Congenital Anomalies Of The Urinary Tract: Subdivisi Urologi Fk Usu Rsup H Adam Malik Medan

Congenital anomalies of the Urinary tract Subdivisi Urologi FK USU RSUP H Adam Malik Medan

 Upper Urinary Tract  Lower Urinary Tract  Male Genital anomalies  Cloaca Dysgenesis

The Prepuce : Phimosis  Physiologic phimosis : in ability to retract the foreskin because natural adhesion exist between the prepuce and the glans

 Phatologic phimosis, occur when the foreskin cannot be retracted after it has been previously retractable

The easest way to differentiated  Gentle proximal traction of the foreskin. Physiologic phimosis : foreskin lay flat against the glans penis and effaces or thin no treatment

 Phatologic phimosis : there is thickened , rolled age, do to scaring and information. Balloning of the foreskin during voiding is often associated with true phimosis circumsision

Phatologic phimosis

Phatologic phimosis

Paraphimosis  The painful swelling of the foreskin distal to a phimotic ring.

 The foreskin has been retracted and cannot then be brought back over the glans penis

 The foreskin has been retracted for the placement of catheter

Paraphimosis

Manual reduction manipulations

Hypospadia Three anatomical anomalies :  an abnormal ventral opening of the urethral meatus  ventral curvature (chordee) of the penis  a hooded foreskin, which is deficient ventrally

However, not all three of these features are present in every case

Intersex and associated anomalies  Disorder of Sex Development / DSD  Cryptorchidism  Persistent prostatic utricle  Abnormalities of the urinary tract are unusual

Classification

based on position of meatus

Management  three specific components to the surgical correction of hypospadias 1. correction of the penile chordee 2. reconstruction of the urethra (urethroplasty) 3. skin coverage of the penis aimed at achieving a normal cosmetic appearance

One stage VS two stage repair

Cryptorchidism or Undescended Testis / UDT

Management : surgery vs laparoscopy

Upper urinary tract 1. Abnormalities of the kidney position & number 1. Simple ectopia 2. Thoracic ectopia 3. Crossed ectopia & fusion (Bauer) 4. Horseshoe kidney 5. Bilateral renal agenesis 6. Unilateral renal agenesis 7. Supernumerary kidney

2. Cystic abnormalities of the kidney (Glassberg) 1. Autosomal dominant polycystic kidney disease 2. Autosomal recessive polycystic kidney disease 3. Medullary sponge kidney (tubular ectasia) 4. Medullary cystic disease (juvenile nephronophtisis) 5. Unilateral multicyctic dysplastic kidney

3. Collecting system abnormalities (Bauer) 1. Calyceal diverticulum 2. Hydrocalycosis 3. Megacalycosis 4. Infundibulopelvic stenosis 5. Ureteropelvic junction obstruction (UPJO)

4. Ureteral abnormalities 1. Duplication of ureter 2. Atresia 3. Mega-ureter 4. Vesicoureteral reflux 5. Ureteral ectopia 6. Ureterocele

Lower urinary tract 1. Extrophy & epispadia 2. Urachus 3. Posterior Urethral Valves (Type I) 4. Megalourethra 5. Miscellaneous