Paediatric Urology

Question 1

Antenatal Hydronephrosis
Ix
DDx

Answer 1

Anatomy: USS, MCUG
Function: MAG3/ DMSA

DDx:
Obstruction
Reflux
‘Normal variant’

Question 2

Antenatal HDN Classification

Answer 2

Onen Classification
1 Pelvis Dilated Alone (They Resolve)
2 Pelvis + Calyceal Dilation (70% Resolve)
3 - As 2 + Thin Medulla but normal cortex
4 - As 2 + No Medulla/ Thin Cortex

Grades 3-4 less likely to resolve -> May need pyeloplasty

Question 3

When to operate on paediatric HDN

Answer 3

Symptomatic
Differential Function <40%
Falling Function

Question 4

Prenatal Treatment of Posterior Urethral Valve

Answer 4

Termination
Vesico-Amniotic Shunt

Question 5

i) Procedures for PUV
ii) OC of PUB

i

Answer 5

i) Cystoscopic - Incision/ Ablation / Laser
ii) Childhood ESRF -1/3, Adulhtood CKD 1/3, 100% have bladder dysfunction

Question 6

VUR:
i) Does it cause ESRD?
ii) NICE Ix for Paediatric UTI

Answer 6

i) No. It is the cause of UTIs which can then cause renal scarring.
ii)
All children USS in 6 weeks
Urgent USS - Atypical UTI/ Recurrent UTI
DMSA - 4-6 months for Atypical/Recurrent UTI
MCUG - 4-6 months for atypical/recurrent UTI

Question 7

VUR:
i) Does it cause ESRD?
ii) NICE Ix for Paediatric UTI

Answer 7

i) No. It is the cause of UTIs which can then cause renal scarring.
ii)
All children USS in 6 weeks
Urgent USS - Atypical UTI/ Recurrent UTI
DMSA - 4-6 months for Atypical/Recurrent UTI
MCUG - 4-6 months for atypical/recurrent UTI

Question 8

Degree of Hypospadias

Answer 8

Question 9

Paediatric Undescended Testes Mx:
i) Palpable but undescended
ii) Impalpable
iii) BL Impalpable

Answer 9

i) Orchidopexy
ii) Laparoscopy
iii) Consider disorder of sexual differentiation

Question 10

Rx for Nocturnal Enuresis

Answer 10

Fluid/Voiding Scheduling
Enuresis Alarm
ADH Analogues (Desmopressin)
Anticholinergics