Pediatric Urology Services
In pediatric urology we concentrate on diseases or illnesses of the urinary tract (urethra, bladder, ureters, and kidneys) and genitals in children. A subspecialty focuses on the unique birth defects in infants, children and adolescents. Additionally, some urologic problems occur while your child is in the uterus and require immediate attention post-birth.
Areas of pediatric urology include:
General Urinary Conditions
Kidneys, ureters, bladder and urethra comprise the urinary system (urinary tract). Its main function is to remove urine from the body and to maintain a proper balance of bodily chemicals to water. The urination sequence begins with kidneys filtering of blood, which pass the urine via the ureter to the bladder. Urine is then released through the urethra.
Urinary Tract Infections (UTIs). Infection of the bladder, ureter, urethra, and sometimes the kidneys by microbes (usually bacteria). Two percent of boys and eight percent of girls will get a UTI. Most of these infections are not serious, but younger kids will have an increased risk of kidney damage from them. Treatment is most always with antibiotics.
Below are some kidney conditions seen in children that might need treatment. From prenatal through childhood, the kidney are easily inspected with ultrasound.
- Kidney Dysplasia. Cysts growing within one/ both kidneys while in the womb. Detectable with ultrasound. Replacement of 1 or 2 entire kidneys by cysts is possible in some cases. The survival of the baby can be endangered in severe cases when both kidneys are affected. Dialysis and kidney transplant following birth may be required.
- Hydronephrosis. This refers to kidney collection system stretching and is diagnosed using ultrasound. Treatment may not be required. In some instances it may ultimately result in vesicoureteral reflux and/or blockage.
- Duplex Kidney. This is a pediatric condition where there are two ureters vs. one flowing from just one kidney. It can happen on 1 or 2 kidneys. Those with duplex kidney may also show a ureter that is enlarged due to blockage.
The bladder stores urine received from the kidneys. Upon urination, the urine is expelled via the urethra tube. Below are common voiding problems seen as problems in bladder emptying or filling.
- Urge Syndrome. Feeling the strong need to urinate frequently then followed by attempts to not urinate by holding the area of the crotch or squatting.
- Vesicoureteral Reflux (VUR). When the urine stored in the bladder backs up into the urinary tract (one or both ureters and sometimes into the kidneys). The condition can lead to kidney damage and may require surgery.
- Bedwetting. This is not normally a medical problem and children will outgrow it. Seek medical advice if this occurs more than twice a week after seven years of age.
- Daytime Wetting. This refers to minor leakage of urine up to large releases.
- Bladder Dysfunction. An impairment or abnormality in the method of bladder functions. More than one type may be seen in children and may include incontinence.
Genital and Reproductive Conditions
Children of both genders may need treatment genital issues below.
- Chordee. This is a birth defect manifesting itself in a downward bend in the penis during erection with possible pain that may impact sexual function as an adult. It is surgically treated before the age of two.
- Labial Adhesion or Fusion. A frequently seen birth defect when the inner lips of the vagina are fused together. In the USA, it affects only about two percent. Separation normally occurs naturally during infancy. If urine flow is restricted, medical treatment is indicated.
- Hydrocele. A sack filled with fluid around a male’s testicle causing his scrotum to swell. This normally goes away a few months after birth, however surgery may be required.
- Undescended Testicle. Testicle remains in fetus’ belly before birth and has not moved into scrotum. In most cases, this corrects itself within three months of birth.
- Hypospadias. When the opening of the urethra is somewhere other than the penis tip. It is seen during physical exam and seen in about one third of a percent in baby boys. Surgery may be required.
- Hernia. The protrusion of a portion of the intestine through a weakened area in the abdominal muscles. The muscles near the labia in females and the scrotum in males are the weak areas. They are very common and seen within first months or years following birth.
- Circumcision Revision/Correction. Surgery that is similar to original circumcision to remediate problems with the previous circumcision such as extra skin left, scar tissue, healing problems.
- Meatal Stenosis. This is seen in boys and refers to an abnormal urethra narrowing at the penis tip. It can be acquired or already exist at birth. Surgery to enlarge the opening is the normal treatment.
- Penoscrotal Webbing. Showing as a fold or web of skin at the attachment of penis to scrotum which obscures the penis shaft. Surgery is the remedy if needed to obviate adulthood complications.
- Testicular Torsion. One of the cords securing the testicle within the scrotum twists around a testicle. This cuts off the supply of blood to the testicle. This can be a surgical emergency.
- Varicoceles. Enlarged varicose veins in the scrotum. This is found in up to 15% of men and form during puberty. It is seen frequently in men with fertility problems in that lower sperm quality and decreased sperm production can result.