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THOMAS • DUFFY RICKWOOD ESSENTIALS OF ESSENTIALS OF SECOND PAEDIATRIC UROLOGY EDITION PAEDIATRIC UROLOGY EDITION SECOND This excellent and superbly illustrated text provides surgical trainees and non-specialists with an updated and extensively revised account of the urological disorders of childhood. The second edition reflects the many EDITED BY SECOND EDITION advances and innovations in paediatric urology since the first edition was published in 2002 and incorporates DAVID FM THOMAS suggestions and feedback from readers and reviewers of the first edition of Essentials of Paediatric Urology. There are new chapters such as “Minimally invasive paediatric urology”, which covers the innovative and ESSENTIALS OF ESSENTIALS PATRICK G DUFFY rapidly advancing contribution made by laparoscopic surgery to effective patient care and "The Child as a ANTHONY MK RICKWOOD Patient", which highlights the important differences of approach to caring for children and adults and provides clarification of the legal and ethical issues surrounding consent. There is also a new multiple choice question chapter with cross-references to the text, as requested by many readers of the first edition, thus providing an aide-memoire for those undergoing speciality examinations. This popular text was never intended to duplicate the large reference books written primarily for specialists. Instead it fulfils a unique role as the only textbook of paediatric urology written primarily for trainees and PAEDIATRIC those practising adult urology, paediatric surgery and paediatric urology. The second edition continues to meet this need as well as providing a ready source of reference for non-specialists including paediatricians and nurses. Like the first edition, the second is accessible and concise with a visual format characterised by extensive use of colour illustrations, flow charts and diagrams. RELATED TITLES OF INTEREST The Kelalis-King-Belman Textbook of Clinical Pediatric Urology, 5th Edition Edited by Steven G Docimo, Douglas Canning and Antoine Khoury ISBN 978-1-84184-504-3 UROLOGY Textbook of the Neurogenic Bladder: Adults and Children, 2nd Edition Edited by Jacques Corcos and Erik Schick ISBN 978-0-415-42316-8 Minimally Invasive Approaches to Pediatric Urology Edited by Steven G Docimo ISBN 978-1-84184-170-0 9781841846330 www.informahealthcare.com Prelims Thomas-8043.qxd 2/29/2008 7:17 PM Page i Essentials of Paediatric Urology Second Edition Edited by David FM Thomas FRCP FRCPCH FRCS St James’s University Hospital Leeds, UK Patrick G Duffy MB BCH BAO FRCS(I) FEBU Great Ormond Street Hospital for Sick Children London, UK Anthony MK Rickwood MA FRCS Formerly of Royal Liverpool Hospital for Sick Children Liverpool, UK Prelims Thomas-8043.qxd 2/29/2008 7:17 PM Page ii © 2008 Informa UK Ltd First published in the United Kingdom in 2002 Second edition published in the United Kingdom in 2008 by Informa Healthcare, Telephone House, 69-77 Paul Street, London EC2A 4LQ. Informa Healthcare is a trading division of Informa UK Ltd. Registered Office: 37/41 Mortimer Street, London W1T 3JH. Registered in England and Wales number 1072954. Tel: +44 (0)20 7017 5000 Fax: +44 (0)20 7017 6699 Website: www.informahealthcare.com All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without the prior permission of the publisher or in accor- dance with the provisions of the Copyright, Designs and Patents Act 1988 or under the terms of any licence permitting limited copying issued by the Copyright Licensing Agency, 90 Tottenham Court Road, London W1P 0LP. Although every effort has been made to ensure that all owners of copyright material have been acknowledged in this publication, we would be glad to acknowledge in subsequent reprints or editions any omissions brought to our attention. Although every effort has been made to ensure that drug doses and other information are presented accurately in this publication, the ultimate responsibility rests with the prescribing physician. Neither the publishers nor the authors can be held responsible for errors or for any consequences arising from the use of information contained herein. For detailed prescribing information or instruc- tions on the use of any product or procedure discussed herein, please consult the prescribing information or instructional material issued by the manufacturer. A CIP record for this book is available from the British Library. Library of Congress Cataloging-in-Publication Data Data available on application ISBN-10: 1 84184 633 3 ISBN-13: 978 1 84184 633 0 Distributed in North and South America by Ta y l o r & Fr a n c i s 6000 Broken Sound Parkway, NW, (Suite 300) Boca Raton, FL 33487, USA Within Continental USA Tel: 1 (800) 272 7737; Fax: 1 (800) 374 3401 Outside Continental USA Tel: (561) 994 0555; Fax: (561) 361 6018 Email: [email protected] Book orders in the rest of the world Paul Abrahams Tel: +44 (0)207 017 4036 Email: [email protected] Composition by C&M Digitals (P) Ltd, Chennai, India Printed and bound in India by Replika Press Pvt Ltd Prelims Thomas-8043.qxd 2/29/2008 7:17 PM Page iii To our wives: Marilyn, Zara and Valerie. Prelims Thomas-8043.qxd 2/29/2008 7:17 PM Page iv Prelims Thomas-8043.qxd 2/29/2008 7:17 PM Page v Contents List of Contributors ix Preface xi Acknowledgements xiii 1Embryology 1 David FM Thomas 2Renal physiology and renal failure 15 Richard Trompetor 3Diagnostic imaging 25 Melanie P Hiorns 4Urinary tract infection 43 Stuart J O’Toole 5Vesicoureteric reflux 57 David FM Thomas and Ram Subramaniam 6Upper tract obstruction 73 David FM Thomas 7Duplication anomalies, ureterocoeles and ectopic ureters 93 Anthony MK Rickwood, Nicholas P Madden and Su-Anna M Boddy 8Posterior urethral valves and other urethral abnormalities 109 Divyesh Desai and Patrick G Duffy 9 Cystic renal disease 121 David FM Thomas Prelims Thomas-8043.qxd 2/29/2008 7:17 PM Page vi vi Contents 10 Prenatal diagnosis 133 HK Dhillon 11 Stone disease in children 143 Patrick G Duffy, David FM Thomas and Martyn E Flett 12 Urinary incontinence 157 Henrik A Steinbrecher, Padraig S Malone and Anthony MK Rickwood 13 Neuropathic bladder 171 Henrik A Steinbrecher, Padraig S Malone and Anthony MK Rickwood 14 The urinary tract in anorectal malformations, multisystem disorders and syndromes 189 Duncan T Wilcox 15 Bladder exstrophy and epispadias 199 Peter Cuckow 16 Hypospadias 213 Duncan T Wilcox and Pierre DE Mouriquand 17 The prepuce 233 Kim AR Hutton 18 Testis, hydrocoele and varicocoele 247 Nicholas P Madden 19 The acute scrotum 265 David FM Thomas 20 Disorders of sex development 275 Henri Lottman and David FM Thomas 21 Genitourinary malignancies 295 Patrick G Duffy and Neil J Sebire 22 Urogenital trauma 307 David FM Thomas 23 Laparoscopic paediatric urology 317 Imran Mushtaq Prelims Thomas-8043.qxd 2/29/2008 7:17 PM Page vii Contents vii 24 Adolescent urology 331 Christopher RJ Woodhouse 25 Children and young people as urological patients 341 David FM Thomas Appendix I Self-assessment section: Questions 349 Appendix II Self-assessment section: Answers 371 Index 375 Prelims Thomas-8043.qxd 2/29/2008 7:17 PM Page viii Prelims Thomas-8043.qxd 2/29/2008 7:17 PM Page ix Contributors Su-Anna M Boddy MS FRCS Melanie P Hiorns MRCP FRCR Department of Paediatric Urology Department of Radiology St George’s Hospital Great Ormond Street Hospital for Sick Children London London UK UK Peter Cuckow MB BS FRCS (Paed) Kim AR Hutton MBCHB CHM FRCS (PAED) Department of Paediatric Urology Department of Paediatric Surgery Great Ormond Street Hospital for Sick Children University Hospital of Wales London Cardiff UK Wa l e s UK Divyesh Y Desai MBBS MS MCHIR (UROL) FEAPU Department of Paediatric Urology Henri Lottman MD FEBU Great Ormond Street Hospital for Sick Children Hôspital Necker-Enfants Malades London Service de Chirurgie Viscérale Pédiatrique UK Paris France HK Dhillon FRCS (ED) Department of Paediatric Urology Great Ormond Street Hospital for Sick Children Nicholas P Madden MA FRCS London Department of Paediatric Surgery and Urology UK Chelsea and Westminster Hospital London Patrick G Duffy MB BCH BAO FRCS (I) FEBU UK Department of Paediatric Urology Great Ormond Street Hospital for Sick Children Padraig S Malone MB MCH FRCSI FRCS London Department of Paediatric Urology UK Southampton General Hospital Southampton Martyn E Flett MB MCH BSC FRCS (PAED) UK Department of Paediatric Urology Great Ormond Street Hospital for Sick Children London UK Prelims Thomas-8043.qxd 2/29/2008 7:17 PM Page x x Contributors Pierre DE Mouriquand MD FRCS (ENG) EFAPU Ram Subramaniam MD Department of Paediatric Urology Department of Paediatric Surgery Claude-Bernard University St James’s University Hospital Debrousse Hospital Leeds Lyon UK France David FM Thomas FRCP FRCPCH FRCS Imran Mushtaq MD FRCS (PAEDS) Department of Paediatric Surgery Department of Paediatric Urology St James’s University Hospital Great Ormond Street Hospital for Sick Children Leeds London UK UK Richard Trompetor MB FRCP FRCPCH Stuart J O’Toole MD FRCS (PAEDS) Department of Nephrology Department of Surgical Paediatrics Great Ormond Street Hospital for Sick Children Royal Hospital for Sick Children London Glasgow UK Scotland UK Duncan T Wilcox MD FRCS Department of Paediatric Urology Anthony MK Rickwood MA FRCS University of Texas (Formerly) Southwestern Medical Center Department of Paediatric Urology Dallas, TX Royal Liverpool Hospital
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  • Pathophysiology, Diagnosis, and Management of Pediatric Ascites

    Pathophysiology, Diagnosis, and Management of Pediatric Ascites

    INVITED REVIEW Pathophysiology, Diagnosis, and Management of Pediatric Ascites ÃMatthew J. Giefer, ÃKaren F. Murray, and yRichard B. Colletti ABSTRACT pressure of mesenteric capillaries is normally about 20 mmHg. The pediatric population has a number of unique considerations related to Intestinal lymph drains from regional lymphatics and ultimately the diagnosis and treatment of ascites. This review summarizes the physio- combines with hepatic lymph in the thoracic duct. Unlike the logic mechanisms for cirrhotic and noncirrhotic ascites and provides a sinusoidal endothelium, the mesenteric capillary membrane is comprehensive list of reported etiologies stratified by the patient’s age. relatively impermeable to albumin; the concentration of protein Characteristic findings on physical examination, diagnostic imaging, and in mesenteric lymph is only about one-fifth that of plasma, so there abdominal paracentesis are also reviewed, with particular attention to those is a significant osmotic gradient that promotes the return of inter- aspects that are unique to children. Medical and surgical treatments of stitial fluid into the capillary. In the normal adult, the flow of lymph ascites are discussed. Both prompt diagnosis and appropriate management of in the thoracic duct is about 800 to 1000 mL/day (3,4). ascites are required to avoid associated morbidity and mortality. Ascites from portal hypertension occurs when hydrostatic Key Words: diagnosis, etiology, management, pathophysiology, pediatric and osmotic pressures within hepatic and mesenteric capillaries ascites produce a net transfer of fluid from blood vessels to lymphatic vessels at a rate that exceeds the drainage capacity of the lym- (JPGN 2011;52: 503–513) phatics. It is not known whether ascitic fluid is formed predomi- nantly in the liver or in the mesentery.
  • RENAL BIOPSY and GLOMERULONEPHRITIS by J

    RENAL BIOPSY and GLOMERULONEPHRITIS by J

    Postgrad Med J: first published as 10.1136/pgmj.35.409.604 on 1 November 1959. Downloaded from 604 RENAL BIOPSY AND GLOMERULONEPHRITIS By J. H. Ross, M.D., M.R.C.P. Senior Medical Registrar, The Connaught Hospital, and Assistant, The Mledical Unit, The London Hospital Introduction sufficient to establish a diagnosis in a few condi- Safe methods of percutaneous renal biopsy were tions such as amyloid disease and diabetic first described by Perez Ara (1950) and Iversen glomerulosclerosis, but cortex with at least io and Brun (I95I) who used aspiration techniques. glomeruli is necessary for an accurate assessment Many different methods have since been described; of the renal structure; occasionally, up to 40 the simplest is that of Kark and Muehrcke (1954) glomeruli may be present in a single specimen. who use the Franklin modification of the Vim- The revelation of gross structural changes in Silverman needle. the kidneys of patients who can be recognized Brun and Raaschou (1958) have recently re- clinically as having chronic glomerulonephritis is viewed the majority of publications concerned of little value and does not contribute to manage- with renal biopsy and have concluded that the risk ment or prognosis. In contrast, biopsy specimensProtected by copyright. to the patients is slight. They mentioned three from patients in the early stages of glomerulo- fatalities which have been reported but considered nephritis, particularly those who have developed that, in each case, death was probably due to the the nephrotic syndrome insidiously without disease process rather than the investigation. haematuria or renal failure or who showy no Retroperitoneal haematomata have been recorded evidence of disease other than proteinuria, may in patients with hypertension or uraemia but are provide useful information.