urology

Question 1

management hernia <1 year

Answer 1

• urgent urology referral

- urgent repair - no place for observation

Question 2

management hernia >1 year

Answer 2

elective referral and repair

Question 3

when does incarcerated hernia occur

Answer 3

occurs when herniated tissue becomes trapped and cannot easily be moved back into place

Question 4

management incarcerated hernia

Answer 4

reduce and repair on same admission

Question 5

presentation hydrocele

Answer 5

• scrotal swelling
• painless (increases with crying, straining, evening)
• bluish colour

Question 6

hydrocele management

Answer 6

conservative until 5years

Question 7

define cryptorchidism

Answer 7

any testis that cannot be manipulated into bottom half of scrotum

Question 8

indications for orchidopexy

Answer 8

• fertility (1% loss germ cells/ month undescent)
• malignancy
• trauma
• torsion
• cosmetic

Question 9

absolute indication for circumcision

Answer 9

balanitis xerotica obliterans (BXO)

Question 10

relative indication circumcision

Answer 10

• balanoprosthitis
• religious
• UTI

Question 11

suggested advantages of circumcision

Answer 11

• reduced UTI
• reduced malignancy
• sexual enhancement
• AIDS/ STDs

Question 12

disadvantages circumcision

Answer 12

- painful
complications
- bleeding
- meatal stenosis 
- fistula
- cosmetic

Question 13

why investigate UTIs in children

Answer 13

• prevent renal scarring (reflux nephropathy and chronic renal failure)
• prevent hypertension

Question 14

who to investigate

Answer 14

all <6 months,
atypical
recurrent

Question 15

definition UTI

Answer 15

pure bacteria growth >10^5
pyuria
systemic upset

Question 16

assessment UTI

Answer 16

• history and examination (FH, bowel habit, voiding dysfunction)
• USS (number, size, position, shape, hydronephrosis)
• renography
• micturating cystourethrogram (MCUG)

Question 17

management vesicoureteric reflux

Answer 17

• conservative (advice, constipation, fluids)
• antibiotic prophylaxis (trimethoprim 2mg/kg)
• STING
• ureteric reimplantation

Question 18

vesicoureteric reflux

Answer 18

condition in which urine flows retrograde, or backward, from the bladder into the ureters/kidneys

Question 19

hypospadias

Answer 19

congenital condition in males in which the opening of the urethra is on the underside of the penis.

Question 20

hypospadias investigation

Answer 20

USS if severe

Question 21

management hypospadias

Answer 21

DO NOT CIRCUMCISE

procedure