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Emergency Medicine Cases

Ep 143 Priapism and Urinary Retention: Nuances in Management

Emergency Medicine Cases

Dr. Anton Helman

Science, Courses, Medicine, Health & Fitness, Education

4.7602 Ratings

🗓️ 14 July 2020

⏱️ 64 minutes

🧾️ Download transcript

Summary

This month's main episode podcast on Urologic Emergencies -  Priapism and Urinary Retention asks: for priapism how much time to do we have to fix it before there’s irreversible tissue damage? How is priapism managed differently depending on the cause? What is the value of a corporal blood gas for managing priapism? What are the indications for cavernosal phenylephrine injections? What are the common medications that cause urinary retention that we often miss leading to needless recurrent urinary retention? Why is a suprapubic catheter in many respects safer than a urethral catheter for managing urinary retention? Which patients are at high risk for complications of post-obstructive diuresis? and many more...

Transcript

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0:00.0

If you work in a big city hospital, when there's an airway catastrophe, it's all hands on deck.

0:07.1

Sweating, you look up, and suddenly the help you called for are all there in a flash.

0:11.7

Everyone and their cousin shows up, and before long, the resuscitation bay feels a little too cozy.

0:19.0

Not so for yourologic emergencies. At 3 a.m. it's crickets. Whether it be priapism,

0:26.1

urinary incontinence, testicular torsion, or other rarer conditions, there's a good chance

0:31.4

your urologist is snoozing at least 30 minutes away. Fortunately for us, this means that as EM docs, we own the first

0:40.3

hour or so of management. And when it comes to that first hour, every minute counts. Today, we'll

0:48.4

be talking about these very emergencies. You may only see one or two of these every few years of

0:53.7

practice, but it's no reason

0:55.7

not to stay up to date. For our male audience, this might be a bit of a cringy episode, so

1:02.4

grab your On Dancetron and buckle up. We're headed below the belt.

1:08.2

Welcome to the Emergency Medicine Cases podcast with your host, Dr. Anton Hellman,

1:13.1

bringing you Canada's brightest minds in emergency medicine from EMC Studios in Toronto.

1:24.6

Now, there's a myriad of urologic emergencies from Fournier's Gangrene to penile fractured,

1:30.6

to nephrolithiasis to UTI, most of which have been covered extensively on EM cases before,

1:36.9

but there are three-time-sensitive emergencies that we're going to get deep into on the next

1:41.9

couple of podcasts, and they are priapism, urinary retention, and testicular torsion.

1:47.9

And we might throw in a few updates on kidney stones to boot.

1:51.6

And to help us along, we have an all-star EM clinician,

1:55.3

my friend and colleague from North York General and St. Michael's Hospitals in Toronto,

1:59.3

Dr. Natalie Wolpert.

2:01.4

Welcome, Dr. Wilportpert. Welcome, Dr.

...

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