Renal and Urology Flashcards
How to manage children under the age of 5 years who have nocturnal enuresis?
can be managed with reassurance and advice
How to manage unilateral undescended testicle in newborn?
review at 3 months - if persistent refer
What complication is present in around 10% of patients with hypospadias?
Cryptorchidism
What can be used for short term control of enuresis?
Desmopressin
How to manage phimosis in child under 2 years of age?
In children less than 2 years of age, phimosis (a non-retractable foreskin) is normal and will most likely resolve with time.
The British Association of Paediatric Urologists states that if the issue is a non-retractile foreskin and/or ballooning during micturition in a child under two, an expectant approach should be taken in case this is physiological phimosis which will resolve in time
What is hypospadias?
a congenital abnormality of the penis which occurs in approximately 3/1,000 male infants.
There appears to be a significant genetic element, with further male children having a risk of around 5-15%
It is usually identified on the newborn baby check. If missed, parents may notice an abnormal urine stream.
Hypospadias is characterised by:
- a ventral urethral meatus
- a hooded prepuce
- chordee (ventral curvature of the penis) in more severe forms
- the urethral meatus may open more proximally in the more severe variants. However, 75% of the openings are distally located..
Associated with cryptorchidism
Inguinal hernia
Management of hypospadias?
once hypospadias has been identified, infants should be referred to specialist services
corrective surgery is typically performed when the child is around 12 months of age
it is essential that the child is not circumcised prior to the surgery as the foreskin may be used in the corrective procedure
in boys with very distal disease, no treatment may be needed.
What is epispadias?
In epispadias, the tube also doesn’t form correctly. The opening is on the top of the penis.
