Overview
Pediatric urology is the diagnosis and treatment of congenital
(i.e., present at birth) and acquired urological conditions and
diseases in children. Pediatric urologists treat conditions of
the male reproductive tract (e.g., undescended testicle) and the
male and female urinary tracts (e.g., urinary tract infection).
The urinary tract consists of the organs that filter the
blood and form urine (kidneys), the tubes that carry urine from
the kidneys (ureters), the organ that stores urine (bladder),
and the tube that carries urine from the bladder and removes it
from the body (urethra).
The most common condition treated by pediatric urologists is
urinary tract infection (UTI).
Other conditions include the following:
- Abnormally located urethral opening (hypospadias)
- Backup of urine from the bladder into the ureter (vesicoureteral
reflux [VUR])
- Bedwetting (nocturnal enuresis)
- Distention of the kidney in utero (antenatal
hydronephrosis)
- Ureteropelvic junction obstruction (UPJ obstruction; may
cause kidney damage)
Pediatric Urological Examination
Most children under the care of a pediatric urologist are
school-aged and younger. UTIs (e.g., cystitis) are most common
in young girls and pediatric urological conditions are usually
congenital and treated at a young age. Conditions such as
vesicoureteral reflux and antenatal hydronephrosis are
frequently diagnosed during prenatal ultrasound and hypospadias
is usually diagnosed during infancy.
The pediatric urological examination includes a medical
history and a comprehensive physical examination. A
history of symptoms, illnesses, injuries, medications, prenatal
ultrasound, and family history are documented. A urinary
catheter may be inserted into the bladder through the
urethra to withdraw urine. Diagnostic tests include the
following:
- Blood tests
- Cystometrogram, which measures bladder pressure at
various stages of filling
- Cystoscopy, which is an examination of the bladder and
ureter
- Intravenous pyelogram, which is a series of x-rays of
the ureter and renal pelvis taken after injecting a contrast
agent
- Magnetic resonance imaging (MRI scan)
- Renal scan
- Ultrasound (to detect blockage in the urinary tract)
- Urinalysis and urine culture (to detect UTI)
- Urodynamic studies, which measure the storage and rate
of movement of urine from the bladder)
- Uroflowmetry, which measures urine flow
- Voiding cystourethrogram (VCUG; used to observe the
urinary tract before, during, and after urination)
