What is Pediatric Urology? And Who is the best Pediatric Urologist in Jaipur

Dr Sandeep Nunia is the best pediatric urologist in Jaipur, Rajasthan, who carries a friendly personality & approach with children, dependent upon the age factor, which leads children to open up with the doctor and explain the problem clearly, which helps paediatrics to understand the root cause of the problem and treat the problem effectively.

Undescended testis disorder is an ailment where the male testicle does not transmit downwards into the scrotum. During the pregnancy, these testicles start developing deep in the abdomen through the help of several hormones. Within the period of 32 weeks, the testicles begin to come down into the scrotum. But, in very few cases like premature infants, it happens that one or sometimes both the testicle does descend completely into the scrotum during birth or delivery. Although in such cases with the period of first 3 to 6 months, the testicles descend naturally, in very few cases, one or both the testicles stay affected.

Certain risk factors may occur in undescended testis case, like the risk of infertility, hernia, testicular cancer, testicular torsion or twisting, and sometimes testicles start moving upwards into the abdomen. With time boys may face psychological issues like stress due to undescended testis problem.

Consult the Best Urologist in Jaipur, Rajasthan, as the only solution to the problem of the undescended testis are specialists as they identify the position of the testicles through a laparoscopic technique where they diagnose the testicles and treat the problem. Immediate consultation is a must; otherwise, this can cause more trouble to an individual.

Hypospadias is an ailment where the opening of the urethra is dislocated from the actual location at the tip of the penis. This abnormal opening can be located anywhere, and accordingly, the problem is considered major (severe) or minor.

1. The urethra opens underneath the intimate part (penis), and severity depends on how close the opening is to the scrotum.
2. The skin develops upside the penis rather than the underside, making the appearance of the foreskin hooded.
3. As the tissues are tightened underneath the penis, which prevents the penis from straightening fully.
4. The difficulty becomes more severe when an individual is grown up and finds it difficult to urinate.
5. It causes bending of the penis, which is visible and affects sexual life as well.
6. On the other part, it causes psychological problems in grown-up/young male.

Treatment to such problems is operation when the problem is more severe, and usually while operating, urologists use foreskin to make new urethra. Recovery also depends on the severity of the problem, though the patient would need to stay in the hospital for at least 2 days or maybe more. The urine will pass through a tube for 10 days, and afterwards, it will be removed.

Kidney, Urine, bladder, and ureters are interconnected as the kidney plays a vital role in urine formation; bladders help urine move out as waste through ureters. Therefore, it may happen with some children that their urine flows back to the bladder through ureters. This condition is called Vesicoureteral reflux, also known as VUR.

This problem may occur during the time of birth. The connection between bladder and ureter can be abnormal, which leads to vesicoureteral reflux, or it may occur due to infrequent or incomplete urination. Apart from this, constipation may cause VUR.

 A child may have VUR if he faces following situations-

Consult the urologist as soon as possible after seeing the above-mentioned symptoms in your child; your doctor will suggest you the best possible medical treatment as per the severity of your child’s problem.

Your doctor may suggest you endoscopic treatment where medication is injected at the joining of the ureter and bladder, and the child is discharged on the same day. Secondly, the urologist may suggest a more cure-able surgery and a good option for severe problems. Lastly, antibiotic used to prevent infections of VUR until it goes by itself.

How Kidney Works In Draining The Urine?

The kidney filters the blood, removes all the waste, water, salt and makes urine out of it. The urine flows into the renal pelvis from the kidney, and afterwards, the ureter carries urine out. Every kidney must have one working ureter to pass out the urine through the kidney and bladder.

Ureteropelvic junction obstruction (UPJ) is a disease where a part of the kidney gets blocked. The blocked area is known as the renal pelvis that is where the kidney is attached to the ureters. The blocked area stops the urine from moving out of the kidney resultantly, leads to kidney damage.

Some of the symptoms of the UPJ are as follows

The urologist will diagnose the kidney and the urine problem and afterwards recommend any treatment. Your urologist may do few tests like as:

1. Taking blood samples and urine samples to check the condition of the kidney’s filtration process.
2. Nuclear renal scan from which the doctor can gather good information about the blockages and the kidney condition with the help of a special camera.
3. CT scan and MRI are used to examine the situation of the kidney, bladder, and ureters.

Bladder exstrophy is a unique kind of ailment that happens by birth and includes parts like the urinary, reproductive, intestinal tract, and musculoskeletal system. Bladder exstrophy is when the abdominal wall and organs underneath it do not fuse adequately. The newborn has an inside out bladder facing outward the body that means a bladder outside the body.

Bladder exstrophy makes abdominal muscles weaker comparatively to normal abdominal; apart from this, it can cause various other problems like incontinence, reflux, infertility, catheterization, and vesicoureteral reflux (upside-down movement of urine from the bladder to kidney).

Bladder epispadias is when the urethra fails to close normally, and the inner lining of the urethra comes out on the surface of the penis. Children with bladder exstrophy also may have bladder epispadias.

Bladder exstrophy and epispadias are causes due to factors like inheritance; overdevelopment of cloacal membrane hinders growth and tissue development. It happens mostly with male, and the first child of parents with bladder exstrophy, also sometimes with the infants born through IVF is at risk of bladder exstrophy.

Without any treatment, children with bladder exstrophy will have urinary incontinence, a high risk of bladder cancer, and sexual dysfunction.

Usually, bladder exstrophy is found when the child is in the womb. Through ultrasound or MRI, doctors can recognize, but in some cases, Ultrasounds and MRI doesn’t work in those situations problem is identified after the birth.

While treatment, urologists perform reconstructive surgery, which includes adequate space for urine storage, create external genitalia, bladder control, kidney functioning. Generally, there are two surgical methods, and researches are going on about which method is better.

Complete repair of bladder exstrophy is a surgical method that is performed once and treats problems, including closing the bladder and the abdomen and repairing the outer sex organ and urethra. The surgery can be conducted after the birth or when the baby is around 2 to 3 months old.

Modern staged repair of bladder exstrophy is divided into 3 stages are 3 operations are performed while carrying out staged repair. This is done in gaps; for example, the first surgery is performed within 72 hours of birth, a second surgery is performed during the age of 6 to 12 months, and lastly, the third procedure is performed at 4 to 5 years.

The first step in the procedure covers the bladder and the abdomen, and the second procedure treats the urethra and the sex organs. Finally, the third procedure includes bladder neck reconstruction.