1] Overview of Hypospadias:

Hypospadias is a condition in which the baby's tube carrying urine forms differently during pregnancy. It can vary in severity, impacting urination direction, fertility, or self-esteem later.

This birth abnormality affects 1 in 125 boys.It can range from minor to more pronounced, but all are manageable. Thankfully, safe and effective surgical techniques can restore natural function and appearance, often in a single outpatient procedure.

How Hypospadias Affects Baby Boys?

Most cases of hypospadias are mild and have no impact on daily life. But in some cases, the opening might cause urine to spray differently. In rarer situations, hypospadias might affect future fertility and/or self-esteem.

Hypospadias treatment:

Hypospadias is a common condition and treatable. Early diagnosis and expert care are key to fixing the baby boy’s urine problem. Our team of expert paediatric urologists will carefully assess your son's unique situation and discuss treatment options, which might include gentle, minimally-invasive surgery. Along with the children's urology doctors and the entire staff of KM NU Hospitals, Ambur are here to guide you every step of the way.

2] Antenatal hydronephrosis definition:

Antenatal hydronephrosis describes swollen kidneys in your unborn baby due to urine buildup. In most cases, it's mild and resolves on its own, but careful monitoring is important.

Causes: Blockages, valve issues, or normal development phases can cause urine backflow, leading to swelling.
Symptoms: No typical symptoms exist, but it's often detected during routine ultrasounds.
Diagnosis: Ultrasounds provide detailed views of the kidneys and urine flow. Additional tests may be needed in severe cases.
Treatment: Most cases require observation only. In rare instances, surgery after birth may be needed to clear blockages.

3] Bedwetting Overview:

Bedwetting, or nocturnal enuresis, is the involuntary release of urine during sleep after a certain age which is around 5 years old. While common in young children, it can also affect teenagers and adults and can be stressful for families as well.

Causes:

• Developmental delays: The bladder and nervous system may not be fully mature, leading to involuntary urination.
• Hormonal imbalances: Antidiuretic hormone (ADH) helps regulate nighttime urine production. Insufficient ADH can cause bedwetting.
• Small bladder capacity : Some children have bladders that fill up quickly, leading to nighttime accidents.
• Psychological factors: Stress, anxiety, and even excitement can trigger bedwetting episodes.

Symptoms:

• Wetting the bed two or more times a week for at least three months after age 5 (primary enuresis)
• Regression to bedwetting after a period of dryness (secondary enuresis)
• Frequent urination during the day
• Difficulty waking up to use the bathroom at night

Diagnosis:

• Paediatric doctors will ask about medical history, symptoms, and family history of bedwetting.
• Physical examination and bladder function tests may be conducted.
• Ultrasounds or X-rays might be used to rule out underlying medical conditions.

Treatment:

• Lifestyle changes: Limiting fluids before bedtime, establishing regular bathroom breaks, and waking up at night to urinate can be helpful.
• Bladder training: Exercises and techniques can help increase bladder capacity and control.
• Alarm systems: Bedwetting alarms sound when moisture is detected, prompting the child to wake up and use the bathroom.
• Medication: In some cases, medications may be prescribed to regulate nighttime urine production.

4] Undescended Testes Overview:

Undescended testes occur when one or both of a boy's testicles haven't dropped down from the abdomen into the scrotum, where they belong. It's quite common, affecting about 1 in 25 newborns.

Causes are mostly unknown, but genetics and developmental factors likely play a role.

Signs & Symptoms: During routine checkups, doctors will gently feel for the testicles in the scrotum. If they're absent, an ultrasound can confirm the diagnosis.

Treatment options: In most cases, the testicles descend naturally within the first few months. If not, Laparoscopic Orchidopexy surgery, Orchidopexy or Orchiopexy surgery is recommended to gently guide them into the scrotum before age 1.

5] Vesicoureteral Reflux (VUR) Overview:

Imagine urine flowing the wrong way – up the tubes from your bladder to your kidneys. This unusual condition, called vesicoureteral reflux (VUR), affects children most often and, while not always symptomatic, can lead to complications if left untreated

What causes VUR?

• Abnormal development of the tubes (ureters) connecting the bladder and kidneys.
• Weak valves at the bladder-ureter junction.

What are the symptoms?

• Frequent urinary tract infections (UTIs): VUR makes it easier for bacteria to enter the kidneys, leading to UTIs.
• Fever and pain: Especially if UTIs reappear frequently.
• Bloody urine: A sign of potential kidney damage.
• Poor bladder control: Leakage or dribbling in children.

How is VUR diagnosed?

• Imaging tests: Ultrasound, cystogram, voiding cystourethrogram to visualize urine flow.
• Urinalysis: To check for bacteria and signs of infection.

When to see a doctor:

• Any concerns about your child's urinary health, especially frequent UTIs.
• Fever, pain, or blood in urine.

Treatment options for VUR:

• Observation: Many children outgrow mild VUR with no treatment.
• Antibiotics: To prevent UTIs while VUR resolves.
• Surgery: In severe cases, correcting the valve or ureter abnormality.

6] Ureteropelvic Junction Obstruction (UPJO) Overview:

Ureteropelvic junction (UPJ) occurs at the point where the ureter (tube carrying urine from your kidney) meets the pelvis of your kidney. When this junction gets blocked, urine flow backs up, causing ureteropelvic junction obstruction (UPJO).

What causes UPJO?

• Abnormal development:The UPJ may not form properly before birth.
• Scarring or inflammation:Injury or infection can narrow the UPJ.
• Kidney stones:Can get stuck in the UPJ, blocking the flow.

What are the symptoms?

• Pain in the flank or back: Often dull, aching, and worse with activity or hydration.
• Nausea and vomiting: From the pressure backup in the kidney.
• Blood in the urine: Sign of irritation or infection.
• Urinary tract infections (UTIs): More prone due to stagnant urine.
• Lump in the abdomen: In severe cases, the kidney may become enlarged.

Diagnosis:

• Imaging tests:Ultrasound, CT scan, or MRI to visualize the UPJ and kidney.
• Kidney (Renal) scan:To assess urine flow and kidney function.

When to see a doctor:

• Any flank pain, especially if persistent or worsens with activity.
• Blood in the urine, nausea, vomiting, or frequent UTIs.
• Lump in the abdomen.

Treatment for UPJO:

• Observation: Mild cases may be monitored without surgery.
• Surgery: Open or minimally invasive procedures (Pyeloplasty surgery) to widen the UPJ and improve urine flow.

7] Overview of Kidney and Bladder Tumours in children

Tumours of the kidney and bladder can affect children even when it is rare. Early detection and prompt treatment are essential for optimal outcomes. Let's explore these childhood cancers:

Causes:

• Kidney: Usually unknown, some genetic syndromes associated.
• Bladder: Rhabdomyosarcoma (muscle cancer) most common, followed by urothelial carcinoma (lining cancer).

Symptoms:

• Kidney: Lump in the abdomen, blood in urine, pain, fever, high blood pressure.
• Bladder: Blood in urine, frequent urination, pain, difficulty urinating.

Diagnosis:

• Imaging tests: Ultrasound, CT scan, MRI.
• Urine tests: To check for blood or cancer cells.
• Biopsy: For definitive diagnosis.

Treatment:

• Surgery: Often first-line treatment for both kidney and bladder tumors.
• Chemotherapy: For more advanced or aggressive tumors.
• Radiation therapy: Less common, but sometimes used after surgery.

When to see a doctor:

• Any blood in urine.
• Persistent abdominal pain or urinary difficulties.
• Unexplained fever or weight loss.

Further, here's a brief overview of some of the other paediatric urological conditions that children also get affected.

Spina Bifida: A birth defect where the spinal cord doesn't close completely, potentially affecting nerve function and bladder control.

Neurogenic Bladder: A dysfunction of the bladder due to nerve damage, impacting its ability to store and empty urine properly.

Hydrocele : A collection of fluid around the testicle, usually painless and harmless, but occasionally requiring surgical drainage.

Hernia : Protrusion of an organ or tissue through a weak spot in the muscle or abdominal wall. Inguinal hernias are common in children, often requiring surgical repair.

These conditions can significantly impact a child's health and well-being. Early diagnosis and intervention are crucial for managing symptoms and preventing complications. If you have any concerns about your child's health, we urge you to seek medical attention from our expert paediatric doctors or contact us at KM NU Hospitals, Ambur.