Who are pediatric urologists and why do you need them

Any type of doctor with pediatric prefixed to their specialization means that they have medical training to treat children. But why would you need a particular kind of doctor for children? 

It’s because children’s bodies function differently from adults. They just can’t come to you for their medical issues, as they don’t know that they have a problem that needs medical care. They are also not very patient, so there goes your answer.

Now, as a next step, you might want to know

What type of medical care does a pediatric urologist offer your child? 

1. Till the age of 4, no one expects children to have their urine passage under their control, but as they get older some of the children still can’t control it. The medical term for it is ‘voiding disorder’ or incontinence.
2. A small percentage of children have a condition called vesicoureteral reflux (VUR). It’s a disorder wherein urine flows in the wrong direction, sometimes towards the kidney. It’s a congenital disorder, which means that it is a birth defect. There are muscular valves to prevent the urine from going back to the kidneys, but with this condition, the valves may be “leaky” and the bladder that stores the urine to be eliminated can’t empty normally.

Symptoms of VUR include

1. Fever with Urinary tract infection (UTI)
2. Children under 2 years having 2 or more occasions of fever and UTI

3. We just mentioned UTI, but what is it? And what are the symptoms to look out for?

A UTI is an infection in any part of a child’s urinary system. It may be an infection in the bladder or the kidneys

Bladder UTI: They may be annoying to the child suffering and may cause discomfort for him/her, but it’s usually not harmful to long-term health. Some of the symptoms are frequent urination or painful passing of urine

Kidney UTI: This condition is harmful, especially with the VUR condition. It’s because urine carries germs and due to VUR, the urine goes back to the kidneys where they cause infection. Watch out for symptoms like high fever, chills, back pain, and urinary problems. This kind of UTI can scar the kidneys and may cause high blood pressure or reduced kidney function. 

4. A pediatric urologist can also fix penis defects in baby boys. A condition called hypospadias leaves an opening in the underside of the natural opening through which urine passes called the meat us. In this condition, the penis may also have an abnormal bent called chordee. It causes sexual problems when they reach adulthood. 

5. A child’s urologist may also need to perform surgery for certain groin conditions in childhood and adolescence. Below are the groin issues for which surgical intervention may be required:

1. Before birth, the testicles that form inside the abdomen must fall into place in the bag of skin underneath the penis for normal sexual development, eventually. But sometimes, especially in the case of the premature birth of baby boys, one or both testicles don’t make it down to the scrotum before birth. 

In such cases, if the testicles don’t take their usual place before the age of 6 months, surgery is required.

1. The testicles that grow inside a baby boy’s abdomen before birth eventually travel down a tube to fall in their usual place, called the scrotum. But sometimes the tunnel doesn’t close, which leaves an opening from the belly into the tunnel where a piece of bowel or an ovary may get trapped. This condition is called an inguinal hernia. The surgery for the condition requires a small incision to be made near the bulge and the contents of the hernia are pushed back into the abdomen and the tunnel where the organs were exiting is closed.

6. A child’s urologist may also perform surgery for kidney stones and related diseases.

7. Kidney, bladder or testis tumors may develop in some children. In such cases, a biopsy of the tumor is needed to determine if it’s malignant or benign after that surgery to remove may be needed and if it comes out to be malignant than cancer treatment may be required.

Other treatments include:-

1. Phimosis (Circumcision)

Sometimes it may happen in the first few years of a baby boy’s life that the foreskin of the penis may be stuck to the head of the penis. It usually loosens up with time. But if the foreskin adheres to the penis head beyond that period, urination is difficult, or the child is in pain and his foreskin is inflamed. Then it’s time to see a doctor. If parents try to self-treat the condition and pull back the foreskin by themselves, it could form a ring that could restrict blood flow to the penis head. 

Such a case is treated either by using steroid creams to stretch the foreskin or in rare cases by a surgery called phimosis circumcision. The surgery is performed on the penis foreskin to partially or entirely remove it.

1. PUJ Obstruction (Pyeloplasty)

The kidney has 2 parts in it. 1st part filters the blood and the 2nd part stores urine before it’s discharged to the urinary bladder. The tube connecting the organs is called the pelvic ureteric junction. Sometimes it may occur in children such that the tube connection is too narrow, the condition is called PUJ obstruction. Such an obstruction

Causes pain during urination, repeated urine infections and damage to the affected kidney. But it could also be silent in terms of symptoms. 

PUJ obstruction could also occur due to blockage of the passageway between the kidney and bladder by a blood vessel that crosses the passageway. But it is far less common in children.

If symptoms of the obstruction show up, then an operational procedure is a must.

After administering general anesthesia to the patient, a laparoscope is inserted through small cuts in the abdomen the natural tube is removed and the kidney and the bladder are reattached. 

1. Small penis size in children

A penis is called micropenis in children if the penis size in a newborn baby boy is less than 0.75 inches. The most common cause of this condition is less secretion of certain hormones by the pituitary gland in the hypothalamus in the brain. The hormones from the gland stimulate the testicles to produce testosterone. If the hormone is not released then there is less testosterone causing a small penis size in children. The best treatment is hormone therapy but if it doesn’t work then the only option is to surgically reconstruct the penis, the surgery is called phalloplasty.