paediatric urology Flashcards
inguinal hernia features
groin swelling
boys>girls
inc risk w prematurity
inguinal hernia Rx
<1yrs = urgent referral and repair >1yrs = elective referral and repair
incarcerated = reduce and repair on same admission
hydrocele
collection of serous fluid in tunica vaginalis
hydrocele features
painless scrotal swelling: worse crying, straining
bluish colour
hydrocele Rx
conservative until 5yrs
elective surgical repair
cryptorchidism
undescended testis
any testis that cannot be manipulated into bottom hald scrotum
indications for orchidopexy
fertility malignancy torsion trauma aesthetic
phimosis
inability to retract foreskin proximally over the glans penis
balinitis xerotica obliterans
non-retractile foreskin
struggle to pass urine
scarred foreskin, narrowed meatus
cirumsicion indications
absolute: BXO
relative: religious, UTI
circumscision disadvantages
painful
complications: bleeding, meatal stenosis, fistula, cosmetic
testicular torsion
twisting of testicle on spermatic cord, constricting vascular supply
tissue ischaemia +/- necrosis
testicular torsion features
testicular pain
scrotal erythema
scrotal swelling/oedema (asymetrical)
appendix testis
appendix testis = embryological remnant on top of epididymis
torsion appendix testis
scrotum red testicular pain blue spot no asymmetry tender to touch
UTI in kids, if missed…
scarring - reflux nephropathy
HTN
renal disease
paed UTI core features
pure growth bacteria >10^5
pyuria
systemic upset: fever, vomit
UTI assessment
Hx and exam
USS
micturation urogram
UTI: USS what does it tell us
number, size, shape, position, hydronephresis
UTI: renograpghy what can it tell us
MAG3: function, reflux
DMSA: function, scarring
Rx VUR
conservative: voiding advice, constipation, fluids
antib prophylaxis - trimethoprim
subureteral deflon injection
ureteric implantation
hypospadias
urethral meatus on ventral surface of penis
anterior, middle, posterior
hypospadias management
USS
surgery: 1 stage or 2 stages procedure
