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Welcome to ERCast, a focused discussion on the questions, quagmires and known unknowns we face everyday in the emergency department.

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Feb 23, 2010

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. 

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An unusual southern accent

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Urology Primer


Priapism a rare condition that causes a persistent, and often painful, penile erection.


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.


Clot retention

blood clots in the bladder prevent urine emptying


Coude Catheter

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.


De Novo

The Latin expression de novo literally means something akin to "from the beginning" or "anew"


Interstitial cystitis

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.



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).


CT Urogram

A urogram is a radiograph, or X-ray image, of the urinary tract. 



transurethral resection of the prostate


Foley catheter

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



David Wirtz
nine and a half years ago

Rob- I'm getting caught up on past podcasts. I thought I was a pretty well trained board certified EP, but I learned more in 5 minutes on this podcast than I think I have anywhere else! I work in a place where there is no urologist on call so this was great stuff.