Pediatric Urology

A 3-month-old boy presents with persistent non-retractile foreskin and ballooning with urination but no infections. Best management?

A newborn with ambiguous genitalia, hyponatremia, hyperkalemia, and virilized female phenotype. Initial life-saving step?

A 6-year-old boy has bedwetting ≥4 nights/week, normal exam, no daytime symptoms, normal UA. First-line therapy?

Absolute contraindication to neonatal circumcision?

A 2-day-old male has classic bladder exstrophy with exposed bladder mucosa. Immediate bedside management?

A 7-year-old girl has continuous dribbling incontinence since toilet training, otherwise dry at night; UA normal. Most likely cause?

Antenatal ultrasound shows unilateral hydronephrosis with AP renal pelvic diameter 18 mm at 32 weeks; newborn is stable. Next step?

A 2-year-old boy with febrile UTI. Which imaging is most appropriate first?

A 10-year-old presents with sudden scrotal pain; exam shows high-riding testis, absent cremasteric reflex. Best next step?

Newborn boy with severe respiratory distress, distended abdomen, poor urine stream, and dribbling; ultrasound shows bilateral hydronephrosis and thick-walled bladder. Likely diagnosis?

Initial management of posterior urethral valves in unstable neonate?

A 3-year-old boy has nonpalpable undescended testis; best timing of orchiopexy?

Retractile testis in a 5-year-old: management?

Classic “blue dot” sign with localized tenderness at upper pole of testis in child suggests:

A 1-month-old with antenatal hydronephrosis has postnatal ultrasound showing SFU grade 3 hydronephrosis; next best test to assess drainage and function?

Indication for pyeloplasty in UPJ obstruction includes:

A 4-year-old girl with daytime urgency, frequency, constipation, and recurrent afebrile UTIs; most important initial intervention?

A 6-year-old boy has scrotal swelling that transilluminates, larger in the evening; no tenderness. Likely diagnosis?

Optimal management of communicating hydrocele in a 2-year-old?

Classic duplex system with ureterocele from upper pole moiety presents with:

In a toilet-trained girl with continuous incontinence and normal voiding pattern, best imaging to confirm ectopic ureter?

Which VUR grade is most likely to resolve spontaneously?

Evidence-based indication for antibiotic prophylaxis in VUR includes:

A 9-year-old boy with left-sided varicocele; testicular asymmetry >20% on ultrasound. Management?

Most common pediatric renal malignancy?

Feature favoring neuroblastoma over Wilms tumor?

A 12-year-old boy with new left scrotal “bag of worms” worse standing; next best test?

Prune belly syndrome triad includes:

Child with gross hematuria post-URI, RBC casts, hypertension, edema. Most likely cause?

First-line test for microscopic hematuria in an otherwise well child with normal exam?

A 5-year-old boy with balanitis xerotica obliterans (lichen sclerosus) and phimosis. Best management?

In girls with recurrent febrile UTIs and normal RBUS, when is VCUG indicated?

Primary nocturnal enuresis with normal daytime bladder function: most effective short-term pharmacologic option for special occasions?

A 1-day-old male with bilateral non-palpable gonads and hypospadias. Immediate priority evaluation?

Urachal remnant presenting with umbilical discharge in a toddler. Best initial imaging?

Posterior urethral valves definitive treatment after stabilization?

A 9-year-old girl with vulvar itching, dysuria, and urine negative for infection; underwear with poor hygiene. Likely cause?

Best test to differentiate obstructive megaureter from refluxing megaureter?

Timing of hypospadias repair in otherwise healthy infant?

A 14-year-old boy has right lower quadrant pain, dysuria, and scrotal pain; Doppler shows normal intratesticular flow with hyperemia of epididymis. Likely diagnosis?

Which study best detects renal cortical scarring after recurrent febrile UTIs in children?

Horseshoe kidney in children is most commonly associated with which urologic issue?

Preferred urine collection for diagnosing UTI in a non–toilet-trained febrile infant?

Circumcision decreases UTI risk most in which group?

Newborn with myelomeningocele: foundational initial bladder strategy?

A 9-year-old with primary monosymptomatic nocturnal enuresis uses desmopressin for camp; key counseling?

In primary vesicoureteral reflux, which factor predicts lower chance of spontaneous resolution?

A 7-year-old with recurrent febrile UTIs and Grade IV VUR despite prophylaxis; best next step?

A 5-year-old with UPJ obstruction has differential renal function 34% and obstructive drainage; management?

Hypospadias hallmark requiring foreskin preservation in newborn?

Which condition most commonly causes continuous incontinence in girls with otherwise normal voiding?

In a child with suspected Wilms tumor, which imaging is standard for staging the abdomen?

Post-streptococcal glomerulonephritis hematuria pattern is typically:

Which anomaly follows the Weigert–Meyer rule in duplex systems?

Optimal therapy for distal ureteral stone 6 mm in a 10-year-old with persistent colic despite analgesia?

The most common cause of pediatric epididymitis in prepubertal boys is:

A toilet-trained child with recurrent UTIs and constipation; first-line intervention?

Classic presentation of testicular tumor in adolescents is:

An 8-year-old with daytime urgency, frequency, no UTIs, small functional bladder capacity; best diagnosis?

After torsion detorsion, contralateral scrotal exploration and fixation are recommended because:

A 12-year-old with dysfunctional voiding exhibits which uroflow pattern?

Most appropriate imaging to confirm renal scarring years after reflux nephropathy?

A 4-year-old with phimosis shows scarring and whitening of preputial ring; likely diagnosis?

Management of paraphimosis in the ED initially includes:

In posterior urethral valves, the long-term renal risk is primarily due to:

A continent catheterizable channel (Mitrofanoff) is created using which structure most commonly?

Malone antegrade continence enema (MACE) is indicated for:

A neonate with bilateral hydronephrosis and oligohydramnios prenatally; postnatal respiratory distress and poor urine output. Likely diagnosis?

Best initial management of torsion of appendix testis in a child?

In a boy with VUR and recurrent infections despite prophylaxis, which modifiable factor must be addressed first?

Diagnostic hallmark of neuroblastoma on labs/imaging?

A 6-year-old with nonpalpable testis found intra-abdominal on laparoscopy; best management?

Child with primary megaureter and stable renal function, asymptomatic; management?

A 9-year-old girl has daytime leakage, holding maneuvers, and delayed voiding; best initial therapy?

When is VCUG indicated after the first febrile UTI?

A 13-year-old presents with right varicocele; which finding mandates evaluation for secondary causes?

In bladder exstrophy, long-term continence often requires which reconstructive principle?

A toddler with a single umbilical artery on prenatal scan should be screened for which issue?

Most likely cause of gross hematuria after minor trauma in a child with known solitary kidney?

Key counseling for families using enuresis alarms?

An infant with antenatal hydronephrosis has postnatal RBUS showing hydroureter and thickened, trabeculated bladder. Next best imaging?

A neonate with duplex system and ectopic ureterocele presents with urosepsis and obstruction. Initial intervention?

A child with primary monosymptomatic nocturnal enuresis became dry on alarm therapy but relapsed months later. Best next step?

In myelomeningocele, when should urodynamics be obtained to risk-stratify the bladder?

Hemodynamically stable child with gross hematuria after blunt flank trauma; preferred imaging?

Common adverse effects to counsel when starting oxybutynin for pediatric OAB?

Girl with continuous dribbling and duplex kidney: RBUS suggests duplex system; VCUG normal. Best imaging to localize ectopic ureter insertion while limiting radiation?

Infant with unilateral multicystic dysplastic kidney (MCDK), normal contralateral kidney. Management?

Severe proximal hypospadias with significant chordee: preferred surgical strategy?

Long-term risk of untreated cryptorchidism includes:

After ablation of posterior urethral valves, the child shows high-pressure bladder on UDS. Bladder protection strategy?

After a typical first febrile UTI with normal RBUS, what is the VCUG recommendation?

Adolescent boy with incidental testicular microlithiasis and no risk factors or symptoms. Best management?

Endoscopic injection material used for minimally invasive correction of primary VUR is:

Indication for circumcision in a school-aged boy includes:

A toddler with infected urachal cyst presents with umbilical erythema and drainage. Appropriate management?