Urologic Disorders: Kidney Stones,Kidney/Bladder/Prostate/Testicular Cancer, BPH, Prostatitis, Erectile Dysfunction — Pathophysiology, Risk Factors (Smoking, Genetic, Occupational Exposure), Clinical Manifestations (Hematuria, Flank Pain, Urinary Retentio

Urologic Disorders: Kidney Stones,Kidney/Bladder/Prostate/Testicular Cancer, BPH, Prostatitis, Erectile Dysfunction — Pathophysiology, Risk Factors (Smoking, Genetic, Occupational Exposure), Clinical Manifestations (Hematuria, Flank Pain, Urinary Retention, LUTS), Diagnostics (Urinalysis, PSA, TRUS, CT, MRI, Tumor Markers, Cystoscopy), Surgical Management (Nephrectomy, TURP, Cystectomy, Orchiectomy, Urinary Diversions – Ileal Conduit, Kock/Indiana Pouch, Orthotopic Bladder), Medications (Antibiotics, Alpha Blockers, 5-alpha Reductase Inhibitors, Chemotherapy, Hormone Therapy), Nursing Interventions (Pre/Postoperative Care, Catheter/CBI Management, Stoma Care, Pain/Respiratory Monitoring), Complications (Infection, Hemorrhage, Erectile Dysfunction, Urinary Obstruction, Metastasis), and Patient Education (Self-Exams, Fluids, Medication Adherence, Lifestyle Modifications) Exam Questions Verified and Provided with Complete A+ Graded Rationales Latest Updated 2026 Stones cause symptoms when they obstruct urinary flow. Places that they lodge: Usually at UPJ where ureter crosses the iliac vessels or UVJ where there are anatomical valves Kidney Cancer Pathophysiology Most primary renal tumors arise from renal cells: Renal cell carcinomas Kidney Cancer Risk Factors (R/T) Cigarette Smoking Genetic - first degree relatives Obesity Hypertension Exposure to environmental factors ——Asbestos ——Cadmium ——Gasoline Phenacetin analgesics - no longer in textbook Polycystic disease resulting in ESKD (ESRD) Males 2X Females/50-70 years is most common agePlus male and 50-70 y/o per Lewis 9th ESRD is now ESKD with K=kidney: renal cystic disease and renal-associated carcinomas may develop in patient with ESRD who is getting maintenance dialysis . Kidney Cancer Metastasis Most common metastasis sites (30% have mets at diagnosis) --Lungs --Liver --Long bones Other metastasis sites: brain, lymph nodes Kidney cancer can extend up into renal vein and vena cava 30% of patients have metastasis at the time of diagnosis. Local extension of kidney cancer can go to renal vein and vena cava. kidney cancer Signs & Symptoms General symptoms Weight loss Weakness Anemia Advanced symptoms Hematuria (painless!!!) Flank pain Palpable mass in the flank or abdomen Fever Hypertension Tumor may produce hormones/hormonelike substances which cause PARANEOPLASTIC SYNDROME Paraneoplastic syndrome: can cause hypercalcemia, hypertension, hyperglycemia kidney cancer Diagnostics IVP with nephrotomography Ultrasound - differentiates between cyst and solid mass tumor Angiography-to determine extent of vascular involvement Percutaneous needle aspiration-biopsy diagnostic tool CT - most commonly used to diagnose-for tumor density, extension of tumor, involvement. MRI Chest X-Ray- look for mets Bone scan-look for mets Liver Function Tests (LFT)-look for mets kidney cancer Treatments Radical nephrectomy --Treatment of choice for stage I or II tumors and selected stage III tumors Partial nephrectomy Radiation therapy Chemotherapy (refractory to most chemo but used for metastatic disease) --5-FU or FDUR (fluxuridine) or Gemzar (gemcitabine) --Refractory result for metastatic renal cell carcinoma- Biological therapy (for metastatic disease) Targeted therapy-preferred method (for metastatic disease) Sutent® (sunitinib) Nexavar® (sorafenib) Torisel® (temsirolimus) and Avastin® (bevacizumab) SE of meds is Capillary leakage syndrome: kidney cancer Prognosis Early stage kidney cancer: 60-70% 5-year survival rate after undergoing radical nephrectomy Metastatic kidney cancer: 3-10% 5-year survival rate, remain stable for prolonged period of time Nursing Interventions (Goals)