Detection of congenital anomalies
The urology system is easily demonstrated sonographicaly even in utero.
The prenatal ultrasound era changed the approach and improved the outcome of various congenital urological anomalies.

Congenital anomalies diagnosed in adulthood
Not all pregnant women undergo prenatal US.
Some of the anomalies are missed – human error.
Most prenatal systematic scans performs around 17-22nd gestational week, however 20% of the hydronephrotic anomalies appears after the 24th week
UPJO,Ureterocele,Cryptorchidism,Hypospadias,Reflux


Adult UPJ Obstruction
The incidence of pediatric UPJO is well defined, affecting around 60-70% of all antenatally dilated systems.
The incidence of adult UPJ is not known.
Adult UPJ is not a rare finding.

Adult UPJ Obstruction presentation
Flank pain, back pain.
UTI/ Pyelonephritis
Hypertension (rare)
Asymptomatic Incidentally detected during evaluation of other symptoms

Adult UPJ Obstruction management options
Nephrectomy.
Reconstructive surgery:
 Open surgery / Laparoscopic / Robotic
 Endoscopic
  Direct incision
      antegrade/retrograde;
      cold knife/electrocautery/laser
  Acucise balloon dilatation and cutting.

Adult cryptorchidism
factors affecting management
Endocrine function.
Fertility.
Risk of malignancy.

The majority of cryptorchid testes cannot contribute to fertility.
Orchidopexy is not the best treatment for postpubertal cryptorchid patients....

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