What is paediatric urology?

Paediatric urology is a branch in urology that focuses specifically on children. Contrary to popular belief, children are not just small adults. They are unable to say what is bothering them, and cannot always answer medical questions. They are also not always able to be patient and cooperative during a medical examination.

If your child has an illness or disease related to the genitals or urinary tract, our team of urologists have the experience and qualifications required to accurately diagnose and treat your child, in a comfortable and non-threatening environment.

Risk factors associated with paediatric urinary tract infection

There are a number of things that increases the risk of your child developing a urinary tract infection. These factors include:

Abnormalities of the urinary tract This may include kidney stones and other urinary obstructions. Any problems that hinders or limits the kidney or bladder’s ability to eliminate urine properly can increase the risk of infections. These problems are either present at birth or may develop soon after.

Improper toilet training Failure to empty the bladder, infrequent urination and constipations are common during toilet training. These patterns make it easier for bacteria to build up in the urine.

An uncircumcised penis The foreskin can trap bacteria which enters the urinary tract and cause infections.

Catheterization is used in hospitals when a child is unable to urinate naturally. Bacteria can enter the catheter and cause an infection.

Previous urinary tract infections The risk for future infections increases with each additional infection.

Common paediatric urology conditions

The most common condition associated with paediatric urology is a urinary tract infection that occurs more frequently in girls than in boys. Other common conditions include:

• hernia – a protrusion of all or part of an organ or tissue through a weakened area
• hydrocele – an accumulation of fluid that can occur in the scrotal sac
• antenatal hydro nephrosis – a fluid-filled enlargement of the kidney prior to birth, typically diagnosed with prenatal ultrasound
• hydro nephrosis – swelling of the kidneys caused by obstruction in the urinary tract
• neurogenic bladder – a disorder resulting from interference in the normal nerve pathways that send signals to the bladder regarding urination
• spina bifida – a neural tube defect in which the tissue surrounding the spinal cord fails to close properly during foetal development
• hypospadias – a congenital condition, usually diagnosed during infancy, in which the opening of the urethra (the tube that carries urine from the body) is on the underside of the penis rather than at the tip
• nocturnal enuresis – bedwetting beyond the age at which a child would be expected to remain dry – believed to be caused by a developmental delay in the bladder and usually something the child outgrows
• ureter pelvic junction obstruction – blockage of the flow of urine in the area where the ureter meets the kidney
• vesicoureteral reflux – a condition in which urine from the bladder backs up into the ureter, often diagnosed during prenatal ultrasound or after a urinary tract infection
• undescended testes – a condition in which at least one testicle fails move into the scrotal sac as the male foetus develops (in most cases, this is resolved on its own in the first year of life)

When to seek medical attention for your child

Seek medical attention within 24 hours if your child:

• Has an unexplained fever
• Is vomiting
• Has urine that is pink, brown, red or foul-smelling
• Experiences a burning pain when urinating
• Has a frequent urge to urinate without being able to pass much urine
• Experience pains below the rib cage and above the waist on one or both sides of the back.
• Has vaginal discharge with urinary symptoms

It is not appropriate to “wait and see what happens” when you suspect that your child has a urinary tract infection. Untreated infections can lead to permanent damage of the kidney, high blood pressure and other serious complications.

Surgery

Paediatric urological diagnostic and treatments can be done with minimally invasive surgery. At West Coast Urology, we specialise in paediatric urological surgical techniques such as orchidopexy, pyeloplasty, hypospadias repair, circumcision, treatment of enuresis, vesicoureteric reflux surgery.

The benefits of minimally invasive urological surgery for our young patients are many, including:

• Fewer complications
• Reduced pain
• Reduced blood loss
• Less scarring
• Less damage to tissue and muscle
• Shorter stay in the hospital
• Quicker return to normal activities