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This volume is concerned with the clinical aspects of urology in childhood; the anatomy, physiology and pathology are discussed only where they have a direct bearing upon the clinical problem, and for a detailed description of these aspects, and of operative technique, the reader is referred to other volumes of this series. Emphasis is laid upon the disorders peculiar to infants and children, so that diseases such as tuberculosis, the manifestations of which in the child differ little from those in the adult, receive less attention. Childhood is deemed to cease with the completion of puberty, though illustrations have sometimes been taken from adolescent cases. The personal views expressed in this work are based upon experience at The Hospital for Sick Children, Great Ormond Street, at St. Peter's and St. Paul's Hospitals, and at the Institute of Urology, University of London. I am deeply indebted to all my colleagues and assistants at these institutions for their help and co-operation both in the trea.tment of cases and in the preparation of this volume. I would particularly wish to thank Mr. T. T. TwrSTINGTON HIGGINS for introducing me to the urology of childhood, Drs. M. BODIAN, R. C. B. PUGH and L. L. R. WHITE for their assistance in matters of pathology, and for preparing specimens for illustration, Dr. "V. W. PAYNE for his advice on biochemistry, Dr.
List of contents
A. Introduction.- I. The basic requirements for paediatric urology.- II. The nature of genito-urinary disease in children.- III. Urological investigations.- IV. Management of surgical cases.- V. Fluid and electrolyte balance in infants.- B. Congenital abnormalities of the upper urinary tract.- I. Renal agenesis.- II. Renal hypoplasia.- III. Cystic disease of the kidneys.- IV. Malrotated, fused and ectopic kidneys.- V. Hydronephrosis due to congenital pelvi-ureteric obstruction.- VI. Congenital ureteric stricture, hypoplasia and valves.- VII. Duplications of the ureter.- VIII. Ectopic ureters.- IX. Ureterocele and ureteric prolapse.- X. Retrocaval ureter.- C. Hydro-ureter and mega-ureter.- I. Normal ureteric function.- II. Radiography and other investigations.- III. Vesico-ureteric reflux.- IV. Hydro-ureter in bladder disorders.- V. Hydro-ureter in other reno-ureteral abnormalities.- VI. Infections.- VII. The mega-ureter-megacystis syndrome.- VIII. Simple mega-ureter.- D. Congenital abnormalities of the lower urinary tract.- I. Urachal anomalies.- II. Rare vesical malformations.- III. Vesical diverticula.- IV. Bladder neck obstruction and urethral fibro-elastosis.- V. Urethral obstructions.- VI. Urethral diverticula and duplications.- VII. Malformations associated with absent abdominal muscles.- VIII. Malformations associated with anal atresia : persistent cloaca.- IX. Ectopia vesicae and epispadias.- X. Hypospadias and allied disorders.- E. Lower urinary tract obstruction.- I. Introductory.- II. Causes of obstruction.- III. Consequences of obstruction.- IV. Symptomatology.- V. Diagnosis and management.- F. Enuresis.- I. Normal development.- II. Incidence.- III. Symptoms and differential diagnosis.- IV. Aetiological factors.- V. Management.- G. The neurogenic bladder.- I. Congenital spinal cord lesions.- II. Poliomyelitis.- H. Non-tuberculous urinary infections.- I. Incidence.- II. Bacteriology and mode of infection.- III. Acute urinary infections.- IV. Chronic and recurrent urinary infection.- V. Chronic pyelonephritis.- VI. Pyaemic kidney; renal carbuncle and perinephric abscess.- VII. Cystitis.- VIII. Parasitic and fungal infections.- I. Urogenital tuberculosis.- I. Incidence.- II. Pathology.- III. Clinical features and management.- IV. Chemotherapy.- J. Calculous disease.- I. Incidence.- II. Aetiological classification.- III. Regional classification.- IV. Management of calculus cases.- K. Neoplastic disease.- I. Neoplasms in infancy and childhood.- II. The kidney.- III. The adrenal gland and retro-peritoneal space.- IV. The bladder.- V. The prostate and urethra.- VI. The penis and scrotum.- VII. The epididymis and spermatic cord.- VIII. The testicle.- IX. The ovary.- X. The vagina and uterus.- L. Hypertension.- I. General observations.- II. Renal hypertension.- M. Renal failure and allied disorders.- I. Acute renal failure.- II. Chronic renal failure.- III. Renal vascular disorders.- IV. Polyuria and the renal tubular disorders.- V. Haematuria and nephritis.- N. The male genital tract.- I. Congenital abnormalities of the penis.- II. Phimosis and paraphimosis.- III. Skin lesions.- IV. Meatal ulcer and stenosis.- V. Genital tract infections.- VI. Urethral injuries, stricture and fistula.- 1. Anterior urethral injuries.- 2. Posterior urethral injuries.- 3. Urethral stricture.- 4. Urethral fistula.- VII. Priapism.- VIII. Undescended testicles.- IX. Other testicular anomalies.- X. Hydrocele.- XI. Varicocele.- XII. Torsion of the spermatic cord and of the testicular appendages.- XIII. Scrotal oedema and gangrene.- O. The female genital tract and urethra.- I. The clitoris and labia.- II. The external urinary meatus.- III. Urethral prolapse.- IV. Urethro-trigonitis.- V. Vulvo-vaginitis.- VI. Urethral injuries and fistulae.- VII. Hydrocolpos and haematocolpos.- VIII. Congenital absence of the vagina.- P. Intersex states and endocrine disorders.- I. Normal development.- II. Female pseudohermaphroditism.- III. Male pseudohermaphroditism.- IV. True hermaphroditism.- V. The practical approach to intersex.- VI. Gonadal agenesis.- VII. Hypogonadism in the male.- VIII. Sexual precocity.- References.- Author Index.
