Department of Urology | Conditions and Treatments

Common and complex conditions diagnosed in the Department of Urology

  • bladder exstrophy and epispadias: a rare, complex birth defect involving the urinary, reproductive and intestinal tracts, as well as the musculoskeletal system.
  • circumcision: a surgical procedure to remove the skin covering the end of the penis, called the foreskin.
  • enuresis (urinary incontinence, bedwetting): medical term for involuntary urination or “wetting”.
  • hernia (inguinal): A hernia occurs when a section of intestine protrudes through a weakness in the abdominal muscles.
  • hydrocele: painless scrotal swelling due to fluid around the testicle. This condition only affects boys.
  • hydronephrosis: a condition where urine overfills, or backs up, into the kidney, which causes the kidney to swell. Infants with hydronephrosis may be diagnosed before or after birth.
  • hypospadias: The opening of the urethra (where urine exits the body) is not in the correct location.
  • kidney stones: small, hard deposits of mineral and acid salts formed within the urinary tract. There are many different kinds of stones. They can obstruct the drainage of urine and frequently cause intense pain.
  • undescended testes
  • ureterocele
  • urinary tract infection (UTI): a bacterial infection in the urinary tract.
  • varicocele
  • vesicoureteral reflux (VUR): In normal kidney-bladder function, urine flows from the kidneys to the bladder. In children with vesicoureteral reflux (VUR), however, the urine also flows backwards, from the bladder up toward the kidneys.
  • voiding dysfunction

Department of Urology Tests and Treatments

If your child is scheduled for one of the following tests or treatments, it may be helpful for you and/or your child to know exactly what to expect:

Voiding cystourethrogram (VCUG): This is a minimally invasive bladder test that uses a special x-ray technology called fluoroscopy to visualize your child's urinary tract and bladder. A small tube is placed inside the bladder through the urethra, and the bladder is filled with dye. The test takes about 30 minutes.

Conditions diagnosed by a VCUG include

  • posterior urethral valves
  • urethral stricture
  • ureterocele
  • vesicoureteral reflux
  • bladder stones
  • bladder tumors

Radionuclide cystogram: The test is done in a similar manner to the VCUG but is only used to diagnose vesicoureteral reflux. The test takes about 30 minutes.

Ultrasound: This is a non-invasive test that allows visualization of the bladder and kidneys. Sound waves are sent through the patient's body, and the results give 2D images of the urinary tract. The test takes about 20 minutes.

DMSA scan: This test is used to determine kidney function or kidney damage and requires a special tracer to be injected intravenously. Once injected, the tracer will light up the kidney after about 3 hours. The test will reveal the presence of kidney infection or kidney damage and takes about one hour.

MAG 3 renal scan: This is a similar test to a DMSA scan, except it also allows us to determine if there is a blockage. The tracer is injected intravenously and is followed as it travels down into the bladder. In patients who have any blockage or obstruction in the urinary tract, the test shows that the tracer does not drain. The test takes about an hour and a half.

Biofeedback treatment: In order for children to achieve normal urinary function, it is essential for them to fully relax their pelvic and urinary sphincter muscles. To help patients relax these important muscles, Boston Children's Urodynamics team uses biofeedback, a non-invasive approach that centers on a software program resembling a video game. Here's what happens with biofeedback:

  • First, skin patch electrodes are placed on the perineum (area between the anus and genitals) and abdomen to measure the child’s state of relaxation.
  • Patients then perform fun, yet challenging exercises: When a patient successfully relaxes his or her muscles, the patient launches and lands computer-generated rocket ships or opens and closes blooming flowers

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