An 8-year-old girl with recurrent urinary tract infections undergoes evaluation. Her history is notable for urinary frequency, urgency, and urge incontinence. On physical exam, she is noted to squat on her heel when she feels the urge to urinate. What is this classic sign called?
A 6-month-old infant is diagnosed with grade III vesicoureteral reflux (VUR) after a febrile urinary tract infection. The parents inquire about management and the possibility of surgery. In the modern management of VUR, what is the primary goal of medical therapy (observation with or without antimicrobial prophylaxis)?
A 3-month-old boy presents with a large, non-tender, fluid-filled mass in his left scrotum that has been present since birth and does not change in size. The mass transilluminates and the testis is palpable and normal. What is the most appropriate management for this condition?
A 6-year-old boy is brought for evaluation of a poor urinary stream. The physical exam is notable for a palpable, walnut-sized mass above the pubic symphysis when his bladder is full. A voiding cystourethrogram is performed. Which of the following conditions is the most common cause of severe obstructive uropathy in children?
A 6-year-old boy presents for repair of a midpenile hypospadias. The parents want to know the ideal timing for the surgery and potential complications. Which of the following is the most common complication following hypospadias repair?
An 18-month-old girl presents with her first febrile urinary tract infection. A renal and bladder ultrasound is performed, which shows grade 3 hydronephrosis on the left. According to the American Academy of Pediatrics guidelines, what is the next recommended imaging study?
A 6-year-old boy with a history of recurrent urinary tract infections is diagnosed with Hinman syndrome (nonneurogenic neurogenic bladder). Which of the following findings is most characteristic of this disorder on a voiding cystourethrogram?
A 12-year-old male with a history of posterior urethral valve ablation presents with enuresis and a palpable bladder after voiding. A urodynamic study is performed and demonstrates high intravesical pressures and poor bladder compliance. Which of the following complications is this patient at significant risk for, even in the absence of infection?
A 3-year-old girl is found to have grade IV vesicoureteral reflux (VUR) on a voiding cystourethrogram performed for a febrile urinary tract infection. Her parents ask about the likelihood of spontaneous resolution. Which factor is associated with a higher rate of spontaneous resolution for grade III-V VUR?
A 2-week-old male infant who was diagnosed prenatally with bilateral severe hydronephrosis undergoes a postnatal ultrasound that confirms the findings. His serum creatinine is 1.2 mg/dL. A voiding cystourethrogram reveals posterior urethral valves. After placing a small feeding tube for bladder drainage, his creatinine remains elevated at 1.1 mg/dL after 48 hours. What is the most appropriate next step in management?
