- •1. Phimosis
- •1.1 Background
- •1.2 Diagnosis
- •1.3 Treatment
- •1.4 References
- •2.2 Diagnosis
- •2.3 Treatment
- •V Therapy
- •3.3 Treatment
- •3.3.1 Complications
- •Tube-onlay
- •15. Duckett jw.
- •4.2 Classification
- •4.2.1 Enuresis
- •4.2.2 Urinary incontinence
- •4.3 Diagnosis
- •4.4 Treatment
- •4.4.1 Nocturnal enuresis (mono-symptomatic)
- •4.4.2 Diurnal enuresis (in children with attention disorders)
- •4.4.3 Urinary incontinence
- •4.4 References
- •14. Madersbacher h, Schultz-Lampel d.
- •5.2.2 Voiding cystourethrography (vcug)
- •5.2.3 Diuresis renography
- •5.2.4 Static renal scintigraphy
- •5.2.5 Intravenous urogram (ivu)
- •5.2.6 Whitaker's test
- •5.3 Treatment
- •5.3.2 Megaureter
- •5.3.3 Ureterocele
- •5.3.4 Retrocaval ureter
- •5.3.5 Bilateral hydronephrosis
- •5.4 References
- •6.3 Treatment
- •6.3.1 Asymptomatic bacteriuria
- •6.3.2 Acute uti without pyelonephritis
- •6.3.3 Pyelonephritis
- •6.3.4 Complicated uti
- •6.3.5 Antibiotic prophylaxis
- •6.4 References
- •7.7.1 Secondary reflux
- •7.2 Classification
- •7.3 Diagnosis
- •7.3.1 Secondary reflux
- •7.4 Treatment
- •7.4.1 Conservative therapy
- •7.4.2 Surgical therapy
- •7.4.3 Endoscopic therapy
- •7.4.4 Open surgery
- •7.4.5 Follow-up
- •7.5 References
- •32. McGladdery sl, Aparicio s, Verrier Jones k, Roberts r, Sacks sh.
- •8.2 Diagnosis
- •8.3 Treatment
- •8.3.1 Conservative treatment
- •8.3.2 Metaphylaxis of paediatric nephrolithiasis
- •8.4 References
- •1. Brandle e, Hautmann r.
- •2. Brandle e, Hautmann r.
- •6. Diamond da, Rickwood am, Lee ph, Johnston jh.
- •19. Kovacevic l, Kovacevic s, Smoljanic z, Peco-Antic a, Kostic n, Gajic m, Kovacevic n, Jovanovic o.
- •20. Kroovand rl.
- •24. Minevich e, Rousseau mb, Wacksman j, Lewis ag, Sheldon ca.
- •9.2 Classification
- •9.2.1 Ectopic ureterocele
- •9.2.2 Orthotopic ureterocele
- •9.2.3 Caecoureterocele
- •9.3 Diagnosis
- •9.3.1 Ureterocele
- •9.3.2 Ectopic ureter
- •9.4 Treatment
- •9.4.1 Ureterocele
- •9.4.2 Ectopic ureter
- •10.2 Classification
- •VI. Miscellaneous (? Dysgenetic testes ? teratogenic factors)
- •10.3.2 Late diagnosis and management
- •10.4 Treatment
- •10.4.1 Genitoplasty
- •10.4.2 Indications for the removal of gonads
- •10.5 References
- •11.1.4 Video-urodynamic evaluation
- •11.1.5 Urethral pressure profile (sphincterometry)
- •11.1.6 Electromyography (emg) of the external sphincter
- •11.2 References
- •22. Starr nt.
- •23. Wan j, Greenfield s.
- •26. Zermann dh, Lindner h, Huschke t, Schubert j.
- •12 Abbreviations used in the text
4.2 Classification
4.2.1 Enuresis
This is defined as a normal void occurring at an inappropriate or socially unacceptable time or place. Children with nocturnal enuresis void in bed while asleep and are generally not aroused by the wetting. The condition is mono-symptomatic and has a clear familial tendency.
Primary nocturnal enuresis
Involuntary bed wetting from the time of birth without an uninterrupted period of at least 6 months.
Secondary (onset) nocturnal enuresis
Involuntary bed wetting after a dry period of at least 6 months.
Nocturnal polyuria enuresis
This describes nocturnal enuresis in children who have urine production in excess of their functional bladder
capacity, as shown by voiding charts.
Diurnal enuresis
Wetting in attention-deficit disorders; voiding is complete; bladder and urethral function are normal.
4.2.2 Urinary incontinence
This is defined as the involuntary loss of urine, objectively demonstrable and constituting a social or hygienic problem. It denotes a symptom (patient's recognition of involuntary urine loss), a sign (the objective demonstration of urine loss) and a condition (the urodynamic demonstration of urine loss). Day-time, night-time or both day- and night-time incontinence may be encountered. Urinary incontinence is classified according to aetiology:
Incontinence associated with anatomic abnormalities of the urinary tract
Ectopic ureter, ureterocele, prune-belly syndrome, bladder exstrophy, epispadias, posterior urethral valves and
cloacal abnormalities.
Incontinence associated with neurogenic disorder
Spinal dysraphism, caudal regression condition and other central nervous system (CNS) disorders.
Functional incontinence in non-neuropathic bladder sphincter dysfunction (urge syndrome and dysfunctional
voiding)
Often associated with recurrent UTIs and occur predominantly in girls.
4.3 Diagnosis
The basic diagnostic evaluation includes:
History (including family and social history)
Physical, urological and gross neurological examination (urinalysis and culture, specific gravity)
Sonography (residual urine, bladder wall thickness, upper tracts)
Frequency-volume chart (after treatment of infection)
If the basic evaluation does not reveal any pathology, an enuresis (uncomplicated, mono-symptomatic) can be assumed and no further examinations are required.
Further evaluation is required if any pathology is revealed in the basic evaluation and includes:
Uroflow (if pathological, repeated uroflow and uroflow-electromyography (EMG) study)
VCUG in case of thickened bladder wall and/or residual urine, in case of pathological, but co-ordinated micturition
(Video) urodynamics on suspicion of functional voiding disturbances
Intravenous urogram (optional if sonography is normal)
Examination under anaesthesia (urethrocystoscopy, urethral calibration, mainly for UTIs)
Extended neurological, radiological and psychiatric examinations (including MRI of the spinal cord)
Radionuclide renal study to assess renal function