24 Genitourinary Surgery
CHAPTER LESSON PLANS & OBJECTIVES
Lesson 24.1: Anatomy and Diagnostics
- 1. Identify key anatomical structures of the genitourinary system
- 2. Discuss common diagnostic tests and procedures of the genitourinary system
Lesson 24.2: Case Planning
- 3. Discuss specific elements of case planning for genitourinary surgery
Lesson 24.3: Common Surgical Procedures
- 4. Describe common pathology of the genitourinary system
- 5. List and describe common genitourinary procedures
Classroom Preparation
Lesson 24.1: Anatomy and Diagnostics
INSTRUCTOR PREPARATION
Textbook Objectives Covered
- 1. Identify key anatomical structures of the genitourinary system
- 2. Discuss common diagnostic tests and procedures of the genitourinary system
National Standards Covered
- • See the Fuller 8e/AST Core Curriculum Mapping Guide on Evolve instructor resources.
Classroom Preparation
Lesson 24.1: Anatomy and Diagnostics
STUDENT PREPARATION (1 hr)
| 1 | READ – Chapter Heading(s) • Introduction • Surgical Anatomy • Retroperitoneal Cavity • Kidney • Adrenal Glands • Ureters • Urinary Bladder • Urethra • Reproductive Structures of the Male Scrotum and Testicles Epididymis Vas Deferens Seminal Vesicles Prostate Gland Bulbourethral Glands Penis ANSWER – Workbook • Chapter 24 PREPARE – Evolve Student Resources • Mock Certification Exam • Review Questions |
| 2 | READ – Chapter Heading(s) • Diagnostic Procedures Urinalysis Blood Tests Imaging Studies ANSWER – Workbook • Chapter 24 PREPARE – Evolve Student Resources • Mock Certification Exam • Review Questions |
50-Minute Lesson Plan
Lesson 24.1: Anatomy and Diagnostics
LECTURE OUTLINE (50 min)
| POWERPOINT SLIDES | CHAPTER HEADING(S) | |
| 1 | ANATOMY: SLIDES 4-5 | • Introduction • Surgical Anatomy • Retroperitoneal Cavity • Kidney • Adrenal Glands • Ureters • Urinary Bladder • Urethra • Reproductive Structures of the Male Scrotum and Testicles Epididymis Vas Deferens Seminal Vesicles Prostate Gland Bulbourethral Glands Penis |
| 2 | DIAGNOSTICS: SLIDE 6 | • Diagnostic Procedures Urinalysis Blood Tests Imaging Studies |
Learning Activities (choose one or more to equal 50 min)
| 1 | DISCUSS (30 min) • Have students identify and discuss the structures of the genitourinary anatomy and their functions. • Appropriate Settings: Traditional/online/flipped classroom |
| 2 | DISCUSS (30 min) • Discuss with the class common diagnostic procedures of the genitourinary system. Appropriate Settings: Traditional/online/flipped classroom |
Critical Thinking Question
What is the main difference between micturating cystourethrogram and retrograde ureteropyelography?
Discussion Guidelines: Discuss that one involves the placement of a catheter into the bladder (micturating cystourethrogram), while the other involves the placement of a catheter into the ureter (retrograde ureteropyelography).
Classroom Preparation
Lesson 24.2: Case Planning and Pathology
INSTRUCTOR PREPARATION
Textbook Objectives Covered
- 3. Discuss specific elements of case planning for genitourinary surgery
National Standards Covered
- • See the Fuller 8e/AST Core Curriculum Mapping Guide on Evolve instructor resources.
Classroom Preparation
Lesson 24.2: Case Planning and Pathology
STUDENT PREPARATION (1 hr)
| 3 | READ – Chapter Heading(s) • Kidney Dialysis Vascular Access for Hemodialysis Peritoneal Dialysis • Renal Calculi • Transurethral Cystoscopy Procedures Personnel Distention and Irrigation Fluids Fluid Waste Management Access and Drainage: Lower Urinary Tract Access and Drainage: Upper Urinary Tract ANSWER – Textbook • Review Questions 1, 2, 4, 5 ANSWER – Workbook • Chapter 24 PREPARE – Evolve Student Resources • Mock Certification Exam • Review Questions |
50-Minute Lesson Plan
Lesson 24.2: Case Planning and Pathology
LECTURE OUTLINE (50 min)
| POWERPOINT SLIDES | CHAPTER HEADING(S) | |
| 3 | CASE PLANNING: SLIDES 8-12 | • Kidney Dialysis Vascular Access for Hemodialysis Peritoneal Dialysis • Renal Calculi • Transurethral Cystoscopy Procedures Personnel Distention and Irrigation Fluids Fluid Waste Management Access and Drainage: Lower Urinary Tract Access and Drainage: Upper Urinary Tract |
Learning Activities (choose one or more to equal 50 min)
| 3 | DEMONSTRATE (50 min) • Demonstrate the various types of urethral catheters, deflating and inflating the balloon. Emphasize where to find the recommended fill volume and why it is prudent not to exceed it. Compare the sizes as expressed in French units. Note that as the number decreases, the size of the catheter also decreases. Leave the catheters out so that the students can handle them as they study. Appropriate Settings: Traditional classroom PRACTICE (50 min) • Pass different types of urology instruments around the class. Have students call out the instrument name as they pass it, using proper passing and handling techniques. Appropriate Settings: Traditional classroom |
Critical Thinking Question
Your patient has just been transported into the cystoscopy room, and you are assisting the circulator to transfer the patient onto the cystoscopy table. The patient is elderly and quite frail. After the general anesthetic has been administered, you assist the circulator in placing the patient into the lithotomy position. One leg settles quite easily into the stirrup, but the other seems very stiff. What is your first course of action? What would be the second thing to do? Are there other precautions to take into consideration?
Discussion Guidelines: The first course of action is as simple as trying another set of stirrups for positioning. Students should also describe a patient assessment, which would include any history of arthritis, joint replacement, or fusions. They should recognize the point when the urologist should assume responsibility for positioning. Additional considerations are ensuring that bony prominences are padded.
Classroom Preparation
Lesson 24.3: Common Surgical Procedures
INSTRUCTOR PREPARATION
Textbook Objectives Covered
- 4. Describe common pathology of the genitourinary system
- 5. List and describe common genitourinary procedures
National Standards Covered
- • See the Fuller 8e/AST Core Curriculum Mapping Guide on Evolve instructor resources.
Classroom Preparation
Lesson 24.3: Common Surgical Procedures
STUDENT PREPARATION (1 hr)
| 4 | READ – Chapter Heading(s) • Transurethral Cystoscopy Procedures • Routine Diagnostic Cystoscopy • Transurethral Resection of a Bladder Tumor (TURBT) • Open Genitourinary Procedures • Instruments • Cystectomy with the Ileal Conduit • Brachytherapy of the Prostate • Procedures of the Ureters and Kidney • Percutaneous Nephrolithotomy (PCNL) • Simple Nephrectomy (Flank Incision) • Kidney Transplant • Procedures of the Prostate • Transurethral Resection of the Prostate • Simple Prostatectomy (Suprapubic) • Perineal Prostatectomy (Open) • Robotic-Assisted Laparoscopic Prostatectomy (RALP) • Surgery of the Male External Genitalia • Circumcision (Adult) • Partial Penectomy • Insertion of Penile Implant • Hydrocelectomy • Orchiectomy ANSWER – Textbook • Review Question 3 ANSWER – Workbook • Chapter 24 PREPARE – Evolve Student Resources • Mock Certification Exam • Review Questions |
| 5 | READ – Chapter Heading(s) • Transurethral Cystoscopy Procedures • Routine Diagnostic Cystoscopy • Transurethral Resection of a Bladder Tumor (TURBT) • Open Genitourinary Procedures • Instruments • Cystectomy with the Ileal Conduit • Brachytherapy of the Prostate • Procedures of the Ureters and Kidney • Percutaneous Nephrolithotomy (PCNL) • Simple Nephrectomy (Flank Incision) • Kidney Transplant • Procedures of the Prostate • Transurethral Resection of the Prostate • Simple Prostatectomy (Suprapubic) • Perineal Prostatectomy (Open) • Robotic-Assisted Laparoscopic Prostatectomy (RALP) • Surgery of the Male External Genitalia • Circumcision (Adult) • Partial Penectomy • Insertion of Penile Implant • Hydrocelectomy • Orchiectomy ANSWER – Workbook • Chapter 24 PREPARE – Evolve Student Resources • Mock Certification Exam • Review Questions |
50-Minute Lesson Plan
Lesson 24.3: Common Surgical Procedures
LECTURE OUTLINE (50 min)
| POWERPOINT SLIDES | CHAPTER HEADING(S) | |
| 4 | PATHOLOGY: SLIDES 14-15 | • Transurethral Cystoscopy Procedures • Routine Diagnostic Cystoscopy • Transurethral Resection of a Bladder Tumor (TURBT) • Open Genitourinary Procedures • Instruments • Cystectomy with the Ileal Conduit • Brachytherapy of the Prostate • Procedures of the Ureters and Kidney • Percutaneous Nephrolithotomy (PCNL) • Simple Nephrectomy (Flank Incision) • Kidney Transplant • Procedures of the Prostate • Transurethral Resection of the Prostate • Simple Prostatectomy (Suprapubic) • Perineal Prostatectomy (Open) • Robotic-Assisted Laparoscopic Prostatectomy (RALP) • Surgery of the Male External Genitalia • Circumcision (Adult) • Partial Penectomy • Insertion of Penile Implant • Hydrocelectomy • Orchiectomy |
| 5 | COMMON SURGICAL PROCEDURES: SLIDES 14-15 | • Transurethral Cystoscopy Procedures • Routine Diagnostic Cystoscopy • Transurethral Resection of a Bladder Tumor (TURBT) • Open Genitourinary Procedures • Instruments • Cystectomy with the Ileal Conduit • Brachytherapy of the Prostate • Procedures of the Ureters and Kidney • Percutaneous Nephrolithotomy (PCNL) • Simple Nephrectomy (Flank Incision) • Kidney Transplant • Procedures of the Prostate • Transurethral Resection of the Prostate • Simple Prostatectomy (Suprapubic) • Perineal Prostatectomy (Open) • Robotic-Assisted Laparoscopic Prostatectomy (RALP) • Surgery of the Male External Genitalia • Circumcision (Adult) • Partial Penectomy • Insertion of Penile Implant • Hydrocelectomy • Orchiectomy |
Learning Activities (choose one or more to equal 50 min)
| 4 | DISCUSS (30 min) • Break the class into small groups. Assign each group a disease or condition of the genitourinary system. Have each group discuss its assigned disease or condition and the specific considerations and surgical treatments. Have each group present its summary to the class. Appropriate Settings: Traditional/online/flipped classroom |
| 5 | DEMONSTRATE (50 min) • Prepare instruments for transurethral procedures for class display. Review care and handling of instrumentation. Appropriate Settings: Traditional classroom PRACTICE (50 min) • Pass different types of urology instruments around the class. Have students call out the instrument name as they pass it, using proper passing and handling techniques. Appropriate Settings: Traditional classroom |
Critical Thinking Question
You and the circulator have transferred your patient to the operating table for a urethral
meatoplasty. The patient is under general anesthesia, and as you remove the blankets to begin the prep, you notice several piercings on the patient’s genitalia. What should be done? Can you prep the jewelry along with the surgical site?
Discussion Guidelines: The students should recognize that the jewelry poses a burn risk secondary to electrocautery use. Special tools for removing piercings should be available in the operating room (OR). It’s usually best to allow the surgeon to remove the jewelry. Treat it as a valuable belonging and follow the institution’s policy regarding patient jewelry. Remind students that some patients will not admit having such body art to the preoperative nurses, and the OR team should bear this in mind
If a male patient is not Jewish, can he undergo a circumcision?
Discussion Guidelines: Explain that circumcision is not performed solely for religious reasons, but also for hygienic reasons.
Assessments
Chapter 24: Genitourinary Surgery
ASSESSMENTS BY OBJECTIVE
| 1-5 | Workbook • Chapter 24 Evolve Instructor Resources • Test Bank Create a quiz using ExamView; sort by objective. Evolve Student Resources • Mock Certification Exam • Review Questions |
| All | Elsevier Adaptive Quizzing • Chapter 24 – Graded quizzes (Mastery Levels 1, 2, and 3) |
