Urologic conditions are problems that can affect the urinary tract. This includes the kidneys, bladder and the tubes that carry urine. Urologic conditions can also involve the reproductive system, such as the genitals.

The urinary tract helps clean the blood by removing extra fluid and waste from the body.

The main parts of the urinary system include:

• Kidneys: The two organs that filter waste and extra fluid from the blood to create urine.
• Ureters: The tubes that carry urine from the kidneys to the bladder.
• Bladder: A hollow organ that stores urine until the body is ready to release it.
• Urethra: The tube that carries urine from the bladder out of the body.

Urologic conditions can cause problems such as:

• Trouble peeing or not being able to empty the bladder fully
• Leaking urine or issues holding it in
• Frequent bladder or urinary tract infections
• Swelling or pain in the belly or private area
• Differences in how the kidneys, bladder or genitals look or work

Some urologic conditions may be present at birth, called congenital conditions or differences. Others can occur in the urinary system when something blocks the normal flow of urine, causing it to back up. Urologic conditions can also include genital tract disorders that affect the reproductive system.

Urologic conditions present at birth:

• Atypical genitalia: When a baby is born with genitals that don’t fit the typical definitions of male or female. They may need tests to check chromosomes and hormones for the cause and the best treatment.
• Bladder exstrophy and epispadias: Bladder exstrophy is a rare condition. It occurs when the bladder doesn’t form right before birth and is often exposed outside the body. Epispadias is a condition that impacts the tube carrying urine from the bladder.
• Inguinal hernia: Occurs when a baby is born with a weak spot in the lower belly, allowing tissue to bulge through. It can cause a soft bulge in the groin area.

Urologic conditions that may block or cause narrowing of the urinary system:

• Hydronephrosis: When one or both kidneys swell because urine can’t drain out properly. This can happen from a blockage or urine flowing the wrong way.
• Meatal stenosis: When the opening at the tip of the penis becomes too narrow, making it hard for a child to pee. This may cause a thin or spraying urine stream, discomfort or frequent peeing.
• Neurogenic bladder: This happens when the bladder nerves don't work properly. It often occurs due to conditions like spina bifida or spinal cord injury. It can lead to problems storing or emptying urine and result in accidents, infections or kidney damage.
• Posterior urethral valves: Extra tissue in the urethra blocks urine from leaving the bladder. This can cause swelling in the bladder and kidneys, leading to infections or kidney damage if not treated early.
• Ureteral duplication: When a child is born with two ureters from a single kidney instead of one. Sometimes, an extra ureter can cause problems. It can lead to urine flow issues, infections or kidney damage if the extra ureter doesn't drain properly.
• Vesicoureteral reflux: This happens when urine flows backward from the bladder into the tubes that carry the urine. It can also back up into the kidneys. This can cause infection and may lead to kidney damage if not treated.

Urologic conditions of the male genital tract:

• Hydrocele: This occurs when fluid collects around one or both testicles. It is often painless but can cause the scrotum or groin to swell. A non-communicating hydrocele often goes away on its own, but a communicating hydrocele often requires surgery.
• Hypospadias: A condition some boys are born with where the hole where pee comes out isn’t at the tip of the penis. It is lower down. The penis may also curve downward a little or a lot.
• Micropenis: This happens when a boy is born with a penis that is much smaller than usual for his age and growth stage, but it looks normal otherwise. Low testosterone levels usually cause it during early growth.
• Scrotal pain: Pain or soreness in the scrotum that holds the testicles. Injury, infection or other conditions can cause this.
• Testicular torsion: Occurs when the cord that holds the testicle twists, cutting off the blood supply. It causes sudden, severe pain and swelling in the scrotum. It needs quick treatment with surgery to save the testicle.
• Undescended and retractile testicles: Undescended testicles occur when one or both testicles haven't moved into the scrotum before birth. Retractile testicles move between the scrotum and groin but return naturally. Both conditions may need treatment if they don’t correct themselves.
• Varicocele: Swollen veins around the testicle that can feel like a lump. It’s usually harmless but can sometimes cause pain or affect fertility.

At Children’s Wisconsin, we offer treatment for a wide range of urologic conditions in kids of all ages.

Hydrocele Repair

A communicating hydrocele does not go away on its own and requires surgery to drain the fluid. A surgeon makes a small incision in the groin area during the procedure to drain the fluid. Sometimes the surgeon will find a hernia during the surgery, which they will also repair.

Neurogenic Bladder and Bowel Treatment

Treating neurogenic bladder and bowel issues aims to control bladder pressure and stop leaks. As a child grows, the focus shifts to allowing them to manage how their bladder and bowel work in daily life. This involves preventing leaks, ensuring safe bladder pressure and allowing convenient bladder emptying.

Treatment options may include:

• Medicines to relax the bladder or manage bowel function
• Botox injections to reduce bladder tightening or squeezing
• A catheter to help empty the bladder
• Surgery to enlarge the bladder or to help manage bowel issues

Nephrectomy

A nephrectomy is a surgery that removes part of or an entire kidney. Doctors perform this procedure on kids with a diseased or severely injured kidney.

Pyeloplasty

Pyeloplasty involves surgery. It fixes a blockage where the kidney meets the ureter, often done to treat hydronephrosis. A doctor may suggest this surgery if narrowing in the area prevents urine from draining properly from the kidney.

Ureteral Reimplantation

Ureteral reimplantation involves surgery. It corrects an issue where urine flows backward from the bladder toward one or both kidneys. This condition, called urinary reflux, can cause infections that damage the kidneys.