Everything You Should Know About Pediatric Urology

September 10,2020 |

Urology is a branch of medicine that focuses on diagnosing, treating, and caring for the urinary tract system of males and females, along with the male reproductive system. While urologic problems are more common in older adults or people with underlying conditions, they can still affect children. When this happens, it’s referred to as pediatric urology and requires a urologist specialized in childrenĀ­. Pediatric urologists are urologists with special skills to care for patients from birth into their teenage years. They have a comprehensive understanding about how underdeveloped systems work and have a strong grasp on how to talk to young children or teens about problems they’re plagued with. In order to better care for your children and understand any urologic warning signs, here’s everything you should know about pediatric urology.

Pediatric Urologist Training

A urologist is considered pediatric when they devote at least 75% of their practice to diagnosing, treating, and caring for the urologic problems that plague infants, children, or young adolescents.1 The primary differences between a urologist and a pediatric urologist is the additional fellowship training that’s required. Pediatric urologists are required to complete:1

  • At least 4 years of medical school
  • One to 2 years of surgical residency
  • At least 4 additional years of residency training in general urology
  • One to 3 years of fellowship training in pediatric urology

This isn’t to say that pediatric urologists are more qualified than adult urologists, they just have a different specialization. Many urologists go on to specialize in one area or another, whether it be pediatrics, urology surgery, urology oncology, reconstructive urologic surgery, urogynecology, and more. Talk to your pediatrician about where you can find a reputable pediatric urologist if your child is showing any symptoms of common urologic problems or pediatric-specific urologic problems like bedwetting or undescended testicles.

Common Pediatric Urology Health Issues

Pediatric urologists treat a number of different health issues that affect children, but they are also knowledgeable in problems that affect adults. Children of all ages can experience urologic problems and since it can be difficult for them to communicate what they’re experiencing, it’s important to understand the warning signs and what to look out for.

Bedwetting

While it’s normal for children to wet the bed every once in a while, especially during potty training and while their bladders continue to develop, it shouldn’t become the norm. Bladder control will take some time to develop, but if you notice your child consistently wetting the bed at 5 or 6 years old, it might be a sign of urinary incontinence. Again, this doesn’t mean the occasional slip up—bedwetting can be triggered by stress or anxiety. Signs of problems are when they’re older and are wetting the bed more often than not. It can be frustrating, but it might be a sign of an underlying condition. Bedwetting is more common in boys than in girls and can be a sign of an underlying problem such as a UTI.2 Talk to a pediatric urologist to understand what’s going on and figure out a treatment plan.

Urinary Tract Infection

When we think of urinary tract infections, we don’t often associate them with children. However, bacteria are not biased and UTIs can affect anyone. While UTIs are more common in girls, boys can still get them. They occur when germs or bacteria get into the urethra and aren’t flushed out during urination. Bedwetting can be a sign of a UTI along with pain or burning while urinating, a general ill feeling, cloudy or bloody urine, foul smelling urine, or the frequent need to urinate. These can be more difficult to catch in children, as they might not express problems to their parents, so try to stay observant and encourage an open line of communication. 

Undescended Testicles

About 3 or 4 out of 100 newborn boys and up to 21 out of 100 premature newborn boys experience undescended testicles.2 This is a condition where the testicles do not drop on their own after a few months. In normal conditions, the testes will drop into the scrotum near the end of pregnancy or once their hormones are stabilized a few months after birth. In the case of undescended testicles, the teste doesn’t fall into the scrotum and instead remains in the abdominal wall. The cause for undescended testicles isn’t completely understood, but it is problematic and requires care from a pediatric urologist.

Vesicoureteral Reflux (VUR)

Vesicoureteral reflux (VUR) is a health problem where urine travels backward from the bladder toward the kidney instead of through the ureters and out of the body.2 It occurs in about 10% of health children, 75% of which are girls.2 VUR can increase your child’s chance of developing a UTI or other complications. Some children are born with it and the cause is unknown where other occurrences seem to be random or affected by genetics. The sole symptom of VUR is a UTI or kidney infection, so it’s important to watch out for early warning signs. There are tests available for VUR and treatment plans to help reverse the urine stream. To learn more about vesicoureteral reflux in children, click here.

Hernias

Hernias occur when an organ pushes through an opening of muscle or tissue that encompasses it. Many adults have experienced a hernia at some point or another and know that it’s often painful and frustrating to deal with. However, hernias can occur at any age. Newborns experience them more often than toddlers or teenagers and they require treatment to avoid serious problems. Since communication is difficult, if not impossible, at this age, it’s important to keep your age out for any bulges that either come and go or increase in size during strain or when your child is crying. If you notice any signs or symptoms of a hernia in your child, see a pediatric urologist as soon as possible. 

Prenatal Hydronephrosis

Sometimes, the backup of urine can cause a swelling in your kidneys called prenatal hydronephrosis.2 This is a condition that occurs during pregnancy and can be identified and diagnosed with an ultrasound. It can be caused by a few different things and is one of the most common abnormalities that doctors find on an ultrasound. It usually resolves itself on its own and doesn’t cause any problems, but there are treatment options if needed. Your OBGYN will monitor prenatal hydronephrosis during pregnancy and if you notice any problems after delivery, you’ll be referred to a pediatric urologist.

Kidney Stones

Kidney stones are small, pebble-like stones that are created due to the build-up and calcification of certain minerals in your urine. Overtime, this can create small to large stones that are painful to pass. Kidney stones can affect anyone, even young children, and sometimes need to be addressed by a pediatric urologist. If you notice any symptoms of kidney stones in your child, contact your doctor to learn about how you can help. If the stones are too big to pass naturally or are causing intense pain, lithotripsy can be performed. Lithotripsy is a treatment that uses shock waves to help break up kidney stones so they’re more manageable and can be passed without surgery. In severe cases, surgery might be required.

Urinary Tract or Genital Development

In some children, the urinary tract system or male genitals don’t develop properly. When this happens, it’s important to work with a pediatric urologist to determine any underlying causes and treatment options to encourage proper development. These are often considered birth defects and can cause problems in your child’s health if left untreated. Depending on the development issue, surgery, catheterization, or medications can be used to correct problems or minimalize any further complications. Some common urinary tract or genital development problems include bladder exstrophy, epispadias, cloacal exstrophy, hydronephrosis, hypospadias, kidney dysplasia, polycystic kidney disease, renal agenesis, and more. To read about urinary tract or genital defects, click here.

Conclusion

If you notice any signs or symptoms of urologic problems in your child, call your doctor immediately. All pediatric urology problems require a proper diagnosis to ensure that the correct treatment is being administered. It’s nearly impossible to see your child in pain, so getting treatment fast is important. If you need any urological supplies or additional educational resources, visit our educational support page or our product selection guide. Byram Healthcare is proud to offer full-service urological care and we have all the high-quality urological supplies that you need. If you need to order any urological supplies, all of your orders can be discreetly delivered to your home, at any time of the day. If you have any urological questions or need personalized, confidential services, our teams of knowledgeable urological customer service specialists are here to help. 

Sources:

1 https://www.healthychildren.org/English/family-life/health-management/pediatric-specialists/Pages/What-is-a-Pediatric-Urologist.aspx

2 https://www.urologyhealth.org/patient-magazine/magazine-archives/2016/spring-2016/did-you-know-pediatric-urology-101

 

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