Urology surgery (and umbilical)

Question 1

What condition is it acceptable to refer for circumcision

Answer 1

Balanitis xerotica obliterans

Question 2

What is phimosis

Answer 2

Foreskin is not retractable

Question 3

Management of phimosis

Answer 3

No intervention needed

By age 14 <1% have persistent phimosis

Question 4

What is balanitis xerotica obliterans

Answer 4

Male equivalent of lichen sclerosis

White plaque ring around foreskin

Question 5

Treatment of balanitis xerotica obliterans

Answer 5

Steroid cream
Circumcision
Foreskin meatoplasty

Question 6

Hydrocoele vs scrotal hernia

Answer 6

Hydrocoele is confined to scrotum so you will be able to feel the spermatic cord above it
Hernia you can’t get above it, lump in groin and is usually reducible

Question 7

Management of scrotal hernia

Answer 7

EMERGENCY
Attempt to reduce it, will most likely need surgery
Surgical exploration

Question 8

Differential for non palpable testes

Answer 8

Ectopic testis
Undescended testis
Hypoplastic inguina
Vanishing testes (cremasteric reflex)

Question 9

Management of undescended/ectopic testis and give the rationale

Answer 9

Operate to move testis into scrotum
Risk of hernia, trauma and torsion
Risk of malignancy and infertility if no intervention
Makes testis palpable so can detect malignancy early

Question 10

Management of umbilical hernia

Answer 10

Repair by age 3 for cosmetic reasons

Question 11

Management of umbilical granuloma

Answer 11

Examine to rule out vitellointestinal duct

Silver nitrate to cauterise