Urology Flashcards
Common cause of urinary retention on females
Mass protruding from urethral meat is
Round filling defect on IVP
Ureterocele
Palpable mass in newborn male
Weak urinary stream
Hydronephrosis
Distended bladder
Next step
Posterior urethral valves
Pass urine catheter
VCUG
Immediate urologic consultation
Bilateral hydronephrosis/PUV
Undescended testicles
Poor anterior abdominal wall musculature
Prune belly (eagle Barrett) syndrome
Female urinary incontinence
Negative work up
Ectopic urethral opening
most common UTI organism
E coli
Timing of VCUG with febrile UTI
After 2nd febrile UTI
Or if renal/bladder US from first febrile UTI is abnormal
Bulge either in suprapubic or scrotal area
Increased in size with crying or straining
Inguinal hernia
Painless swelling on scrotum
Transilluminates
Management
Hydrocele
If unresolved by age 2, surgical correction
Left scrotum painless swelling
Heavy sensation
Bag of worms
Swelling decreases when patient lies down
Varicocele
Surgery when affected testicular volume is less than unaffected testicle
Management of Undescended testicle
Urology consul by 3-6 mo
Orchiopexy y by 12-18 mo
Associated syndromes with hypospadias
Silver russel syndrome
Laurence moon biedl syndrome
Pouts syndrome
Beckwith wiedemann syndrome
Management for hypospadias
Surgical Correction by 6-12 mo
NO circumcision
Micropenis
Poor feeding
Hypotonia
Prader willi syndrome
Penile length for endocrine/genetic consult
< 2.5cm
Unilateral scrotal pain
Dysuria
Fever
Cremasteric reflex present
+Phrehn sign (alleviation of pain with scrotal elevation)
Epididymitis
Management of epididymitis
If sexually active, Ceftriaxone and doxycycline
If not sexually active, cephalexin or Bactrim
Sudden severe scrotal pain
Cremasteric reflex absent
Pain not alleviated with scrotal elevation
Testicular torsion
Higher risk in cases of bell clapper deformity
Focal tenderness of superior testis
Classic blue dot sign
Torsion of appendix testis
Pain
Edema
Marked tenderness of scrotum/testis
Orchitis
Inability to retract foreskin
> 3 yo
Management
Phimosis
Topical steroid cream
Gentle retraction
Good hygiene
Circumcision if no improvement
Foreskin that cannot be brought back to normal position after retracted
Management
Paraphimosis
Surgical emergency
Common bacteria for urethritis
Management
Gonorrhea
Chlamydia
IM ceftriaxone + PO doxycycline x 7 days
Silk glove sign
Inguinal hernia
