Specialized pediatric urological surgery treats a wide range of urologic conditions in children. This specialty spans the neonatal period through to the onset of adolescence. In this guide, we highlight pediatric urological procedures, presurgical preparation, and postsurgical care to inform parents and help them ensure their children receive the best care possible care.
Understanding Pediatric Urological Surgery: What Parents Need to Know
What is a Pediatric Urologist?
A pediatric urologist can diagnose, treat, and manage urinary and genital issues common in children. They are experienced and qualified in treating illnesses and diseases related to the kidneys, bladder, and ureters. And can include their reproductive organs.
The Common Types of Pediatric Urological Conditions
The most common pediatric urological surgical treatments are for congenital pathologies, inflammatory conditions, and functional disorders.
- Hypospadias: A congenital condition where the opening of the urethra isn’t at the tip of the penis but on its underside.
- Cryptorchidism: A condition where one or both testicles fail to descend into the scrotum.
- Vesicoureteral Reflux (VUR): A condition where urine may pass back into the kidneys, predisposing them to infections.
- Hydronephrosis: The swelling of the kidney is a consequence of urinary obstruction or other causes.
- Ureteropelvic junction obstruction: UPJ obstruction is where urine-carrying tubes exit from the kidney, causing a blockage in the outflow of urine.
Other less-common reasons to see a pediatric urologist can include:
- Kidney stones
- Urinary Tract infections
- Neurogenic Bladder (caused by spina bifida or spinal cord injury)
- Bladder exstrophy
Learn more: Common Urological Issues in Children
Pediatric Urological Surgical Techniques
The age, condition, and complexity of the problem influence the surgeon’s approach to selecting the right approach to pediatric urology procedures. There are general surgical procedures across all child-age groups.
Open Surgery: This refers to traditional surgery where a relatively large incision is made to access the area of concern.
Laparoscopic Surgery: An operation done with a small incision. This minimally invasive surgery uses a camera and a small specialized instrument.
Robotic-Assisted Surgery: In robotic surgery, a keyhole surgery technique, the surgeon performs the surgery using robotic arms for higher precision.
Preparation for Pediatric Urological Surgery – The Preoperative Assessment
The surgical team conducts a detailed pre-operative assessment before surgery. This ensures the child is physically in shape and capable of achieving a positive health outcome from the procedure. Typically, the evaluation includes the following.
Medical History and Physical Examination
The surgeon takes a medical history and carries out a physical exam. This determines the underlying health problems affecting the child.
Diagnostic Testing
Ultrasonography, X-rays, and MRIs are ordered to assess the severity of the urological situation.
Consultation
The surgeon works with other specialists. Some patients warrant consultations with other medical specialists to discuss particular issues associated with anesthesia or surgery.
Pre-Surgery Parental Guidance and Counseling
The surgeon prepares the parents for their child’s surgery with a briefing. They will discuss the procedure, its potential risks, and its expected outcome.
Critical components in guiding and counseling the parents include the following.
Briefing
The surgeon provides the parents with information regarding:
- The surgical procedure
- The processes followed during the procedure
- The amount of time the procedure will take
- The recovery time required
Discussion of Risk
The surgeon discusses the risks and potential complications with the surgical procedure, including infection, bleeding, and anesthesia issues.
Emotional Support
The healthcare provider offers reassurance to parents to quell their fears. They respond to questions, discuss after-care plans, and provide further support resources.
Preparing the Child for Urological Surgery
The surgeon determines if the child is psychologically and physiologically prepared for surgery. They use simple, age-appropriate explanations regarding the surgery to alleviate fear and anxiety.
- Comfort Measures – Carrying a favorite toy or blanket can comfort the patient and give them a feeling of security.
- Preoperative fasting – Correct compliance with the preoperative fasting instructions from the surgeon is essential to prevent anesthesia-related complications.
Recovery After Pediatric Urological Surgery
Recovery is a critical stage after surgery for the child to recover well and with minimal complications. Care in the postoperative period includes pain management to bring the child comfort. Health providers issue prescriptions and dispense guidelines for pain treatment options.
Patients and parents work closely with staff to learn about:
- How to keep the surgical site clean and dry
- When to change the wound dressing to fast-track healing
- They receive information about the signs of infection at the surgical site
- Reminded about restricted activities
- How to avoid any strain on the surgery site
The surgeon will explicitly inform the patient and their parents of the guidelines and instructions on the timelines. This includes resuming normal activities and any activities to avoid during the recovery period.
The pediatric urologist will follow the child's ongoing progress with follow-up visits to their office. Visits involve examining the surgical site to ensure that healing occurs correctly. They will evaluate the surgery's success in correcting the urological condition and restoration of normal functioning.
The parents will be informed of ongoing routine care and further treatments required in the future. Long-term measures will be set in place to ensure the sustained optimal health and well-being of the child.
In some cases, doctors may need to closely monitor the patient to prevent the urological condition from coming back. The child’s development may affect the long-term success of the surgery. Therefore, the surgeon may need to review the child’s progress from time to time.
The psychosocial factors relating to the urological condition and the surgery must be factored in for the child's general well-being. This helps them cope with the psychological or emotional effects of the experience.
ADULT PEDIATRIC UROLOGY & UROGYNECOLOGY
The attentive, compassionate physicians, providers, and staff at Adult Pediatric Urology & Urogynecology are committed to providing innovative, quality patient care in our state-of-the-art facility.
From screening and prevention to treatment and recovery, our health professionals will be there for you. Our team of dedicated physicians has been serving residents of Nebraska, Iowa, and South Dakota for more than 25 years.
