Paediatric Urology Flashcards
How does a hernia present?
- Groin swelling
- Boys 9:1
- Most are indirect
- Prematurity is a risk
How can a hernia be managed?
- <1 yr: urgent referral and repair
- > 1yr: elective referral and repair
- Incarcerated (trapped): reduce and repair on same admission
What is a hydrocele and how does it present?
- Scrotal swelling
- Painless
- Increased with crying, straining and in the evening
- Bluish colour
How can a hydrocele be managed?
Conservative until 5yrs of age
What is a cryptorchidism?
Any testis that cannot be manipulated into the bottom half of the scrotum
When is the incidence of cryptorchidism higher?
In premature babies and those of low birth weights
What are the indications for an orchidopexy?
- Fertility
- Malignancy
- Trauma
- Torsion
- Cosmetic
What are the indications for a circumcision?
- Absolute: balanitis xerotica obliterans
- Relative: balanoprosthitis, religious and UTI
What are the disadvantages of a circumcision?
- Painful
- Bleeding
- Meatal stenosis
- Fistula
- Cosmetic
Why should a UTI be investigated and when?
- To prevent renal scarring
- Prevent hypertension
- All under 6 months
- Atypical and recurrent
What are the features of a UTI?
- Pure growth bacteria > 10^5
- Pyuria
- Fever and vomiting
How can a UTI be assessed?
- History and exam
- USS
- Renography:
- MAG3: drainage, function and scarring
- DMSA: function and scarring
- Micturating cystourethrogram (MCUG)
How can Vesico-uteric reflux be managed?
- Conservative: voiding advice, constipation and fluids
- Antibiotic prophylaxis (trimethoprim)
- STING
- Ureteric reimplantation
What is a hypospadias and how are they classified?
- Urethral meatus on the ventral aspect of the penis
- Anterior, middle and posterior
Which anomalies are associated with hypospadia?
- Upper tract
- Intersex (ambiguous genitalia)
