Urology

Question 1

when do you repair a hydrocele?

Answer 1

if communicating - Most resolve by 2yrs, Sx if older than 2 yrs
if non communicating - Most resolve by one year, Sx only if large, tense or hard to ID testicle

Question 2

when do you surgically repair varicocele?

Answer 2

if note > 20% decrease in testicular volume-starts affecting spermatogenesis
if painful or if
cosmetic

Question 3

what should you consider if you note varicocele on the right or in a child < 10?

Answer 3

consider abdo or retroperitoneal mass

Question 4

what are exam findings of varicocele?

Answer 4

left sided
feels like bag of worms
worse with standing and vasalva
resolve when lie down

Question 5

8 year old male with gradual onset of hemiscrotal pain. Some pain at upper pole of testicle and a blue dot. Dx and mgnt?

Answer 5

1. Torsion of testicular appendages

2. limit act, resolves 7-10 day, analgesia. Sx only if really painful or unclear etiology.

Question 6

what are clinical features of epididymitis?

Answer 6

gradual onset of pain
becomes generalized
no N/V
\+ dysuria
\+ pyuria
cause - Chlamydia more than gono

Question 7

if you find epididymitis in a prepubertal male, what should you think of?

Answer 7

Urinary tract obstruction - PUV, ectopic ureter, stricture\

? bugs

Question 8

What is the Dx of a 3 yrs old african american with blood in her underwear?

Answer 8

urethral prolapse

mgnt: Estrogen cream for 3 weeks, sitz baths, Sx is curative

Question 9

what are the causes of a micropenis?

Answer 9

hypogonadotripic hypogonadism - Kallman, prader-willi
hypergonadotropic hypogonadism (primary testicular failure)
idiopathic

Question 10

what are complications of circumcision?

Answer 10

meatal stenosis
bleeding
wound infection
secondary phimosis
removal of insufficient foreskin
fibrous penile adhesions