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; common sense approach to UTIs.

Massengill. Hematuria. Pediatrics in Review 2008; 29: 342-348

Very good review article on hematuria in pediatrics, diagnosis, approach to history and physical examination, when to refer to nephrology.

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 tips.

Clinical Resources

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) on nocturnal enuresis

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 (AAP, NICE, etc) – this is the AAP practice guidelines for first UTI in 2 month to 2 year olds

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.

Review article which summarizes the recent advances in the pathogenesis, host susceptibility factors, diverse clinical presentations, and treatment of the condition.

Clinical Presentations