A Guide to Clinical Practice Humana Press Edited by Jeannette M. Potts, MD Essential Urology ESSENTIAL UROLOGY Potts_FM_Final2 12/16/03, 11:32 AM1 CURRENT CLINICAL UROLOGY Eric A. Klein, MD, SERIES EDITOR Essential Urology: A Guide to Clinical Practice, edited by Jeannette M. Potts, 2004 Management of Prostate Cancer, Second Edition, edited by Eric A. Klein, 2004 Management of Benign Prostatic Hypertrophy, edited by Kevin T. McVary, 2004 Laparoscopic Urologic Oncology, edited by Jeffrey A. Cadeddu, 2004 Essential Urologic Laparoscopy: The Complete Clinical Guide, edited by Stephen Y. Nakada, 2003 Pediatric Urology, edited by John P. Gearhart, 2003 Urologic Prostheses: The Complete Practical Guide to Devices, Their Implantation, and Patient Follow-Up, edited by Culley C. Carson, III, 2002 Male Sexual Function: A Guide to Clinical Management, edited by John J. Mulcahy, 2001 Prostate Cancer Screening, edited by Ian M. Thompson, Martin I. Resnick, and Eric A. Klein, 2001 Bladder Cancer: Current Diagnosis and Treatment, edited by Michael J. Droller, 2001 Office Urology: The Clinician’s Guide, edited by Elroy D. Kursh and James C. Ulchaker, 2001 Voiding Dysfunction: Diagnosis and Treatment, edited by Rodney A. Appell, 2000 Management of Prostate Cancer, edited by Eric A. Klein, 2000 Potts_FM_Final2 12/16/03, 11:32 AM2 ESSENTIAL UROLOGY A GUIDE TO CLINICAL PRACTICE Edited by JEANNETTE M. POTTS, MD Glickman Urological Institute, Cleveland Clinic Foundation, Cleveland, OH HUMANA PRESS TOTOWA, NEW JERSEY Potts_FM_Final2 12/16/03, 11:32 AM3 © 2004 Humana Press Inc. 999 Riverview Drive, Suite 208 Totowa, New Jersey 07512 www.humanapress.com For additional copies, pricing for bulk purchases, and/or information about other Humana titles, contact Humana at the above address or at any of the following numbers: Tel.: 973-256-1699; Fax: 973-256-8341, E-mail: humana@humanapr.com; or visit our Website: http://humanapress.com All rights reserved. No part of this book may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, microfilming, recording, or otherwise without written permission from the Publisher. All articles, comments, opinions, conclusions, or recommendations are those of the author(s), and do not necessarily reflect the views of the publisher. Due diligence has been taken by the publishers, editors, and authors of this book to assure the accuracy of the information published and to describe generally accepted practices. The contributors herein have carefully checked to ensure that the drug selections and dosages set forth in this text are accurate and in accord with the standards accepted at the time of publication. Notwithstanding, as new research, changes in government regulations, and knowledge from clinical experi- ence relating to drug therapy and drug reactions constantly occurs, the reader is advised to check the product information provided by the manufacturer of each drug for any change in dosages or for additional warnings and contraindications. This is of utmost importance when the recommended drug herein is a new or infrequently used drug. It is the responsibility of the treating physician to determine dosages and treatment strategies for individual patients. Further it is the responsi- bility of the health care provider to ascertain the Food and Drug Administration status of each drug or device used in their clinical practice. The publisher, editors, and authors are not responsible for errors or omissions or for any consequences from the application of the information presented in this book and make no warranty, express or implied, with respect to the contents in this publication. Production Editor: Robin B. Weisberg Cover illustration layout by Jeannette M. Potts. Cover illustration by Michelle Wolf. Cover design by Patricia F. Cleary. This publication is printed on acid-free paper. ANSI Z39.48-1984 (American National Standards Institute) Permanence of Paper for Printed Library Materials. Photocopy Authorization Policy: Authorization to photocopy items for internal or personal use, or the internal or personal use of specific clients, is granted by Humana Press Inc., provided that the base fee of US $25.00 per copy is paid directly to the Copyright Clearance Center at 222 Rosewood Drive, Danvers, MA 01923. For those organizations that have been granted a photocopy license from the CCC, a separate system of payment has been arranged and is acceptable to Humana Press Inc. The fee code for users of the Transactional Reporting Service is: [1-58829-109-X/04 $25.00]. Printed in the United States of America. 10 9 8 7 6 5 4 3 2 1 E-ISBN 1-59259-737-8 Library of Congress Cataloging-in-Publication Data Essential urology : a guide to clinical practice / edited by Jeanette M. Potts. p. ; cm. (Current clinical urology) Includes bibliographical references and index. ISBN 1-58829-109-X (alk. paper) 1. Genitourinary organs Diseases. [DNLM: 1. Urologic Diseases. 2. Urogenital Diseases. WJ 140 E78 2004] I. Potts, Jeanette M. II. Series. RC871.E883 2004 616.6 dc22 2003016746 Potts_FM_Final2 12/16/03, 11:32 AM4 To my children, Bradley and Ellen, and to my mentors, Jonathan Ross, MD and Elroy Kursh, MD Dedication Potts_FM_Final2 12/16/03, 11:32 AM5 Potts_FM_Final2 12/16/03, 11:32 AM6 Preface vii As a medical urologist with a background in family medicine, I have enjoyed the overlapping aspects of urology and primary care. Urological diseases are often brought to the attention of primary care providers who must then diagnose and manage these disorders. Essential Urology: A Guide to Clinical Practice is intended to provide support to primary care physicians through its review of common genitourinary problems. It is meant to enhance the recognition of urological disease as well as outline current manage- ment strategies. Disorders of the urinary tract may be encountered during pregnancy, either as a maternal diagnosis or as a fetal anomaly detected in utero. Children as well as adults require screening and monitoring of genitourinary disorders, some of which are gender-specific. Urinary tract infections may be manifestations of risk factors, anatomical or functional abnormalities, specific to age and/or gender. These issues are presented in this text. Hematuria, frequently encountered in the primary care setting as an incidental finding, is discussed in a comprehen- sive chapter, followed by related chapters detailing urological imaging studies and the evalu- ation and management of nephrolithiasis, respectively. Urinary function is addressed in the chapters reviewing female incontinence, interstitial cystitis, and bladder outlet obstruction secondary to benign prostatic hyperplasia. Screening for urological cancers, particularly prostate and bladder cancers, is reviewed. We have included a chapter summarizing comple- mentary therapies in urology and a chapter that introduces alternative approaches to frequently diagnosed abacterial prostatitis/pelvic pain syndrome. Finally, we address the quality-of-life impact and medical significance of erectile dysfunction and its treatment. Essential Urology: A Guide to Clinical Practice addresses various life stages and respective urological conditions and should be a valuable resource to family practitio- ners, internists, pediatricians, obstetricians, physician’s assistants, and nurse clinicians. Jeannette M. Potts, MD Potts_FM_Final2 12/16/03, 11:32 AM7 Potts_FM_Final2 12/16/03, 11:32 AM8 Preface vii List of Contributors xi Value-Added eBook/PDA xii 1Management of Urologic Problems During Pregnancy: A Rationale and Strategy 1 Kevin R. Loughlin 2 Pediatric Potpourri 17 Jonathan H. Ross 3 Urinary Tract Infections in Children 33 Richard W. Grady 4 Screening and Early Detection for Genitourinary Cancer 47 Ian M. Thompson and Joseph Basler 5 Basic Imaging in Urology 61 Martin B. Richman and Martin I. Resnick 6 Hematuria 91 Mark J. Noble 7 Evaluation and Medical Management of Kidney Stones 117 John C. Lieske and Joseph W. Segura 8Management of Female Urinary Incontinence 153 Raymond R. Rackley and Joseph B. Abdelmalak 9 Interstitial Cystitis 169 Kenneth M. Peters 10 Urinary Tract Infections in Adults 183 Joseph B. Abdelmalak, Sandip P. Vasavada, and Raymond R. Rackley 11 Evaluation and Treatment of Benign Prostatic Hyperplasia 191 Elroy D. Kursh 12 Prostatitis/Chronic Pelvic Pain Syndrome 203 Jeannette M. Potts 13 Erectile Dysfunction 213 Drogo K. Montague and Milton M. Lakin 14 Complementary Medications in Urology 225 Elliot Fagelman, Bridgit Mennite, and Franklin C. Lowe Index 235 Contents ix Potts_FM_Final2 12/16/03, 11:32 AM9 [...]... function Urology 19 93; 42: 747–752 23 Barron WM The pregnant surgical patient: Medical evaluations and management Ann Intern Med 19 84; 10 1: 683–6 91 24 Loughlin KR Caring for your pregnant patient Contemp Urol 19 92; 4: 22–38 25 Kammerer WS Non-obstetric surgery during pregnancy Med Clin North Am 19 79; 6: 11 57– 11 64 26 Babaknia A, Hossein P, Woodruff JD Appendicitis during pregnancy Obstet Gynaecol 19 77;... Anaesth 19 88; 60: 24–27 16 Lindheimer MD, Katz AI The renal response to pregnancy In: Brenner BM, Rector RC, eds The Kidney, 2nd Ed W.B Saunders Co., Philadelphia, PA, 19 81, pp 17 62 18 19 17 Hsia TY, Shortliffe LM.: The effect of pregnancy on rat urinary tract dynamics J Urol 19 95; 15 4 (2pt2) 684–689 18 Schulman A, Herlinger H Urinary tract dilatation in pregnancy Br J Radiol 19 75; 48: 638–645 19 Tong... during pregnancy Anesthesiology 19 65; 26: 3 81 392 9 Archer GW, Marx GF Arterial oxygenation during apnea in parturient women Br J Anaesth 19 74; 46: 358–360 10 Barron WM Medical evaluation of the pregnant patient requiring nonobstetric surgery Clin Perinatol 19 85; 12 (3):4 81 496 11 Hathaway WE, Bonnar J Perinatal Coagulation Grune and Stratton, New York, NY, 19 78, pp 27– 51 12 Letsky E The hematological... than the average patient (11 7) The physiological changes that occur during pregnancy usually do not compromise the continence mechanisms in patients with either urinary or fecal continent diversions (11 9 12 1) Hill and Kramer (12 2) reported the management of pregnancy after augmentation cystoplasty in 15 patients They found urinary tract infection or pyelonephritis in 9 of the 15 patients and premature... Pheochromocytoma in pregnancy is most dangerous if it remains undiagnosed (10 6 11 1) In these circumstances, maternal mortality exceeds 50% (11 2 11 4) Deaths have been caused primarily by malignant hypertensive crisis and/or shock, which is most often precipitated by delivery The signs and symptoms of pheochromocytoma during pregnancy are essentially no different than in the nonpregnant patient The patients... Scientific Publications, Oxford, England, 19 80, pp 43–78 13 de Swiet M The cardiovascular system In: Hytten F, Chamberlain G, eds Clinical Physiology in Obstetrics Blackwell Scientific Publications, Oxford, England, 19 80, pp 3–42 14 Kakkar VV The current status of low-dose heparin in the prophylaxis of thrombophlebitis and pulmonary embolism World J Surg 19 78; 2: 3 13 15 Simpson KH, Stakes AF, Miler M Pregnancy... 19 89; 70: 9 91 995 6 Veland K, Parer JT Effects of estrogens on the cardiovascular system of the ewe Am J Obstet Gynecol 19 66; 96: 400–406 7 Goodman RP, Killam AP, Brash AR, Branch RA Prostacyclin production during pregnancy: Comparison of production during normal pregnancy and pregnancy complicated by hypertension Am J Obstet Gynecol 19 82; 14 2: 817 –822 8 Prowse CM, Gaensler EA Respiratory and acid-base... incidence of urolithiasis in pregnancy to be 1 in 15 00 deliveries, which is the same as in the nonpregnant female However, pregnancy-specific causes of abdominal pain during pregnancy are much more common than the aforementioned problems For example, ectopic pregnancy occurs in every 1 in 300 pregnancies; placental disruption occurs in every 1 in 10 0 pregnancies ( 31) Smoleniec and James (32) have emphasized... pregnancy (10 ) In addition, the fibrinolytic activity of the plasma is depressed (11 ,12 ), as well as both a reduction of the velocity of venous blood flow in the lower extremities and a rise in venous pressure (12 ,13 ) All of these factors contribute to a significantly increased risk of venous thromboembolism in the pregnant woman This risk appears to be greatest in the third trimester or immediately postpartum... tomography scanning for localiza- 10 Loughlin tion of pheochromocytoma during pregnancy We have successfully used abdominal ultrasound to document the presence of pheochromocytoma during pregnancy At the present time, there are no reports on the use of meta-(I -1 3 1) iodobenzylguanidine during pregnancy After the diagnosis of pheochromocytoma has been established, the α-adrenergic blockade should be instituted . Service is: [ 1- 5 882 9 -1 09-X/04 $25.00]. Printed in the United States of America. 10 9 8 7 6 5 4 3 2 1 E-ISBN 1- 5 925 9-7 3 7-8 Library of Congress Cataloging-in-Publication Data Essential urology : a. by Jeannette M. Potts, MD Essential Urology ESSENTIAL UROLOGY Potts_FM_Final2 12 /16 /03, 11 :32 AM1 CURRENT CLINICAL UROLOGY Eric A. Klein, MD, SERIES EDITOR Essential Urology: A Guide to Clinical. Greenberg et al. (11 6) have reported the use of magnetic resonance imaging as an alternative to computed tomography scanning for localiza- 01_ Lou-_00 1- 0 16 _10 .30.03 12 /2/03, 7:52 AM9 10 Loughlin tion