Summary Book Urogenital

7/24/2019 Summary Book Urogenital

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ANATOMI SISTEM URINARIA

TRACTUS URINARIUS,

Ren = Ginjal

Ureter

Vesica urinaria = Blaas Urethra

REN = NEPROS = GINJALLETAKNYA = RETROPERITONEAL

Ginjal Kanan

Atas setentan !enan "erte#ra th$racal %

Ba&ah setentan !enan "erte#ra lu'#al (

Ginjal Kiri

Atas setentan !enan "erte#ra th$racal (

Ba&ah setentan !enan "erte#ra lu'#al )

Bentu*n+a se,erti *acan

U*uran -./ 0 / 0 (./ c'

Berat %/1 r 2la*i 3 la*i4 5 %(/ r ,ere',uan4

CAPSULA RENALIS (PEMBUNGKUS GINJAL)

Pe'#un*us ter!iri atas 6a,sula 7i#r$saleta*n+a ,alin luar

6a,sule a!i,$sa jarinan le'a*7unsi 'enahan ,a!a te',atn+a

8ascia renalis+an lansun 'e'#un*us injal

HILUS RENALIS

A!alah suatu saluran +an *eluar 'asu* *e injal $ran 3 $ran terse#ut antara lain 9

Vena

Areteri

:uctusureter

STRUKTUR GINJAL

Ka,sul Ginjal

K$rte*s Ginjal !aerah luar. #e&arna c$*lat !enan u*uran *uran le#ih %c'

;e!ulla Ginjal!aerah !ala'. !iju',ai 9 strial, 6 pra!is r"#alis a#$ %&%#$#a

'is"%t papilla r"#alis, *l%!#a r"#alis

Pel"is Ginjal saluran ,enu',ul

+ASCULARISASI

Berasal !ari arteri renalis +an si7atn+a En! arteri

+as%larisasi9 A< su,rarenalis. A< ,hrenica. !an A< Renalis

+- S%prar"#alis a#a##er'uara *e!ala' V< ca"a in"eri$r


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+- S%prar"#alis iri #er'uara *e!ala' V< renalis

I##"r.asi / "rasal 'ari s"ra%t Ga#$lia C*"liaa

SIRKULASI RENAL

A< RenalisAa< Interl$#ularesAa< ArcuataAa< Interl$#arisAa< Gl$'ularis a77erens

Arteri$l l$'erularis a77erentV"< Interl$#ularisV"< ArcuataV"< Interl$#ulares

URETER

A!alah saluran antara injal !enan *an!un *e'ih. #erju'lah se,asanARKAN A:A TI:AK KO;PLIKA>I

I>K >E:ERANA

2UN6U;PLI6ATE: TYPE4

I>K BERKO;PLIKA>I

26O;PLI6ATE: TYPE4

BER:A>ARKAN LOKA>I I>K BACA

CANITA (SISTITIS,SYND URETRA AKUT)

PRIA (SISTITIS, PROSTATIS)

I>K ATA>

PIELONE8RITI> AKUT KRONIK

:ian$sa ana'nese #er!asar*an9

Is atas / n+eri ,inan. !e'a'. 'eniil. 'ual. 'untah !an he'aturi

Is a4a5 /,$la*isuria. !isuria. n+eri su,ra,u#i*

P"!"risaa# isis / 8e#ris. n+eri te*an su,ra ,u#i*. n+eri *et$* su!ut *$st$"erte#ra

La*rat*ri%! / :arah rutin 2LEUKO>ITO>I>4. urin rutin 2LEUKO>ITURIA4

P"!"risaa# p"#%#&a#$ / :PL. *ultur urin !an tes resistensi *u'an. 7$t$ BNODIVP !an U>Ginjal

0ia$#*sa Ba#'i#$ / I>K se!erhana. I>K #er*$',li*asi. #atu saluran *e'ih

PENATALAK>ANAAN

N*# 3ar!a*l*$is/

Ban+a* 'inu' 2#ila 7unsi injal #ai*4

;enjaa hiene enitalia e*sterna

3ar!a*l*$is /

Anti'i*r$#a #er!asar*an ,$la *u'an +an a!a

Trimetopirm-sulfametokaol, sifropolaksi!, leflo"oksasi!, #ll

KO;PLIKA>I

Batu saluran *e'ih

O#stru*si saluran *e'ih

>e,sis

Ganuan 7unsi injal


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NEPHROTIC S7N0ROME (NS)

;eru,a*an *ea!aan *linis +an !itan!ai 9%< EAVY PROTEINURIA 2 1 ;G;(A;4

(< ;ARKE: YPOALBUNE;IA 2 (G:L4

)< E:E;A< YPER6OLE>TEROLE;IA 2 ((1 ;G:L

Ka!an *a!an !isertai ((@ D e'aturia

%/D(1@ D i,ertensi)(@ D Penurunan G8R

Ne,hr$tic s+n!r$'e 'eru,a*an *ea!aan 7unsi !ari #er#aai ,en+a*it l$'erulus ;E

KLASI3IKASI NEPHROTIC S7N0ROME

8- PRIMAR7 NSPen+a*it ,ri'er !i l$'erulus

9- SECON0AR7 NS

Pe+e#a# ,ri'er !iluar l$'erulus a*i#atn+a !i l$'erulus

:- CONGENITAL NS

SECON0AR7 NS

Pe+e#a# ter#an+a* 9 >LE.ANAPYLA6TOI6 PURPURA. >I6KLE 6ELL :I>>EA>E.

>YPILI>. ;ALARIA 2FUARTANA4. BLEE 3 >TING. :RUG AN: TOIN. 'is 9

(p"#iilla!i#", G*l', H"r*i#, Capt*pril, Tria!t"r"#, p*is*# Oa)

>e'ua Ne,hr$tic s+n!r$'e ,a!a ,er'ulaan ,en+a*itn+a9%< :i #i$,s+ 9 ?1@ ;6N>(< :i$#ati !enan ster$i!

D Perlu !$sis tini

D T$0in H !ari +an lainPen+e#a# ,eru#ahan ,er'ea#ilitas ,a!a l$'erulus #ase 'e'#rane 9

%< >ialic aci! !an ,r$te$cl +an #er*uran

(< Neati7 chare 2'uatan listri* !i en!$thel.L

:enan !ila*u*ann+a #i$s+ injal 'a*a a*an 'ene'u*an hasil se#aai #eri*ut 9

%< Liht ;icr$sc$,e(< electr$ne ;icr$sc$,e

)< I''un$7l$urescence ;I6R

Pat*$"#"sis / a!an+a lesi Gl$'erulus sehina 'enin*at*an ,er'ea#ilitas ,r$te$cl '$le*ul*ecil *eluar !ari urine 2al#u'in4. sehina terja!ilah ea"+ ,r$teinuriah+,$al#u'ine'ia

e!e'a< >'all '$lecule lain +an *eluar #ersa'a al#u'in +aitu immunoglobuline G, transferin i# %t"r*!i'ana ,a!a saat itu !i7erensiasi se*s !i'ulai. serta urethra

'ulai #er*e'#an. *e'u!ian ,a!a !i#$$% 8< i# %t"r*. ,a!a saat itu ,er*e'#anan urethraselesaierin in7ertil

BAK j$n*$*

Bentu* ,enis a#n$r'al

Teruta'a ,a!a ti,e ,en$scr$tal 5 ,erineal

>cr$tu' Bi7i!u' serin !iju',ai 2lihat a'#ar #eri*ut4

3i$%r" > Tip" p"#*sr*tal3i$%r" ? Tip" P"ri#"al3i$%r" @ Tip" Sr*tal


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PEMERIKSAAN PENUNJANG

R$utine

PA 9 #uccal s'ear 5*ar+$t+,in

Genetic se0

Ka!an ,erlu 3 urethr$c+st$sc$,+IVP0IAGNOSA BAN0ING

Canita !enan An!r$enie! a!ren$Denital s+n!r$'e

PENGOBATAN

Te*ni* re,air 9 a!a (11 cara

>atu taha, 9 ch$r!ect$'+ J urethr$,last+

:ua taha, 9

I< 6h$r!ect$'+

II< Urethr$,last+;asin 3 'asin !enan jara* ) 3 %( #ulanPA:IAE,is,a!ia a!alah suatu *elainan *$nenital. !i'ana 'eatus urethrae e0ternus terleta* ,a!a #aian

!$rsal< Pa!a e,is,a!ia *e!ital tu+er%leterleta* !$rsa! !ari 'uara sinus ur$enital. meatus

uret'raterleta* !i!$rsal !an serin !isertai e$trop'ia +la##er

CEBBE: PENI>

Ce##e! ,enis a!alah suatu *elainan *$nenital. !i'ana ter#entu* 'e'#ran *ulit ,a!a !aerahantara "entral ,enis !an scr$tu'< :erajat &e##e! ,enis #er"ariasi 9

Rinanti!a* 'eni'#ul*an *eluhan

Berat*eluhan jelas

P"#atalasa#aa#

Rinan!i#iar*an saja


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Berat*$re*si !enan 'e'#uan &e#

KELAINAN 1 KELAINAN PA0A SCROTUM

6RYPTOR6I:I>;

i!!en testis

testis ti!a* tera#a !ala' scr$tu' Penurunan testis !i,enaruhi $leh 9

%< +,$thala'icD,ituitar+Dtesticular a0is

(< Pr$!u*si an!r$en $leh testis

)< Taret tissue< Gu#ernaculu'

/< Te*< Intra a#!$'en

< Panjan "asa s,er'ati*a-< Panjan "as !e7erens

?< Patensi canalis inuinalis

;a+$ritas su!ah turun ,a!a tahun ,erta'a

Peru#ahan stru*tural ,a!a usia ( tahun

K$',li*asi

D In7ertilitasD Ne$,lasia

D ernia

D T$rsi$ testisD Psi*$Dse*sual

TERAPI

%< $r'$nal 3 6G %/11 iu'(3 i" 3 M hari(< O,erati7 $rchi$,e0+ se#elu' ( tahun

Y:RO6ELEA!alah ,enu',u*an cairan !i !ala' 9

D Tunica "ainalis

D Pr$cessus "ainalis. *a!an *a!ana ,a!a s,er'ati$ c$r!

Ter#ai atas 9#ro%ele %ommu!i%a!s, #a! !o! %ommu!i%a!s

+!r$cele ,ri'er 9

%< Ti,e "ainal(< Ti,e *$nenital 2*$'uni*ans4

)< Ti,e in7antil

< Ti,e 7uni*ular 27uni*$*el4

:ian$sa #er!asar*an ana'nese +an cer'at +aitu 'assa scr$tu' +an 'e'#esar. ti!a* n+eri

*ecuali #esar se*ali atau in7e*si *e'u!ia jua #er!asar*an ,e'eri*saan 7isi* +an !iju',ai 9

D K$nsistensi *isti*7lu*tuasiD Bila #esar*eras tean

D N+eri 2D4

D Transillu'inasi 2J4

D Testis #era!a !i#ela*an #a&ah 'assa


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D Bila #esar se*ali teansulit untu* !ira#a testisn+a 2*a!an *a!an ,erlu as,irasi

!ahulu4

D 6airan as,irasi*unin 'u!a jernih 2!ila*u*an secara steril4

T"rapi

Khusus ,a!a #a+i 5 ana* 9

Tera,i $,erati7 hi!r$*el *$nenital ,ri'er #eru,a liasi ,r$sessus "ainalis ,erit$nei se,erti,a!a herni$t$'i ana*< :ahulu serin !iuna*an tera,i sl"r*si#$ t5"rap !enan

'e'asu**an larutan NaD'$rhuate 2scler$sin aent4 *e!ala' tuni*a "ainalis< Na'un cara initi!a* #er*e'#an *arena #an+a* terja!i *$',li*asi #eru,a ne*r$sis< A!a #e#era,a tin!a*an

$,erasi +an !a,at !ila*u*an +aitu 9

%< Ber'an 9 !enan cara 'e'#u*a *ant$n 5 'eneeluar*an cairan< 6ara ini si',el

ta,i serin *a'#uh 2resi!i74(< Cin*el'an9 e*sisi *ant$n 2tuni*a "ainalis testis4

)< Ber'an D &in*el'an 9 D a#unan *e!ua cara !iatas. reati7 si',el !an #an+a*

!i,a*aie#ai*n+a ,eri*sa

ultraso!o&rafi< K$',li*asi 9

Pene*anan ,e'#uluh !arah atr$7i testis

e'at$*el $leh *arena trau'a

>PER;ATO6ELE

;asa *istis. ti!a* n+eri. #erisi s,er'a leta* !iatas 5 ,$steri$r !ari testis. ter,isah !ari testisI

D N+eri

D In7ertilitasD K$s'eti*


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TRAUMA URETHRA

Trau'a urethra #iasan+a le#ih #an+a* !ite'u*an ,a!a la*i la*i !i#an!in*an &anita< Biasan+a

$leh *arena 7racture ,el"is. stra!!le injur+< Trau'a ureter !a,at #eru,a 9 terputus, luka ro+ek .luka memarTrau'a uretra ter#ai atas ( +aitu. anterior "bulbosa pendulosa#, posterior

"prostatica membranacea#.;elalui a'#aran Uretr$a' 6$la Pint$ 5 ;c 6$llu'

'e'#ai !erajat ce!era uretra !ala' ) jenis

%< Urethra ,s$teri$r ,utus ti!a* !ite'u*an. han+a 'enala'i ,ereanan

Uretr$a' 9 ti!a* a!a e0tra "asasi *$ntras. han+a ,ereanan urethra(< Urethra ,$steri$r ,utus ,a!a ,er#atasan ,r$stat$'e'#ran$us< :ia,hra'a ur$enital

ti!a* ,utusUretr$a' 9 a!a e0tra"asasi *$ntras ta,i !iatas !ia,hra'a ur$enital

)< Urethra ,$steri$r. !ia,hra'a ur$enita 5 ,r$0i'al urethra ,ars #ul#$sa rusa*tatus ,si*$l$is

Rasa ,erca+a !iri

Ke'a',uan 'en+elesai*an 'asalah

Peran s$sial ,e*erjaan

Trau'a se*sual

P"!"risaa# 3isi

U'u' 9 ha#itus. !istri#usi ra'#ut. 'asa $t$t

Kar!i$"ascular 9 T:. !en+ut na!i ,eri7er

A#!$'en 9 he,at$'eali. s,len$'eali

Genitalia E*sterna 9 hi,$s,a!ia. *ur"atura ,enis. #urrie! ,enis. testis #esar. testis

*$nsistensi. !ll

Kelainan neur$l$i

P"!"risaa# La*rat*ri%!

:arah ,eri7er len*a,

Urinalisa

Ka!ar ula !arah

Li,i! ,r$7ile

8aal injal

$r'$nal 9 test$ster$n. ,r$la*tin

E'%asi Pasi"# (pr*s"s 1 9)

;eli#at*an ,asanan

Pa!a taha, ini !i!is*usi*an

Penilaian ulan ,r$ses 3 %

E!u*asi ,asien ,asanan

Ke'un*inan uji !ian$sti* ta'#ahan !an ruju*an

M"r%a5 3at*r P"#"a ( pr*s"s 1 :)Pen+e#a# :E +an re"ersi#le

O#at 3 $#atan

Kelainan h$r'$nal

Trau'a *elainan anat$'i

Ga+a hi!u, !an ,si*$sial

OBAT 3 OBATAN


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:a,at 'e',enaruhi 7unsi ere*si

;e*anis'e *$',le*s !an *$ntr$"ersia

Penaruh in!i"i!u

:a,at #er,enaruh jua terha!a, li#i!$. eja*ulasi. $ras'e

O+at a!& #apat me!e+a+ka! DE 3

Antihi,ertensi 9 !iureti*. #eta #l$c*er. A6E 3 I. 66B

Antiarit'ia 9 :i$*sin

Antian!r$en 9 GnR a$nis. *et$*$na$l. s,ir$n$la*t$n

(#l$c*er 9 si'eti!in

O#at 3 $#atan re*reati7 9 al*$h$l. 'arijuana. *$*ain. her$in

KELAINAN OR;ON

:e7isiensi test$ster$n 2 ) 3 @ ,en!erita :E4

Tera,i test$ster$ninje*si t$,i*al

La*u*an c$l$* !u#ur 5 ,e'eri*saan P>A

BP 5 ri&a+at *an*er ,r$stat ti!a* #$leh !i#eri*an

ati 3 hati ,en!erita PK

;$nit$r res,$n *linis 5 *a!ar test$ster$n

TRAU;A KELAINAN PENI>

Trau'a ,el"is,erineu'

Usia 'u!a. tera,i 9 re"as*ularisasi a< e,iastri*a in7eri$r *e a< !$rsalis ,enisIKO>EK>UAL

;er$*$*

;inu' al*$h$l +an #erle#ihan Pen+alah unaan $#at 3 $#ata re*reati7

Keti!a* har'$nisan

al !iatas !a,at !iruju**an *e ahli ji&a untu* ,eru#ahan a+a hi!u,. !an #ersaa' tera,i ,ilihan

T"rapi li#i p"rta!a ( pr*s"s F ;)

Tera,i se*s,si*$tera,i

O#at $ral

P$',a "a*u'

OBAT ORAL

Kerja sentral A,$'$r,hine

Kerja sentral !an ,eri7er

Penth$la'ine

Kerja ,eri7er

>il!ena7il sitrat

Var!ena7il

Ta!ala7il


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T"rapi li#i "'%a ( pr*s"s 1 < )

In!i*asi ji*alau tera,i ,erta'a aal atau 'e'an ,ilihan !ari ,asien< A!a !ua 'aca' +aituin$eksi intracavernosa, %G& intrauretra.

T"rapi li#i "ti$a ( pr*s"s 1 6 )In!i*asi. tera,i lini ,erta'a !an *e!ua aal atau ,ilihan !ari ,asien< ;aca' 3 'aca' ,r$stesis

,enis +aitu 9

>e'i rii!

>el7 c$ntaine! in7lata#le

8ull+ in7lata#le

Pr$tesis ,enis an*a *e,uasan ,en!erita 3 M(@. ,asanan 1 3 ?1 @< Alasan *eti!a* ,uasan.

,enis le#ih *ecil !ari ,a!a +an !ihara,*an !an le#ih !inin< K$',li*asi in7e*si %D %1 @. serta*eaalan 'e*ani* / @ !ala' / tahun

III< Ganuan Oras'e 5 eja*ulasi

Ganuan eja*ulasi ter!iri !ari 9%< Pre'ature eja*ulasi

Keti!a*D'a',uan untu* 'enun!a &a*tu eja*ulasi sa',ai 'en!a,at*an *e,uasan

,a!a !iri 5 ,asanann+a< Biasan+a !ise#a#*an $leh ,r$#le' ,si*$l$is< Tera,i #isa!enan ,eru#ahan ,$la ,erila*u. *$nsellin. >>RIs 2selecti"e ser$t$nnin u,ta*e

inhi#it$r4

(< :ela+e! ejaculati$n an! anejaculati$n:ise#a#*an $leh anuan neur$l$is s,inal injur+. :;. ,e'#e!ahan !aerah ,el"is

Summary Book Urogenital

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