Smith and Tanago's general urology 19th ed.

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Preface

 Urological diseases in a concise and well-organized format. The book is up-to-date, to the point, and readable

Medical students will find this book useful because of its concise, easy-to-follow format, and its breadth of information on

common urological diseases. Residents, as well as practicing physicians in urology, family practice, or general medicine, will find

  and current reference, particularly because of its emphasis on diagnosis and treatment. This nineteenth edition has been thoroughly updated with clinical information and current references. The reader will find that this edition is written in an uncomplicated, straightforward manner that provides relevant clinical information and guidelines for diagnosis and management of urologic conditions. Chapters on immunotherapy in urologic malignancies, radiotherapy of urologic tumors, urinary incontinence, and vascular interventional radiology have all undergone extensive revision. For this current edition, we have added two chapters on the timely topic of gender dysphoria and introduction to clinical research design. Many illustrations and figures have been modernized and improved with added color. The classic fine anatomic drawings demonstrate well the important clinical findings. This book has been one of the leading sources of information for students, trainees, and urologists around the world. In addition to English, this book has been published in many other foreign languages, like Chinese, French, Greek, Italian, Japanese, Korean, Portuguese, Russian, Spanish, and Turkish. We greatly appreciate the patience and efforts of our McGraw-Hill staff, the expertise of our contributors, and the support of our readers. it an efficie

Urology deals with diseases and disorders of the adrenal gland, the male genitourinary tract, and the female urinary tract. These systems are illustrated in Figures 1–1 and 1–2

ADRENALS

Gross Appearance A. Anatomy

Each kidney is capped by an adrenal gland, and both organs are enclosed within Gerota’s (perirenal) fascia. Each adrenal gland weighs 4–5 g. The right adrenal is triangular in shape; the left is more rounded and crescentic. The average dimensions are 3 cm width, 5 cm length, and 1 cm thickness. Each gland is composed of a cortex, chiefly influenced by the pituitary gland, and a medulla derived from chromaffin tissue (Avisse et al, 2000; O’Donoghue et al, 2010). 

B. Relations 

Figure 1–2 shows the relationships between the adrenals and other organs. The right adrenal lies between the liver and the vena cava. The left adrenal lies close to the aorta and is covered on its lower surface by the pancreas. The spleen lies superior and lateral to it.

Histology

The adrenal cortex, which makes up 85% of the mass, is composed of three distinct layers: the outer zona glomerulosa, the middle zona fasciculata, and the inner zona reticularis. The medulla lies centrally and is made up of polyhedral cells with hormone-containing granular cytoplasm. These chromaffin cells are accompanied by a small number of sympathetic ganglion cells.

A. Anatomy