<p>Why is a 12 hour erection a bad thing? How should we manage the patient with bloody urine? A curbside consult with urologist Brian Shaffer, MD. </p
<p>An unusual southern accent</p
<p>and much more...</p
<p><em><strong><span style="font-size: x-large; color: #0000ff;">Urology Primer</span></strong></em></p
<p><strong><span style="font-size: large;">Priapism<span style="font-size: 10px; font-weight: normal;"> a rare condition that causes a persistent, and often painful, penile erection.</span></span></strong></p
<p>Priapism is drug induced, injury related, or caused by disease, not sexual desire. As in a normal erection, the penis fills with blood and becomes erect. However, unlike a normal erection that dissipates after sexual activity ends, the persistent erection caused by priapism is maintained because the blood in the penile shaft does not drain. The shaft remains hard, while the tip of the penis is soft. If it is not relieved promptly, priapism can lead to permanent scarring of the penis and inability to have a normal erection.</p
<p><strong><span style="font-size: large;">Clot retention</span></strong></p
<p>blood clots in the bladder prevent urine emptying</p
<p><span style="font-size: large;"><strong>Coude Catheter</strong></span></p
<p>a semi-rigid catheter that has a curve or bend at the tip. The curved tip allows it to navigate over the curvature of the prostate or any other urethral obstruction it may encounter. A Coude catheter is specifically designed for this purpose. Coude catheters are available in size 8 French to size 26 French.</p
<p><strong><span style="font-size: large;">De Novo</span></strong></p
<p>The Latin expression de novo literally means something akin to "from the beginning" or "anew"</p
<p><strong><span style="font-size: large;">Interstitial cystitis</span></strong></p
<p>also called painful bladder syndrome — is a chronic condition characterized by a combination of uncomfortable bladder pressure, bladder pain and sometimes pain in your pelvis, which can range from mild burning or discomfort to severe pain.</p
<p><strong><span style="font-size: large;">Cystoscopy</span></strong></p
<p>the use of a scope (cystoscope) to examine the bladder. This is done either to look at the bladder for abnormalities or to help with surgery being performed on the inside of the urinary tract (transurethral surgery).</p
<p><strong><span style="font-size: large;">CT Urogram</span></strong></p
<p>A urogram is a radiograph, or X-ray image, of the urinary tract. </p
<p><strong><span style="font-size: large;">TURP</span></strong></p
<p>transurethral resection of the prostate</p
<p><strong><span style="font-size: large;">Foley catheter</span></strong></p
<p>a thin, sterile tube inserted into the bladder to drain urine. Because it can be left in place in the bladder for a period of time, it is also called an indwelling catheter. It is held in place with a balloon at the end, which is filled with sterile water to hold it in place. The urine drains into a bag and can then be taken from an outlet device to be drained</p
Being Black in America is dangerous. We hear about the deaths by police shooting or white supremacist - and by gun violence generally, which disproportionately plagues Black communities. But we hardly ever discuss the persistent discrepancy in life expectancy between white and black. There are many ways to attack the latter through healthcare policy and practice -- if we are willing. That remains the question for America 48 years after King was killed.
I would like to say "well done, Mark Zuckerberg" as Facebook tops 1 billion active users! But all this is while 1 billion people in the world never see a health worker in their entire lives.
The internet is the most powerful tool of our generation and there is no doubt that its influence will increase further in the future. I think we can all recognise the success of an enterprise such as Facebook and it is certainly a commendable feat to bring 1 billion people closer together on a regular basis. Well done Mark Zuckerberg!
But does this not highlight some bigger questions? When will we see the internet making a real difference?
I don't mean to belittle any enterprise such as Facebook which excites and energises a huge community, but when will we see a movement that has such an impact to save and improve billions of lives every month?
The WHO Global Health Workforce Alliance estimates that there are a billion people alive today who will never see a health worker in their lives... Ever! We are not short of the tools to change this.
So, how will this movement come about? Will it be a political push? Will it be an established company that walks in the 'right' direction? Or could it come from the grassroots?
I believe this is one of the greatest challenges of our generation, and the most exciting challenge I can think of. As a doctor and co-founder of Meducation, we have started a movement in the right direction. Meducation aims to unite the medical community - yes all of it, but we know our limits.
You can not make such an impact in one step. Most of the charitable solutions and philanthropic activity takes us huge leaps in the right direction and these are of significant importance, but will we ever see the sort of impact possible if we can't maintain the ability to push forwards with the attrition needed to effectively get this right.
I would assume that most of those who have set up an innovative and successful solution to a problem would say that they could not achieve this with an element of freedom to experiment, try different methods and approaches before finding the formula that works. Is it not the same with this problem?
The solution is going to grow from the grassroots and for us at Meducation, although we are starting with health workers in the UK, we certainly see the hopeful future where the health workers in the developing countries can gain access to the educational material and support they need from the rest of the community. With the global medical community working closely together, we will be better placed to help the 1 billion people who would have never see a health worker in their lives.
So well done Mark.... but there are still bigger fish to fry.
If I had a penny, okay a pound, for every time a patient responded to the request to practice examining them said, 'Well, we all gotta learn', I would be a very rich medical student. (I'd like to add that this is said in a strong West-country accent, just so that you feel like you're really there.) I'm sure that the majority of my colleagues would agree.
Today has been no different except for the fact that one of the patients I met described themselves as a 'whistleblower'. It was like my subconscious slapping me around the face and telling me to stop procrastinating. Why, you ask? Well I'm starting to get a little nervous actually, in exactly two weeks I'll be presenting my thoughts on whistleblowing (you might remember me going on about this during dissertation season) to a load of academics and healthcare professionals. My sphincters loosen up at the thought of it*
Within five minutes of meeting this patient, they had imparted their wise words on me 'Chantal, just remember when you become a doctor - if you're absolutely sure that you're right about something then never be afraid to speak up about it.' Like music to my ears. Well, until he told me that he was convinced that 'cannabis cures all ills.'
Each to their own.
*I sincerely apologise, poor medic joke. Yuck.
Written by Chantal Cox-George,
3rd Year Med Student at University of Bristol