Genitourinary System

The genitourinary system excretes waste products, helps maintain fluid and electrolyte balance, and is the basis for later normal sexual development. Anatomic malformations of this system may be numerous and include the kidneys, ureters, bladder, urethra, or external and internal genitalia. Normally, the fetus is able to urinate into the amniotic sac by 10 weeks gestation. Maternal oligohydramnios may indicate that this is not occurring, and suggests an obstruction of the fetal genitourinary system. Failure to urinate by 24 hours of age may indicate an anatomic or functional disorder in the neonate. Acute and chronic renal dysfunction must also be considered in infants with excessive or decreased urinary excretion. Imaging studies, including radiographs, contrast studies (e.g., intravenous pyelogram, voiding cystourethrogram), ultrasonography, or radionu-cleotide scan may be necessary to define disorders of this system. Analysis of the urine, including microscopic, biochemical and culture, may also be necessary to delineate some of these disorders. Finally, evaluation of ambiguous genitalia may require complex endocrine evaluation as well as chromosomal analysis.

Low Set Ears Infants

Figure 4.1. Frontal view of an infant with renal agenesis showing the typical Potter facies. The facies results from oligohydramnios causing prolonged intrauterine compression on the entire face. The nose is flattened, there are large vertical creases below the eyes, the ears are low set and dysplastic, and there is mild micrognathia.

Oligohydramnios Causes

Figure 4.2. Lateral view of another infant with renal agenesis causing the Potter facies. Note the flattening of the nose and the low-set ears. Pressure deformity from the oligohydramnios in these infants may cause limb deformities (congenital dislocation of the hips, genu recurvatum, talipes equinovarus). The oligohydramnios may result in pulmonary hypoplasia, and amnion nodosum may be present on the fetal surface of die placenta.

Figure 4.2. Lateral view of another infant with renal agenesis causing the Potter facies. Note the flattening of the nose and the low-set ears. Pressure deformity from the oligohydramnios in these infants may cause limb deformities (congenital dislocation of the hips, genu recurvatum, talipes equinovarus). The oligohydramnios may result in pulmonary hypoplasia, and amnion nodosum may be present on the fetal surface of die placenta.

Figure 4.3. This infant with sirenomelia ("mermaid fetus") has the typical Potter facies, as renal agenesis with resulting oligohydramnios is always present. Sirenomelia is characterized by fusion of all or part of the lower limbs and is a condition incompatible with life.

Figure 4.4. Fetal surface of the placenta showing amnion nodosum. Note the small nodules which occur as a result of the oligohydramnios. The nodules consist of vernix caseosa, lanugo, and squamous epidielial cells from the fetal skin. (Sotelo-Avila, C)

Figure 4.5. Abdominal distention with a large mass on the left side. This was a large multicystic kidney. Differential diagnosis of abdominal masses includes hydrometrocolpos, ovarian masses, sacrococcygeal ter-atoma, urinary tract abnormalities, and neuroblastoma.

Figure 4.6. Transillumination of the abdomen in the same infant as in Figure 4-5 shows a large cystic mass on the left side. Abdominal masses in the newborn are most commonly cystic radier than solid.

Figure 4.5. Abdominal distention with a large mass on the left side. This was a large multicystic kidney. Differential diagnosis of abdominal masses includes hydrometrocolpos, ovarian masses, sacrococcygeal ter-atoma, urinary tract abnormalities, and neuroblastoma.

Female Genitalia Deformity
Bacterial Vaginosis Facts

Bacterial Vaginosis Facts

This fact sheet is designed to provide you with information on Bacterial Vaginosis. Bacterial vaginosis is an abnormal vaginal condition that is characterized by vaginal discharge and results from an overgrowth of atypical bacteria in the vagina.

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Responses

  • Marina
    Is genitourinary system metabolic?
    15 days ago

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