Congenital anomalies of

the Urinary tract

Subdivisi Urologi FK USU RSUP H Adam Malik Medan
 Upper Urinary Tract

 Lower Urinary Tract

 Male Genital anomalies

 Cloaca Dysgenesis
 The Prepuce : Phimosis

 Physiologic phimosis : in ability to retract the

foreskin because natural adhesion exist between the
prepuce and the glans

 Phatologic phimosis, occur when the foreskin

cannot be retracted after it has been previously
retractable
 The easest way to
differentiated
 Gentle proximal traction of the foreskin. Physiologic
phimosis : foreskin lay flat against the glans penis and
effaces or thin no treatment

 Phatologic phimosis : there is thickened , rolled age, do to

scaring and information. Balloning of the foreskin during
voiding is often associated with true phimosis
circumsision
Phatologic
phimosis
Phatologic
phimosis
 Paraphimosis

 The painful swelling of the foreskin distal to a

phimotic ring.

 The foreskin has been retracted and cannot then be

brought back over the glans penis

 The foreskin has been retracted for the placement of

catheter
Paraphimosis
 Manual
reduction
manipulations
 Hypospadia

Three anatomical anomalies :

 an abnormal ventral opening of the urethral meatus

 ventral curvature (chordee) of the penis

 a hooded foreskin, which is deficient ventrally

However, not all three of these features are present in

every case
 Intersex and associated
anomalies
 Disorder of Sex Development / DSD

 Cryptorchidism

 Persistent prostatic utricle

 Abnormalities of the urinary tract are unusual

Classification
based on position of meatus
 Management

 three specific components to the surgical correction

of hypospadias

1. correction of the penile chordee

2. reconstruction of the urethra (urethroplasty)

3. skin coverage of the penis aimed at achieving a

normal cosmetic appearance
One stage VS two stage repair
 Cryptorchidism
or
Undescended Testis / UDT
 Management :
surgery vs laparoscopy
 Upper urinary tract

1. Abnormalities of the kidney position & number

1. Simple ectopia
2. Thoracic ectopia
3. Crossed ectopia & fusion (Bauer)
4. Horseshoe kidney
5. Bilateral renal agenesis
6. Unilateral renal agenesis
7. Supernumerary kidney
2. Cystic abnormalities of the kidney (Glassberg)
1. Autosomal dominant polycystic kidney disease
2. Autosomal recessive polycystic kidney disease
3. Medullary sponge kidney (tubular ectasia)
4. Medullary cystic disease (juvenile
nephronophtisis)
5. Unilateral multicyctic dysplastic kidney
3. Collecting system abnormalities (Bauer)
1. Calyceal diverticulum
2. Hydrocalycosis
3. Megacalycosis
4. Infundibulopelvic stenosis
5. Ureteropelvic junction obstruction (UPJO)
4. Ureteral abnormalities
1. Duplication of ureter
2. Atresia
3. Mega-ureter
4. Vesicoureteral reflux
5. Ureteral ectopia
6. Ureterocele
 Lower urinary tract

1. Extrophy & epispadia

2. Urachus
3. Posterior Urethral Valves (Type I)
4. Megalourethra
5. Miscellaneous