PEDIATRICS Vol. 57 No. 6 June 1976, pp. 971-974
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Current Trends in Pediatric Urology

John R. Woodard M.D., F.A.A.P., A. Barry Belman M.D., F.A.A.P., and Harry C. Miller M.D., F.A.A.P.

With 29 papers presented before the Urology Section (Washington, D. C., October 18 to 23, 1975), the annual meeting of the American Academy of Pediatrics is rapidly becoming the major forum for pediatric urology in this country. The content of this year's papers highlights much of what is current in this growing subspecialty. The topics discussed largely fell into three major categories, i.e., genitourinary anomalies, problems relating to or resulting from obstructive uropathy, and genitourinary neoplasms.

ANOMALIES OF THE GENITOURINARY TRACT

Hypospadias and cryptorchidism are two of the most common genital anomalies. Following his excellent movie on embryology of the male external genitalia, C. J. Devine presented a series of 200 consecutive patients with hypospadias surveyed for associated anomalies. Over one fourth of these patients had other birth defects, some multiple. Hernia, hydrocele, and cryptorchism were commonly associated anomalies. Of particular importance, he found that 16 of 160 (10%) of the patients so examined had abnormal excretory urograms (IVP). Over one half of the pyelographic abnormalities were surgical lesions such as hydronephrosis and vesicoureteral reflux. On the basis of this extensive experience Dr. Devine recommended that all patients with hypospadias undergo excretory urography.

In managing the child with no palpable testes, S. D. Levitt and his associates pointed out that bilateral cryptorchism is much more common than anorchia but that surgical exploration, unless extensive, has not proven completely reliable in making the differentiation. They proposed a test whereby the presence of a functioning testis might be determined prior to exploratory surgery, thereby possibly avoiding the need for such surgery.