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Pediatric urology

Specializing in urological issues in children

Pediatric urology is a surgical subspecialty of medicine dealing with the disorders of children's genitourinary (urinary and reproductive) systems. Via Christi’s pediatric urologists know how important the health of your child is. They provide care for both boys and girls ranging from birth to early adult age.

The most common problems are those involving disorders of urination, reproductive organs and testes.

Antenatal hydronephrosis

During an ultrasound evaluation during pregnancy, the fetal kidney can be assessed. Hydronephrosis is when the fetal kidney becomes dialated due to excessive urine production and/or impairment to drainage. This may resolve after birth or it may result in deterioration of the renal function. Your urologist can help assess the best treatment for this condition.

Bladder control – bedwetting and daytime urinary incontinence

Most children gain control of urine at night by 4 to 5 years of age, but bedwetting may still occur in 15 percent of children by age six years. This may occur from a variety of reasons including increased production of urine while asleep, maturational lag and unstable bladder contractions. The evaluation of bedwetting or nocturnal enuresis is relatively simple and there are a variety of treatments available, including medicine, behavioral management or non-invasive procedures.

Circumcision/incomplete circumcision

Circumcision is a commonly performed procedure in the newborn period, most often done by the obstetrician before discharge from hospital. However, many newborns may go uncircumcised for a variety of reasons - newborn illness, prematurity or voluntarily by parental choice. The parents may opt for circumcision subsequent to the newborn being discharged from the hospital.

Occasionally a child or adult may require circumcision repair or even a first-time circumcision. This is best accomplished via ambulatory or same day surgery under general anesthesia.  This allows an appropriate amount of foreskin to be removed and offers the best functional and cosmetic result in a pain-free fashion.

Undescended testis

This is a common abnormality seen in 1-3 percent of newborn boys. During fetal development, the testis develop inside the abdominal cavity and should move through the lower abdominal wall (inguinal canal) and into the scrotal sac. It is unknown exactly what causes an arrest of this descent, but the surgical intervention is commonly performed to correct this problem.

Ureteropelvic junction obstruction

Bladder and kidney stones

Genitourinary malformations and birth defects

While uncommon, there are a number of genital abnormalities that a child can be born with. If you suspect a problem, consult your physician.

Pediatric urological conditions are usually congenital and treated at a young age. Some conditions are diagnosed during prenatal ultrasound or during infancy. Similar to adult care, pediatric urological exams begin with a medical history and physical examination. A history of symptoms, illnesses, injuries, medications, prenatal ultrasound and family history are documented. A urinary catheter may be inserted into the bladder through the urethra to withdraw urine.

Diagnosis

Types of diagnostic exams for pediatric urological issues may include:

  • Blood tests
  • Cystometrogram, which measures bladder pressure at various stages of filling
  • Cystoscopy, which is an examination of the bladder and ureter
  • Intravenous pyelogram, which is a series of X-rays of the ureter and renal pelvis taken after injecting a contrast agent
  • Magnetic resonance imaging (MRI scan)
  • Renal scan
  • Ultrasound, often used to detect blockage in the urinary tract
  • Urinalysis and urine culture to detect urinary tract infections
  • Urodynamic studies, which measure the storage and rate of movement of urine from the bladder
  • Uroflowmetry, which measures urine flow
  • Voiding cystourethrogram, used to observe the urinary tract before, during and after urination  

Treatment

Treatment of pediatric urological issues varies depending on the condition. The most common treatment options include:

  • Behavioral modification
  • Hormonal therapy
  • Medication and antibiotics
  • Surgery and reconstruction

With children, it is critically important to continue to monitor and follow up on urological conditions, as their bodies are constantly changing.