Children

The University of North Carolina at Chapel Hill is one of the four medical centers in North Carolina that can offer a Pediatric Urologic Services specialty.  This practice in the Department of Urology is devoted solely to the management of children with both simple and complex urological problems, including vesicoureteral reflux, hydronephrosis, undescended testicles, hernias, hydroceles, and genital reconstruction for problems such as hypospadias or ambiguous genitalia.  Endoscopic and laparoscopic equipment is used in the evaluation and treatment of patients from newborn to adult.  State-of-the-art laparoscopic procedures for pyeloplasty and genital reconstruction minimize morbidity and subsequently decrease hospital stay.  Further speciality in managing rare congenital problems such as female pseudohermaphroditism, prune belly syndrome, bladder exstrophy, and urethral valves is available.

Vesicoureteral (Vesico = bladder, ureteral = ureter) Reflux is the backward flow of urine from the bladder up the ureter to the kidney.  Reflux is caused by an abnormal attachment to the ureter to the bladder resulting in a small, nonfunctioning valve which allows the urine to flow back up to the kidney.  The prevalence of reflux is higher in girls (about 3/4) and fair-skinned children and appears to be inherited from the parents in some children; approximately 1/3 of the child's brothers and sisters will also have reflux.

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Hydronephrosis (Hi-dro-nef-roe-sis) is a condition where urine overfills, or backs up, into the kidney, which causes the kidney to stretch (dilate), much like a balloon when it is filled with water. Infants with hydronephrosis may be diagnosed prenatally (before birth) or after birth during evaluation for other issues or after a urinary tract infection.

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The testicles of most baby boys are descended at birth into the scrotal sac.  About 3% of boys will have hidden or undescended testicles.  The testicle can often be felt in the inguinal canal in the area of the groin.  It is highly unlikely that the baby's testicles will descend into their proper place after the first six months of life, and certainly after one year of age the testicles will need to be surgically brought into position.  The surgery to bring down the testicles into the scrotum is called orchiopexy (orchio = testicle, pexy = stitch into place) and is perforemd as an outpatient procedure under general anesthesia.

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Hypospadias (hi-poe-SPAY-dee-us) is an abnormality of the penis in which the opening of the urethra (the tube which drains urine during voiding) is located on the underside of the penis, instead of at the tip of the penis.

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There are many causes of wetting and soiling problems in children.  The pattern of wetting may be due to a medical condition (such as a urinary tract infection) or emotional stress (starting a new school, new sibling etc).  It can also be a matter of normal development, with no medical cause.  Knowing the cause of wetting will help your child’s doctor decide on the best treatment.

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