Urinary Tract Abnormalaties

Question 1

What is vesicoureteric reflux?

Answer 1

It is a a developmental anomaly of the Vesicoureteric junction.

The ureters are displaced laterally and enter directly into the bladder rather than at an angle.

Due to this urine can reflux up back into the ureters.

This can range from mild to severe, in severe disease this can lead to renal scarring.

It also predisposes to UTI’s.

Question 2

How common is vesicoureteric reflux in the general population and in those with UTI?

Answer 2

Less than 1% in the general population

In those with febrile UTI’s incidence between 30-70%

Question 3

What are the diagnostic tests for VUR?

Answer 3

VCUG (voiding cystourethrogram)

Renal bladder US

Question 4

Describe the following condition: renal agencies?

Answer 4

Absence of both kidneys leads to severe oligohydraminos and potter’s syndrome

Question 5

Describe the following condition: multicystic dysplastic kidney?

Answer 5

A non-functioning structure with large fluid filled cysts and no renal tissue or connection to the bladder.

Question 6

Describe the following condition: polycystic kidney disease?

Answer 6

An autosomal dominant condition in which there is some renal function but over time the kidney tissue is replaced by non functioning cysts therefore resulting in end age kidney failure.

Question 7

Describe the following condition: pelvic or horseshoe shaped kidneys?

Answer 7

Shape of kidneys obstruct outflow therefore predisposing to infection.

Question 8

Describe the following condition: duplex system?

Answer 8

Varies from a bifid pelvis to complete division and two ureters. Can cause problems with reflux and obstruction.

Question 9

Describe the following condition: posterior urethral valves?

Answer 9

A valve in the urethra which causes bladder outlet obstruction and reflux.

Urethra does not usually have valves.

Question 10

Describe the following condition: hypospadias?

Answer 10

It is a condition where there is embryological defect in which the urethral opening is not in the correct position.

Instead of being in the centre of the glans it may be on the shaft of the penis or just superior to the testes.

Question 11

What is neuropathic bladder?

Answer 11

It is a condition in which the bladder doesn’t void properly due to a neurological condition or spinal cord injury

Question 12

What are some of the symptoms associated with neuropathic bladder?

Answer 12

Incontinence

Urinary dribbling

UTI’s

Kidney damage from hydronephrosis