Pediatric Urology

Management of childhood urological disorders such as hypospadias, pelvi-ureteric junction obstruction, undescended testis, and pediatric stone disease with specialized surgical expertise.

Pediatric urology addresses a spectrum of congenital and acquired urological conditions in children, requiring specialized surgical expertise to ensure optimal outcomes. Disorders such as hypospadias, pelvi-ureteric junction (PUJ) obstruction, undescended testis, and pediatric stone disease are prevalent and demand precise diagnosis and tailored management. These conditions, if untreated, can lead to complications like impaired renal function, infertility, or recurrent infections. Advances in minimally invasive techniques and multidisciplinary care have revolutionized their management, improving long-term prognosis.

Hypospadias

A congenital anomaly where the urethral opening is located on the underside of the penis, affects approximately 1 in 250 male newborns. Surgical correction, typically performed between 6 and 18 months, involves reconstructing the urethra to achieve normal function and appearance. Techniques like the tubularized incised plate (TIP) repair offer high success rates, with complication rates below 10% in experienced hands. Pediatric urologists must balance functional outcomes with cosmetic results, as psychological impacts can persist into adulthood. Long-term follow-up is essential to monitor for complications like fistulae or strictures.

Pelvi-ureteric junction obstruction

A blockage at the junction of the renal pelvis and ureter, can cause hydronephrosis and progressive renal damage. It is often detected prenatally via ultrasound. Management depends on severity; mild cases may resolve spontaneously, while significant obstruction requires surgical intervention. Pyeloplasty, often performed laparoscopically or robotically, is the gold standard, with success rates exceeding 95%. Minimally invasive approaches reduce recovery time and scarring, critical for pediatric patients. Regular imaging post-surgery ensures preserved renal function.

Undescended test

Undescended test is (cryptorchidism), affecting 3-5% of full-term male infants, poses risks of infertility and testicular cancer if untreated. Orchiopexy, the surgical fixation of the testis in the scrotum, is recommended between 6 and 12 months to optimize fertility potential. Laparoscopic orchiopexy is effective for intra-abdominal testes, offering diagnostic and therapeutic benefits. Early intervention reduces malignancy risk, though lifelong self-examination is advised. Parental education is crucial to address concerns about fertility and cosmetic outcomes.

Pediatric stone disease

Pediatric stone disease, though less common than in adults, is rising due to dietary changes and obesity. Stones can cause pain, infection, or obstruction, necessitating prompt management. Extracorporeal shock wave lithotripsy (ESWL) and ureteroscopy are preferred for smaller stones, while percutaneous nephrolithotomy is reserved for larger stones. Metabolic evaluation is vital to identify underlying causes like hypercalciuria, preventing recurrence. Hydration and dietary modifications are cornerstone preventive strategies.

The complexity of these conditions underscores the need for specialized pediatric urological expertise. Multidisciplinary teams, including nephrologists, radiologists, and anesthesiologists, enhance care quality. Minimally invasive techniques, such as robotic surgery, have reduced morbidity, while advances in prenatal diagnostics enable early intervention. Psychological support for patients and families addresses the emotional burden of surgical interventions. Long-term follow-up ensures functional and psychosocial outcomes, highlighting the importance of dedicated pediatric urology centers in managing these intricate disorders effectively.

Dr. Ritesh Mongha is a Pediatric Urology Specialist in Faridabad – Book Appointment Today