GU Flashcards
(49 cards)
Bladder exstrophy Definition
Posterior bladder wall
extrudes through lower
abdominal wall
Bladder exstrophy Sx
-Bladder mucosa appears as mass of bright-red tissue
-urine leaks from ureters onto
the skin
Bladder exstrophy Tx
- bladder tissue is covered w/ plastic until surgery
- closure within 24-48 hours after birth
Epispadias Definition
- Males: meatal opening located on dorsal surface of penile shaft
-Females: cleft of ventral urethra that extends to bladder neck
Hypospadias Definition
Urethral meatus located anywhere along the course of urethra on ventral surface of penile shaft
Hypospadias Post-op care
-No tub baths until stent/catheter removed
-Double diapering
-No ride-on toys, no hip straddle position x 2 weeks
-Infection sx
-ABX if ordered
-Hydration status
-Blood in urine is normal at first but only pink tinged
Obstructive Uropathy Definition
Structural/functional abnormalities of urinary system
that interfere with urine flow
Obstructive Uropathy Complications
-Pressure by urine backup causes hydronephrosis
-Cessation of glomerular filtration
-Metabolic acidosis
-Impairment of kidney’s ability to concentrate urine
-Urinary stasis
-Restriction of urinary outflow
Obstructive Uropathy Tx
-Surgical correction
Prune Belly Syndrome Defintion
-AKA Eagle-Barrett syndrome
-Failure of ABD
musculature to develop
Prune Belly Syndrome Sx
-Skin covering ABD wall is thin and resembles a wrinkled prune
- urinary tract anomalies
-poor ureteral peristalsis
-enlarged bladder
-increased UTI
Prune Belly Syndrome Tx
-ABD wall reconstruction and correction of GU defects
Enuresis Definition
-Repeated involuntary voiding by a child old enough to have expected bladder control
-Primary: never had a dry night
-Secondary: was dry for 6 months then started wetting self
Enuresis Tx
-Fluid restriction
-Bladder training
-Enuresis alarms (last resort)
-Double-voiding
-Medications (DDAVP, TCAs, Oxybutynin Chloride)
-Meds SE:
UTI Definition
-Bacterial, viral or fungal origin
-Upper UTI (Pyelonephritis): ureters, renal pelvis, renal
parenchyma
-Lower UTI (Cystitis): Urethra and bladder
UTI Causes
-Urinary stasis
-Poor hygiene
-Inadequate cleansing
-Constipation
-Sexual activity
-Vesicoureteral reflux
UTI Sx
-Infants: irritability, unexplained fever, hypothermia, failure to thrive, poor feeding, vomiting
and diarrhea
-Older children: mimic more “classic” sx (cloudy, painful, bloody urine)
UTI Tx
-Fluids
-ABX (Bactrim (SJS), then cephalosporin)
-Follow up cultures
-Dx: midstream, clean-catch urine culture > 100,000 colony forming units (cfu) of a single bacteria or > 50,000 cfu of single bacteria cultures from sterile specimen
Dx: Radiologic studies
-Education: no bubble bath, cotton underwear, sexual activity, diet, fluids, wipe right
UTI increases kidney dmg if:
-UTI in infant < 1 year of age
-Delay in Dx and effective ABX Tx
-Anatomic obstruction or nerve supply interruption
-Recurrent episodes of upper UT
Phimosis Definition
- Foreskin over glans penis and cannot be retracted
- Normal in uncircumcised infants and young males
Phimosis Tx
-Circumcision
-Betamethasone Cream BID for 4-8 weeks (steroids reduce swelling/inflammation)
Cryptorchidism Definition
- One or both testes fail to descend through inguinal canal into scrotum
Cryptorchidism Complications
-infertility
-malignancy
Cryptorchidism Tx
- orchiopexy if testes don’t descend on its own
