Paediatric Urology Flashcards
Presentation of urological problems
Fever Vomiting Anaemia HTN Renal failure Pain Changes in urine Abnormal voiding Mass Visible abnormalities Incidental Antenatal - asymptomatic
What is a inguinal hernia?
A groin swelling
Which gender gets inguinal hernias more?
b>g 9;1
When is there an increased risk of hernia?
Prematurity
Treatment of hernia
< 1 y. o - urgent referral - repair > 1 y .o = elective referral and repair Incarcerated = reduce an repair on same admission
What is hydrocele?
Scrotal swelling
Who is hydrocele common in?
Newborns
Presentation of hydrocele
Painless Pain increases with - crying - straining - evening Bluish colour
Management of hydrocele
Conservative until 5 y / o
What is cryptorchidism?
Any testis that cannot be manipulated into the bottom half of the strotum
Types of cryptorchidism
True
Retractile
Ectopic
Ascending testis
What is orchidopexy?
A surgery to move an undescended (cryptorchid) testicle into the scrotum and permanently fix it there.
Indications for orchidopexy
Fertility Malignancy Trauma Torsion Cosmetic
What is circumcision?
Removal of the foreskin
Indications for circumcision
Balanitis Xerotica Obliterans (BXO) - absaloute indication
Balanoposthitis
Religious
UTI
Disadvantages of circumcision
Painful
Complications of circumcision
Bleeding
Metatal stenosis fistula
Cosmetic
What is the acute scrotum?
Scrotal pain, swelling and redness of acute onset
Differentials of acute scrotum
Torsion testis Torsion appendix testis Epididymis Trauma Haematocele Incarcerated inguinal hernia
What is the investigation of UTIs done to prevent?
Renal scarring
- reflux nephropathy and chronic renal failure
HTN
Who with UTIs are investigated?
All < 6 / 12
Atypical
Recurrent
What amount of bacteria is considered a UTI?
> 10 5
Presentation of UTI in children
Pyuria
Systemic upset
- fever
- vomiting
Investigations of UTI in children
History and exam U
USS
Renogrpahy
MCUG
What is Vesicoureteral reflux (VUR)?
A condition where urine flows backward from the bladder to one or both ureters and sometimes to the kidneys
Management of VUR
Voiding advice Constipation Fluids Antibiotic prophylaxis STING - mild / moderate with symptoms Ureteric reimplantation
What is hypospadias?
Urethral meatus on the VENTRAL aspect of the penis
Classification of hypospadias
Anterior
Middle
Posterior
Associated anomalies of hypospadias
Upper tract
Intersex (ambiguous genitalia)
Investigations of severe hypospasias
USS
What should NOT be done in managing hypospadias?
Circumcision
What is phimosis?
Non retractable foreskin
What age is phimosis normal and may regress with time?
< 2 y/o
