Urology-Notes

Question 1

What is the presentation of testicular torsion?

Answer 1

testicle is high and horizontal

cord isn’t painful, but the testis is swollen and VERY painful. no ipsi cremasteric reflex

Question 2

What is the workup and treatment for testicular torsion?

Answer 2

really try not to delay the time to the OR
can do scrotal U/S if you have time
go to surgery for detorsion and orchiopexy where they sew the testicles to the wall

Question 3

What is the presentation of epididymitis?

Answer 3

fever
pyuria
tender cord
U/S to r/o testicular torsion

Question 4

What is the treatment for epididymitis?

Answer 4

35 yo: cipro (want to cover enteric pathogen)

Question 5

What is the workup for obstruction or infection of the urinary tract?

Answer 5

ultrasound
CT if you suspect a tumor
Give antibiotics and decompress so you can urinate!
Can do a ureteral stent (from kidney–>bladder)
can do percutaneous nephrostomy

Question 6

What is the most common cause for a newborn boy to not urinate in the first day of life? Another thing to look for?

Answer 6

posterior urethral valves

**also check for meatal stenosis

Question 7

What is the workup and treatment for posterior urethral valves?

Answer 7

voiding cystourethrogram

bladder cath followed by endoscopic resection

Question 8

What are the consequences of a low implantation of a ureter?

Answer 8

asymptomatic in boys

in girls–feel the need to constantly void

Question 9

Freshman in college who gets colicky flank pain after a night of binge drinking?

Answer 9

ureteropelvic junction obstruction

you’re totally fine until you need to diurese a lot and then your body can’t handle it and you get colicky flank pain.

Question 10

What % of children with febrile UTIs have vesicoureteral reflux?

Answer 10

40%!

Question 11

What should you do for a child’s first febrile UTI?

Answer 11

Renal and bladder U/S first.
by the time they have second one start thinking VUR, then you can do voiding cystourethrogram. But shouldn’t do until urine culture is negative.

Question 12

What can be a secondary cause of VUR? What are some possible complications of it?

Answer 12

secondary cause: posterior urethral valves
possible complications: recurrent UTIs
antenatal hydronephrosis
ultimately: renal scarring

Question 13

Which patients should you do a straight cath with?

Answer 13

those who wear diapers

Question 14

What is an absolute contraindication to circumcision?

Answer 14

hypospadia. b/c you need to use the foreskin to fix the defect later.

Question 15

What are some different causes of urinary tract obstruction?

Answer 15

posterior urethral valves
ureteropelvic junction obstruction
ureterovesicle junction obstruction
ureterocele

Question 16

What is Potter Sequence?

Answer 16

oligohydramnios from urinary tract obstruction
pulmonary hypoplasia
low set ears
wide-set eyes
flat facies
micrognathia
club foot

Question 17

What is Prune Belly Syndrome?

Answer 17

absent abdominal musculature
undescended testes
urologic problems

Question 18

What is the workup and treatment for prune belly syndrome?

Answer 18

renal u/s
diuretic renography
surgical correction

Question 19

How do you work up and treat ureteral injury?

Answer 19

IV pyelogram (IV contrast with KUB)
percutaneous nephrostomy
retrograde ureteral cath