Pediatric urology is a medical specialty that focuses on the diagnosis and treatment of conditions affecting the urinary tract, which includes the kidneys, bladder, ureters and urethra in children. The specialty also includes the genital organs.

Some childhood urological disorders do not cause serious symptoms and may be outgrown, but some can cause issues including problems with urination, persistent urinary tract infections (UTI) and kidney stones. Some pediatric urological conditions can lead to serious health issues that persist into adulthood, such as chronic kidney disease and infertility, if left untreated.

Types of Pediatric Urology Issues

Some common urologic issues affecting children include:

• bladder exstrophy, when the bladder develops outside the abdomen
• dysuria, or painful urination
• enuresis, which is bedwetting and other bladder control problems
• hematuria, or blood in the urine
• hernia, when the intestine or other organ pushes through an opening in surrounding muscle or tissue
• hypospadias, an underdeveloped urethra
• kidney stones
• neonatal hydronephrosis, an enlargement in newborns of the part of the kidney where urine collects
• obstruction of the pelviureteric junction, a blockage where the kidney connects to the ureter
• overactive bladder
• phimosis, a recurrent infection in some boys who aren’t circumcised
• retractile testis, where the testicle moves between the groin and scrotum
• recurrent UTIs
• undescended testis, or testicles that have not dropped into the scrotum
• urologic cancers such as Wilms tumor or rhabdomyosarcoma of the bladder
• varicocele, swelling of veins in the scrotum
• vesicoureteral reflux, abnormal flow of urine from the bladder back up the ureters toward the kidneys
• voiding dysfunction

Causes of Pediatric Urology Issues

Pediatric urologic conditions may be congenital, present at birth, or acquired, which means they develop at some point during childhood. The exact cause may be unknown or may occur for a wide variety of reasons such as:

• birth defects such as spina bifida and other structural problems in the urinary tract
• conditions such as diabetes or obstructive sleep apnea  
• genetic factors
• infections
• injuries
• lifestyle factors such as stress and anxiety
• medical conditions that affect growth and development

Signs and Symptoms of Pediatric Urology Issues

Symptoms vary depending on the specific urologic condition, but may include:

• abdominal swelling
• bloody or cloudy urine
• fever
• high blood pressure
• loss of appetite
• shortness of breath
• urinary incontinence, a loss of bladder control

How Are Pediatric Urology Issues Diagnosed?

In addition to physical examinations, reviews of medical history and discussions of symptoms, diagnostic tests for pediatric urological disorders may include:

• blood and urine laboratory tests
• imaging studies such as ultrasound, CT scan, magnetic resonance urography and voiding cystourethrogram to look for anomalies, evaluate urinary organ function and measure urine flow

Treatments for Pediatric Urology Issues

Treatment for pediatric urological issues depends on the specific condition, and may include:

• injections — for vesicoureteral reflux
• medications — such as antibiotics to treat UTIs, drugs such as oxybutynin to calm an overactive bladder, or medicines potassium citrate or thiazide diuretics to prevent kidney stones
• minimally invasive surgery — including laparoscopic, endoscopic and robot-assisted surgery to correct or reconstruct anatomical anomalies, remove blockages and improve organ function
• therapeutic interventions — such as percutaneous nephrolithotomy or shock wave lithotripsy to remove or break up kidney stones