Paediatric Urology Flashcards
Systemic Presentation of paediatric urology
Fever, Vomiting, Failure to Thrive Anaemia Hypertension renal failure
Local Presentation of paediatric urology
Pain Changes in urine Abnormal Voiding Mass Visible abnormalities Incidental
Antenatal Presentation of Paediatric urology
Asymptomatic
Permits immediate postnatal assessment
Presentation of a Hernia
GROINSwelling
2% of boys
99% indirect
increased with Prematurity
Hernia Management
< 1 year
URGENT referral
Repair - No place for observation
if you wait the hernia will incarcerate
> 1 year
elective referral ad repair
Incarceration
Reduce and repair on same admission
Biggest risk is compression of the blood supply and loss of the testis on that side
Presentation of a Hydrocoele
SCROTAL swelling
very common in new born - almost normal
PAINLESS
increased with Crying , straining or in the evening
(generally sue to increased time upright)
Bluish colour
management of Hydrocoele
Conservative until 5 years of age
What is Cryptorchidism
An undescended Teste
any testicle that cannot be manipulated into the bottom half of the scrotum
Subcategories of cryptorchidism
True
Retractile - normal but vigorous is babies
Ectopic - May be in the wrong place
Indications for orchidopexy
Fertility 1% germ cell loss/ month undescended Malignancy RR x 3 (if intra abdo) Lifetime risk < 1 x
Trauma
Torsion
Cosmetic
indications for Circumcision
removal of foreskin
Complete
Balantis Xerotica obliterans (BXO)
Whit scarring of foreskin
Relative
Balantoprostititis
Religion
UTI
Disadvantages to Circumcision
Pain Complications Bleeding Meatal Stenosis Fistual Cosmetic
Look Different
The Acute Scrotum `
Age Related
DDx
Torsion Testis, Torsion appendix testis, Epididymitis
If in doubt explore
6-8 hours to recover the testis
Why investigate a UTI
to prevent Renal Scarring
Reflux nephropathy and chronic renal failure
Prevent Hypertension
Who do we investigate with a UTI
All <6 mo
Atypical
Recurrent
