Children with renal abnormalities Flashcards
Lesions may be
Congenital
Infective
Tumours
Inflammatory
Traumatic
Congenital problems
Unilateral absent kidney
- one good kidney sufficient for a normal life
Mayer- Rokitansky syndrome
Mayer- Rotikansky syndrome
Abnormalities of the vagina (agenesis), uterus, fallopian tubes associated most commonly with an absent kidney
UTI
Pyuria
Urine culture
Difficulties in obtaining MSU
Suprapubic aspiration
Dipstick for nitrites
High index of suspicion
VUR
Commonest surgical cause of UTI
May be diagnosed after UTI
Antenatal diagnosis
Secondary reflux when associated with other abnormalities
Vesicoureteral reflux
Urine flows backwards from the bladder through the ureters
Management of VUR
Mostly non-operative
Many will stop refluxing after about the age of 5 years
Uroprophylaxis
Good follow up
UTI may result in
Pyonephrosis- destroy kidney
Mega ureter
Not as common as PUJ
May be associated with other problems like duplex system
Associated ureteroceles
Rarely simple stenosis
Has to be differentiated from V-U reflux
PUV
Posterior urethral valve disorder
Obstructive developmental anomaly in the urethra and genitourinary system of males
Present in the neonatal period
Infant may be very ill
Outcome depends on initial renal damage
Buried penis
Penis covered by excess skin in the pubic area or scrotum
Hypospadias
Opening of the urethra is on the underside of the penis
