Disorders Of The genitourinary System Flashcards
Pathological features of hypospadias
Hint:VEGHAs
Ventral curvature of penis/Chordee
Ventral opening of external meatus
Spatulated/flattened glands
Dorsal pre-putial hood
Bifid scrotum
Empty scrotal sac
Classification of hypospadias
Glanula
Corona
Penile
Scrotal
Perineal
Physical examination of hypospadias
Inspect the external genitalia
Inspect the scrotum
Inspect the perineum
Palpate the abdomen
Examine other systems-VATERL
VATERL
Vagina
Anus
Trachea
Esophagus
Renal
Limbs
What forms the collecting duct
Pronephros initially but later mesonephros
Unilateral kidney incidence
1 in 550 births
Bilateral kidney incidence
1 in 4000live births
Unilateral renal agenesis
Incidental finding with compensatory hypertrophy of the contralateral kidney
Unilateral renal agenesis components
VATERL
Ipsilateral ADRENAL AGENESIS
Blind ENDING Ureteric STUMP
Pelvi- Ureteric Junction(PUJ) obstruction
Common abnormality of the ureter
More in boys than girls
Affects left more than right
which urinary bladder disorder is assc with epispadia-
bladder exstrophy
bladder exstrophy-
absence of ant abd wall and ant wall of urinary bladder
condition assc with undesceneded testis and renal agenesis
Apenia
micropenis results from-
hypogonadotropic hypogonadism
PUV-
cong mucosal folds in post urethra
common cause of bladder obs
PUV
natural history of PUV-
Prog.renal failure -ESRD(40%)
Prenatal diagnosis
Failure of bladder emptying
Thickened bladder wall
Hydronephrosis
Renal dysplasia
Oligohydromnios
Post natal diagnosis of Puv-neonates
NEONATAL PERIOD
OBSTRETRIC HX OF OLIGOHYDRAMNIOS
PALPABLE MASSES
RESPIRATORY DISTRESS
LIMB DEFORMITIES
SMALL CHEST CAVITY
INDENTATION OF THE KNEES AND ELBOWS
POTTER’S FACIES
N.B Potter’s syndrome (dysmorphic facial features, fetal growth retardation, positional limb deformations, pulmonary hypoplasia).
OLDER CHILD DIAGNOSIS -PUV
OLDER CHILD
VOIDING DYSFUNCTION PRESENTS AS URINARY INCONTINENCE,ENURESIS
POOR URINARY STREAM
POST VOID DRIBBLING
STRAINING AT MICTURATION
UTI
FAILURE TO THRIVE BECAUSE OF RENAL INSUFFICIENCY
Penis and associated urethra develop from 3 structures:
Glans: Genital tubercle
Penile urethra: (genital) urethral folds
Scrotum: primitive genital swellings
Hypospadias occurs due to
failure (arrest) of complete fusion of (genital) urethral folds.
The most common site of
undescended testis is the superficial inguinal ring
Affects about- of boys and about of premature babies-undescended testis
3-4%
30%
Chordee: may be due to
Skin tethering
Fibrous band adjacent to urethra
Short urethra
Corporal disproportion
Not present in all patients
Splayed and flattened glans (spade-like)
Sometimes appears rather large
A cause of anxiety for mothers (sexual acceptability)
Ectopic ureter-male termination
Terminate proximal to the external sphincter :
1)bladder neck or prostatic urethra, 2)seminal vesicle,
3)ejaculatory duct ,
4)vas deferens
5) or the epididymis
Female ureter ternination-ectopic ureter
Female- ureters may terminate at the bladder neck/urethra, vestibule, vagina or the uterus
