Urology Conditions We Treat

• Urology Conditions
• Bladder
• Incontinence and Infection
• Genitalia
• Kidney
• Urethra
• Ureter
• Other Conditions

The CHOC Urology Center treats a wide spectrum of pediatric urological conditions and disorders in both male and female patients. Our highly trained pediatric urology specialists are experts in diagnosing and treating the conditions listed below.

Bladder

Bladder Exstrophy Exstrophy of the bladder is a condition in which the bladder is exposed on the outside of the patient’s body. Learn more about bladder exstrophy and how it is treated.

Bladder Stones Bladder stones are similar to kidney stones but occur in the bladder. Stones can be formed for many different reasons and can be made up of many different elements.

Diverticulum Bladder diverticulum are small pouches of the bladder muscle that someone can either be born with or acquire over time.

Dysfunctional Bladder Bladder dysfunction refers to problems with urination. For the bladder to function correctly, the nerves in the spinal cord send messages from the brain to the bladder to control the flow of urine. These messages may not be transmitting from the brain to the bladder as they should in patients with dysfunctional bladder. Learn more about dysfunctional bladder.

Dysuria Dysuria is difficult or painful urination and is often associated with urinary tract infections. Learn more about urinary tract infections.

Hematuria Hematuria is the presence of red blood cells (RBCs) in the urine. This may be microscopic or macroscopic. Microscopic hematuria is not visible to the naked eye but noted when the urine is examined by a microscope. Macroscopic hematuria is blood in the urine that one can see. Learn more about hematuria.

Neurogenic Bladder Neurogenic bladder, also known as “neuropathic bladder,” is a condition in which the nerves that carry messages from the bladder to the brain and from the brain to the muscles of the bladder do not work properly. Learn more about the causes, diagnosis and treatment of eurogenic bladder.

Urinary Retention Patients with urinary retention are unable to fully empty their bladder. Urinary retention can be caused by a blockage in the urinary tract or by nerve problems that interfere with the signals between the brain and the bladder.

Incontinence and Infection

Constipation Constipation is the infrequent passage of small amounts of hard, dry bowel movements, usually fewer than three times a week. Some individuals who are constipated find it painful to have a bowel movement and often experience straining, bloating, bowel leakage and the sensation of a full bowel. Learn more about constipation and how it is treated.

Daytime Incontinence Daytime incontinence may be diagnosed if a child is wetting or does not have the ability to control urination during the day. Learn more about childhood incontinence.

Noctural Enuresis (Bed Wetting) Children classified with nocturnal enuresis, also known as “bed wetting” experience urination overnight after age 6. Learn more about childhood incontinence.

Urinary Frequency Urinary frequency is the need to urinate more often than normal and is often related to a urinary tract infections, bladder dysfunction, incontinence or other medical problem. Learn more about childhood incontinence.

Urinary Tract Infections A urinary tract infection (UTI) occurs when microorganisms, usually bacteria from the digestive tract, enter into any portion of the urinary tract and cause an infection. Learn more about urinary tract infections and how they are diagnosed and treated.

Urinary Urgency Individuals with urinary urgency feel the need to urinate frequently and urgently. When urinary urgency takes place, the signals that coordinate urination are disrupted and the individual experiences an uncontrollable urge to urinate that can cause incontinence. Learn more about childhood incontinence.

Genitalia

Balanitis Balantitis is an inflammation in the foreskin of a penis.

Testicular Cancer Testicular cancer is a germ cell cancer treated in conjunction with the Solid Tumor Treatment Program at the Hyundai Cancer Institute at CHOC. The best way to monitor for testicular cancer is through regular self-exam. All boys from the start of puberty on should do self-examinations. If there are any concerns resulting from the self-examination, we encourage the boy and his family to make an appointment with the CHOC Urology Center for a more thorough examination. Learn how to complete testicular self-examinations.

Chordee Chordee is a downward bend of the penis. This is often associated with hypospadias, but may occur independently. Learn more about preparing for chordee surgery and caring for the patient afterward. Learn more about the CHOC Urology Center Hypospadias Program.

Circumcision Circumcision is a surgical procedure to remove the foreskin, which is the skin covering the head of an uncircumcised penis. Learn the facts about circumcision and postoperative care for an older child undergoing circumcision.

Disorders of Sex Development A sex development disorder exists when a child’s gender is in question at birth because genitals may not appear clearly male or female. Learn more about disorders of sex development.

Epididymal Head Cyst The tubules found behind each testicle are called the epididymis. Cysts in this area appear during puberty and are asymptomatic (typically have no obvious symptoms). Intervention is rarely required.

Epididymitis Epididymitis is an infection in epididymis. This is commonly caused by bacteria.

Epispadias Often seen in patients with exstrophy of the bladder, episadias occurs when the urethral opening is in an abnormal location. This can also occur in patients without bladder exstrophy.

Hernia As a male baby grows during pregnancy the testicles move from the abdomen into the scrotum through a canal called the inguinal canal. The canal will normally close to keep the testicles in the scrotum. If the canal does not close completely, intestine and fluid from the abdomen can continue to move through this canal into the scrotal area. This creates a bulge noticeable in the groin area. Hernias are most common in boys but can also occur in girls. An incarcerated hernia is a medical emergency and a child should seek immediate medical assistance if a hernia is unable to be reduced (cannot be pushed in), is hard or becomes painful or red. Learn more about hernia and how to care for the patient before and after hernia surgery.

Hydrocele A hydrocele occurs from a buildup of fluid in the tunica vaginalis (a thin pouch that holds the testes within the scrotum). Learn more about hydrocele.

Hypospadias A birth defect in which the opening of the urethra (the tube through which urine leaves the body) is not in its normal place. Learn more about the specialized treatment provided at the CHOC Urology Center Hypospadias Program.

Labial Adhesions Labial adhesions are caused when the labia (vaginal lips) have not parted in a female child. Learn more about how labial adhesions are treated.

Meatal Stenosis Meatal stenosis is a narrowing of the opening of the urethra, the tube through which urine leaves the body. Learn more about how meatal stenosis is treated.

Meatal Webs After a circumcision a membrane may heal across the urethra of the penis. This is often found during a physical examination by the child’s doctor or discovered when a child “sprays” urine when he begins toilet training. Learn more about meatal web correction done in the CHOC Urology Center.

Micropenis Micropenis is defined as a normally structured penis that is below the normal size range for a child. Learn more about micropenis.

Parameatal Cyst Parameatal cysts are small growths found near the head of the penis. These cysts are benign (not cancerous) and usually do not have any other symptoms associated with them. While they can resolve on their own in babies, they are easily removed in older children with minimal risk of them recurring.

Paraphimosis Paraphimosis occurs when the foreskin is retracted behind the coronal groove of the penis and cannot be returned to the unretracted position. This can cause entrapment of the penis, impairing the drainage of blood and may be a medical emergency. Learn more about paraphimosis.

Phimosis Condition in which the foreskin cannot be retracted. Learn more about phimosis.

Preputial Adhesions Preputial adhesions are one of the most common complications following a circumcision. This occurs when the raw surfaces of a newly circumcised penis are allowed to rest next to each other and they subsequently will heal together. These adhesions often cause the penis to look uncircumcised and will cover the coronal groove that should be seen after a circumcision.

Retractile Testicle A retractile testicle is a testicle that is sometimes noticed in the scrotum and sometimes not. These are caused by an active cremasteric reflex in a boy. Learn more about retractile testicle.

Scrotal Pain Scrotal pain, also known as orchitis, is any pain that occurs in the scrotum. A pain diary should be completed to better understand that characteristics of the pain.

Skin Bridges A skin bridge is a piece of skin that has adhered itself to the glans of the penis after a circumcision. This looks similar to a prepuital adhesion with the difference being that there is space underneath the bridge. These bridges often do not cause pain but as a child ages, depending on the significance of the bridge, it may cause his penis to appear tethered, or bent, when erect. These can often be corrected in an in-office procedure. Learn more about skin bridge repair.

Spermatocele Also known as a spermatic cyst, spermatocele are benign cysts that can form near the top and/or behind the testicles. These cysts are usually painless. They are normally smooth and filled with a cloudy while fluid usually containing sperm. They are similar in characteristic to epididymal cysts and normally do not need surgical intervention.

Testicular Atrophy When a boy’s testicle(s) shrink, he may have testicular atrophy. This condition may be associated with another medical conditions such as testicular torsion or undescended testicles.

Torsion Testicular torsion is a twisting of the testicles and the spermatic cord. This is a painful event for males and is considered a medical emergency. While it generally occurs in adolescent boys, it may also occur during fetal development or shortly after a baby is born. Learn more about testicular torsion and how it is diagnosed and treated.

Undescended Testicle Also known as cryptorchidism, undescended testes is a condition in which one or both of the testes have not dropped down into the scrotal sac. Learn more about undescended testicles.

Varicocele This is a condition in which varicose veins develop around the testes. It is a common condition noted in adolescent males and sometimes requires surgical correction. Learn more about varicocelectomies.

Kidney

Cross-Fused Ectopic Kidney An ectopic kidney that did not develop in the normal location in a child may fuse with a kidney on the opposite side. This is referred to as a cross-fused ectopic kidney.

Duplicated Kidney A kidney with two separate collecting systems with two ureters draining the kidney is a duplicated kidney. Children who have an ureterocele may also have a duplicated kidney. A duplicated kidney can be complete or incomplete. A complete duplication has the two ureters from the one kidney connecting directly into the bladder. An incomplete duplication has the two ureters joining into one ureter before it enters the bladder. This condition is also referred to as ureteral duplication. Learn more about duplicated kidney.

Horseshoe Kidney Horseshoe kidney occurs during fetal development as the kidneys move into their normal position. With horseshoe kidney, however, as the kidneys of the fetus rise from the pelvic area, they fuse together at the lower end or base. By fusing, they form a “U” shape, which gives it the name “horseshoe.” Learn more about horseshoe kidney.

Hydronephrosis Hydronephrosis is a swelling of a kidney due to urine accumulation. Learn more about hydronephrosis grading and pyeloplasty surgery.

Kidney Laceration A kidney laceration is a cut or tear on the kidney. These lacerations can be caused by any trauma to the abdomen, such as a fall, an automobile accident or a bike accident.

Kidney Stones A kidney stone is a hard mass that develops when chemicals in the urine crystallize or form into a mass within the kidney. Learn more about kidney stones and how they are treated.

Multicystic Dysplastic Kidney Multicystic dysplastic kidney (MCDK), is a condition that occurs in utero during a child’s development. A kidney does not form and is instead replaced by a collection of cysts.

Pelvic Kidney If a kidney does not ascend as it should in fetal development it may remain in the pelvic area and is called a pelvic kidney.

Pyelonephritis Pyelonephritis is an infection of the kidneys that is usually a result of an infection that has spread up the tract or from an obstruction in the urinary tract. Pyelonephtisis can be an indicator of vesicouretral reflux. Learn more about vesicoureteral reflux.

Solitary Kidney Most people are born with two kidneys. A person with a solitary kidney has only one kidney. A child can be born with one kidney, have two kidneys but only one working kidney or lose one kidney to a disease. While many people with one kidney can lead a normal, healthy life, some people experience reduced kidney function and high blood pressure.

Ureteropelvic Junction (UPJ) Obstruction Ureteropelvic junction (UPJ) obstruction is a blockage in the ureter where the ureter meets the kidney pelvis. It is a cause of hydronephrosis. Learn more about hydronephrosis and pyeloplasty.

Ureterovesical Junction (UVJ) Obstruction Ureterovesical junction (UVJ) obstruction is a blockage in the ureter where the ureter meets the bladder. It is a cause of hydronephrosis or megaureter. Learn more about hydronephrosis and pyeloplasty.

Urethra

Posterior Urethral Valves Posterior urethral valves (or PUV) are an abnormality of the posterior urethra that occurs in utero. This causes urine not to be effectively eliminated and can cause complications in the bladder, ureters and kidneys. Learn more about PUV.

Urethral Prolapse A urethral prolapse happens when the inner lining of the urethra sticks out through the opening of the urethra. This condition occurs most commonly to school-aged girls before puberty.

Urethral Stricture The urethra is the tube through which urine flows out of the body. A urethral stricture refers to a narrowing of the urethra, whether that narrowing affects the flow of urine or not. Urethral stricture is more common in boys than girls.

Ureter

Duplicated Ureter Children who have an ureterocele may also have a ureteral duplication, a condition in which a child has two ureters for one kidney that drain independently into the bladder.

Ectopic Ureter The ureters are the tubes that carry urine from the kidneys to the bladder. An ectopic ureter drains urine somewhere outside the bladder. Ectopic ureters are often associated with duplex kidney. Learn more about duplicated kidneys.

Megaureter Megaureter (dilated ureter) is an enlargement of one or both of the ureters of a child. Learn more megaureter and how it is diagnosed and treated.

Ureterocele If a ureter does not develop properly it can bulge and cause a small pouch into the bladder. This can block the flow of urine into the bladder. This pouch is called a ureterocele. Ureteoceles are often associated with duplicated kidneys.

Vesicoureteral Reflux (VUR) Vesicoureteral reflux occurs when urine in the bladder flows back into the ureters and often back into the kidneys. Learn more about VUR.

Other Conditions

Cloacal Anomaly There are many variations to cloacal anomalies. Normally the urethra, vagina and rectum all have separate openings on the exterior. Children with cloacal anomalies may have all three tracts merging into one common opening. Learn more about cloacal anomalies.

Congenital Adrenal Hyperplasia Congenital adrenal hyperplasia (CAH) is a genetic disorder which occurs when the adrenal gland produces an overabundance of certain male hormones called androgens. Children with CAH are born with a reproductive tract that is not normally developed. Learn more about CAH and other disorders of sex development.

Myelomeningocele (Spina Bifida) Spina bifida is a birth defect that occurs when the tissue surrounding the spinal cord do not close properly. Myelomeningocele is the most severe type of spina bifida in which the meninges and the spinal cord do not develop properly and can stick out of the open lesion. Children with spina bifida often need to be followed by many specialties, and at CHOC we are proud to offer a special spina bifida program. Learn more about spina bifida care at CHOC.

Prune Belly Also called Eagle-Barrett syndrome, prune belly syndrome is a condition found primarily in newborn males. These children have poorly developed abdominal muscles, so the stomach looks like a shriveled prune. In addition, the testicles are often undescended and there are problems with the urinary tract. Learn more about prune belly syndrome.

Urachal Reminant Before a baby is born, the urachus is a tube that connects the bladder to the umbilical cord. The urachus normally disappears before birth. When it does not disappear, a urachal cyst or remnant remains. The remant can lead to complications and is typically removed surgically.

Urogenital Sinus Urogenital sinus (UG Sinus) is a defect in females that occur during fetal development that involves the genitourinary tracts. There are many variations to this defect but the most common involve a merging of the genital tract and urinary tract into one exit out of the body. Learn more about urogenital sinus.