SonoKids URO scrotal

The etiology of acute scrotal pain can vary from a benign process such as mild trauma, appendicular torsion, or epididymo-orchitis to an emergent process such as an incarcerated inguinal hernia, testicular torsion, or rupture. Furthermore, testicular insult often results in a reactive hydrocele that can both cloud the diagnosis and impair the physical examination. Traditionally, the acute scrotum was managed with immediate exploration, but emergency physicians and urologists have increasingly used Doppler ultrasonography to assess vascular flow, aide in the diagnosis, and ultimately guide triage of those patients who require urgent intervention...

Extratesticular cystic and solid scrotal masses are commonly encountered in pediatrics. The most common extratesticular malignancy is paratesticular rhabdomyosarcoma. The remainder of the common pathologies encountered -- appendage torsion, epididymitis and varicoceles -- are mostly benign. These frequently encountered benign lesions are confidently differentiated from paratesticular rhadbomyosarcoma using high-frequency scrotal sonography in combination with clinical features. Less commonly encountered extratesticular masses may not be as easily classified; however, these also have distinguishing features that can enable differentiation from malignancy...

PURPOSE: The most common cause of acute scrotum in prepubertal boys is torsion of the testicular or epididymal appendages. The purpose of this retrospective study was to characterize the features of these lesions as viewed on sonographic (US) and color Doppler US examination. METHODS: During a 220-week period, 527 male patients 0-17 years old had been referred from the pediatric emergency department for scrotal US evaluation. Torsion of the appendix testis or appendix epididymis had been diagnosed in 19 (3...

Penile fracture is a urologic emergency requiring prompt surgical intervention. Ultrasound may help clarify the diagnosis in cases of uncertain history and physical examination. The author presents a case of suspected pediatric penile fracture, in which point-of-care ultrasound helped to rule out the condition and facilitated disposition of the patient.

OBJECTIVE: The purpose of this study was to derive a pilot clinical decision tool with 100% negative predictive value for testicular torsion based on prospectively collected data in children with acute scrotal pain. METHODS: This was a prospective cohort study of a convenience sample of newborn to 21-year-old males evaluated for acute (72 hours or less) scrotal pain at an urban children's hospital emergency department (ED). A pediatric emergency medicine fellow or attending physician documented history and examination findings on a standardized data collection form...

Pathology in the urinary tract is one of the most frequent queries when children are referred for an ultrasound examination. Comprehensive ultrasound examinations can answer most clinical questions of the urogenital tract with minimal patient preparation and without the use of ionising radiation. Therefore, optimised imaging protocols should be available in all radiology departments where children are examined. This review suggests a preferred imaging protocol for urogenital imaging in children and gives an overview of the different structures of the urogenital tract, the normal age-related sonographic anatomy, and gives examples of the most commonly encountered diseases of the urogenital system in children...

Torsion of the testis is a urological emergency most commonly occurring in adolescent boys. Hyperbaric oxygen treatment (HBOT) has been shown to alleviate reperfusion injury in experimental ischaemia of the testis. We report a 13-year-old boy who had prolonged right testicular ischaemia. Despite surgery, the colour of the testis remained poor. He underwent a post-operative course of 10 HBOT over 8 days, with restoration of blood flow on colour Doppler and reduction of oedema. At four-month followup, the testis appeared normal on ultrasonography...

We describe the case of an 18-year-old male with a history of nephrolithiasis presenting with acute urinary retention and penile pain. Point-of-care ultrasound was used to rapidly identify a urethral calculus causing obstruction of urinary outflow and allowed for expedited care. Further visualization of the kidneys gave reassurance that the presentation was not complicated by the presence of hydronephrosis.

BACKGROUND: In patients with a non-palpable testis (NPT) on physical examination, the testis is assumed either to be situated intra-abdominally or to be hypoplastic or absent. Diagnostic laparoscopy in these boys is considered the preferable first step. In this study the diagnostic value of pre-operative ultrasound for NPT is assessed in comparison with laparoscopy. METHODS: All boys aged under the age of 17 years who were diagnosed with an NPT by a pediatric surgeon from 2000 till 2012 were evaluated...

OBJECTIVE: A large proportion of boys referred for undescended testis (UDT) is not managed optimally prior to the referral, with the majority seen at >1 year of age and many having unnecessary ultrasound (US). Our objective was to assess the magnitude of these problems in our area and to determine if unnecessary US decreased following interventions to educate referring providers (RPs). MATERIALS AND METHODS: A chart review was done on new patients referred for UDT from January 2010 to June 2012...