Collecting System Issues Flashcards
Ureteroceles
Mimic UTIs Most common cause of urinary retention in females May be a mass on urethral meatus Or a round filling defect on IVP --> urinary Tract obstruction
Vesicoureteral reflux
Likely if UTI presents early in life.
Dx: VCUG
Vesicoureteral reflux treatment
Avoid HTN, renal insufficiency/failure
Usually improves with time
Ppx Abx no longer recommended unless high grade reflux
If febrile, always have to check and treat UTI.
Urethral stricture causes
Trauma (catheter)
GC infection
If gross hematuria post trauma, catheter insertion is contraindicated
Posterior urethral valves
Male only
Palpable bladder
weak urinary stream, if no urine output then put in a foley
Prenatal US bilateral hydronephrosis and reduced renal parenchyma
If kid has bilateral hydronephrosis, need immediate VCUG to rule out PUV.
Need immediate urological consult for surgery
Renal failure can occur even after correction
Syndromes associated with hypospadias
SLOB
Silver Russell syndrome
Laurence-moon-biedl syndrome
Opitz syndrome
Beckwith wiedemann syndrome
Can circumcision be done with hypospadias?
No.
When should surgical correction be done to fix hypospadias?
6 months, at least within first year of life.
Congenital micropenis
<2.5 cm (1 inch)
Needs endo and genetic work up
Prader-Willi syndrome Kallmann syndrome GH deficiency Septo-optic dysplasia Hypoglycemia
Epididymitis vs orchitis
Epididymitis has dysuria
Orchitis does not. Seen with mumps.
Inclusion cysts
Tiny white bumps on tip of uncircumcised penis
Benign.
Smegma
White debris under prepuce of uncircumcised kid <3 yo.
Testicular cancer
Firm, painless, solid scrotal mass
Dx: bilateral ultrasound
lactate dehydrogenase
b-HCG
alpha-fetoprotein
Caucasians Cryptorchidism Gonadal Dysgenesis Previous testicular cancer Family history Klinefelter syndrome
