predominant locations in the prostate where BPH and prostate cancer develop and relate this fact with the associated signs and symptoms of the two conditions. The student will also be able to describe medical and surgical treatment options for both BPH and prostate cancer.
  6. Renal Mass - The student will be able to provide a differential diagnosis for a renal mass found incidentally on CT, and describe treatment options for a mass suspicious for malignancy.