Paediatric Urology Flashcards
What are common urology conditions?
- Hernias and hydroceles
- Undescended testes
- Childhood UTI
- Peno-scrotal conditions
How does the presentation of urological conditions differ from adults?
- Systemic
- Fever, vomiting
- Failure to thrive
- Anaemia
- Hypertension
- Renal failure
- Local
- Pain
- Changes in urine
- Abnormal voiding
- Mass
- Visible abnormalities
- Incidental
- Antenatal
- Asymptomatic
- Permits immediate postnatal assessment
Inguinal hernia - epidemiology
(sex)
Inguinal hernia - presentation
- Lump in left/right groin that appears and reappears
- Key feature is groin and not scrotum
Inguinal hernia - management
- <1 year
- Urgent referral
- Repair – no place for observation
- >1 year
- Elective referral and repair
- Incarcerated
- Reduce and repair on same admission
Hydrocele - presentation
- Lump in scrotum that appears and disappears
- Bluish colour
- Painless
Hydrocele - management
- Conservative until 5 years old
What is cryptorchidism?
Undescended testes
Cryptochidism - presentation
- Scrotum empty at bath time
Cryptochidism - management
- Maybe orchidectomy
- Indications – fertility, malignancy, trauma, torsion, cosmetic
Normal non-retractile foreskin - presentation
Young presentation (physiological):
- Non-retractile foreskin
- Recurrent balanitis
- Pinhole meatus
Balinitix xerotica obliterans - presentation
- Older children
- Non-retractile foreskin
- Struggling to pass urine
- Scarred foreskin, narrow meatus
Balinitix xerotica obliterans - management
- Steroid cream
- Circumcision
- Removal of foreskin
- Indications – balanitis xerotica obliterans, balanoprosthitis, religious, UTI
What are indications for circumcision?
- Indications – balanitis xerotica obliterans, balanoprosthitis, religious, UTI
Testicular torsion - presentation
- Unilateral testicular pain
- Scrotum red, asymmetry, acutely tender to touch
Testicular torsion - management
- Emergency, operation asap
Torsion appendix testis - presentation
- Unilateral testicular pain
- Red scrotum
- NO ASYMMETRY
- Blue spot seen
- Tender to touch
UTI - definition
- Pure growth bacteria > 105
- Pyuria
UTI - clinical features
- Pyuria
- Systemic upset
- Fever, vomiting
UTI - investigations
- USS
- Renography
- MAG3 – drainage, function, reflux
- DMSA – function, scarring
- Micturating cystourethrogram (MCUG)
Vesiculoureteral reflux (VUR) - pathology
- Urine flows backwards from bladder to one or both ureters and sometimes kidneys
Vesiculoureteral reflux (VUR) - management
- Conservatrive
- Voiding advice, constipation, fluids
- Antibiotic prophylaxis
- Trimethoprim
- STING
- Ureteric reimplantation
Hypospadias - pathology
- Urethral meatus on ventral aspect of penis
Hypospadias - classification
- Anterior (most common)
- Middle
- Posterior
Hypospadias - associated abnormalities
- Upper tract
- Ambiguous genitalia
Hypospadias - investigations
- US
- Karyotype
- Only if severe
Hypospadias - management
Surgery
