Pediatric urologists are specialists who treat conditions of the male and female genitals and urinary tract in children. This could include numerous problems, such as bedwetting, pain, or serious health issues.
Genitals are the reproductive organs. Urologists specifically focus on the penis, testicles, and vagina.
The urinary tract is the body’s drainage system. It consists of:
- Kidneys: Organs that filter wastes and extra fluid from the blood to create urine
- Ureters: Tubes that carry urine from the kidneys to the bladder
- Bladder: The sac in the lower abdomen that stores urine until it is released from the body
- Urethra: The tube that drains urine from the bladder to outside of the body
The different parts of the system work together to get rid of waste and extra fluid through urination. This system is very important — it prevents the buildup of wastes and extra fluid in the body. It also makes red blood cells that carry oxygen throughout the body and produces the hormones that control blood pressure.
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What Sets Children’s Apart?
- At our Urology Clinic, we have the ability to perform many procedures in our office that would normally require anesthesia, such as meatomies (procedures to widen the opening of the urethra) using local anesthesia. This saves families time and money, and avoids risks of general anesthesia.
- We perform robotic surgery in patients as young as 2 months old. Robot-assisted procedures give surgeons the most precise control over surgical instruments, and generally mean a quicker recovery time and less scarring. We use robotic surgery for reimplantation (putting ureters back into the bladder), reconstruction of part of the kidney, and repairing ureter problems.
- Our surgeons are members of worldwide provider networks that connect them to the top surgeons in the world. This allows them to stay up-to-date with the best practices and treatments for our patients.
- Children’s only employs urologists who are board-certified in the subspecialty of pediatric urology. In addition to board certification in urology, subspecialty requires fellowship training in pediatric urology and dedication to solely treating pediatric patients. This means that our urologists have the highest level of training and are especially knowledgeable about the unique needs of children.
- Our providers constantly participate in research, which guarantees that they have the most advanced knowledge of urological conditions and treatments.
- About 3 in every 100 boys born at full term (9 months) have at least one undescended testicle at birth.
- Among babies born prematurely (before 37 weeks of pregnancy), that number is about 30 in every 100.
- About 3 in 100 children develop a urinary tract infection every year.
Conditions We Treat
Bladder Dysfunction ClinicThe Urology Clinic at Children’s hosts the Bladder Dysfunction Clinic. This is the only pediatric clinic fully dedicated to treating what’s called voiding dysfunctions — when a child’s urination patterns are not typical for someone their age. Voiding dysfunction can come in many forms, including bedwetting, frequent need to use the bathroom, not being able to urinate, or leaking urine.
Treatment varies from child to child, depending on the type and cause of the problem. We may teach behavior modification techniques, such as emptying the bladder on a regular basis or drinking more water. If the problem persists, we may move to more advanced measures, such as medication or behavioral therapy.
At the Bladder Dysfunction Clinic, we don’t just treat the problem. We also focus on eliminating fear and embarrassment, instilling pride and confidence, and making children feel like normal kids.
Hernias And HydrocelesA hernia is tissue that forms a bulge in a weak area of the wall of the abdomen. The intestine can also bulge out through this area. When a hernia happens in the groin, it is called an inguinal hernia. Both boys and girls can have inguinal hernias, but they are more common in boys.
Hernias can get stuck outside of the abdomen, blocking blood flow to the small intestine. This is considered a medical emergency, as it can cause part of the intestine to die. If the intestine dies, bacteria from the intestine can get into your child’s system, potentially leading to shock or organ failure. This can be life-threatening.
Treatment involves surgery to fix the hernia. We perform laparoscopic single incision hernia repairs. This means that we use only one tiny cut, rather than multiple large cuts. It means a quicker recovery time and leaves almost no scar.
Hydroceles, which only occur in males, are fluid-filled sacs in the scrotum, which is the pouch of skin that holds the testicles. They often go away on their own, without requiring surgery. However, we may recommend surgery if the hydrocele is large, causes problems with blood flow, is infected, is painful or uncomfortable, or if your child also has a hernia.
HydronephrosisHydronephrosis is swelling of the kidney. It occurs when urine cannot drain from the kidney to the bladder, and builds up inside the kidney. Underlying illnesses or risk factors, such as kidney stones, a blocked ureter (tube that carries urine from the kidney to the bladder), infection, or birth defects of the urinary system, are usually the causes of hydronephrosis. If we detect it before your baby is born (usually during an ultrasound), it is called prenatal hydronephrosis.
Treatment depends on the cause of the urine buildup. For example, if it is caused by an infection, we may be able to treat it with antibiotics. If there is a blockage, we may need to perform surgery. For prenatal hydronephrosis, we usually don’t need to perform treatment. We will evaluate the cause after your child is born, and then decide if treatment is needed.
HypospadiasThe urethra is the tube that brings urine from inside the bladder to outside of the body. In males, the meatus (opening of the urethra) is normally at the tip of the penis. Hypospadias is a birth defect in which the meatus is located somewhere other than the tip of the penis. It can also cause the penis to be curved.
This condition can make it difficult to control the direction that urine comes out. In most cases, treatment involves surgery to correct the location of the meatus and the curve of the penis.
Kidney StonesUrine contains salts and minerals. When the amount of salts and minerals gets too high, a solid piece of material called a kidney stone may form in the kidney.
A small stone can often pass through the urinary tract and out of the body on its own, causing little or no pain. However, a larger stone can get caught in the ureter (tube that brings urine from the kidneys to the bladder), blocking the flow of urine and causing pain.
If the stone isn’t passing on its own, is blocking the urinary tract, or is causing severe pain, we may need to remove the stone via surgery, or use shock wave lithotripsy — a procedure that breaks the stone into small pieces so that it can pass without surgery. We also recommend drinking plenty of water to help move the stone along and keep the body hydrated.
MegauretersUreters are the tubes that carry urine from the kidneys to the bladder. They are usually about a quarter of an inch wide. If a ureter is wider than three-eighths of an inch, it is considered a megaureter. Some megaureters block the flow of urine, while others cause vesicoureteral reflux (urine flows backwards and up into the kidneys).
Megaureters don’t always cause symptoms, but they can cause severe infections or blockages that lead to kidney damage. The typical surgery for megaureters is ureteral reimplantation, where we put the ureters back into the bladder, and ureteral tapering, where we trim the widened part of the ureter.
Many medical centers avoid performing ureteral reimplantation on infants. But at Children’s, we have performed this procedure on infants many times and have seen great success.
Neurogenic BladderNeurogenic bladder is a lack of bladder control that stems from problems with the brain, spine, or nerves (e.g. diabetes, infection in the brain). Children born with spinal cord problems, such as spina bifida (birth defect of the brain, spinal cord, or nerves), are also at an increased risk of having neurogenic bladder.
The main symptom of neurogenic bladder is incontinence. This is when your child urinates on himself or herself two or more times each month after potty training. It can also increase the risk of kidney stones, urinary tract infections, or hydronephrosis (swelling of the kidney due to excess urine buildup).
Treatment generally involves treating the underlying condition that’s causing neurogenic bladder.
Prenatal Urologic ConditionsCertain urological problems, such as hydronephrosis (swelling of a kidney) or obstructed urinary tracts, can be found before birth. They are discovered through a mother’s prenatal ultrasounds.
If you find out that your child has a urological problem, they probably won’t need treatment right away. Once your baby is born, we’ll evaluate the problem and decide whether or not treatment is required.
Undescended Testicles (Cyptorchidism)Testicles (the male reproductive organs) grow in the abdomen while a baby is still a fetus. In the third trimester of pregnancy, the testicles move downward into a pouch of skin called the scrotum. Undescended testicles is a condition where one or both of the testicles do not move down into the scrotum. While this doesn’t typically cause symptoms, it can increase the risk of testicular cancer or infertility later in life.
In most cases, the problem corrects itself within the first year of life. If it does not, your child may need hormone injections or an orchiopexy — surgery to bring the testicles into the scrotum.
The traditional approach to orchiopexy is called inguinal, and involves one incision in the groin and one on the scrotum. At Children’s, we offer the scrotal approach. This procedure includes only one cut on the scrotum to minimize your child’s scars and shorten your child’s hospital stay.
Undescended testicles are usually discovered at birth, but in cases where it is found later in life, the testicle may need to be removed.
Ureteropelvic Junction ObstructionUreters are the tubes that carry urine from the kidneys to the bladder. Ureteropelvic junction obstruction occurs at the spot where a kidney attaches to a ureter, blocking urine from flowing out of the kidney. Urine may build up, causing damage to the kidney.
Ureteropelvic junction obstruction can be temporary for children younger than 18 months. If the obstruction does not clear, we use surgery to remove the obstruction. During recovery from the procedure, your child may need a tube called a stent to drain urine from the kidney.
Urinary Tract Infection (UTI)A urinary tract infection (UTI) occurs when bacteria gets into the kidneys or bladder. It can cause pain with urination, frequent need to urinate, pressure in the lower pelvis or lower back, or a general ill feeling.
UTIs are treated with antibiotics. Young infants — under 6 months — may need to stay in the hospital to receive antibiotics through an IV during treatment.
Urinary Incontinence And BedwettingWhen a child involuntarily urinates on himself or herself two or more times per month after potty training, it’s called urinary incontinence. Incontinence that only happens during the night is called bedwetting. Slow physical development or unhealthy bathroom habits, such as holding in urine too long, can lead to incontinence. Certain diseases or medical conditions, such as bladder or kidney infections, sleep apnea, or diabetes, can increase the risk of incontinence.
After we find the underlying condition, Treatment can involve medication, exercises to strengthen the sphincter, which are the muscles that keeps urine in the body, or lifestyle modifications, such as urinating every 2 to 3 hours or avoiding caffeinated drinks.
Vesicoureteral RefluxThe urinary tract is the system that is responsible for removing wastes and extra water from the body. When it is functioning correctly, the kidneys filter out the wastes and water, creating urine. Then, tubes called ureters carry the urine to the bladder. Urine flows out of the body through a tube called the urethra.
Vesicoureteral reflux occurs when urine flows backwards, going back up into the kidneys. This causes repeat urinary tract infections, which can lead to scarring of the kidney. In some cases, this scarring can lead to high blood pressure or kidney failure later in life.
Usually, treatment for vesicoureteral reflux involves treating urinary tract infections as soon as they develop, and using antibiotics long-term for preventing infections, until the reflux goes away. We may perform surgery if your child has kidney infections, fever, or severe vesicoureteral reflux that doesn’t go away within one year.
Kidney Stone Clinic
Kidney Stone Clinic
What To Do Next
Make An Appointment
Unless required by your insurance, your child does not need a referral to be seen at the Urology Clinic. Call 402-955-4002 to schedule an appointment.
What To Bring To The First Appointment
Please bring the following items to your child’s appointment:
- New patient paperwork (if provided)
- Imaging results (e.g., X-ray, MRI, CT)
- Previous medical records for the condition being treated
For Referring Providers
The Physicians’ Priority Line is your 24-hour link to pediatric specialists at Children’s for referrals, emergency and urgent consults, physician-to-physician consults, admissions, and transport services. Call 855-850-KIDS (5437).
Learn more about referring patients.