Office Paediatric Urology

Over the past two decades, an ever-changing evolution has occurred in Paediatric Urology, where there is a far-reduced surgical scope with increasing emphasis on ambulatory (medical) Urology. Outpatient pediatric urology clinic practices have shifted from an 80% yield to surgery to a 20–25% yield. Much of this has occurred as primary and secondary medical issues, representing a significant part of the “primary care” physicians’practices. Therefore, it is paramount to educate family physicians and pediatricians on common pediatric urology conditions initially seen in their practices. More importantly, primary care physicians must be able to differentiate conditions that require referral to the surgical specialist (and the ideal timing for referral) from those that should be managed conservatively in the primary care setting. In this Chapter we will discuss the management of common pediatric urology conditions such as Bladder and Bowel Dysfunction, a common yet underdiagnosed condition that represents 40% of pediatric urology practices worldwide and requires conservative management in the vast majority of cases. We will also discuss the diagnosis, recommended history and physical examination, investigations and management of undescended testicles, inguinal hernia/hydrocele, phimosis (including circumcision indications andcontraindications), antenatal hydronephrosis, vesicoureteral reflux (VUR) and hematuria.