Pediatric Surgery Genito-Urinary Services

Treatment/procedure options:

Managing ambiguous genitalia typically involves a multidisciplinary team approach, including pediatric endocrinologists, geneticists, urologists, and psychologists. The treatment and management strategies are tailored to each child and may include:

• Diagnostic evaluations: These can include chromosome analysis, hormone level tests, ultrasound exams, and sometimes more advanced imaging to understand the underlying cause and to help guide management decisions.
• Psychosocial support: It's crucial for the family and, eventually, the individual to receive psychological support and counseling to navigate the complexities associated with DSD.
• Medical management: In some cases, hormone therapy may be recommended to support development in line with the identified gender of rearing.
• Surgical intervention: Decisions about surgery are highly individual and depend on various factors, including the child's health and the family's preferences. Surgical options might aim to reconstruct the genitalia to align more closely with the gender of rearing. Such decisions are sensitive and involve thorough discussions about the potential risks and benefits, timing, and the child’s right to participate in decision-making about their body as they are able.

Treatment/procedure options:

If epididymitis progresses to form an abscess (a collection of pus), surgical drainage may be necessary.

Treatment/procedure options:

Surgical repair is the standard treatment for inguinal hernias to prevent the risk of strangulation (cutting off the blood supply to the protruded intestine), which is a medical emergency. The surgery, called herniotomy or herniorrhaphy, involves pushing the protruded intestine back into the abdomen and reinforcing the weakened area of the abdominal wall. This procedure is typically performed using minimally invasive techniques, especially in older children, and is highly successful with a low risk of complications.

Treatment/procedure options:

Many hydroceles in infants resolve without treatment during the first year of life as the body absorbs the fluid. Regular check-ups may be recommended to monitor the hydrocele's size. Surgical treatment, known as hydrocelectomy, may be necessary if the hydrocele persists beyond the first year, becomes very large, or causes discomfort. The surgery involves removing the fluid and closing or removing part of the sac to prevent fluid from accumulating again.

Treatment/procedure options:

Treatments/Procedures: Treatment for orchitis depends on the underlying cause:

• For viral orchitis, such as from mumps, treatment is primarily supportive and may include bed rest, ice packs to reduce swelling, elevation of the scrotum, and pain relievers like ibuprofen or acetaminophen to manage discomfort.
• For bacterial orchitis, antibiotics are prescribed based on the suspected or confirmed bacteria. This treatment is especially important if the orchitis is part of epididymo-orchitis to effectively clear the infection. Surgery may be necessary if an abscess develops.

Treatment/procedure options:

Immediate surgical intervention is required to untwist the spermatic cord and restore blood flow to the testicle. The sooner the surgery is performed, the better the chances of saving the affected testicle; ideally, surgery should occur within 6 hours of symptom onset to ensure the best outcomes. During the procedure, called orchiopexy, the surgeon will untwist the spermatic cord and may secure both testicles to prevent recurrence of torsion.

Treatment/procedure options:

Most cases can be managed conservatively with bed rest, scrotal elevation, and medications. In most cases, the symptoms of appendix testis torsion resolve as the body absorbs the necrotic tissue of the twisted appendix over time, usually within a week. Surgical intervention is rarely required but may be considered if the diagnosis is uncertain or if symptoms do not improve with conservative treatment. The goal of surgery would be to confirm the diagnosis, rule out testicular torsion, and possibly remove the necrotic appendix to relieve symptoms.

Treatment/procedure options:

If the testicle does not descend on its own, surgery is usually recommended, typically around 6 to 18 months of age. Orchiopexy involves relocating the testicle to the scrotum and securing it in place. This procedure is highly successful and can be performed with minimal complications.

Treatment/procedure options:

Treatment includes antibiotics for infection and surgical removal of the urachus, often done laparoscopically.