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Y4R4 - Surgery II 👨‍⚕️ > L9: Congenital Anomalies of Urinary Tract > Flashcards

L9: Congenital Anomalies of Urinary Tract Flashcards

1
Q

Normal Kidney Radiology

A
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2
Q

Terminology of Endoscopic Ultrasound (EUS)

A
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3
Q

Def of Hydronephrosis

A

Dilatation of the renal pelvis and calyces with urine.

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4
Q

Incidence of Antenatal Hydronephrosis

A
  • The commonest anomaly detected on prenatal ultrasound (US).
  • Reported in 1-4% of all pregnancies.
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5
Q

SFU Grading of Antenatal Hydronephrosis

A
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6
Q

Causes of Antenatal Hydronephrosis

A
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7
Q

Causes of Antenatal Hydronephrosis

  • Most Common Cause
A

Transient Hydronephrosis

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8
Q

Causes of Antenatal Hydronephrosis

  • Most Common Pathological Cause
A

Ureteropelvic Junction Obstruction (UPJO)

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9
Q

Causes of Antenatal Hydronephrosis

  • Most Common Cause in Boys
A

Posterior Urethral Valve (PUV).

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10
Q

Prognosis of Antenatal Hydronephrosis

A
  • 50% of ANH resolve spontaneously.
  • Only 10% require surgery.
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11
Q

Congenital Anomalies of Urinary Tract

A
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12
Q

Epidemeology of UPJO

A
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13
Q

Etiology of UPJO

A
  1. Abnormal canalization.
  2. Adynamic segment.
  3. Extrinsic cause.
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14
Q

CP (Presentation) of UPJO

A
  • Antenatal US.
  • Incidental.
  • Febrile UTI.
  • Abdominal pain.
  • Hematuria.
  • Abdominal mass.
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15
Q

INVx for UPJO

A
  • Renal/Bladder US
  • Diuretic Renogram
  • MRU
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16
Q

INVx for UPJO

  • US
A
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17
Q

INVx for UPJO

  • Diuretic Renogram
A
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18
Q

INVx for UPJO

  • MRU
A
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19
Q

TTT of UPJO

A
  • Watchful Waiting
  • Surgery
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20
Q

TTT of UPJO

  • Watchful Waiting
A
  • Antenatal cases.
  • US every 3 months.
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21
Q

TTT of UPJO

  • Surgery
A
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22
Q

Surgery in UPJO

  • Indications
A
  1. Symptomatic.
  2. Progressive hydronephrosis.
  3. Deterioration of renai function.
  4. Bilateral.
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23
Q

Surgery in UPJO

  • Procedures
A
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24
Q

Surgery in UPJO

  • Pyelopalsty
A
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25
Q

Surgery in UPJO

  • TTT approach & Risk Assessment
A
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26
Q

Incidence of Horseshoe Kidney

A

1/400.

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27
Q

Chatacters of Horseshoe Kidney

A
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28
Q

Def of VUR

A
  • A dynamic event in which urine is flowing from the bladder towards the kidney.
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29
Q

Incidence of VUR

A
  • 1% of children have VUR.
  • 10% of ANH have VUR.
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30
Q

Etiology of VUR

A
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31
Q

CP of VUR

A
  • Antenatally → Antenatal HN.
  • Postnatally → May present with pyelonephritis.
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32
Q

Pathogenesis & Complications of VUR

A
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33
Q

INVx for VUR

A
  • US
  • VCUG
  • DMSA
34
Q

INVx for VUR

  • US
A
35
Q

INVx for VUR

  • VCUG
A

For Grading

(The Best)

36
Q

INVx for VUR

  • Tc99m DMSA Renal Scan
A
  • For assessment of renal function & scarring.
37
Q

Grading of VUR

A
38
Q

Grading of VUR

  • Ureter
A
39
Q

Grading of VUR

  • Collecting System
A
40
Q

Grading of VUR

  • Fornices
A
41
Q

Grading of VUR

  • Renal parenchyma
A
42
Q

TTT of VUR

A
  • Conservative
  • Surgery
43
Q

TTT of VUR

  • Conservative
A
44
Q

TTT of VUR

  • Surgery
A
45
Q

Surgery in VUR

  • Indications
A
46
Q

Surgery in VUR

  • Procedures
A
  • Ureterovesical reimplantation
  • Endoscopy
  • Nephrectomy
47
Q

Surgery in VUR

  • Ureterovesical reimplantation
A
48
Q

Surgery in VUR

  • Endoscopy
A
49
Q

Surgery in VUR

  • Nephrectomy
A

if non/poorly functioning kidney.

50
Q

Def of Primary Obstructive Megaureter

A
  • Obstructive dilatation of the ureter above an adynamic ureteral segment at the ureterovesical junction.
51
Q

TTT of Primary Obstructive Megaureter

A
52
Q

TTT of Primary Obstructive Megaureter

  • Temporary TTT (<1yr)
A

Urinary Diversion
- Terminal Ureterostomy (Cutaneous Ureterostomy)

53
Q

TTT of Primary Obstructive Megaureter

  • Permenant TTT (after 1 yr)
A

Uretero-vesical reimplantation.

54
Q

Duplex Collecting System

A

(Ureteral Duplication - Duplex Kidney)

55
Q

Def of Duplex Collecting System

A
  • A complete or incomplete duplication of the collecting system (pelvicalyceal system and ureter).
56
Q

Types of Duplex Collecting System

A
  • Complete Dilatation
  • Incomplete Dilatation
57
Q

Types of Duplex Collecting System

  • Complete Duplication
A
  • Two ureteric buds arising from the Wolffian duct (Mesonephric ducts) → Kidney with 2 pelvicalyceal systems & 2 ureters.
58
Q

Types of Duplex Collecting System

  • Incomplete Dilatation
A

Early division of the ureteric bud, two types:

  • Bifid Ureter: Kidney with 2 pelvicalyceal systems & 2 ureters that merge and share a single ostium into the bladder (Y-shaped ureter).
  • Bifid Pelvis: Kidney with 2 pelvicalyceal systems that merge into a single ureter at the ureteropelvic junction.
59
Q

CP of Duplex Collecting System

A
60
Q

Def of Ureterocele

A
  • Cystic dilation of the intramural ureter (intravesical segment of ureter).
61
Q

Effect of Ureterocele

A
  • It obstructs the ipsilateral kidney and may obstruct the bladder neck or urethra (ectopic ureterocele).
62
Q

Incidence of Ureterocele

A

It’s more common with duplex kidneys.

63
Q

Def of PUV

A
  • Congenital malformation in males only where membranous folds of the urogenital membrane obstruct the membranous and prostatic urethra (posterior urethra).
64
Q

Epidemeology of PUV

A
65
Q
  • Most common cause of lower urinary tract obstruction in male neonates.
A

PUV

66
Q
  • Single most common urologic cause for chronic renal failure and need for renal transplantation in children.
A

PUV

67
Q

CP of PUV

A
68
Q

CP of PUV

  • Antenatal
A
  • Key-hole sign.
  • Thick-walled bladder.
  • Hydronephrosis.
  • Oligohydramnios.
69
Q

CP of PUV

  • Neonatal
A
  • Distended bladder.
  • Hydronephrosis.
  • Respiratory distress from pulmonary hypoplasia.
70
Q

CP of PUV

  • Older Children
A
  • UTI.
  • Difficulty/weak steam.
  • Incontinence.

Read INVx & Management at the endddd

71
Q

Def of Hypospadius

A
72
Q

Epidemeology of Hypospadius

A
73
Q

Dx of Hypospadius

A
74
Q

Dx of Hypospadius

  • Complaint
A
75
Q

Dx of Hypospadius

  • INVx
A

in selected cases

76
Q

TTT of Hypospadius

A
77
Q

TTT of Hypospadius

  • Age of Repair
A
78
Q

TTT of Hypospadius

  • Steps of Repair
A
79
Q

INVx in PUV

A
80
Q

Management of PUV

A

Y4R4 - Surgery II 👨‍⚕️ (33 decks)

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