Pediatric Urology in the Central Coast of California

There are several pediatric urology conditions, which we treat. We see boys for cryptorchidism/undescended testes & phimosis. We see boys and girls for vesicoureteral reflux (VUR) and ureteropelvic junction obstruction (UPJO).

Cryptorchidism (Undescended Testes)

All boys are supposed to be born with two testicles that have descended into the scrotum prior to birth. However, there are some boys that are born premature and others that actually are delivered at full-term and the testicles never made it down to their proper anatomical location in the scrotum. For the testicles to develop normally, they need to be there. Therefore, if they have not come down on their own, they can be brought down surgically. This is necessary for them to develop to their optimal potential for fertility and testosterone production. Additionally, these testicles that have not descended are at higher risk for developing testicular cancer and need to be brought down so that they can be monitored.

Vesicoureteral Reflux (VUR) and Ureteropelvic Junction Obstruction (UPJO)

VUR and UPJO are congenital abnormalities involving the ureter. Normally, urine is supposed to freely drain from the renal pelvis of the kidney, down into the ureter without any obstruction. However, if the ureter was not connected normally or there are vessels that are crossing over the ureter, then there may be an obstruction. As the urine drains down the ureter, once it gets into the bladder, it is not supposed to be able to reflux back up into the ureter or the renal pelvis of the kidney. This also can happen as a congenital anomaly.

For many children, they may outgrow these ureteral problems. If they have not, by a certain age, they will need to be repaired surgically. If a UPJO is not corrected, that can lead to kidney failure and also increase the individuals risk for your new truck, infections and pain. The UPJO is usually fixed laparoscopically with a dismembered pyeloplasty, which is the gold standard. This involves disconnecting the ureter and re-implanting it in an unobstructive manner. UPJO can also be repaired with an endoscopic incision using a laser, but this is not as successful as the gold standard.

When the ureter has vesicoureteral reflux, it will need to be corrected as these individuals will have a higher risk for urinary tract infections. It can be repaired with a simple endoscopic injection of a bulking agent. If the reflux is minor, or it may potentially need a ureteral reimplant, which would be done surgically as well.