Urology Flashcards
How can paediatric urology problems present systemically?
fever vomiting failure to thrive anaemia hypertension renal failure
How can paediatric urology problems present locally?
pain changes in urine abnormal voiding mass visible abnormalities
How can paediatric urology problems present antenatally?
asymptomatic
permits immediate postnatal assessment
what are inguinal hernias?
groin swelling
B>G
increase with prematurity
how are inguinal hernias managed
<1 year
URGENT referral & repair
> 1 year
elective referral & repair
incarcerated
reduce and repair on same admission
hydroceles
SCROTAL swelling
painless: increases with crying, straining, evening
bluish colour
who are hydroceles very common in?
new-borns
how are hydroceles managed?
conservative until 5 years of age
cryptorchidism
testis do not descend into scrotum
types of cryptorchidism?
true undescended testis
retractile testis
(ascending testes)
why are the testis located in the scrotum?
keep sperm cool for viability
indications for ochidopexy?
fertility
malignancy
trauma
torsion
cosmetic
orchidopexy
fixation of testis into the scrotum
circumcision
removal of the foreskin
indications for circumcision?
absolute
- balanitis xerotica obliterans
relative
- balanoprosthitis
- religious reasons
- UTI
advantages of circumcision?
prevents UTI & malignancy
sexual enhancement (increased nerve endings in prepuce)
disadvantages of circumcision?
painful
complications: bleeding, fistula, meatal stenosis
looks different
differential diagnosis for acute scrotum?
- torsion testis
- epididymitis
- trauma, haematocele, incarcerated inguinal hernia
How long are the testis viable in an acute scrotum?
6-8 hours
why are UTIs investigated?
prevent renal scarring
prevent hypertension
1
1
UTI
pure growth of bacteria >10^5
pyuria
systemic upset: fever, vomiting
how are UTIs assessed?
history and examination
ultrasound scan
renography
MAG3 - drainage, function, reflux
DMSA- function, scarring
micturating cystourethrogram (MCUG)
How is VUR managed?
conservative
antibiotic prophylaxis (trimethoprim (2mg/kg nocte))
STING
ureteric reimplantation
hypospadias
urethral meatus on the ventral aspect of the penis
- anterior 50%
- middle 30%
- posterior 20%
associated anomalies of hypospadias?
- upper tract
- ambiguous genitalia
how is hypospadias investigated?
US
karyotype
how is hypospadias managed?
DO NOT CIRCUMCISE
one stage or 2 stage surgical procedure
