• GU trauma
• Acute scrotum
• Testicular torsion
• Fournier's gangrene
• Testicular trauma
• Penile fracture
• Priapism
• Paraphimosis - foreskin stuck behind glans → penile swelling and necrosis
• Manual reduction
• Squeeze edema out (manually +/- compress with Coban for 20-30 min)
• Reduce foreskin with motion similar to pushing down on syringe plunger (grip foreskin between index and middle fingers of both hands, then use both thumbs to push down on glans while pulling up on foreskin)
• 
• If unsuccessful, emergency dorsal slit/circumcision
• Recommend no foreskin manipulation x 1 week; elective circumcision
• Obstructed infection
• Decompress at level of obstruction; antibiotics
• Ureteral obstruction - stent or nephrostomy tube (treat cause of obstruction, e.g. stone, after infection resolves
• Bilateral hydronephrosis - make sure there is not bladder outlet obstruction that can be treated with a Foley
• Post-obstructive diuresis - polyuria after relieving complete urinary obstruction
• Usually self-limiting < 48 hr, but prolonged diuresis can lead to electrolyte imbalances/salt loss
• Acute spinal cord compression from cancer metastasis (e.g. prostate cancer)
• Consider degarelix (Firmagon) - potent GnRH antagonist
• GnRH agonist like Lupron can cause testosterone surge that will make mets/compression worse

Pediatric urologic emergencies

• Testicular torsion
• Neonatal torsion...large firm unilateral scrotal mass in newborn
• Mcould argue not really an emergency if 
• Salvage < 1%; usually painless for child (bc occurred in utero)
• Consider contralateral orchiopexy prior to 6 mo of age (this is the main 'emergency' risk/medicolegal issue if you wait too long and the other testis torses)
• Obstructed uropathy with infection
• e.g. infected ureterocele in septic child
• Ambiguous genitalia
• e.g. severe hypospadias + non-palpable gonads
• ...due to a/w DSD that cause life-threatening fluid/electrolyte imbalance, e.g. salt wasting with congenital adrenal hyperplasia (CAH)
• Monitor electrolytes (Na, K), vitals, fluid balance, daily weights
• Also check ACTH, 17α-OHP to confirm CAH
• Obtain karyotype, pelvic US to confirm