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Disorders of The Genito-Urinary in Children Cikgu Noy
Disorders of The Genito-Urinary in Children Cikgu Noy
Disorders of The Genito-Urinary in Children Cikgu Noy
Tubules :
reabsorb needed
substances (water,
protein, electrolytes,
glucose, amino acids)
from filtrate and allow
unneeded substances to
leave the body in urine
Maintaining body fluid volume and
composition
Secretes hormones:-
Renin – helps with the regulation of blood
pressure
Erythropoietin – stimulates red blood cell
production by the bone marrow
Metabolised Vitamin D – responsible for
calcium metabolism
Urinalysis
(BUN) test measures the amount of nitrogen in blood that comes from the waste
product urea.
Blood urea nitrogen (BUN) and creatinine tests can be used together to find the BUN-to-
creatinine ratio (BUN:creatinine). body in the urine.
Renal Ultrasound
An injection of x-ray contrast media via a needle or cannula into
the vein, typically in the arm. The contrast is excreted or removed
from the bloodstream via the kidneys, and the contrast media
becomes visible on x-rays almost immediately after injection
a urologic procedure where the physician
injects contrast into the ureter in order to
visualize the ureter and kidney.
Incidence
Common age of onset for UTI is 2-6 years
Girl>Boy - Female has shorter urethra
Uncircumcised male prone to develop UTI
Causative organisms – E. Coli
Route of entry -bacteria ascending from the
area outside of the urethra.
Vesico-ureteral reflux
Infections – URTI, GE
Poor perineal hygiene - fecal organisms are
the most common infecting organisms due
to the proximity of the rectum to the
urethra.
Short female urethra
Urethritis – infection of the urethra
Irritability
Poor feeding Weight loss
Vomiting (failure to weight gain)
Urinary Nausea and vomiting
frequency/urgency Low abdominal or
Dysuria flank pain
Foul-smelling urine Fever and chills
Cloudy urine Fatigue
Incontinence during Small amount of urine
day and/or night while micturating
Increased irritability despite feeling of
urgency
Central pyrexia but peripherally cold
Poor colour
Pale, grey mottled skin
Quiet and lethargic child
Poor tone
Tachycardic and hypertensive
Obtaining a urine specimen:-
- Urine bag
- Clean catch urine
- Mid-stream urine
- Catheterisation
1. PRIMARY REFLUX
- caused by abnormal position of the
ureteral bud on the wolffian duct during
development of the urinary tract, resulting
in smaller, tunneled segment of the ureter
2. SECONDARY REFLUX
- occurs as a result of acquired bladder
dysfunction
Daily low dose of prophylactic antibiotic to
prevent UTI
Urinalysis and urine ME/CS – every 3 to 4
months to evaluate for UTI
Monitor ↑BP
Surgery – reimplantation of the ureter into the
bladder
Indicated due to recurrent UTI despite
antibiotics, Grade 5 reflux or progressive renal
injury
Definition
Hypospadias is a congenital
anomaly in which the actual
opening of the urethral meatus is
“below” the normal placement on
the glans of penis
Occurs from incomplete development of the
urethra in utero
Exact causes unknown – may be genetic,
environmental or hormonal factor
Stenosis of the opening could occur – may lead
to UTI or hydronephrosis
May interfere with fertility if left uncorrected
The location of the meatus may make it difficult
for the child to urinate standing up
The choice of surgical correction is affected
primarily by the severity of the defect
Surgery is done when the child’s age is less
than 18 months
Reconstruction of the meatal opening is done –
Meatal advancement granuloplasty (MAGPI)
The goal for surgical correction:-
To enhance the child’s ability to pass urine in
the standing position with a straight stream
To improve the physical appearance of the
genitalia for psychological reasons
To preserve a sexually adequate organ
1. Ashwill, J.W. and Droske, S. C. 1997. Nursing
Care of Children. Principles and Practice. USA:
W.B. Saunders.