The bladder and urethra normally function as a coordinated unit to store and discharge urine from the body. Both structural and functional disorders of the bladder or urethra can be responsible for bleeding, incontinence, infection, discomfort, pain, and obstruction that…
Acknowledgments We thank Dr. Andrew J. Kirsch of Georgia Urology for the use of his video on the Deflux injection procedure and Dr. Charles Concodora and Dr. Paul Noh of Cincinnati Children’s Hospital for the use of their video of…
Hydronephrosis and ureteral malformations are among the most common anomalies in the urinary tract in children. Many of these conditions are now detected prenatally. Urinary tract dilation is present in 1 in 100 fetuses, but significant uropathy is found in…
Anomalies of renal formation and position result in interesting radiographs, but their clinical importance lies in their associated conditions. For example, the multicystic dysplastic kidney (MCDK) often involutes, yet the initial evaluation needs to determine if the contralateral kidney is…
The term acute scrotum is defined as sudden onset scrotal pain with or without swelling and erythema. Early recognition and prompt management are imperative because of the possibility of testicular torsion as the etiology with permanent ischemic damage to the…
Undescended Testes Normal testicular descent relies on a complex interplay of numerous factors. Any deviation from the normal process can result in a cryptorchid or undescended testis (UDT) ( Fig. 51.1 ). UDT is a common abnormality that can have…
Inguinal hernias have been documented since the dawn of recorded history. The term “hernia” comes from the Greek hernios, meaning offshoot or bud. Because an inguinal hernia is present in many different species of animals, particularly primates, prehistoric humans likely…
Umbilical Hernia Umbilical hernia is a common disorder in children and is frequently evaluated and treated by pediatric and general surgeons. Unlike other hernias of childhood, a fascial defect is present at birth but may resolve without the need for…
The two primary congenital abdominal wall defects are omphalocele and gastroschisis. Although often considered together, they are distinct and separate entities in every way from their etiology to management principles. Differences between gastroschisis and omphalocele are illustrated in Figure 48.1…
The essential role of the spleen in the defense against bacterial organisms is well documented. King and Schumacker first described the susceptibility of splenectomized infants to infection in 1952. The immunologic role of the spleen led pediatric surgeons to initiate…