Paediatric Urology Flashcards
What are the systemic manifestation of urological problems in children?
Fever Vomiting Failure to thrive Anaemia Hypertension Renal failure
What are the local manifestations of urological problems in children?
Pain Changes in urine Abnormal voiding Mass Visible abnormalities
What is the management for hernias?
<1 year (urgent referral and repair)
>1 year (elective referral and repair)
Incrcerated (Reduce and repair on same admission)
What is a hydrocele?
Scrotal swelling
What are the symptoms of hydrocele?
Painless
Increases with crying, straining, evening g
Bluish colour
What are the management of hydrocele?
Conservative until 5 yrs
What are cryptorchidism?
Any testis that cannot be manipulated into the bottom half of the scrotum
What are the indications for orchidopexy?
Fertility
Trauma
Torsion
Cosmetic
What are the possibilities outcomes of an impalpable testis?
Atrophic
Intra-abdominal
Absent
What are the indications for circumcision?
Balanitis Xerotica Obliterans (BXO)
Balanoprothitis
Religious
UTI
What are the advantages of circumcision?
Possible UTI prevention
Reduces penile cancer
Sexual enhancement
What are the complications of circumcision?
Painful Bleeding Meatal stenosis Fistula Cosmetic
What is the differential diagnosis of an acute scrotum?
Torsion testis
Torsion appendix testes
Epididymitis
What are the possible causes of antenatal hydronephrosis?
Vesico-ureteric reflux (VUR) VUJ obstruction Posterior urethral valves Multicystic kidneys Duplication anomalies PUJ obstruction (pelvi-ureteric junction)
What is the postnatal management of PUJ obstruction?
Postnatal USS
Renography
Surgery
What are the advantages of antenatal ultrasound?
Permits early detection of renal pathology
Early intervention improves overall outcomes
What are the disadvantages of antenatal ultrasound?
No evidence base for criteria for intervention
No consensus for early discharge
Increased parental anxiety
Why should UTIs be investigated?
Prevent renal scarring (reflux nephropathy and chronic renal failure)
Prevent hypertension
What is the criteria for UTI?
Pure growth bacteria >10^5
Pyuria
Systemic upset (Fever, vomiting)
What can be used to assess UTI?
History and examination
USS
Renography
Micturating Cystourethrogram (MCUG)
What is the management for VUR?
Conservative (voiding advice, constipation, fluids)
Antibiotic prophylaxis (trimethoprim)
Submucosal teflon injection
Ureteric reimplantation
What is hypospadias?
Urethral meatus on the ventral aspect of the penis
What is included in the assessment of hypospadias?
Site od meatus Chordee Deficient prepuce Rotation Scrotal abnormality
