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AIIMS capsule
2018
A 20-years-old male presents with hard painless testicular swelling. On
investigation AFP is 308. No para aortic or iliac nodes as well as no
mediastinal lymph nodes found. USG shows uniform echotexture and
small areas of necrosis. Surrounding structures are normal. What is the
AfraTafreeh.com
next best step:
1. FNAC
2. Trucut biopsy
3. High inguinal orchidectomy
4. PET-CT
 AfraTafreeh.com

Management

Testicular mass suspicious USG Tumor markers

on clinical examination scrotum if suspicious

High inguinal High inguinal incision

Biopsy orchidectomy if and delivery of testis
malignant

Surveillance by CECT
Stage 1 Sem & Non Sem
and tumor markers
CECT abdomen +
chest

Rest of stages BEP regimen

Sem & Non Sem
2018
A 20-years-old male presents with hard painless testicular swelling. On
investigation AFP is 308. No para aortic or iliac nodes as well as no
mediastinal lymph nodes found. USG shows uniform echotexture and
small areas of necrosis. Surrounding structures are normal. What is the
AfraTafreeh.com
next best step:
1. FNAC
2. Trucut biopsy
3. High inguinal orchidectomy
4. PET-CT
 AfraTafreeh.com

2019
If a child with acute scrotal pain and swelling where testicular
torsion is highly suspected, how would you proceed:
1. Immediate scrotal exploration only on side of swelling
2. Immediate scrotal exploration on same side and delayed exploration on
the other side
3. Immediate scrotal exploration on both sides
4. Observation
Torsion
• Common age 10 to 20 years
• Commonest cause
• Clapper bell deformity
• Clinical test AfraTafreeh.com
• Prehn’s test
• IOC
• Doppler
• Treatment
• Bilateral scrotal exploration
 AfraTafreeh.com

2019
If a child with acute scrotal pain and swelling where testicular
torsion is highly suspected, how would you proceed:
1. Immediate scrotal exploration only on side of swelling
2. Immediate scrotal exploration on same side and delayed exploration on
the other side
3. Immediate scrotal exploration on both sides
4. Observation
2019
Arrange the following types of renal injury in order from lower to higher grade:

A. Subcapsular perirenal hematoma

B. Hematomas confined Gerota’s fascia

C. Avulsion of the pedicle

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D. Shattered kidney

1. a→b→c→d
2. d→c→b→a
3. a→c→b→d
4. b→d→a→c
AfraTafreeh.com
2019
Arrange the following types of renal injury in order from lower to higher grade:

A. Subcapsular perirenal hematoma

B. Hematomas confined Gerota’s fascia

C. Avulsion of the pedicle

AfraTafreeh.com
D. Shattered kidney

1. a→b→c→d
2. d→c→b→a
3. a→c→b→d
4. b→d→a→c
 AfraTafreeh.com

2020
Girl child with dribbling of urine otherwise normal voiding
what is the cause?
1. Grade 4
2. Uretrocele
3. Congenital Megaureter
4. Ectopic ureter
Complete duplication
• Weigert Meyer law

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 AfraTafreeh.com

2020
Girl child with dribbling of urine otherwise normal voiding
what is the cause?
1. Grade 4
2. Uretrocele
3. Congenital Megaureter
4. Ectopic ureter
2021
All of the following are lower urinary tract
symptoms except?
• Incontinence during intercourse
AfraTafreeh.com
• Sudden urge to urinate
• Incontinence while asleep
• Dribbling while asking the patient to lie in supine and
asking to cough
 AfraTafreeh.com

Prostate
• Lower urinary tract symptoms
• Voiding / Obstructive symptoms
• Hesitancy
• Poor flow
• Intermittent stream
• Dribbling
• Sensation of poor bladder emptying
• Episodes of near retention
• Storage / irritative symptoms
• Frequency
• Nocturia
• Urgency
• Urge incontinence
• Nocturnal incontinence

Tuesday, March 28, 2023 @ Dr. Sujoy Neogi

2021
All of the following are lower urinary tract
symptoms except?
• Incontinence during intercourse
AfraTafreeh.com
• Sudden urge to urinate
• Incontinence while asleep
• Dribbling while asking the patient to lie in supine and
asking to cough
 AfraTafreeh.com

2021

Most common cause of bladder outlet obstruction

in a male child?
• PUV
• AUV
• Urethral atresia
• Ureterocele
Pediatric urology: PUV
• Presence of valves
• Location of valves?
• Distal to verumontanum

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 AfraTafreeh.com

Pediatric urology: PUV

• Presence of valves
• Location of valves?
• Distal to verumontanum
• Obstruction to urine outflow
• Effects of PUV
• High pressure bladder
(trabeculation,diverticula)
• Unilateral / bilateral ureteric reflux
• Renal failure
• Pulmonary hypoplasia
• Investigation of choice : MCU
• Dilated posterior urethra – Key hole sign
Pediatric urology: PUV

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 AfraTafreeh.com

Pediatric urology: PUV

Pediatric urology: PUV
• Management
• Antenatal management: Vesicoamniotic shunting
• Post natal
• Cystoscopic fulgration of valves
• Management of renal failure
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• Ureteric reimplantation (Optional)
 AfraTafreeh.com

Pediatric urology: PUV

AfraTafreeh.com
 AfraTafreeh.com

2021

Most common cause of bladder outlet obstruction

in a male child?
1. PUV
2. AUV
3. Urethral atresia
4. Ureterocele
2021
A 50-year-old male patient came to the outpatient department
with complaints of hematuria. A 2x2 cm bladder mass was seen
which is a high-grade transitional cell carcinoma. Which among
the following is the ideal management?
AfraTafreeh.com

• Neoadjuvant chemotherapy
• Partial Cystectomy
• Transurethral resection of the mass
• Radical cystectomy
 AfraTafreeh.com

Urine for Cystoscopy

Painless USG MRI / TURBT
malignant
hematuria
cells
Take home message Bladder Ca
• Smoking IMPORTANT

• Superficial tumors as dangerous & problematic as invasive

• Non muscle invasive bladder carcinomas

• TURBT
AfraTafreeh.com
• Intra-vesical BCG
• Muscle invasive bladder carcinoma
• Radical cystectomy is the treatment for
• External / internal diversion
• Systemic MVAC
• CIS
• Intra-vesical chemotherapy
• In cases of too many recurrences  Radical cystectomy
 AfraTafreeh.com

2021
A 50-year-old male patient came to the outpatient department
with complaints of hematuria. A 2x2 cm bladder mass was seen
which is a high-grade transitional cell carcinoma. Which among
the following is the ideal management?
• Neoadjuvant chemotherapy
• Partial Cystectomy
• Transurethral resection of the mass
• Radical cystectomy
2021
An elderly male, age 60 years patient presented with left
testicular swelling and ataxia. What is the diagnosis?
• Germ cell tumor
• Glioblastoma multiforme AfraTafreeh.com

• Non-Hodgkin's lymphoma
• Hodgkin's lymphoma
 AfraTafreeh.com

2022
What is the correct volume of the prostate?
• 20cc
• 50cc
• 70cc
• 100cc
2022
30 male blunt injury to the abdomen. There was no blood
at tip of meatus. Nil urine output after
Foley’s Cathetrisation. The next best management foe
the patient? AfraTafreeh.com

• SPC
• Foleys cathetrisations.
• Laprotomy
• Pelvic packging with b/l nephrostomy.
 AfraTafreeh.com

Bladder injury
• Two types
• Extra-vesical
• Pelvic fracture associated
• Swelling in lower abdomen
• Tear drop sign in MCU
• Management may be prolonged catheterization
• Intra-vesical
• Trauma abdomen in full bladder
• Suspicion when no urine and abdominal distension (CVP normal)
• Management is laparotomy
2022
30 male blunt injury to the abdomen. There was no blood
at tip of meatus. Nil urine output after
Foley’s Cathetrisation. The next best management foe
the patient? AfraTafreeh.com

• SPC
• Foleys cathetrisations.
• Laprotomy
• Pelvic packging with b/l nephrostomy.
 AfraTafreeh.com

2022

•RCC
•Angiomyolipoma
•Oncocytoma
•Adenoma
Angiomyolipoma
• Benign lesions of kidney
• Associated with Tuberous sclerosis
• High fat content
• 25% chance of malignancy
AfraTafreeh.com
 AfraTafreeh.com

2022

1. RCC
2. Angiomyolipoma
3. Oncocytoma
4. Adenoma
2022

• Degloving/ Orthoplasty (Chordee correction)

• Glanulopasty
AfraTafreeh.com
• Urethroplasty
• Meatoplasty
 AfraTafreeh.com

Hypospadias
• Chordee correction
• Urethroplasty
• Meatoplasty First step
• Glansplasty
• Scrotoplasty
• Preprutioplasty / circumcision
2022

• Degloving/ Orthoplasty (Chordee correction)

• Glanulopasty
AfraTafreeh.com
• Urethroplasty
• Meatoplasty