Paediatric Urology

Urological conditions are the conditions affecting the organs of genitor-urinary system including kidneys, ureters, urethra, and reproductive organs. Urology conditions are more common in children and also a matter of concern. Because some children may not be able to explain their problems while some may feel embarrassed to discuss with their parents or physicians. Paediatric urologists may help solve your child’s problems as they are specially trained physicians to treat these conditions in children. 

Although there are several urologic problems affecting the children, the most common conditions include bed wetting and urinary tract infections. Some of the common urologic disorders that may trouble your child are discussed along with their signs and symptoms.

Urinary incontinence: It is commonly known as bed-wetting and it is the inability to control or hold the passage of urine. In children, urinary incontinence is called Enuresis. Urinary incontinence in some children may be a normal part of growing up and disappears naturally over time. However, if this does not resolve or the condition is bothersome, treatment is required to treat the underlying cause.  Children with urinary incontinence may have a sudden strong urge to urinate, frequent urination, bedwetting, daytime wetting, and anxiety and worry. Nocturnal enuresis or bedwetting is the involuntary release of urine when the child is sleeping. This condition occurs between the ages of five and ten years. Worry and anxiety are the major cause of bedwetting. Children with urinary incontinence are treated with medications and behavioral therapy that includes bladder training, kegel exercises and scheduled bathroom trips. However some children may have anatomic abnormalities and in these cases surgical treatment may be recommended.

Urinary tract infections: A urinary tract infection (UTI) is an infection within the urinary tract anywhere from kidneys through ureters, bladder, prostate (in men) and urethra. Young children with UTIs may have high fever, poor appetite, and irritability. Urinary tract infections (UTIs) are managed with antibiotic therapy administered either by mouth, IV or both depending on the type, age of child and severity of infection. Untreated UTIs in children increases their risk of kidney damage causing kidney scars, poor kidney function, poor kidney growth, and high blood pressure.

Vesicoureteral Reflux: Vesicoureteral reflux (VUR) is an abnormality where the urine flows backwards from the bladder into the ureters. The condition is more common in girls. It is caused when a child is born with an impaired valve located at the point where ureter joins the bladder, other anatomic abnormalities, or neural conditions such as spina bifida. A urinary tract infection is the most common indication of VUR. Other common symptoms include sudden and strong urge to urinate, burning pain during urination, frequent urination, blood in urine, cloudy or foul-smelling urine, fever, abdominal pain, poor growth, vomiting, diarrhea, lack of appetite, and lethargy. As the child gets older, child may develop bedwetting, high blood pressure, protein in the urine, and kidney failure. The treatment for primary VUR includes use of antibiotics for UTI. Surgery is considered for a child with severe VUR or VUR caused by anatomic abnormalities.

Undescended Testes: It is a condition in which one or both of the testes fail to descend from the abdomen into the scrotum. Usually the condition resolves over the time, and the undescended testicle moves into place by the age of six months. In some cases, if the testicle does not come down, surgery is needed to move it into the proper location.

Hypospadias: It is a birth (congenital) defect found in boys in which the urethra fails to grow to its complete length. The outlet for urine on the penis is located on the underside of the penis rather than on the tip of the penis. Males with this condition have malformed foreskin that makes the penis look hooded. Treatment includes surgery performed between the age of 6 and 9 months to reposition the opening of the urethra.

Hydroceles and hernias: A hydrocele is an accumulation of fluid around the testicles causing the scrotum to swell. This is caused due to non-closure of the tube through which the testicles descend into scrotum. This condition usually disappears after few months following birth. If the condition does not disappear, the child may develop hernia, where a section of the intestines runs through the still-opened pathway. If the child develops hernia minor surgery may be needed.

Consult your paediatric physician if you observe in your children or if your children complain of any of these symptoms.