Urological diseases that occur in children differ from “adult” diseases. This is due both to the characteristics of the child's body, and with a large number of congenital pathologies. Doctor pediatric urologist-andrologist, pediatric surgeon at SM-Clinic Viktor Gubarev told what urological diseases can be encountered in childhood and what parents should pay attention to.
The structure of the upper urinary tract and bladder in girls and boys is similar, so many pathologies are characteristic of both sexes. For example, hydronephrosis is a disease in which patency is impaired at the junction of the renal pelvis into the ureter. Because of this, the pelvis and calyces of the kidney expand. If left untreated, hydronephrosis leads to a gradual deterioration in kidney function.
There are no obvious symptoms of congenital hydronephrosis, this disease is well diagnosed during ultrasound screenings during pregnancy and after childbirth. School-age children may have complaints of pulling or pain in the lower back. To make a diagnosis, ultrasound is performed, and to clarify it, a comprehensive X-ray urological examination is required.
Depending on the age of the child and the stage of the disease, either observation or surgery is performed. The current treatment options are ureteral stenting or ureteropelvic plastic surgery – this is the so-called “gold standard” in the treatment of hydronephrosis.
Another congenital disease is the megaureter, in which the ureter dilates. If there are no complications, then this pathology also does not have pronounced symptoms, and it can be suspected on ultrasound screening.
“Complications are possible in the form of a urinary tract infection, while there are changes in urine, its color, smell,” says Viktor Gubarev. – The child has a fever, there is a pronounced malaise. If a megaureter is suspected, it is necessary to conduct an ultrasound and complex X-ray urological examination, supplemented, if necessary, by nephroscintigraphy – this is a research method that allows you to evaluate the function of each kidney. ”
Treatment of a megaureter can be conservative or surgical, depending on the age of the child, the cause of the dilatation of the ureter, and the severity of the kidney damage.
“There is no universal approach to the treatment of megaureter, therefore, treatment tactics are always selected individually for the patient,” the doctor specified.
A common disease that occurs in boys is phimosis. This is a narrowing of the foreskin, in which it is impossible to release the glans penis. Another sign may be swelling of the foreskin during urination and a thin stream of urine. If these signs are present, you should immediately consult a doctor for an examination, Viktor Gubarev warns.
As the urologist explains, all boys are born with physiological phimosis. It is a natural defense mechanism of the male genital organ. As the child grows, the physiological narrowing of the foreskin should gradually subside by about 10 years of age. If there are cicatricial changes in the foreskin, difficulty urinating and hygiene problems, phimosis is considered pathological.
“Narrowing of the foreskin can be so pronounced that the normal act of urination is disrupted,” says Viktor Gubarev. “This, in turn, can lead to bladder pathology, and in more advanced cases, to damage to the upper urinary tract.”
Among the complications of phimosis, the doctor also calls balanoposthitis, a microbial-inflammatory process in the foreskin area. and head of the penis. It occurs mainly due to the fact that phimosis makes proper hygiene impossible.
Phimosis can be cured conservatively or with surgery. The doctor chooses the method of treatment in each case based on the severity of the cicatricial process and the presence of complications. With conservative treatment, a local hormonal ointment is prescribed, after the end of the course, the doctor controls the result. During surgical treatment, circumcision of the foreskin is performed.
Viktor Gubarev added that in order to reduce the risks of complications of the listed diseases, it is important to visit a doctor on time.