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Pediatric Urology


Cost Difference :
Much less as compared to the other European Countries

Pediatric Urology is a specialize branch of medicine that deals with the disorders of children's genitourinary systems (kidneys, bladder, ureters and genitalia). This kind of disorder is mostly found in the children, both boys and girls, ranging from newborn to 15 years of age. The most common problems which involves this disease is the disorder of urination and testes.

Pediatric Urology comprises of many diseases from the very common to the very rare such as:

Hydronephrosis : This disorder means the presence of extra urinary fluid in the kidney. It is only a physical phenomenon rather than a disease that take place with many diseases. It can happen due to the obstruction of the ureters or bladder outlet and also result from reflux.

Tumors of the kidney : The symptoms of the kidney tumors includes abdominal pain, abdominal mass, blood in the urine, vomiting and failure to grow. Some of the most common types of Kidney tumors are Wilm's tumor, Mesoblastic Nephroma, Neuroblastoma which is found commonly in the adrenal gland, but can be exist anywhere along the sympathetic nervous system. The treatment of the tumors require surgery, chemotherapy, and radiation.

Kidney stone : Kidney stones in children is very rare as compare to adults. These can be frequently caused by errors of metabolism present in the body by birth, reflux and obstruction. Some types of Kidney stone are Calcium oxalate, Uric acid, Cystine stones, Struvite stones. The first step of treating kidney stone is to recognized the type and then identify the root cause behind he stone formation.

Urinary tract infection : This type of the infection is the first sign of a abnormality of bladder present at the time of birth or kidney malfunction. If there is no proper examination of the urine, these Urinary Tract Infection may go unnoticed. Some of the important symptoms of the UTI includes: Dysuria( burning sensation while urination), always have the feeling of frequent and urgent urination, foul smelling of the urine, nighttime incontinence means bed wetting and fever. To rule out any possibility of the UTI, ultrasound of renal and bladder as well as VCUG should be performed. Almost 30% to 40 % of the children who suffers from the UTI along with fever have history of urological abnormality from birth.

Vesicoureteral reflux : Vesicoureteral reflux is an abnormal movement of urine from the bladder into the kidneys. It can be categorized into 5 grades-1, the mildest and 5, the most severe. Most children suffers from grade 1-2 reflux, in the majority of cases, it resolves itself with the gradual passage of time. In half of the cases grade 3 reflux resolves whereas grade 4 and 5 will resolve in a minority of cases. Surgery is essential to correct reflux because surgery helps to lengthen the path of the ureter as it travels into the bladder.

Prune Belley Syndrome : It is an unique condition found specifically in males who have a wrinkled abdominal wall. Generally this condition prevails due to absence of abdominal musculature, bilaterally undescended testes and other urinary tract abnormalities, including an extremely large bladder and severe reflux with dilated ureters and varying degrees of dysplasia of the kidneys. This syndrome can be diagnosed at the time of birth.

Exstrophy : It is a rare congenital bladder disorder. This disease results when the tissue which makes up the abdominal wall is deficient. It is also seen that such cases bladder is a flat sheet on the abdominal wall instead of a sphere inside the pelvis. Urine leaks out of the abdominal wall from the exposed urethral orifices. This is associated with pubic separation and epispadias. It is a severe congenital curvature and foreshortening of the penis.

Neural Tube Defects : Neural tube defects take place when the bones of the spine does not form properly, leaving the spinal cord and its nerves and coverings to project out through the skin (or lie just below it). Since the bladder and the urinary sphincters function under neurological control from the spinal cord, damage to the spinal cord can result in lower urinary tract malfunction which, if not treated properly can lead to renal damage. The most common symptoms of neural tube defects are frequent infections, nighttime incontinence and urinary frequency.

Pediatric Genital Abnormalities : It can be classified into various types of abnormalities such as Hypospadias, Episadius, Chordee, Male/Female Genitalia, Undescended testicles, Inginual hernia Hydrocele. Among them, the most common one is hypospadias abnormality. In this condition the urethral opening is not at the penis tip but further down on the ventral surface (i.e., between the head of the penis and the scrotum). Surgery is require to correct this abnormality because it may affect in future fertility, sexual intercourse, cosmesis and the ability to void in the standing position.

Diagnostic Tests To Detect Pediatriac Urology
Pediatric Urology can be detected with the help of tests such as
  • Blood test- the most primary test.
  • Renal scan- this test is conducted to determine whether the kidney is working properly , whether there is any obstruction in the kidneys, and whether the blood pressure is caused due to the kidneys or not.
  • Cystometrogram-it measures the bladder pressure at the various stages of the filling.
  • Cystoscopy-it is a test for the bladder and ureter.
  • Intravenous pyelogram- this test contains series of x-rays of the ureter and the renal pelvis conducted after injecting a contrast agent.
  • Magnetic resonance imaging (MRI scan).
  • Ultrasound- this test is done to detect blockage in the urinary tract.
  • Urinalysis and urine culture-to detect the problem of Urinary tract Infection.
  • Urodynamic studies- this test measures the storage and rate of movement of urine from the bladder.
  • Uroflowmetry-it helps to measure the flow of urine.
  • Voiding cystourethrogram(VCG)-this test is done to observe the urinary tract before, during and after urination.
It is important to understand the embryology, anatomy and physiology to detect and treat these congenital disorders.
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