Pediatric Urology is a unique specialty. Historically, these patients were managed by general pediatric surgeons and adult urologists. Realization that: 1. Children with urological problems could not be managed the same way as children with general surgical conditions and 2.Since these problems are “manufacturing defects” they share nothing in common with adult urological problems which arise from “wear and tear” paved the way to its inevitable independence. Pediatric Urology was considered a sub-specialty as far as 20 years before, in the Americas and Europe, and is now globally acknowledged as a Specialty in its own right, independent, from general pediatric surgery and adult urology. It is imperative to understand that, the Urological disease process in a child is completely different from that of an adult.
With the exception of UM Specialist Centre, Pediatric Urology as a specialty has not existed in Malaysia.
In other Centre’s even today, unfortunately, children with Urological problems are being managed by general Pediatric Surgeons and adult Urologists.
Pediatric Urology has been a niche unit in our hospital since 2013.
- Urotherapy services for children with urinary incontinence, both daytime symptoms like urgency, frequency to name a few and nighttime incontinence(bed-wetting)
- Uroflow-EMG to diagnose children with dysfunctional voiding
- Video Urodynamic studies for children with Neurogenic Bladders
- Office Ultrasound scans to monitor the kidneys and the bladder
- Biofeedback to re-train the pelvic floor
Conditions managed exclusively by the unit
- Hydronephrosis ± hydroureter (swelling of the kidney and the drainage tubes)
- Vesico-Ureteric reflux (backflow of urine towards the kidney)
- Pelvi-Ureteric junction obstruction also called PUJO (blockage at the level of the kidney)
- Duplex kidneys needing surgery e.g.: Ureterocele (kidney split into an upper and lower half with blockage of the tubes)
- Bladder and Cloacal exstrophy (babies born with exposed bladder and infrequently along with the intestines)&Persistent Cloaca (one opening at the bottom)
- Spina Bifida with Neurogenic Bladder
- Urinary incontinence (day time)
- Enuresis (bedwetting)
- Posterior urethral Valves (blockage at the bladder outlet)
- Hypospadias ± chordee (abnormal placement of hole through which one passes urine with or without a bend in the penis)
- Buried / Concealed penis
- Phimosis (inability to retract the foreskin)
- Ambiguous genitalia (multidisciplinary team approach)
- Tumor surgery (Wilms tumor)
Conditions commonly managed with the general pediatric surgeons
- Hernia (swelling in the groin)
- Hydrocele (swelling around the testes)
- Undescended testes (testes that have not reached the scrotum or are abnormally located)