Pediatric Nursing Demystified

Urinary Tract Congenital Anomalies

What Went Wrong?

Urinary tract congenital anomalies consist of abnormal ureter, bladder or

urethra whose cause is unknown. The most common urinary tract congenital

anomalies are

Duplicated ureter:Either a complete duplication of the ureter or incom-

plete duplication where two duplicate ureters are joined together prior to

entering the bladder.

Ureter stenosis:Narrowing of the ureter.

Exstrophy bladder:The bladder is inside out and exposed on the out-

side of the abdomen.

Ureterocele:The ureter balloons into the bladder to form a pouch.

Hypospadia:Abnormal position of the urinary meatus in boys.

Signs and Symptoms

Signs and symptoms depend on the nature of the anomaly but might

include

• Fever


• Chills


• Reduced urine output


• Flank pain


• Burning on urination


• Recurrent infection


• Abnormal voiding pattern


• Dark color urine

Test Results

Urography: Shows anomaly

Retrograde pyelography: Shows anomaly

Cystoureterography: Shows anomaly

Treatment

Administer antibiotic if there is a bacterial infection.

Surgical repair of the anomaly.

Nursing Intervention

Daily weights.

Strict intake and output.

Insert indwelling urinary catheter if ordered.

Cover the exposed area (i.e., exstrophy bladder) with sterile saline

dressing.

Teach the family how to care for the child at home.

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CHAPTER 12/ Genitourinary Conditions^263