pendahuluan urologi
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UROLOGIUROLOGI
Prof. DR. Dr. H. Rifki Muslim SpB, SpUProf. DR. Dr. H. Rifki Muslim SpB, SpU
PENDAHULUANPENDAHULUANPenyakit Penyakit : - Tract. Urogenitalis: - Tract. Urogenitalis
- Tract. Urinarius - Tract. Urinarius
Anatomi + Fisiologi :Anatomi + Fisiologi :Ginjal Ginjal : - Retro peritoneal: - Retro peritoneal
- 150 gram- 150 gram
- Cortex - Cortex medulla medulla
- Nefron (p.d, glomerulus, tubulus)- Nefron (p.d, glomerulus, tubulus)
- Kaliks minor ( 8 – 12 )- Kaliks minor ( 8 – 12 )
mayor ( 2 – 3 )mayor ( 2 – 3 )
- Pedikel (dari post.) : - Pyelum – A - V- Pedikel (dari post.) : - Pyelum – A - V
Ureter Ureter : - 30 cm: - 30 cm - Penyempitan alamiah 3- Penyempitan alamiah 3 - - øø 3 – 5 mm 3 – 5 mm - Peristaltik- Peristaltik
BuliBuli : - Isi 350 – 450 ml: - Isi 350 – 450 ml - m. detrusor- m. detrusor - Segmen intravesical ureter 2 ½ - Segmen intravesical ureter 2 ½
cmcm
Ureter Ureter : - 30 cm: - 30 cm - Penyempitan alamiah 3- Penyempitan alamiah 3 - - øø 3 – 5 mm 3 – 5 mm - Peristaltik- Peristaltik
ProstatProstat : - Bentuk segi 3: - Bentuk segi 3 - 20 gram- 20 gram - Lobus 5 (ant, post, med, 2 lat)- Lobus 5 (ant, post, med, 2 lat)
TestisTestis : - 4 X 3 X 2,5 cm: - 4 X 3 X 2,5 cm - Sel sertoli + leydig (sperm.)- Sel sertoli + leydig (sperm.)
PenisPenis : - 2 corp cavernosa: - 2 corp cavernosa - 1 corp. spongiosa - 1 corp. spongiosa urethra urethra
UrethraUrethra : : - - øø 8 – 9 mm8 – 9 mmP. Post. 2 ½ cmP. Post. 2 ½ cm
- U. Post- U. Post P. Post. 2 ½ cmP. Post. 2 ½ cmP. Post. 2 ½ cmP. Post. 2 ½ cm
- U. Ant- U. Ant P. Post. 2 ½ cmP. Post. 2 ½ cm - Panjang 18 – 20 cm- Panjang 18 – 20 cm
- - øø 8 mm8 mm- Panjang lurus 4 cm- Panjang lurus 4 cm
GEJALAGEJALA
I.I. SistemikSistemik
II.II. SakitSakit
III.III. Gastro intestinalGastro intestinal
IV.IV. SeksualSeksual
V.V. Lain-lainLain-lain
VI.VI. MiksiMiksi
I.I. GEJALA SISTEMIKGEJALA SISTEMIK1.1. PanasPanas2.2. BB BB 3.3. AnoreksiaAnoreksia4.4. LemahLemah
II.II. GEJALA SAKITGEJALA SAKIT1.1. Lokal :Lokal :
• Ginjal Ginjal Pinggang sudut costovertebra Pinggang sudut costovertebra• VU VU supra pubik supra pubik• Testis Testis skrotum skrotum• Prostat Prostat perineum perineum
2.2. Dijalarkan Dijalarkan Kolik Kolik• 1/3 prox ureter : pinggang, epigastrium, testis1/3 prox ureter : pinggang, epigastrium, testis• 1/3 tengah 1/3 tengah : Mc. Burney ( Sin : Mc. Burney ( Sin • 1/3 distal 1/3 distal : Supra pubik, inguinal : Supra pubik, inguinal
scrotum, scrotum, paha medial paha medial
III.III. GEJALA GASTRO INTESTINALGEJALA GASTRO INTESTINAL1.1. NauseaNausea2.2. VomitusVomitus3.3. Kejang PerutKejang Perut4.4. Gejala “ Peptic – ulcer “Gejala “ Peptic – ulcer “5.5. “ “ Peritonismus “Peritonismus “
IV.IV. GEJALA SEXUALGEJALA SEXUAL1.1. Libido Libido 2.2. ImpotensiImpotensi3.3. Coitus sakitCoitus sakit4.4. HemospermaeHemospermae5.5. InfertilitasInfertilitas
V.V. GEJALA MIKSIGEJALA MIKSIDisuriaDisuria
1.1. PolakisuriaPolakisuria NocturiaNocturia2.2. PolyuriaPolyuria3.3. UrgencyUrgency4.4. Burning sensation (stranguria)Burning sensation (stranguria)5.5. DisuriaDisuria6.6. EnuresisEnuresis7.7. AnuriaAnuria8.8. OliguriaOliguria9.9. Retensio urineRetensio urine partialpartial
totaltotal10.10. Hesitancy (delayed urination)Hesitancy (delayed urination)11.11. StrainingStraining12.12. Kaliber kecilKaliber kecil13.13. Pancaran lemahPancaran lemah14.14. Terminal dribblingTerminal dribbling
15.15. Sense of residual urineSense of residual urine16.16. Kencing tiba-tiba berhentiKencing tiba-tiba berhenti17.17. Pancaran terbelahPancaran terbelah18.18. InkontinensiaInkontinensia : - True Inc: - True Inc
- Stress inc- Stress inc - Over flow / Paradoxal inc- Over flow / Paradoxal inc - False inc- False inc - Urgency inc- Urgency inc
19.19. PneumaturiaPneumaturia20.20. FecaluriaFecaluria21.21. Claudy urineClaudy urine22.22. PyuriaPyuria23.23. HematuriaHematuria
- Waktu (initial, total, terminal)- Waktu (initial, total, terminal)- Sakit (Painless, Painfull)- Sakit (Painless, Painfull)- Warna- Warna
24.24. ChyluriaChyluria