Genitourinary Complaints

(hematuria, dysuria, polyuria, frequency, pain)

Balanitis
Enuresis
Phimosis
Testicular torsion
Vesicoureteral reflux
Vulvovaginitis

  • Describe the anatomy and physiology of the genitourinary system
  • Identify infectious and non-infectious causes of urinary complaints
  • Distinguish between glomerular versus non-glomerular hematuria
  • Apply basic principles of pharmacology and indications for drugs used in the management of urinary tract infections
  • Describe the pathophysiology of male genital complaints, including phimosis, balanitis and testicular torsion
  • Describe the pathophysiology of infectious and non-infectious vulvovaginitis
  • Differentiate between diurnal and nocturnal enuresis, and when enuresis requires treatment

Overview & Foundational Knowledge

Williams GJ, Hodson EH, Isaacs D & Craig JC.  Diagnosis and management of urinary tract infection in children.  Journal of Paediatrics and Child Health 2012; 48: 296-301.

This review summarizes the most relevant recent primary studies, systematic reviews and guidelines

Meyers K. Evaluation of hematuria in children. Urology Clinics of North America 2004; 31: 559-573.

Evaluation from the basics to differential diagnosis and a paragraph on each individual disease.

Saulsbury FT. Henoch-Schonlein purpura.  Current Opinion in Rheumatology 2010; 22: 598-602. 

A short update on recent advances in the genetic susceptibility, pathogenesis and treatment of Henoch–Schonlein purpura.

Kiddoo DA.  Nocturnal enuresis. CMAJ 2012; 184(8): 908-910.

Brief “primer” on nocturnal enuresis.

Hellerstein S & Linebarger J. Voiding Dysfunction in Pediatric Patients. Clinical Pediatrics 2003; 42: 43-9.

Clinical criteria for the various voiding disorders with management

Clinical Resources

Wolfsdorf et al. Diabetic ketoacidosis in children and adolescents with diabetes. Pediatric Diabetes 2009; 10 (Suppl 12): 118-133.

International Society for Pediatric and Adolescent Diabetes (ISPAD) Clinical Practice Consensus Guidelines 2009 Compendium

Management of primary nocturnal enuresis

http://www.cps.ca/en/documents/position/primary-nocturnal-enuresis

http://www.cps.ca/fr/documents/position/enuresie-nocturne-primaire

Canadian Paediatric Society Position Statement (2005, 2013)

Urinary Tract Infection: Clinical Practice Guideline for the Diagnosis and Management of the Initial UTI in Febrile Infants and Children 2 to 24 Months. Pediatrics 2011; 128: 595-610.

http://pediatrics.aappublications.org/content/128/3/595.full.pdf#page=1&view=FitH

There are many UTI guidelines – this is a recent one for younger children.

Estrada CR Jr, Passerotti CC, Graham DA, et al. Nomograms for predicting annual resolution rate of primary vesicoureteral reflux: results from 2462 children. J Urol 2009; 182: 1535.

Useful to estimate probability of spontaneous resolution of childhood vesicoureteric reflux.

Ahn SY & Ingulli E.  Acute poststreptococcal glomerulonephritis: An update.  Current Opinion in Pediatrics 2008; 20: 157-162.  

This review summarizes the recent advances in the pathogenesis, host susceptibility factors, diverse clinical presentations, and treatment of the condition.

Clinical Presentations