Chapter 20 Paediatric Urology

Specialist paediatric urological conditions include hypospadias, epispadias, bladder exstrophy, vesicoureteral reflux, renal duplications, urolithiasis and urinary tract obstruction. Surgical referrals for foreskin problems are common in early childhood, and reassurance is often all that is needed after taking a careful history and examination. The genital tubercle becomes a penis under the influence of androgens with a tubular urethra arising from the urethral plate. The urethral plate develops a diamond-shaped groove whose edges fold over and fuse in the midline, forming a tube. In girls, the urethral plate’s homologue forms the vestibular groove with edges that do not fuse but form the labia minora. Epispadias is a rare dorsal penile defect with an opening whose upper limit lies anywhere from the penopubic junction to the glans. Ureterovesical junction obstruction is the second most common cause of antenatal hydronephrosis and arises from an adynamic and stenotic region obstructing the distal ureter near the bladder.

Multiple Choice Questions
Weblinks

Journal articles

https://www.ncbi.nlm.nih.gov/books/NBK448199/ (free)

This article emphasises the importance of a prompt diagnostic work-up to preserve testicle viability in this true urological emergency – testicular torsion.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5352742/ (free)

Hypospadias, all there is to know: a concise review article describing this congenital anomaly from embryology to postoperative outcomes.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3168776/ (free)

This article thoroughly discusses differences in polycystic kidney diseases by highlighting their respective complications and prognosis.

Book

https://www.pediatricurologybook.com/about.htm

A free online paediatric urology textbook with up-to-date information written by experts.

Webpage

https://radiopaedia.org/articles/fetal-hydronephrosis?lang=us

This webpage demonstrates radiographic presentations of various causes of fetal hydronephrosis.

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