Paed Urology Flashcards
Who gets inguinal hernias?
Mostly boys
Bowel (girls can get ovaries in it as well)
How does an inguinal hernia present?
A groin swelling
Often ass with prematurity
Are inguinal hernias in kids direct or indirect?
Indirect
how do you manage an inguinal hernia?
If <1yr –> Urgent referral and repair as can incarcerate easily
If >1yr –> Elective referral and repair
What do you do if an inguinal hernia incarcerates?
Reduce and repair immediately as it can compress the vessels –> Death of testes
What’s the main reason you’ll see a scrotal swelling in an infant?
Hydrocele
What features of a swollen scrotum fit with hydrocele?
- Painless
- Bluish colour
- Increases with crying, straining or in the evening (esp if walking)
How do you treat a hydrocele?
They’re very common in newborns and most spontaneously resolve so treat conservatively till ~5 then surgery
What could cause Cryptorchidism?
1) True absence of testes
2) Retractile - physiological response to cold
3) Ectopic
4) Ascending
What is an ascending teste?
In scrotum as a baby but 4-5yrs later it’s gone, possibly because body grows faster than spermatic cord –> testes pulled up into the canal
When we find undescended testes we do Orchidopexy, why?
1) Fertility
2) Malignancy
3) Trauma (more at risk if stuck in canal)
4) Torsion (more likely)
5) Cosmetic
What is the only absolute indication for a circumcision?
Balantitis Xerotica Obliterans
White scarring of foreskin
Who else might we circumcise?
- Religious/cultural reasons
- Balanoposthitis
- to reduce UTI risk in high risk people with dilated urinary tracts/renal failure
What is the acute scrotum?
Acute onset swelling and/or pain of the scrotum
What could cause Acute Scrotum and at what age?
Testicular Torsion (neonates and 10+)
Torsion Appendix Testes (from infant to puberty)
Epididymitis (Neonates & 10+, never happens in kids)