Pediatric Urology

Pediatric Urology and Symptoms

Malformations of the urinary tract: Bladder infections are the most common type of urinary tract infections (UTI) in children. Any other part of the child’s urinary tract can become infected including urethra, bladder, ureters, or kidneys. This is more common in girls. Bacteria found in bowels causes UTI in most children. The methods followed are Pyeloplasty, Hypospadias, Circumcision, Cryptorchidism.

SYMPTOMS

Pain and burning while urinating
Fever could be just a cause for an infection
Babies and young children may have different symptoms
Chills
Loss of appetite
Nausea
Vomiting
Lower abdominal pain
Lower back pain or discomfort
Change in frequency of urination
Change in color and smell of pee

Prevalence

Babies(0-2)
Children (2-18)

Diagnosis

Learn about the investigations and the diagnosis

Medical history is taken
Physical examination is done
Other tests to diagnose infections
Imaging tests may also be done.
Ultrasound

Treamment

● Antibiotics and drinking lots of water may help flush bacteria
● Better bathroom habits and avoiding constipation
● Pyeloplasty
● Hypospadias
● Circumcision
● Cryptorchidism

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Patient safety is our priority

Risks and complications

● Recurrent infections
● Kidney damage

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What's important after discharge?

● Encourage drinking plenty of fluids
● Good bathroom habits
● Prevent constipation
● Multivitamins: Vitamin C helps keep bacteria away
● No bubble baths
● Frequent diaper change
● Proper wiping for girls
● Cotton underwear
● Regular bathroom visits

As soon as you suspect your child has UTI, consult a pediatric urologist.
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PEDIATRIC UROLOGY

Cryptorchidism

Cryptorchidism and Symptoms

(Undescended Testicle) ---A testicle that has not moved into the bag of skin below the penis before birth.

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Prevalence of Cryptorchidism

More than 1 million cases per year in India are treated.
Treatable by a medical professional
Requires a medical diagnosis
Lab tests or imaging rarely required
Medium-term: resolves within months.

Diagnosis of Cryptorchidism

Learn about the investigations and the diagnosis

Laparoscopy-- A small tube containing a camera is inserted through a small incision in the abdomen. The doctor might be able to fix the undescended testicle during the same procedure. A surgery may be needed in some cases.
Open surgery-- Direct exploration of the abdomen or groin through a larger incision might be necessary in some cases
Imaging tests, such as an ultrasound and MRI, are not recommended
Tests of hormone levels

Treamment of Cryptorchidism

● An undescended testicle is usually treated with surgery
● The surgery done is known as orchiopexy
● The surgeon carefully manipulates the testicle into the scrotum and stitches it into place
● This procedure is done either by using a laparoscope or with open surgery
● Early surgical treatment can lower the risks of later complications
● Hormone treatment involves the injection of human chorionic gonadotropin (HCG)

Surgery
● The surgery of orchiopexy takes about 45 minutes, but recovery from anaesthesia might take several hours
● Orchiopexy is an outpatient surgery that will be done at a children’s hospital
● When general anaesthesia is needed, there are special rules for eating and drinking that has to be followed in hours before surgery
● During surgery the child will be given a numbing medication
● The surgeon makes a small incision in the groin and locates the testicle
● There is a hernia sac in this area that has to be repaired first
● A second incision is made in the scrotum to make a pocket under the skin to place the testicle into the scrotum
● At the end of the procedure, the surgeon will close both the incisions with dissolvable sutures

Results
● Orchiopexy, has a success rate of nearly 100%
● Fertility for males after surgery with a single undescended testicle is nearly normal but falls to 65% with two undescended testicles.
● Surgery might reduce the risk of testicular cancer but does not eliminate it.

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Patient safety is our priority

Instructions before surgery

● For children above 12 years, do not give any solid food or non-clear liquids like milk, formula, juices with pulp, coffee, chewing gum or candy
● For infants under 12 years, the baby can be fed with formula milk 6 hours before surgery
● In case of breast fed kids, they can be fed 4 hours before the procedure.

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What's important after discharge?

● Usually, the doctors use stitches that dissolve on their own in 3 or 4 weeks
● The incision will ooze fluid for 2 to 3 days, feeling better each day
● Mild moderate pain continues to remain for several days after surgery
● The dressing has to be kept dry and hence bath should be avoided for a week
● Follow-up with the doctor would be needed few months after surgery
● Please contact the doctor in case there is swelling, redness, oozing, or odour around the wound or fever above 99.5-degree F, or no relief from pain.

DO YOU HAVE QUESTIONS ABOUT CRYPTORCHIDISM?
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