L21 Urology

Question 1

Lesions may be (6)

Answer 1

Congenital

Infective

Tumours

Inflammatory

Traumatic

Others (e.g. autoimmune)

Question 2

Where is the kidney formed from?

Answer 2

Metanephros

Uretic bud branches

Question 3

What is a duplex kidney?

Answer 3

kidney with 2 ureters

Question 4

Congenital problems

Answer 4

Unilateral absent kidney

• one good kidney sufficient for a normal life
• you can’t be a kidney donor

Mayer Rokitansky syndrome:
Abnormalities of the vagina (agenesis), uterus, fallopian tubes associated most commonly with an absent kidney (unilateral)

Horse shoe kidney

Question 5

UTI

Answer 5

Pyuria

Urine culture

Difficulties in obtaining MSU

Suprapubic aspiration

Dipstix for nitrites

High index of suspicion

Question 6

VUR

Answer 6

Commonest ‘surgical’ cause of UTI

May be diagnosed after UTI

Antenatal diagnosis

Secondary reflux when associated with other abnormalities

Question 7

Management of reflux

Answer 7

Mostly non-operative

Many will stop refluxing after about the age of 5 years

Uroprophylaxis

Good follow up

Question 8

UTI (2)

Answer 8

Infection not very common

UTI may result in pyonephrosis - destroy kidney

May be diagnosed antenatally

Investigation - ultrasound nuclear scan - (MCU)

Uroprophylaxis

Question 9

Mega-ureter

Answer 9

Not as common as PUJ

May be associated with other problems like duplex system

Associated with urteroceles

Rarely simple stenosis

Has to be differentiated from V-U reflux

Question 10

PUV

Answer 10

Presents in the neonatal period (usually)

Infant may be very ill

Antenatally diagnosed and some managed antenatally

Outcome depends on initial renal damage