Urology Flashcards
what is acute scrotum
acute onset of scrotal swelling, redness and pain
ddx of acute scrotum
- testicular torsion
- torsion appendix testis
- epididymitis
- haematocele
- incarcerated inguinal hernia
- trauma
- what is a hernia
- epidemiology
- management
- groin swelling
epidemiology:
- increased risk in premature babies
- commoner in males
- 1/3 of presentations under 1 are incarcerated hernias
management:
- if under 1–> emergency referral and repair
- if > 1 –> elective referral & repair
- if incarcerated hernia –> same day repair
main type of hernia to arise in children?
indirect
what are incarcerated hernias?
when some of the bowel gets trapped “incarcerated” in the hernia and causes obstruction etc –> child VERY unwell and if not treated promptly can lead to death
- what is hydrocele
- epidemiology
- symptoms & signs
- collection of fluid within tunica vaginalis that surrounds testes
- very common in newborns
- symptoms and signs:
- blue-ish colour
- painless but increase with crying / coughing
types of hydrocele?
- simple
- communicating
- where tunica vaginalis is connected to peritoneal cavity
examination findings of hyrocele?
will transilluminate with light
management of hydrocele?
simple- conservative
communicating- surgery
DDx of scrotal/inguinal swelling in newborn?
- undescended testes
- hydrocele
- testicular torsion
- inguinal hernia
what is cryptorchidism?
this is when 1 or both testis have failed to descend from the abdomen to the scrotum
what are the risks associated with undescended testes in older children?
higher risk of
- malignancy
- infertility
- testicular torsion
Mx of cryptorchidism?
- conservative
- most will descend in first 3-6months
- if not, orchidopexy
what is circumcision and what are the indications for it
- removal of the foreskin
- indications
- absolute indications
- Balanitis Xerotica Obliterans
- relative
- phimosis
- paraphimosis
- religious
- absolute indications
definition of UTI
- bacteria > 105
- pyuria
- systemic symptoms
- fever, vomiting etc
reasons and when to investigate UTI?
- to prevent renal scarring / hypertension
- always investigate in any case <6months old; recurrent; atypical presentation
investigation of UTI?
- USS
- Micturating Cystourethrogram (MCUG)
- to diagnose VUR
Mx of UTI in < 3 months w fever?
IV Abx - ceftriaxone
oral Abx if > 3 months and otherwise well
what Ix can you use to assess for damage from recurrent /atypical UTIs
DMSA scan
management of Vesico Ureteric Reflux
- conservative
- voiding & fluids / avoid constipation
- avoid excessively full bladder
- prophylactic Abx
- ureteric re-implantation
what are hypospadias?
congenital condition when the urethral meatus is on the ventral aspect of the penis
types of hypospadias?
anterior - most common
middle
posterior - least common
- associated anomalies with hypospadias
- management
- associated with abnormal genitalia + upper tract abnormalities
- do not circumcise, reconstructive surgery
