Urology

Question 1

How can paediatric urology problems present systemically?

Answer 1

fever
vomiting
failure to thrive
anaemia
hypertension
renal failure

Question 2

How can paediatric urology problems present locally?

Answer 2

pain
changes in urine
abnormal voiding
mass
visible abnormalities

Question 3

How can paediatric urology problems present antenatally?

Answer 3

asymptomatic

permits immediate postnatal assessment

Question 4

what are inguinal hernias?

Answer 4

groin swelling

B>G

increase with prematurity

Question 5

how are inguinal hernias managed

Answer 5

<1 year
URGENT referral & repair

> 1 year
elective referral & repair

incarcerated
reduce and repair on same admission

Question 6

hydroceles

Answer 6

SCROTAL swelling
painless: increases with crying, straining, evening
bluish colour

Question 7

who are hydroceles very common in?

Answer 7

new-borns

Question 8

how are hydroceles managed?

Answer 8

conservative until 5 years of age

Question 9

cryptorchidism

Answer 9

testis do not descend into scrotum

Question 10

types of cryptorchidism?

Answer 10

true undescended testis

retractile testis

(ascending testes)

Question 11

why are the testis located in the scrotum?

Answer 11

keep sperm cool for viability

Question 12

indications for ochidopexy?

Answer 12

fertility

malignancy

trauma

torsion

cosmetic

Question 13

orchidopexy

Answer 13

fixation of testis into the scrotum

Question 14

circumcision

Answer 14

removal of the foreskin

Question 15

indications for circumcision?

Answer 15

absolute
- balanitis xerotica obliterans

relative

• balanoprosthitis
• religious reasons
• UTI

Question 16

advantages of circumcision?

Answer 16

prevents UTI & malignancy

sexual enhancement (increased nerve endings in prepuce)

Question 17

disadvantages of circumcision?

Answer 17

painful

complications: bleeding, fistula, meatal stenosis

looks different

Question 18

differential diagnosis for acute scrotum?

Answer 18

• torsion testis
• epididymitis
• trauma, haematocele, incarcerated inguinal hernia

Question 19

How long are the testis viable in an acute scrotum?

Answer 19

6-8 hours

Question 20

why are UTIs investigated?

Answer 20

prevent renal scarring

prevent hypertension

Question 21

1

Answer 21

1

Question 22

UTI

Answer 22

pure growth of bacteria >10^5

pyuria

systemic upset: fever, vomiting

Question 23

how are UTIs assessed?

Answer 23

history and examination

ultrasound scan

renography
MAG3 - drainage, function, reflux
DMSA- function, scarring

micturating cystourethrogram (MCUG)

Question 24

How is VUR managed?

Answer 24

conservative

antibiotic prophylaxis (trimethoprim (2mg/kg nocte))

STING

ureteric reimplantation

Question 25

hypospadias

Answer 25

urethral meatus on the ventral aspect of the penis

• anterior 50%
• middle 30%
• posterior 20%

Question 26

associated anomalies of hypospadias?

Answer 26

• upper tract

- ambiguous genitalia

Question 27

how is hypospadias investigated?

Answer 27

US

karyotype

Question 28

how is hypospadias managed?

Answer 28

DO NOT CIRCUMCISE

one stage or 2 stage surgical procedure