WhatsAppSurgical Treatment of Urinary System and Genital Organ Disorders in Children
The Academic Hospital Pediatric Urology Department provides the diagnosis and surgical treatment of congenital and acquired disorders of the kidneys, urinary tract, bladder and genital organs. The department cares for children of every age, from the newborn period through adolescence. Where required, work is coordinated with the nephrology, urology and pediatrics departments. Thanks to its laparoscopic and robotic surgery infrastructure, minimally invasive methods are applied as the first choice.
Contents
- What Is Pediatric Urology?
- Which Diseases and Conditions Are Treated?
- When Should You Consult Us?
- Diagnostic Methods
- Preoperative Assessment and Preparation
- Operations and Surgical Treatments Performed
- Postoperative Care and Follow-up
- Pediatric Urology at Academic Hospital
- Frequently Asked Questions
- References
What Is Pediatric Urology?
Pediatric urology is the surgical specialty that diagnoses and treats disorders of the kidneys, ureters, bladder, urethra and genital organs in patients aged 0 to 18 years. Unlike adult urology, congenital anomalies are at the forefront; for this reason the field requires close collaboration with pediatric anatomy, pediatric nephrology and pediatric anaesthesia.
Which Diseases and Conditions Are Treated?
The department covers the full range of urological problems seen in children, from congenital anomalies to acquired disorders of the urinary system.
- Hypospadias: a congenital condition in which the urinary opening is abnormally positioned on the underside of the penis
- Undescended testis (cryptorchidism): failure of one or both testicles to descend into the scrotum
- Phimosis: inability to retract the foreskin, leading to recurrent infection or difficulty passing urine
- Hydrocele: accumulation of fluid around the testicle, most often of congenital origin
- Vesicoureteral reflux (VUR): backflow of urine from the bladder to the kidney, predisposing to recurrent kidney infection
- Ureteropelvic junction obstruction (UPJ obstruction): narrowing at the point where urine passes from the kidney into the urinary tract, causing fluid accumulation in the kidney (hydronephrosis)
- Kidney stones in children: stone formation caused by dietary problems, metabolic disease or anatomical disorders
- Recurrent urinary tract infections: bladder and kidney infections that recur for anatomical or functional reasons
- Nocturnal enuresis (bedwetting): bedwetting at night occurring at least twice a week at the age of 5 and above
- Neurogenic bladder: loss of bladder control due to spinal cord or nervous system damage, with spina bifida and myelomeningocele as the leading causes
- Varicocele in adolescents: enlargement of the veins within the scrotum, which becomes significant during puberty
- Ectopic kidney and horseshoe kidney: congenital anomalies in which the kidney is not in its normal position
When Should You Consult Us?
Consultation with the Pediatric Urology Department is recommended if any of the following signs and symptoms are present; conditions such as sudden pain and swelling in the scrotum may require urgent assessment.
- Testicles that cannot be felt in the scrotum at birth or afterwards
- Deformity of the penis or an abnormal direction of the urinary stream
- Recurrent febrile urinary tract infection (more than twice a year)
- Blood in the urine (haematuria)
- Flank pain or pain in the lower abdomen
- Burning or straining when passing urine, or a weak urinary stream
- Bedwetting that continues beyond the age of 5
- Kidney enlargement or hydronephrosis detected on ultrasound
- Sudden pain or swelling in the scrotum (suspected testicular torsion: requires urgent assessment)
Diagnostic Methods
The Academic Hospital Pediatric Urology Department has a comprehensive diagnostic infrastructure:
| Method | What it shows |
|---|---|
| The first line imaging method for assessing kidney size, the presence of hydronephrosis and bladder wall thickness. It involves no radiation. | |
| A dynamic X-ray method showing whether contrast material in the bladder flows back into the ureter or kidney during voiding; it is the standard test for diagnosing VUR. | |
| DMSA scintigraphy detects scar tissue in the kidney, while MAG3 scintigraphy assesses kidney function and drainage. | |
| A test that documents bladder filling and emptying function through pressure and volume measurements; it is used in the investigation of neurogenic bladder and recurrent infections. | |
| The preferred radiation free method for detailed imaging of upper urinary tract anomalies. | |
| Basic laboratory tests used in the investigation of infectious causes and metabolic disorders. | |
| Blood and urine testing for metabolic factors that predispose to stone formation, such as hypercalciuria and hyperoxaluria. |
Preoperative Assessment and Preparation
Comprehensive preoperative preparation is essential for safe surgery in pediatric urology.
- Anaesthetic assessment: the pediatric anaesthesiologist evaluates the child's general health, weight and accompanying conditions in order to determine the appropriate anaesthetic method
- Fasting protocol: fasting of 6 to 8 hours is applied for solid food, 4 hours for breast milk and 2 hours for clear fluids; fasting times for infants and children are adjusted according to age
- Laboratory and imaging confirmation: a complete blood count, coagulation tests and any required imaging reports are completed before surgery
- Information for parents: the aim of the operation, the method used, the expected benefits and possible risks are shared with the family, and written consent is obtained
- Preoperative antibiotic prophylaxis: started at the surgeon's discretion in cases with a high risk of infection
Operations and Surgical Treatments Performed
The treatment plan is determined according to the child's age, the diagnosis and the severity of the disease. In mild cases medical treatment or a watchful waiting approach takes priority; when surgery is required, minimally invasive methods are preferred.
| Operation / procedure | How it is performed |
|---|---|
| A reconstructive operation that moves the urethral opening to its normal position and, where necessary, corrects curvature of the penis; it is generally planned between 6 and 18 months of age. | |
| The testicle is brought down into the scrotum and fixed there, either laparoscopically or by open surgery. It is recommended before the age of two. | |
| Injection of a biocompatible gel into the ureteral orifice from inside the bladder; a minimally invasive cystoscopic procedure that corrects VUR. | |
| A reconstructive operation performed to relieve UPJ obstruction; minimally invasive methods shorten the recovery period. | |
| Breaking up a kidney stone with sound waves without entering the body; applied in selected pediatric patients. | |
| A thin camera is passed through the urethra to reach the ureter and kidney, and the stone is fragmented with a laser. | |
| Standard surgical procedures for phimosis and hydrocele. | |
| A clean intermittent catheterisation (CIC) programme, anticholinergic drug therapy and, where necessary, surgical options. | |
| Behavioural measures, alarm devices and medical treatment protocols (desmopressin). |
Postoperative Care and Follow-up
In pediatric urological surgery the postoperative period covers both the safe course of recovery and the assessment of long term outcomes.
- Pain management: pain is kept under control with age appropriate analgesia protocols, and parents are informed about wound care and pain management at home
- Wound care and restrictions: individual advice on bathing, physical activity and clothing is given according to the type of surgery
- Catheter and drain follow-up: after some operations a bladder catheter or ureteral stent is placed for a short period; it is removed before discharge or instructions are given for care at home
- First follow-up visit: a wound check and functional assessment are usually carried out 1 to 2 weeks after surgery
- Long term follow-up: after reconstructive operations such as hypospadias repair and pyeloplasty, urinary flow, kidney function and anatomical healing are monitored with annual check-ups
- Return to physical activity: restrictions last a few days after minor procedures, 2 to 4 weeks after laparoscopic surgery and 4 to 6 weeks after open surgery
Book an appointment with the Pediatric Urology department.
Book an AppointmentPediatric Urology at Academic Hospital
The Academic Hospital Pediatric Urology Department carries out outpatient assessment, diagnostic investigation and surgical treatment under one roof for every age group, from the newborn period through adolescence. Thanks to its laparoscopic and robotic surgery infrastructure, minimally invasive methods are applied as the first choice in suitable cases. The department works routinely with the following units:
- Pediatric Nephrology: monitoring of kidney function and assessment of recurrent urinary tract infections
- Urology: continuity of care during the transition to the post-adolescent period
- Pediatrics: first consultation, growth monitoring and referral to the department
- Anaesthesia and Reanimation: pediatric anaesthetic assessment and patient safety during surgery
- Radiology: ultrasound, VCUG and MR urography examinations
- Clinical Microbiology: urine culture and identification of the infectious agent
Frequently Asked Questions
Answers to the questions most frequently asked about pediatric urology are given below.
References
The general information given on this page about urological conditions in childhood, diagnostic methods and surgical treatment approaches is supported by the reliable health sources listed below.
- European Association of Urology (EAU), "Paediatric Urology Guidelines", uroweb.org
- National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), "Urinary Tract Infections in Children", niddk.nih.gov
- National Institutes of Health, StatPearls, "Vesicoureteral Reflux: Overview and Management", ncbi.nlm.nih.gov
The information on this page is for informational purposes only; it does not replace medical examination, diagnosis or treatment. Please consult a healthcare institution regarding your complaints.
