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.