surgical issues in infants

Question 1

undescended testes in infant

• how to manage
• what not to do

Answer 1

if < 3 months, review at 3 months
if at 3 months and not palpable -> refer
don’t do USS, not good prognostic value

Question 2

hypospadias in infants

• how to manage
• what not to do

Answer 2

if urinary stream is poor -> refer immediately
if nonurgent - recheck at 6 months, then refer for surgery by 12 months
do not give circumcise

Question 3

phimosis in infants

- how to manage

Answer 3

usually physiological, so jsut ignore it
can use corticosteroids to loosen it up
if persistent difficulty with urination -> refer to urology

Question 4

Inguinal hernias - neonates Mx
reducible -
irreducible -

Answer 4

reducible - urgent referral to paed general surgery for management within 2 weeks
irreducible/-incarcerated - urgent referral to ED for emergency surgical management

Question 5

Femoral hernias - neonates Mx

Answer 5

emergency surgical management for all

Question 6

hypospadias in infants

- treatment options

Answer 6

• monitor until 6 months of age

- surgical referral

Question 7

hypospadias in infants

- contraindicated treatments

Answer 7

circumcision

Question 8

hypospadias in infants

- indications for surgical referral

Answer 8

• poor urinary stream (refer immediately)

- doesn’t heal by 6 months (review at 12 months)

Question 9

reducible inguinal hernia in neonate - management

Answer 9

urgent referral to paeds gen surg for management within 2 weeks

Question 10

non-reducible / incarcerated inguinal hernia in neonate - management

Answer 10

urgent referral to paeds gen surg via ED for emergency surgical management