Paediatric Urology Flashcards
What are presentations seen in paediatric urology?
Systemic - fever, vomiting, failure to thrive, anaemia, hypertension and renal failure
Local - pain, changes in urine, abnormal voiding, mass, visible abnormalities and incidental
What is the presentation of an inguinal hernia?
Lump in groin - swelling
More boys than girls
Increased risk with prematurity
Biggest risk is they will incarcerate
What is the management of an inguinal hernia in children?
Under 1 year - urgent referral and repair
Over 1 year - elective referral and repair
Incarcerated - reduce and repair on same admission
What is the presentation of a hydrocele?
Lump in scrotum which is bluish colour
Baby well
Very common in newborns
Worse when crying and straining
Worse in evenings
Conservative management until 5 years old
What is the presentation of undescended testes?
Any testis that cannot be manipulated into the bottom half of the scrotum
True undescended testis or retractile testis
Can also have ascending testis - present later
What are the indications for orchidopexy?
Fertility
Malignancy risk
Trauma
Torsion
Cosmetic
What is balanitis Xerotica Obliterans?
Scaring condition of the foreskin
White scaring seen
Steroid cream can be used but need circumcision
Indications for circumcision is BXO, balanoprosthitis, religious and UTI
What are the complications of circumcision?
Bleeding, meatal stenosis, fistula and cosmetic
What is the presentation of testicular torsion?
Testicular pain and scrotum red
Acutely tender to touch
Asymmetry
What is the presentation of torsion appendix testis?
Testicular pain, scrotum red, no asymmetry, blue spot seen and tender to touch
Describe acute scrotum
Age related
Torsion testis, torsion appendix testis and rarely epididymitis
6-8 hours to recover testis
Why is UTI investigated in children?
Prevent renal scaring (reflux nephropathy and chronic renal failure) and prevent hypertension
What is the definition of a UTI?
Pure growth of bacteria >10^5 and pus cells
Pyuria
Systemic upset - fever and vomiting
How is UTI assessed?
FH, bowel habit and voiding dysfunction
US scan
Renography - MAG3 and DMSA
Micturating cystourethrography (MCUG)
What is the management of VUR?
Conservative - voiding advice, constipations and fluids
Antibiotic prophylaxis - trimethoprim
STING - mild/ moderate with symptoms
Ureteric reimplantation
What is hypospadias?
Urethral meatus on the ventral aspect of the penis
Classified - anterior (more common), middle and posterior (most severe)
Associated with upper tract abnormalities
What is the investigation and management of hypospadias?
US, karyotype only if severe
Management - one stage or 2 stages procedure
