Paediatric Urology

Pediatric Urology deals with disorders of the Genitourinary System in children, that include the kidneys, ureters, bladder, sexual and reproductive organs. Pediatric urological disorders are present in children from birth and are very different from that of adult urological problems.

A wide range of urologic problems affects children.

They include -:

• Disorders of the Kidneys – like cysts and tumors of the kidney, Infections like after Renal abscess Hydronephrosis etc.
• Disorders of the Ureter - like Pelviureteric junction obstruction,Vesicoureteric junction obstruction, Vesicoureteral reflux, etc
• Disorders of the bladder – like neurogenic bladder, Bladder Exstrophy etc
• Disorders of the urethra – like phimosis, Posterior Urethral valve, hypospadias, epispadias etc
• Disorders of the Genitalia – like undescended testis, intersex, imperforate hymen.
• Tumors of the kidney – like Wilm’s tumor etc.

Nowadays, with advanced imaging, a number of urological problems can be managed successfully by careful observation, thus delaying or even avoiding the surgery completely. Advances in technology and instrumentation have made more and more Laparoscopic and Endoscopic urological surgeries possible in children, eliminating many problems associated with open surgery. It is performed with great expertise, precision and care, considering the fact that the patient being operated on is a small child. The management of urological problems, if any, in a child can be planned even before the delivery of a child.

Interesting case

7 year old female child presented with fever and pain and Lower abdomen. She was evaluated and USG KUB showed multiple bladder calculi within a ureterocoele. A Ureterocoele is an congenital abnormality where the distal end of the ureter becomes dilated and forms a pouch like structure. This usually causes blockage in the ureters and causes back pressure and damage to the kidney.

CT urogram confirmed the diagnosis and so the child underwent surgery - the ureterocoele was opened and the stones were released and the ureteroele was excised. The left ureter was disconnected from the bladder and reimplanted.