History & Physical Examination in Pediatric Urology
A child is not a small adult, and the paediatric urologic assessment reflects that.
The big picture
A child is not a small adult, and the paediatric urologic assessment reflects that: much of the "history" comes from before the child was born (antenatal scans, pregnancy events), the examination must be age-adapted and opportunistic, and the findings have to be interpreted against normal development (a non-retractile foreskin in an infant is normal, not pathological). The aim is to gather the right developmental and antenatal history and to examine a child without alarming them.
The framework: the paediatric history (antenatal, perinatal, developmental, family), and the age-adapted physical examination with its key normal-versus-abnormal distinctions.
Mechanism pathway
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Diagnostic algorithm
Each step answers one question. Tap to expand.
Board traps
A non-retractile foreskin is normal in infancy — do not forcibly retract.
Antenatal findings (hydronephrosis, oligohydramnios) are key history — posterior urethral valves present this way.
An abdominal mass in a child → think Wilms tumour (family history, Beckwith–Wiedemann).
Distinguish a truly undescended testis from a retractile one (a calm, warm exam helps).
Atypical genitalia → consider DSD and whether they match the sex of rearing.