Pediatric Urology

• Recurrent unexplained fever, particularly in infants and toddlers
• Crying or visible discomfort during urination
• Hematuria (blood in urine), even if minimal
• Increased urinary frequency or urgency
• Prolonged time taken to pass urine or straining
• Daytime urinary incontinence or persistent nocturnal enuresis
• Lower abdominal discomfort (suprapubic region) or flank pain
• Abnormal appearance of external genitalia

These must not be ignored, but discussed with your pediatrician or a specialist doctor.

• Urinary tract infections (UTIs)
  Often present as unexplained fever in young children due to an underlying urinary infection.
• Pain or burning during urination
  Typically indicates irritation or infection of the urinary tract.
• Bedwetting beyond expected age
  May reflect delayed bladder maturity or underlying functional bladder issues.
• Abnormal urinary stream
  Suggests possible obstruction or anatomical abnormality in the urinary pathway.
• Phimosis (non-retractile foreskin)
  Usually physiological in young children but may cause hygiene or urinary concerns if persistent.

• Hydronephrosis
  Swelling of the kidney due to urine buildup, often detected on antenatal scans.
• Vesicoureteral reflux (VUR)
  Backflow of urine from the bladder to the kidneys, increasing risk of recurrent infections.
• Ureteropelvic junction (UPJ) obstruction
  Blockage at the junction of the kidney and ureter, impairing urine drainage.
• Posterior urethral valves (PUV)
  Congenital obstruction in male infants causing poor urinary flow and risk of kidney damage.
• Undescended testis (cryptorchidism)
  Testis not located in the scrotum, requiring monitoring or surgical correction.

A urine routine test is often the first step in the diagnosis. Then an ultrasound of the abdomen and pelvis, non-invasive, no radiation. If needed, we may advise a micturating cystourethrogram (MCU), where we observe urine flow during voiding, or a nuclear scan to assess kidney function. The tests are required based on symptoms, age, and clinical findings.

Most parents wonder if their child will need surgical care. The answer is sometimes yes, often no, depending on the condition and its complexity. Simple UTIs are treated with antibiotics and hydration. In cases of VUR, low-dose antibiotics may be used for a period to prevent recurrence. Many children outgrow mild reflux. Surgery is considered when there is a clear obstruction, risk to kidney function, or a structural abnormality that won’t correct on its own. For example, hypospadias repair is usually done between 6 and 18 months of age. Undescended testis ideally corrected before 1 year. We increasingly use minimally invasive techniques. Smaller incisions, faster recovery. But the decision is always individualized.

• Ensure adequate daily fluid intake
• Encourage regular and complete bladder emptying
• Avoid prolonged urine holding, especially in school-going children
• Maintain appropriate perineal hygiene (front-to-back cleaning in girls)
• Address constipation proactively
• Avoid local irritants such as harsh soaps or bubble baths

At UMC Hospitals, our approach is straightforward: careful listening, minimal but appropriate investigations, and clear communication. We understand that parents often come with anxiety, sometimes guilt. It’s addressed gently. Children are not just “small adults.” Their anatomy, behaviour, and even their fears are all different. So the care has to adapt. Most importantly, many of these conditions, when identified early, are manageable. Consult our highly trained pediatric urologist in Navi Mumbai for further assistance and care.