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Pediatric urology problems which are faced among children

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The growing years of children come with ups and downs; days of laughter, joy and also days of distress, anxiety. While the good days which does not have worries, anxieties are not remembered much and days of distress, worries are hard to forget. If a child has a serious medical condition, or disease it can be a reason of constant worry, unhappiness for the parents. But some conditions are there, which should not be treated as disease and are outgrown with age.

One area of specialization related to genitourinary diseases of children is pediatric urology. The area deals with problems of both boys and girls from birth till they are young adults. The most common problems are related to disorders of urination, and reproductive organs. Some of the most common problems for pediatric urology are Bladder control such as bedwetting and bladder control problems; undescended testes; Hypospadias, Epispadias, bladder and kidney stones, chordee and other malformation of the penis; Phimosis; Neurogenic bladder; Antenatal hydronephrosis; and some more.

Bladder control problem which leads to bedwetting and incontinence during day time is one of the most common problems for pediatric urology. Though most children gain control on the bladder by the age of four or five, about 15% children cannot control bladder and bedwetting happen till the age of six. The reasons could be a few such as increased production of urine during sleep, maturational lag and unstable bladder contractions. The evaluation of bedwetting involves history, physical examination and analysis or urine. The treatment is specific for each child which can be instituted, which may involve medical management, managing behavior, or conservative treatment. Most cases of bedwetting are resolved at the rate of 10% per year as the child progresses towards young adult.

Another problem related to Pediatric urology is Hypospadias, which is congenital and is present in newborn boys which can be 1:250. This is a kind of abnormality in which the opening is not at the end of the head of the penis. The opening from where the stream starts, is positioned at some other place which could be anywhere from the head of the penis to the scrotal area. Another bend or curvature may be there which is called chordee. The chances of chorded are more, if the opening is far away from the head of the penis. If the child has Hypospadias, circumcision should not be performed which helps in using the foreskin for corrective surgery.

One of the most common problems of Pediatric Urology in Pune is Undescended testis which is seen in 1-3% of newborn boys. The abnormality happens if during fetal development, the testes do not move down to the scrotal sac and gets arrested in abdominal cavity. The reason for the arrest is not known, but the testes should move down to the scrotal sac in the alter stage of fetal development. Some descend also happens in the first three months after birth, but the spontaneous descend stops thereafter. The only way to correct the problem is surgery, which is accomplished through an incision in the groin area and chances of success are high.

To conclude, one word on retractile testis which is a phenomenon in which the testis has the tendency to move upwards or out of the scrotal sac. Ureteropelvic Junction Obstruction, is a condition in which partial blockage of ureter happens in which it enters the kidney. This causes dilation in the collecting system within the kidney which is called hydronephrosis. If the condition is severe, it results in diminished function of the kidneys.

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