Urology and Surgery Flashcards
How do urological problems present systemically?
Fever Vomiting Failure to thrive Anaemia Hypertension Renal failure
How do urological problems present locally?
Pain Changes in urine Abnormal voiding Mass Visible abnormalities Incidental
How do urological problems present antenatally?
Asymptomatic
Permits immediate postnatal assessment
What is Hernia?
A groin swelling where tissue exits through a hole in the abdominal wall.
Most commonly through deep inguinal ring.
B>G 9:1 due to descent if testis.
When does the deep inguinal ring close?
3rd trimester
Hernias more risk in prematurity.
What is the management for hernia?
<1 year old then urgent referral to be repaired.
>1 year old can just watch and wait, elective referral for repair.
Incarcerated (stuck) - reduce and repair on same admission.
What is a hydrocele?
Scrotal swelling where fluid collects in the thin sheath surrounding the testicle.
What are some features of Hydrocele?
Very common in new borns and usually resolve by themselves.
Painless
Bluish colour
Increases with crying, straining, in evening.
What is the management of Hydrocele?
Watch and wait until 5yrs.
May repair when older if requested.
What is Cryptorchidism?
Any testis that can’t be manipulated into the bottom half of the scrotum.
What are the different types of Cryptorchidism?
True cryptorchidism - undescended testis
Retractile - sit high and can be pulled down but string back.
Ectopic - come down in wrong place e.g. thigh
Ascending testis
Why are testes in the scrotum?
Enzymes of spermatogenesis work better in lower temperatures.
Scrotum = 34 degrees.
When does the normal descent of testes take place?
3rd trimester event.
What are the indications for orchidopexy?
Fertility - 1% loss of germs cells per month of undescent. Malignancy Trauma Torsion Cosmetic
What is circumcision?
Removal of the foreskin.
What are the indications for circumcision?
Balanitis Xerotica Obliterans (BXO)
Balanoprosthitis
Religious reasons
UTI
What are some complications of circumcision?
Bleeding
Meatal stenosis
Fistula
Cosmetic
What is meant by acute scrotum?
Unremitting pain within testes.
What are some causes of acute scrotum?
Torsion testis Torsion appendix testis Epididymitis Trauma Haematocele Incarcerated inguinal hernia
How long do you have before a torsion testis becomes necrotic?
6-8hours
Why do we investigate UTI?
Prevent renal scarring (reflux nephropathy, CRF)
Prevent hypertension