Pediatric urology treatment in Turkey: a wide range of care

The Urology Clinic of the ANADOLU Medical Center offers, within the framework of a multidisciplinary approach, diagnostic and treatment services to patients (men, women, and children) suffering from urological disorders and pathologies.

Pediatric urology in particular represents a very important pole of the ANADOLU Center. Indeed, some urological diseases appear in early childhood and can lead to serious problems. Pediatric urology is a branch of urology that requires special professional training. For optimal care, specialists in pediatric urology work closely with related areas of pediatrics.

Among the wide range of pediatric urology care offered by the ANADOLU Center, we find:

Circumcision

Circumcision of newborn boys is a surgical procedure that involves cutting the foreskin that covers the glans penis. Most of the time, it is carried out within a few days (the 7and in the Muslim tradition) following birth.

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According to scientific studies, circumcised boys are less likely to contract:

  • Penile cancer later in life;
  • HIV infection;
  • A urinary tract infection during their childhood.

Also, female partners of circumcised men are less likely to get cervical cancer.

Surgery of the testicles (orchiopexy)

Shortly before birth, the testicles pass from the abdominal cavity to the bursa through the inguinal canal. But sometimes one or both testicles do not descend. The doctor first tries to get them through specific manipulations. Otherwise, you will have to practiceorchiopexy : it is a surgical intervention which consists in fixing the undescended testicle to the scrotum (skin which envelops the testicles).

Hydrocele (accumulation of fluid in the testicles)

A hydrocele is the accumulation of fluid in a “pocket” surrounding the testicle. This anomaly causes the increase in volume of a purse. It is a mild disease that does not risk becoming infected or progressing to a more serious disease. On the other hand, it can cause discomfort, pain or aesthetic damage.

Hypospadias (opening of the urethra below the penis)

Hypospadias, an anomaly with a genetic component, is a malformation of the penis, with a voiding orifice that is out of place. This is an extremely common malformation that currently affects 1 in 300 boys.

Obstruction of the ureteropelvic junction

This pathology is an anomaly of the junction between the kidney and the ureter. The urine produced by the kidney passes through the renal cavities and then into the ureter which leads it into the bladder. It is most often a congenital anomaly consisting of a narrowing at the exit of the renal pelvis due to a canal that is too narrow or to external compression (vessels of the lower part of the kidney). Blocking can be total or partial. And it can cause kidney damage, formation of kidney stones, or infection. This disorder is treated either by open or robotic surgery, or by pyeloplasty (remodeling of the uretero-pelvic junction).

Vesico-ureteral reflux

Vesicoureteral reflux (VUR) is defined as the countercurrent flow of urine from the bladder to the ureter and kidney (upper urinary tract).

Three methods are used in the treatment of this pathology: (a) open surgery, (b) endoscopy (or Sting): technique which consists in injecting into the wall of the bladder, near the emergence of the ureters, a gel which will compress the vesico-ureteral junction; (vs) ureteral reimplantation: operation which consists in creating an anti-reflux system which prevents urine from going up from the bladder towards a kidney.

Urinary incontinence – Enuresis

Urinary incontinence is the involuntary loss of urine through the urethra. These leaks, when they occur in children, are taken care of from the age of 5-6 years. Before this age, they are considered normal.

Enuresis refers to the disorder which consists of the involuntary emission of urine, most often at night, in a child over 5 years old. We speak of primary enuresis when the cleanliness during the night has never been acquired, and of secondary enuresis when the child has already been clean for more than 6 consecutive months.

About 15% of children, mostly boys, are affected by this problem. Bedwetting can be caused by:

  • a poorly functioning bladder that contracts involuntarily when it is full;
  • too long and too deep paradoxical sleep during which the child dreams that he is going to the toilet;
  • urinary malformation;
  • psycho-emotional problems.

The treatment of enuresis is based primarily on educational and hygienic measures. Parents should encourage their child and make him feel confident.

Kidney tumors in children (Wilms tumor)

Wilms tumor starts in embryonic kidney cells. It is the most common type of kidney cancer in children. It is usually diagnosed in children between the ages of 2 and 4 years old.

The treatment of this cancer is based on three methods: (a) robotic surgery; (b) laparoscopy: procedure that examines the abdomen or pelvis using a laparoscope (a thin, tube-like instrument with a light source and a lens); (vs) nephrectomy: surgery to remove part or all of a kidney.

Neurogenic bladder (bladder control dysfunction)

Neurogenic bladder is a lack of bladder control caused by a nervous problem (stroke, spinal cord injury, tumour, etc.). Urinary incontinence is the main symptom.

To cure this pathology, two essential operations are required: (a) the urodynamic assessment (BUD): examination that measures urinary volumes, pressures and flow rates in order to study dysfunctions of the bladder during its filling and emptying phase; (b) bladder augmentation: surgery that enlarges the bladder using a section of the child’s intestine.

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