Paediatric Urology

Question 1

What is an inguinal hernia?

Answer 1

protrusion of a viscus through the inguinal canal - get groin swelling

Question 2

incidence of inguinal hernia

Answer 2

2% boys : 9:1
99% indirect
increased risk with prematurity

Question 3

reducible hernia

Answer 3

can push back into original cavity

Question 4

irreducible/ incarcerated hernia

Answer 4

unable to push back into original cavity

Question 5

obstructed hernia

Answer 5

bowel contents unable to pass through hernia

Question 6

strangulated hernia

Answer 6

blood supply of contents is occluded

Question 7

management of inguinal hernia

Answer 7

Surgery
<1 year URGENT referral - repair
> 1 year elective referral and repair

Question 8

management of incarcerated inguinal hernia

Answer 8

reduce and repair on same admission

Question 9

What is hydrocele ?

Answer 9

SCROTAL swelling

like hernia but just the fluid gets through

Question 10

hydrocele is very common in

Answer 10

newborns

Question 11

symptoms of hydrocele

Answer 11

painless

increases with crying, straining , evening

Question 12

management of hydrocele

Answer 12

conservative until 5 yrs of age - usually just gets better

Question 13

What is Cryptorchidism

Answer 13

any testis that cannot be manipulated into the bottom half of the scrotum
crypto = hidden - orchid = Testis

Question 14

true cryptorchidism

Answer 14

undescended

Question 15

retractile cryptorchidism

Answer 15

can pull down - without any tension - when they go up like in the cold they go all the way up again
just leave this type

Question 16

ectopic cryptorchidism

Answer 16

not in the right place

Question 17

Ascending crytorchidism

Answer 17

down but down keep up with growth - gradually pulled up

Question 18

incidence of cryptorchidism

Answer 18

increased risk in prematurity

Question 19

absolute indications for circumcision

Answer 19

Blanitis Xerotica Obliterans (BXO)

Question 20

Acute Scrotum means

Answer 20

testicular pain

Question 21

differential diagnosis of acute scrotum

Answer 21

torsion testis, torsion appendix testis, epididymitis

Question 22

how many hours do you have to recover the testis?

Answer 22

6-8

Question 23

why investigate UTI?

Answer 23

prevent renal scarring
reflux nephropathy and chronic renal failure
prevent hypertension

Question 24

who to investigate when they have a UTI

Answer 24

all <6/12, atypical, recurrent

Question 25

definition of UTI

Answer 25

pure growth bacteria > 10^5
pyuria
systemic upset
fever, vomiting

Question 26

incidence of UTI

Answer 26

boys> girls in infancy then other way round after 1

increased incidence with vesicouteric reflux and structural abnormalities

Question 27

symptoms of UTI infants

Answer 27

often non - specific - fever, poor feeding , vomitting

Question 28

symptoms of UTI older child

Answer 28

dysuria, haematuria, suprapubuic/ loin tenderness

Question 29

Investigations for UTI

Answer 29

urine dipstick - leucocytes +/- nitrites/ blood

positive urine culture

Question 30

when does UTI require imaging?

Answer 30

recurrent/ atypical

or in infant < 6 months

Question 31

what imaging can be done for UTI

Answer 31

renal USS

micturating cystourethrogram MAG3 + DMSA = renography

Question 32

treatment of UTI

Answer 32

appropriate anitbiotics

consider prophylactic AntiBs in high risk children

Question 33

complications of UTI

Answer 33

calyces dilatation, renal scarring, chronic renal failure

Question 34

conservative management of VUR

Answer 34

voiding advice, constipation, fluids

Question 35

drug treatment of VUR

Answer 35

antibiotic prophylaxis
until age 4
trimethoprim

Question 36

Surgical treatment of VUR

Answer 36

STING

Question 37

what is hypospadias?

Answer 37

urethral meatus on the ventral aspect of the penis

Question 38

associated anomalies with hypospadias

Answer 38

upper tract

ambiguous genitalia

Question 39

management of hypospadias

Answer 39

surgical reconstruction

DO NOT CIRCUMCISE