Urology Flashcards
What does paediatric urology cover?
Kidneys
Bladder
Testes
Penile abnormalities
What are systemic presentations of urological problems?
Fever Vomiting Failure to thrive Anaemia Hypertension Renal failure
What are local presentations of urological problems?
Pain Changes in urine Abnormal voiding Mass Visible abnormalities Incidental
What are antenatal presentations of urological problems?
Asymptomatic
Permits immediate postnatal assessment
What type of hernia is common in paediatric urology?
A groin swelling
What sex is most likely to have a hernia?
Male
What type of hernia is more common?
Indirect
When is there increased risk of a hernia?
Prematurity
What is the management of hernias in <1yrs?
Urgent referral
Repair
What is the management of hernias in >1yrs?
Electrical referral and repair
What is the management of an incarcerated hernia?
Reduce and repair on same admission
What is a hydrocele?
Scrotal swelling, fluid collects in thin sheath surrounding testicle
What are the signs of a hydrocele?
Painless
Increases with crying, straining, evening
Blueish colour
What is the management of a hydrocele?
Conservative until 5yrs
What is cryptorchidism?
Any testis that cannot be manipulated into bottom half of scrotum
What are the types of cryptorchidism?
True
Retractile
Ectopic
(Ascending testis)
What are testes in scrotum?
Temperature control
What are risk factors for cryptorchidism?
Prematurity
Low birth weight
FHx
What is orchidopexy?
Surgery to move the testicles into the correct position inside the scrotum
What are indications for orchidopexy?
Fertility Malignancy Trauma Torsion Cosmetic
What are the types of indications for circumcision?
Absolute
Relative
What is an absolute indication for circumcision?
Balanitis Xerotica Obliterans (BXO)
What is Balanitis Xerotica Obliterans (BXO)?
Type of lichen schlerosus of the male genitalia is a common cause of acquired phimosis
What are relative indications for circumcision?
Balanoprosthitis
Religious
UTI
What is balanoprosthitis?
Inflammation of foreskin and glans
What are the disadvantages of circumcision?
Painful
Complications: bleeding, mental stenosis, fistula, cosmetic
What is an acute scrotum?
New onset pain, swelling, and/or tenderness of the intrascrotal contents
What are differentials for acute scrotum?
Torsion testis
Torsion appendix testis
Epididymitis
Trauma, haematocele, incarcerated inguinal hernia
Why investigate possible UTI?
Prevent: renal scarring, reflux nephropathy, chronic renal failure and hypertension
Which age group in particular do you investigate for UTI?
<6mo, atypical, recurrent
When is UTI significant in pads?
Pure growth bacteria >10^5
Pyruia
Systemic upset: fever, vomiting
What is the assessment for UTI?
History/exam (FHx, bowel habit, voiding dysfunction)
US: number, size, position, shape, hydronephrosis
Renography: MAG3 and DMSA
Micturating cystourethrogram (MCUG)
What are the imaging techniques for UTI?
US
Renography: MAG3 and DMSA
Micturating cystourethrogram (MCUG)
What can be checked on a MAG3 for UTI?
Drainage, function, reflux
What can be checked on DMSA for UTI?
Function, scarring
What are the grades of VUR?
Grade 1-5
What is the management of
Conservation: voiding advice, constipation advice, fluids
Antibiotic prophylaxis (trimethoprim)
STING (mild/moderate with symptoms)
Ureteric preimplantation
What is VUR
Vesicoureteral reflux(VUR) is when the flow of urine goes the wrong way.
What is STING in VUR?
Deflux® is a sugar-based medicine (a polysaccharide) used to treat VUR. It is injected through the cystoscope at the site of the VUR, where the ureters open into the bladder.
A Deflux® injection prevents urine from flowing back up the ureters from the bladder. If infected urine flows into the kidneys, it may cause pyelonephritis (infection of the kidney) which can damage them.
What is hypospadias?
Congenital condition in males in which the opening of the urethra is on the underside of the penis (ventral aspect)
What are the classifications of hypospadias?
Anterior
Middle
Posterior
What is main type of hypospadias?
Anterior (50%)
What is the management of hypospadias?
One stage or 2 stages procedure
What is an associated anomaly of hypospadias?
Intersex (ambiguous genitlia)
What is the investigation if severe hypospadias?
US
