23. Urology Flashcards
What are the presenting signs of a urological problem
Vomiting FTT Anaemia Hypertension Renal failure
Localised features of urological problem
Pain Changes in urine Abnormal voiding Mass Visible abnormalities
How does antenatal present
Asymptomatic
Permits immediate
postnatal assessment
What systemic problems may a child with a urological problem present with?
fever, vomiting, failure to thrive, anaemia hypertension renal failure
Discuss hernias?
Groin swelling 2% boys Boys 9:1 99 indirect (inguinal ring doesn't close) Increase risk with prematurity <1 year 33% imcarcerate
How do you mange a hernia under 1 year?
Urgent referral- fax/phone
Repair- no place for observation
How do yiu treat hernias over 1 year
Elective referral and repair- reduce them if they’re incarcerated. Repair on same admission
What is a hydrocele?
What is the management
Scrotal swelling
Common in newborns
Painless - worse on crying
Blueish colour
Conservative management until 5 years of age
What is cryptorchidism?
Hidden testis- undescended testis
- True cryptorchidism- undescended
- Retractile testis
- Ectopic- testis in the wrong place
Why would you operate on undescended testis?
Reduction of fertility
Malignancy risk
Trauma- May fracture testis
Torison- more likely to fix
What are the indications of circumcision
Absolute- balantits xerotica obliterans (BXO)
Relative- blanoprosthitis, religious, reduced risk of UTI
What is the acute scrotum?
Testicular pain- depends on age what most likely is (symptom not a condition)
Treat 6-8 hours from onset
What are the differentials of an acute scrotum
Torsion testis, torsion, appendix testis, epididymitis
(Less common) trauma, heamatoclele, incarcerated inguinal hernia
Why do we treat UTI early?
Prevent renal scarring
How is UTI defined
Urinal bacteria> 10^5 with pyruria
