Paediatric Urology
Total Page:16
File Type:pdf, Size:1020Kb
Load more
Recommended publications
-
Te2, Part Iii
TERMINOLOGIA EMBRYOLOGICA Second Edition International Embryological Terminology FIPAT The Federative International Programme for Anatomical Terminology A programme of the International Federation of Associations of Anatomists (IFAA) TE2, PART III Contents Caput V: Organogenesis Chapter 5: Organogenesis (continued) Systema respiratorium Respiratory system Systema urinarium Urinary system Systemata genitalia Genital systems Coeloma Coelom Glandulae endocrinae Endocrine glands Systema cardiovasculare Cardiovascular system Systema lymphoideum Lymphoid system Bibliographic Reference Citation: FIPAT. Terminologia Embryologica. 2nd ed. FIPAT.library.dal.ca. Federative International Programme for Anatomical Terminology, February 2017 Published pending approval by the General Assembly at the next Congress of IFAA (2019) Creative Commons License: The publication of Terminologia Embryologica is under a Creative Commons Attribution-NoDerivatives 4.0 International (CC BY-ND 4.0) license The individual terms in this terminology are within the public domain. Statements about terms being part of this international standard terminology should use the above bibliographic reference to cite this terminology. The unaltered PDF files of this terminology may be freely copied and distributed by users. IFAA member societies are authorized to publish translations of this terminology. Authors of other works that might be considered derivative should write to the Chair of FIPAT for permission to publish a derivative work. Caput V: ORGANOGENESIS Chapter 5: ORGANOGENESIS -
Webbed Penis
Kathmandu University Medical Journal (2010), Vol. 8, No. 1, Issue 29, 95-96 Case Note Webbed penis: A rare case Agrawal R1, Chaurasia D2, Jain M3 1Resident in Surgery, 2Associate Professor, Department of Urology, 3Assistant Professor, Department of Plastic and Reconstructive Surgery, MLN Medical College, Allahabad (India) Abstract Webbed penis belongs to a rare and little-known defect of the external genitalia. The term denotes the penis of normal size for age hidden in the adjacent scrotal and pubic tissues. Though rare, it can be treated easily by surgery. A case of webbed penis is presented with brief review of literature. Key words: penis, webbed ebbed penis is a rare anomaly of structure of Wpenis. Though a congenital anomaly, usually the patient presents in late childhood or adolescence. Skin of penis forms the shape of a web, covering whole or part of penis circumferentially; with or without glans, burying the penile tissue inside. The length of shaft is normal with normal stretched length. Phimosis may be present. The penis appears small without any diffi culty in voiding function. Fig 1: Penis showing web Fig 2: Markings for double of skin on anterior Z-plasty on penis Case report aspect Our patient, a 17 year old male, presented to us with congenital webbed penis. On examination, skin webs Discussion were present on both lateral sides from prepuce to lateral Webbed penis is a developmental malformation with aspect of penis.[Fig. 1] On ventral aspect, the skin web less than 60 cases reported in literature. The term was present from prepuce to inferior margin of median denotes the penis of normal size for age hidden in the raphe of scrotum. -
Case Report Full Text Online At
Case Report Full text online at http://www.jiaps.com Penile agenesis A. K. Bangroo, Ramji Khetri, Sashi Tiwari St Stephen's Hospital, Tis Hazari, Delhi Correspondence: AK Bangroo, 103, Administrative block, St. Stephens Hospital, Tis Hazari, Delhi-110054, India. E-mail: [email protected] ABSTRACT Penile agenesis is an extremely rare disorder with profound urological and psychological consequences. The goal of treatment is an early female gender assignment and feminizing reconstruction of the perineum. KEY WORDS: Aphallia, Penile agenesis, Ambiguous genitalia Penile agenesis (PA) is an extremely rare developmental the scrotal folds which were preserved for subsequent anomaly with the reported incidence of 1 in 30 million genital reconstruction. births[1]. PA is believed to result from either the absence of the genital tubercle, or its failure to develop.[2] Several DISCUSSION investigators claim the absence of corpora cavernosa and corpora spongiosum as a prerequisite for the diagnosis of The earliest case report of aphallia was by Imminger in penile agenesis.[3] Except for the reported XX-XY mosaic, 1853[2] since then only 75 cases have been reported in the patients have 46 XY karyotypes.[4] More than half of these literature[6]. Skoog and Belman[5] suggested three variants, have associated anomalies, including developmental de based on urethral position in relationship to the anal fects of the caudal axis, genitourinary and gastrointestinal sphincter, as: Postsphincteric; Presphincteric tract anomalies.[5] The scrotum, testes and testicular func (Prostatorectal fistula) and Urethral atresia. More proxi tion are usually normal[2]. mal the bladder outlet, greater is the likelihood of other anomalies and death.[5] CASE REPORT A two-day-old 3.2 kg genotypic male (46XY) neonate was brought, by a social organization, to our hospital with the complaint of absence of penis, and passage of meco nium mixed with urine through rectum. -
Guidelines on Paediatric Urology S
Guidelines on Paediatric Urology S. Tekgül (Chair), H.S. Dogan, E. Erdem (Guidelines Associate), P. Hoebeke, R. Ko˘cvara, J.M. Nijman (Vice-chair), C. Radmayr, M.S. Silay (Guidelines Associate), R. Stein, S. Undre (Guidelines Associate) European Society for Paediatric Urology © European Association of Urology 2015 TABLE OF CONTENTS PAGE 1. INTRODUCTION 7 1.1 Aim 7 1.2 Publication history 7 2. METHODS 8 3. THE GUIDELINE 8 3A PHIMOSIS 8 3A.1 Epidemiology, aetiology and pathophysiology 8 3A.2 Classification systems 8 3A.3 Diagnostic evaluation 8 3A.4 Disease management 8 3A.5 Follow-up 9 3A.6 Conclusions and recommendations on phimosis 9 3B CRYPTORCHIDISM 9 3B.1 Epidemiology, aetiology and pathophysiology 9 3B.2 Classification systems 9 3B.3 Diagnostic evaluation 10 3B.4 Disease management 10 3B.4.1 Medical therapy 10 3B.4.2 Surgery 10 3B.5 Follow-up 11 3B.6 Recommendations for cryptorchidism 11 3C HYDROCELE 12 3C.1 Epidemiology, aetiology and pathophysiology 12 3C.2 Diagnostic evaluation 12 3C.3 Disease management 12 3C.4 Recommendations for the management of hydrocele 12 3D ACUTE SCROTUM IN CHILDREN 13 3D.1 Epidemiology, aetiology and pathophysiology 13 3D.2 Diagnostic evaluation 13 3D.3 Disease management 14 3D.3.1 Epididymitis 14 3D.3.2 Testicular torsion 14 3D.3.3 Surgical treatment 14 3D.4 Follow-up 14 3D.4.1 Fertility 14 3D.4.2 Subfertility 14 3D.4.3 Androgen levels 15 3D.4.4 Testicular cancer 15 3D.5 Recommendations for the treatment of acute scrotum in children 15 3E HYPOSPADIAS 15 3E.1 Epidemiology, aetiology and pathophysiology -
Guidelines on Paediatric Urology S
Guidelines on Paediatric Urology S. Tekgül, H. Riedmiller, E. Gerharz, P. Hoebeke, R. Kocvara, R. Nijman, Chr. Radmayr, R. Stein European Society for Paediatric Urology © European Association of Urology 2011 TABLE OF CONTENTS PAGE 1. INTRODUCTION 6 1.1 Reference 6 2. PHIMOSIS 6 2.1 Background 6 2.2 Diagnosis 6 2.3 Treatment 7 2.4 References 7 3. CRYPTORCHIDISM 8 3.1 Background 8 3.2 Diagnosis 8 3.3 Treatment 9 3.3.1 Medical therapy 9 3.3.2 Surgery 9 3.4 Prognosis 9 3.5 Recommendations for crytorchidism 10 3.6 References 10 4. HYDROCELE 11 4.1 Background 11 4.2 Diagnosis 11 4.3 Treatment 11 4.4 References 11 5. ACUTE SCROTUM IN CHILDREN 12 5.1 Background 12 5.2 Diagnosis 12 5.3 Treatment 13 5.3.1 Epididymitis 13 5.3.2 Testicular torsion 13 5.3.3 Surgical treatment 13 5.4 Prognosis 13 5.4.1 Fertility 13 5.4.2 Subfertility 13 5.4.3 Androgen levels 14 5.4.4 Testicular cancer 14 5.4.5 Nitric oxide 14 5.5 Perinatal torsion 14 5.6 References 14 6. Hypospadias 17 6.1 Background 17 6.1.1 Risk factors 17 6.2 Diagnosis 18 6.3 Treatment 18 6.3.1 Age at surgery 18 6.3.2 Penile curvature 18 6.3.3 Preservation of the well-vascularised urethral plate 19 6.3.4 Re-do hypospadias repairs 19 6.3.5 Urethral reconstruction 20 6.3.6 Urine drainage and wound dressing 20 6.3.7 Outcome 20 6.4 References 21 7. -
The Reproductive System
27 The Reproductive System PowerPoint® Lecture Presentations prepared by Steven Bassett Southeast Community College Lincoln, Nebraska © 2012 Pearson Education, Inc. Introduction • The reproductive system is designed to perpetuate the species • The male produces gametes called sperm cells • The female produces gametes called ova • The joining of a sperm cell and an ovum is fertilization • Fertilization results in the formation of a zygote © 2012 Pearson Education, Inc. Anatomy of the Male Reproductive System • Overview of the Male Reproductive System • Testis • Epididymis • Ductus deferens • Ejaculatory duct • Spongy urethra (penile urethra) • Seminal gland • Prostate gland • Bulbo-urethral gland © 2012 Pearson Education, Inc. Figure 27.1 The Male Reproductive System, Part I Pubic symphysis Ureter Urinary bladder Prostatic urethra Seminal gland Membranous urethra Rectum Corpus cavernosum Prostate gland Corpus spongiosum Spongy urethra Ejaculatory duct Ductus deferens Penis Bulbo-urethral gland Epididymis Anus Testis External urethral orifice Scrotum Sigmoid colon (cut) Rectum Internal urethral orifice Rectus abdominis Prostatic urethra Urinary bladder Prostate gland Pubic symphysis Bristle within ejaculatory duct Membranous urethra Penis Spongy urethra Spongy urethra within corpus spongiosum Bulbospongiosus muscle Corpus cavernosum Ductus deferens Epididymis Scrotum Testis © 2012 Pearson Education, Inc. Anatomy of the Male Reproductive System • The Testes • Testes hang inside a pouch called the scrotum, which is on the outside of the body -
Level Estimates of Maternal Smoking and Nicotine Replacement Therapy During Pregnancy
Using primary care data to assess population- level estimates of maternal smoking and nicotine replacement therapy during pregnancy Nafeesa Nooruddin Dhalwani BSc MSc Thesis submitted to the University of Nottingham for the degree of Doctor of Philosophy November 2014 ABSTRACT Background: Smoking in pregnancy is the most significant preventable cause of poor health outcomes for women and their babies and, therefore, is a major public health concern. In the UK there is a wide range of interventions and support for pregnant women who want to quit. One of these is nicotine replacement therapy (NRT) which has been widely available for retail purchase and prescribing to pregnant women since 2005. However, measures of NRT prescribing in pregnant women are scarce. These measures are vital to assess its usefulness in smoking cessation during pregnancy at a population level. Furthermore, evidence of NRT safety in pregnancy for the mother and child’s health so far is nebulous, with existing studies being small or using retrospectively reported exposures. Aims and Objectives: The main aim of this work was to assess population- level estimates of maternal smoking and NRT prescribing in pregnancy and the safety of NRT for both the mother and the child in the UK. Currently, the only population-level data on UK maternal smoking are from repeated cross-sectional surveys or routinely collected maternity data during pregnancy or at delivery. These obtain information at one point in time, and there are no population-level data on NRT use available. As a novel approach, therefore, this thesis used the routinely collected primary care data that are currently available for approximately 6% of the UK population and provide longitudinal/prospectively recorded information throughout pregnancy. -
MANAGEMENT of CONCEALED PENIS in CHILDREN Mohamed A
AAMJ, Vol. 6, N. 2, April, 2008 ـــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ MANAGEMENT OF CONCEALED PENIS IN CHILDREN Mohamed A. Abdel Aziz, Samir H.Gouda, Sayed H.Abdalla, Sabri M. Khaled, and Ahmed T. Sayed Paediatric Surgery, Urology, And Plastic Departments, Faculty of Medicine, Al-Azhar University, Cairo. ------------------------------------------------------------------------------------------------- SUMMARY Objectives: A concealed penis or inconspicuous penis is defined as a phallus of normal size buried in prepubic tissue (buried penis), enclosed in scrotal tissue (webbed penis), or trapped by scar tissue after penile surgery (trapped penis). We report our results using a standardized surgical approach that was highly effective in both functional and cosmetic terms. Materials and Methods: From April 2003 to October 2007, Surgery for hidden penis from multiple causes was performed in 80 children. Their age ranged from 10 months to 8 years (mean 4.2 years). Tacking sutures were taken from the subdermis of the ventral penoscrotal junction to the tunica albuginea in some cases. A combination procedure with tacking of the penopubic subdermis to the rectus fascia, penoscrotal Z plasty, circumcision revision or lateral penile shaft Z plasty also was performed in some patients. Results: Cosmetic improvement was noted in all cases except one patient that needed re- fixation of the Buck’s fascia to the dermis without significant complications. Conclusions: Surgery for hidden penis achieves marked aesthetic and often functional improvement. Degloving the penis to release any abnormal attachment then fixing the Buck’s fascia to the dermis of the skin has an essential role in preventing penile retraction in most cases. INTRODUCTION Concealed or inconspicuous penis is an uncommon condition that may present from infancy to adolescence. -
Urologic Malignancies
Scope • Anatomy •Urologic Malignancies • Trauma • Emergencies • Infections • Lower Urinary Tract Obstruction • Upper Urinary Tract Obstruction • Pediatric Urology • Key Points Emmanuel L. Barcenas Urologist/Urologic Surgeon Urology Specialty Group and Associates • Doctor of Medicine, SWU • Diplomate, Philippine Board of Surgery and the Philippine Board of Urology • Fellow, Philippine Urological Association • Fellow, Philippine College of Surgeons • Member, Philippine Endourological Society • Member, Phillippine Society of Urooncologists Urologic Malignancies Urologic Malignancies •Bladder Cancer •Testicular Cancer •Kidney Cancer •Prostate Cancer Urothelial Tumors of the UB •Transitional cell epithelium lines the urinary tract from the renal pelvis, ureter, urinary bladder, and the proximal two-thirds of the urethra •Tobacco use is the most frequent risk factor (50% in men and 40% in women), followed by occupational exposure to various carcinogenic materials such as automobile exhaust or industrial solvents. Detection of Urothelial Cancer •Painless gross hematuria occurs in 85% of patients & requires a complete evaluation that includes cystoscopy, urine cytology, CT scan, & a PSA. •Recurrent or significant hematuria (>3 RBC’s/HPF on 3 urinalysis, a single urinalysis with >100 RBCs, or gross Hematuria) is associated with significant renal or urologic lesion in 9.1% Detection of Urothelial Cancer • Patients with microscopic hematuria require a full evaluation, but low-risk patients do not require repeat evaluations. • High-risk individuals primarily are those with a smoking history & should be evaluated every 6 months. • The level of suspicion for urogenital neoplasms in patients with isolated painless hematuria and nondysmorphic RBCs increases with age. • White light cystoscopy with random bladder biopsies is the gold standard for tumor detection History & Staging •Low-grade papillary lesions are likely to recur in up to 60% of patients but invade in less than 10% of cases. -
Guidelines on Testicular Cancer
GUIDELINES ON TESTICULAR CANCER (Limited text update March 2015) P. Albers (Chair), W. Albrecht, F. Algaba, C. Bokemeyer, G. Cohn-Cedermark, K. Fizazi, A. Horwich, M.P. Laguna, N. Nicolai, J. Oldenburg Eur Urol 2011 Aug;60(2):304-19 Introduction Compared with other types of cancer, testicular cancer is relatively rare accounting for approximately 1-1.5% of all cancers in men. Nowadays, testicular tumours show excellent cure rates, mainly due to early diagnosis and their extreme chemo- and radiosensitivity. Staging and Classification Staging For an accurate staging the following steps are necessary: Postorchiectomy half-life kinetics of serum tumour markers. The persistence of elevated serum tumour markers after orchiectomy may indicate the presence of disease, while their normalisation does not necessarily mean absence of tumour. Tumour markers should be assessed until they are normal, as long as they follow their half-life kinetics and no metastases are revealed. A chest CT scan should be routinely performed in patients diagnosed with non-seminomatous germ cell tumours (NSGCT), because in up to 10% of cases, small subpleural nodes may be present that are not visible radiologically. 110 Testicular Cancer Recommended tests for staging at diagnosis Test Recommendation GR Serum tumour markers Alpha-fetoprotein A hCG LDH Abdominopelvic CT All patients A Chest CT All patients A Testis ultrasound (bilateral) All patients A Bone scan or MRI columna In case of symptoms Brain scan (CT/MRI) In case of symptoms and patients with meta- static disease with mul- tiple lung metastases and/or high beta-hCG values. Further investigations Fertility investigations: B Total testosterone LH FSH Semen analysis Sperm banking should be offered. -
Paratesticular Metastasis of High Grade Prostate Cancer Clinically
CASE REPORT Urooncology Doi: 10.4274/jus.481 Journal of Urological Surgery, 2017;4:26-28 Paratesticular Metastasis of High Grade Prostate Cancer Clinically Mimicking Hemato/Pyo-hydrocele Paratestiküler Metastazla Presente Olan Yüksek Dereceli Prostat Adenokarsinomu Hikmet Köseoğlu1, Şemsi Altaner2 1Başkent University Faculty of Medicine, Department of Urology, İstanbul, Turkiye 2Başkent University Faculty of Medicine, Department of Pathology, İstanbul, Turkiye Abstract Secondary metastatic lesions of the testicles are very rare and they originate mainly from prostate adenocarcinoma. They are generally diagnosed incidentally, however, they very rarely manifest as a palpable testicular mass. In this paper, we present, a case of paratesticular metastasis from high- grade prostate cancer clinically mimicking pyo-/hemato-/hydrocele. A 75-year-old man, who had been followed up elsewhere for a huge hydrocele based on scrotal Doppler ultrasonography and scrotal magnetic resonance imaging reporting no suspicion for malignancy, but a pyo-/hemato-/ hydrocele was determined to have testicular metastasis originating from prostate adenocarcinoma. Keywords: Hydrocele, testis, neoplasm metastasis, prostate, adenocarcinoma Öz Testisin metastatik lezyonları oldukça nadirdir ve çoğunlukla prostat kanserinden köken almaktadırlar. Genellikle rastlantısal olarak tanı alırlar; ancak çok nadir testiste palpe edilebilen kitle ile belirti verirler. Bu olgu bildirisinde klinik olarak pyo-/hemato-/hidrosel olarak izlenen olguda yüksek dereceli prostat kanseri metastazı -
EAU-Guidelines-On-Paediatric-Urology-2019.Pdf
EAU Guidelines on Paediatric Urology C. Radmayr (Chair), G. Bogaert, H.S. Dogan, R. Kocvara˘ , J.M. Nijman (Vice-chair), R. Stein, S. Tekgül Guidelines Associates: L.A. ‘t Hoen, J. Quaedackers, M.S. Silay, S. Undre European Society for Paediatric Urology © European Association of Urology 2019 TABLE OF CONTENTS PAGE 1. INTRODUCTION 8 1.1 Aim 8 1.2 Panel composition 8 1.3 Available publications 8 1.4 Publication history 8 1.5 Summary of changes 8 1.5.1 New and changed recommendations 9 2. METHODS 9 2.1 Introduction 9 2.2 Peer review 9 2.3 Future goals 9 3. THE GUIDELINE 10 3.1 Phimosis 10 3.1.1 Epidemiology, aetiology and pathophysiology 10 3.1.2 Classification systems 10 3.1.3 Diagnostic evaluation 10 3.1.4 Management 10 3.1.5 Follow-up 11 3.1.6 Summary of evidence and recommendations for the management of phimosis 11 3.2 Management of undescended testes 11 3.2.1 Background 11 3.2.2 Classification 11 3.2.2.1 Palpable testes 12 3.2.2.2 Non-palpable testes 12 3.2.3 Diagnostic evaluation 13 3.2.3.1 History 13 3.2.3.2 Physical examination 13 3.2.3.3 Imaging studies 13 3.2.4 Management 13 3.2.4.1 Medical therapy 13 3.2.4.1.1 Medical therapy for testicular descent 13 3.2.4.1.2 Medical therapy for fertility potential 14 3.2.4.2 Surgical therapy 14 3.2.4.2.1 Palpable testes 14 3.2.4.2.1.1 Inguinal orchidopexy 14 3.2.4.2.1.2 Scrotal orchidopexy 15 3.2.4.2.2 Non-palpable testes 15 3.2.4.2.3 Complications of surgical therapy 15 3.2.4.2.4 Surgical therapy for undescended testes after puberty 15 3.2.5 Undescended testes and fertility 16 3.2.6 Undescended