urology

Question 1

what are the complications of undescended testis?

Answer 1

1. infertility
2. torsion
3. testicular cancer
4. psychological

Question 2

how is unilateral undescended testis managed?

Answer 2

referral should be considered from 3 months of age, ideally seen by a surgeon before 6 months of age

^{N.B. testes should descend in a male child by 3 months of age}

Question 3

what is the treatment for unilateral undescended testis?

Answer 3

orchidopexy

performed at around 1 year of age

Question 4

how is bilateral undescended testes managed?

Answer 4

reviewed by a senior paediatrician within 24 hours as child may need urgent endocrine or genetic investigation

Question 5

what is physiological phimosis?

Answer 5

non-retractile foreskin +/- ballooning during micturition in a child under 2

Question 6

phimosis: what should be avoided and why?

Answer 6

forcible retraction; scar formation

Question 7

phimosis: what is important for the child?

Answer 7

personal hygiene

Question 8

when do you consider treatment for phimosis?

Answer 8

if child is over 2 years of age, has recurrent balanoposthitis / UTI

Question 9

what is hypospadias?

Answer 9

congenital abnormality of the penis

occurs in ~3/1000 male infants

genetic element

Question 10

how is hypospadias usually identified?

Answer 10

newborn baby check

if missed, parents may notice abnormal urine stream

Question 11

what is hypospadias characterised by?

Answer 11

1. a ventral urethral meatus
2. a hooded prepuce
3. chordee (ventral curvature of the penis) in more severe forms
4. urethral meatus may open more proximally in the more severe variants. 75% of the openings are distally located

Question 12

how is hypospadias managed?

Answer 12

• once identified, infants referred to specialist services
• corrective surgery typically performed around 12 months of age
• essential that child is not circumcised prior to surgery as foreskin may be used in corrective procedure
• in boys with very distal disease, no Rx may be needed