In addition to treating male and female urological conditions, Rogue Valley Urology physicians are also experienced in pediatric urology. When it comes to your little ones, we offer safe and effective care to help them achieve normal, fully functioning urological health.
Many boys are born with tight or excess skin covering the tip of the penis, known as foreskin, which can cause infections and painful sex in adulthood. Circumcision is the process of surgically removing the foreskin. It can be done for religious reasons, family tradition, or more often a means of preventive health care. The health benefits of circumcision include easier hygiene and lowered risk of urinary tract infections, sexually transmitted infections, and penile cancer. Circumcision is fairly common for newborn boys in the United States, and while it is possible to perform a circumcision later in life, it’s a more complex procedure.
- The American Urological Association’s webpage on Circumcision.
Bed-wetting and voiding dysfunction
Children typically achieve bladder control by age 3 or 4. Nighttime bed-wetting (nocturnal enuresis) occurs when they can’t control their bladder during sleep. This could happen because they are producing more urine than their bladder can hold overnight, they sleep too soundly to notice cues to urinate, their bladder wants to empty too soon, or due to irregular bowel movements. Most children outgrow bed-wetting, but some may require medical attention if it continues past age 5. A urine alarm, a system that rings when the bed gets wet, often helps teach children to recognize bladder sensations at night.
Voiding dysfunction occurs when children do not empty their bladders normally. They may exhibit frequent urination, urgency, a tendency to suppress urination, or daytime leakage. A lot of children with voiding dysfunction also have problems with their bowels, such as constipation, and by correcting that issue you can improve bladder control. We may recommend diagnostic imaging studies to rule out anatomical causes of voiding dysfunction. For some types of voiding dysfunction, behavioral changes, such as encouraging frequent trips to the bathroom, can help break the cycle. Medication can increase bladder capacity for children with small bladders and increased water consumption helps flush out the urinary tract and may reduce constipation. Biofeedback is also an option, to teach children to control the muscles that control the bladder.
- The American Urological Association’s webpage on Bed Wetting.
The normal path urine takes when exiting the body is from the kidneys to the bladder, through tubes called ureters. However, in some instances, urine can flow backwards, from the bladder to the kidneys. This condition is called vesico-ureteral reflux, and it is most often caused by a birth defect that forms an ineffective flap valve between the ureter and bladder. It can also occur in children with infrequent urinary patterns. Reflux can allow bacteria from the bladder to enter the kidney, leading to infection that can cause kidney damage. It can also cause urinary tract infections.
We can measure your child’s reflux through an X-ray of the urinary tract and determine the type of care that is appropriate. Since lesser grade reflux often fades over time (typically around age 5 or 6) due to growth of the valve, our main course of action will likely be to prevent UTI and kidney damage until that development can occur. Surgery to repair the reflux is another less common treatment.
- The American Urological Association’s webpage on Vesico-Uretal Reflux.
As a male fetus develops, his testicles are initially located within the abdomen. During the latter part of pregnancy, hormonal development causes the testicles to descend into the scrotum, where they will generate sperm and testosterone. Sperm cannot develop at normal body temperature, and the scrotum serves to keep the testicles cooler. If the testicles remain undescended, the sperm will not mature.
It is easy to diagnose undescended testicles during a routine infant examination. Typically only 3-4 percent of newborns will have this condition, although that number is greater in babies born prematurely. Nearly half of these testicles will spontaneously drop during the first three months of life. If that does not happen, surgery is required. This will generally be performed between six and 18 months of age.
- The American Urological Association’s webpage on Undescended Testicles.
The urethral meatus is the opening at the tip of the penis. If the meatus becomes narrowed or blocked, it can cause urinary problems. Meatal stenosis is most often found in circumsized boys, when the newly exposed tip of the penis is mildly injured by rubbing against the diaper or the skin. Injury can also occur due to inflammatory skin conditions or extended use of urinary catheters. Over time, chronic irritation can result in scarring that causes the meatus to narrow. The most reliable treatment we can offer is surgery to enlarge the meatus.
- The American Urological Association’s webpage on Meatal Stenosis.
Hypospadias is a common birth defect that causes the urethral meatus (opening of the urethra) to form on the underside of the penis instead of at the tip, sometimes resulting in penile curvature. In addition, the foreskin is usually underdeveloped, creating a hooded appearance that leaves the tip of the penis exposed. It is the hooded foreskin that most often sheds light on the problem. Hypospadias causes the penis to not only look different, but also perform inefficiently. Through surgery, we can straighten the shaft of the penis, create a urinary channel that opens at the tip, and circumcise or reconstruct the foreskin. Surgery often takes place when the boy is between three and 18 months. It, however, can be treated at any age.
- The American Urological Association’s webpage on Hypospadias.