Children’s urological diseases
Urological conditions in children differ from those in adults, often requiring diagnostic procedures and specialized treatment. Pediatric imaging physicians, pediatric anesthetists, and physicians from other specialties work together in hospitals to provide children with urogenital disorders with professional, prompt, and quality care.
Medical services include tests and diagnostic procedures that are performed both outpatient and in hospital, as well as the treatment of children with acquired or congenital urogenital diseases.
Urinary incontinence in children
Urinary incontinence refers to the loss of bladder control. It is a normal condition in children under 3 years. When a urinary loss occurs in a child who is old enough to have sphincter control we talk about urinary incontinence or enuresis.
Causes of secondary nocturnal enuresis:
– Ureteral-bladder malformations with impaired renal function.
– Conditions that increase bladder irritability: urinary tract infections, intestinal parasites).
– Medical conditions that increase blood volume: diabetes, sickle cell anemia.
– Kidney failure.
How to treat
A very important part of the treatment is the education of the family regarding the cause and the clinical evolution of the incontinence. Education helps to decrease the negative psychological impact of urinary accidents.
The treatment of primary nocturnal enuresis mainly involves education and motivational therapy. In the case of secondary enuresis, treating the cause can bring relief in terms of enuresis.
– Hormone therapy. Oxybutynin hydrochloride – is indicated for children older than 5 years for diurnal or nocturnal enuresis.
– Psychological therapy. If nighttime bed-wetting is caused by stress or anxiety, psychological counseling is helpful.
– Treatment of diurnal urinary incontinence. The treatment must be done according to the cause. Constipation is often among the causes, so it is necessary to treat constipation. Keeping a journal of urination can help identify children who have reduced functional bladder capacity, frequent urination, and/or emergency urinary insufficiency.
Varicocele in children
Varicocele is more often diagnosed at puberty because at this stage, the testicles develop faster, implicitly the blood flow at this level intensifies. It is present in about 15% of boys.
Most often, varicocele appears on the left side, this being related to the anatomical features of the testicular vein. Varicocele is a common cause of infertility, so it is a condition that should not be neglected.
In general, varicocele has no symptoms. At other times, suggestive manifestations may occur:
– Feeling of heaviness in the testicle, which worsens during or after exercise.
– One testicle may look larger than the other.
– Discomfort in the scrotum.
The main complication of varicocele is sterility in adulthood (sperm motility is affected).
Most often, varicocele is detected on clinical examination of the testicles. A scrotal or testicular ultrasound may be needed to confirm the diagnosis.
Treatment: If varicocele does not cause pain, the urologist recommends, in most cases, the annual ultrasound evaluation.
If varicocele is accompanied by symptoms, surgical treatment is recommended. Following the operation, which is often performed by laparoscopy, the blood flow is redirected by sectioning the affected veins, resuming normal circulation in the testicle, while maintaining its function.
Balanitis in children: symptoms and treatment
Balanitis is an irritation or an infection of the penile gland, often associated with phimosis and inflammation of the foreskin.
In the case of balanitis, redness and swelling of the tip of the penis are usually observed. Other possible symptoms include:
– redness and swelling of the penis;
– redness and swelling of the foreskin in uncircumcised children;
– rash in the diaper area;
– pain when urinating or changing a diaper.
The diagnosis of balanitis is made by the doctor based on the examination of the penis. If the basic treatment does not start working within 7 days, your doctor may suggest a few tests to see if there is an infection or complication. Sometimes a dermatological consultation may be necessary.
The treatment for balanitis is essentially the same as the treatment for any rash. It is advisable to improve the baby’s skincare methods, change the diaper as often as possible, and keep the skin clean and dry. Avoid rubbing the area and leave the diaper area free during the day.
Balanoposthitis: causes and treatment
Balanitis – inflammation of the head of the penis, fasting – inflammation of the foreskin. These conditions are always accompanied by each other and for this reason, they are brought together in a single term – balanoposthitis.
The cause of balanoposthitis lies in the accumulation of special substances – smegma under the foreskin and in its infection. This is happening to people who do not pay enough attention to the toilet of the head penis or those suffering from phimosis. Sometimes the reason for balanoposthitis becomes purulent urethritis, an allergic reaction, diabetes.
Symptoms of balanoposthitis:
– burning and itching in the head region of the penis;
– the unpleasant sensation when opening the foreskin;
– edema and redness of the head of the penis and foreskin.
In some cases, the general condition may worsen – weakness occurs,
increases body temperature insignificantly.
Treatment of balanoposthitis
Balanoposthitis occurs when the course of the disease is caused by phimosis. In the acute phase of inflammation is a minimal intervention – longitudinal dissection of the foreskin, but after the acuity of the process, the foreskin is subjected to a circular dissection (cutting operation).
Orchitis or inflammation of the testicle
Orchitis is an inflammation of the testicle. The disease may require surgical intervention, therefore, requires immediate and adequate treatment.
The main causes of orchitis in children:
– bacterial infection;
In 90% of cases, the disease is caused by bacteria transmitted through the blood. Orchitis is a common complication of mumps that develops in 10–30% of patients, as well as flu, sore throat, and other serious infectious diseases.
Acute orchitis in a child is manifested by the following symptoms:
– redness (hyperemia);
– pain in the testicle;
– an increase in the testicle in size;
– temperature increase;
– weakness, general deterioration of health.
As a rule, signs of inflammation are observed on one side.
Urologists treat orchitis in adolescents and children with antibacterial drugs (antibiotics). The course is for 1-2 weeks.