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Uro Peds (GU system (Bladder
Hematuria (non-glomerular) (Ureters
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Uro Peds
GU system
Bladder
- Hematuria (non-glomerular)
Urethrea
- posterior urethral valves
- hypospadias
- epispadias :whale:
Ureters
- UretoPelvic Junction Obstruction
- UretoVesicular Junction Obstruction
- Ectopic Ureter (formerly: low implantation of ureter)
- VesiculoUreter Reflux
Kidney
- malignancy (Wilm's)
- Hematuria (glomerular)
-
Posterior Urethral Valves PUV
Path: Day 1: :baby::skin-tone-2: can't get urine out of the bladder
- Redundant tissue
- effectively causes postobstructive uropathy ( like BPH)
Pt:
- ± oligohydramnios seen in prenatal care
- US :loudspeaker:: see hydro:balloon:
- no urinary output
- distended bladder
- ± ↑ Cr, but maybe hidden bc mom's kidneys are fine
Dx: US :loudspeaker:
- see hydro :balloon:
- f/u: VCUG to r/o reflux
- insertion of catheter decompresses bladder, lots of piss comes out
Tx: Cath then Sx :hocho:
Hypospadias/ Epispadias
Think of an erect penis :eggplant:
During a development the top and bottom of the vagina are zipped up from the bottom, folding in the middle
Path: one is too fast or slow
- urethra happens at a different spot
- epi: dorsal hole :whale:
- hypo: ventral hole
Pt: Clinical
Dx: Clinical
Tx:
- Never do a circumcision :forbidden::scissors:
- need that extra tissue to rebuild urethra
UretoPelvic Junction Obstruction UPJO
UretoVesicular Junction Obstruction (cousins)
Path: obstruction at pelvis → hydronephrosis :balloon:
- narrow lumen, not substantial to cause a problem: works at normal urinary flows
- obstruction @ level of the bladder → hydronephrosis of bladder on up
Pt: normal for most of their life at normal urinary flows
- w/ increased flow, there is an obstruction
- :man::skin-tone-2:teenager w/ 1st alcohol :beer_mugs: binge
- colicky abd px that spontaneously resolves
Dx: US :loudspeaker: = hydro :balloon:
Tx: Sx :hocho:
Ectopic Ureter (formerly Low implantation)
Path: 1 bad ureter
- 1 to the bladder
- 1 implants anywhere
- :boy::skin-tone-2: boys: always implants above the external sphincter
- :girl::skin-tone-4:girls: normal urinary behavior & the other implants in the vagina = constant leak
- girl will never have been dry
- like a fistula, but too early in life
Dx: US :loudspeaker: = no hydro
- f/u: VCUG r/o reflux
- Radionucleotide scan: assesses renal function
Tx: Reimplant :hocho:
Vesiculouretal reflux
Path: retrograde flow
Pt: Prenatal US :loudspeaker: w/ hydro :balloon:
- on test: immigrant
- recurrent UTI
- pyelonephritis :biohazard_sign:
Dx: US :loudspeaker: = hydro :balloon:
Tx: poss to outgrow, suppressive Abx :pill:(mild cases)
- tricky subject; LY
- explore anatomy in this vid
- consider hematuria
- Ddx for kidney problems
- Dx tests in kids