Hypospadias
Cause: A congenital anomaly where the urinary opening is located on the underside of the penis instead of the tip.
Symptoms: Abnormal urinary stream, downward penile curvature (chordee), difficulty with urination, cosmetic concerns.
Treatment: Hypospadias Repair – Surgical reconstruction to straighten the penis and create a functional urethra with normal appearance. Modern techniques give good cosmetic and functional results.
Epispadias
Cause: A rare congenital defect where the urinary opening is on the upper surface of the penis or near the clitoris in females.
Symptoms: Urinary leakage, incontinence, abnormal genital appearance.
Treatment: Epispadias Repair – Surgery to reconstruct the urethra, improve continence, and restore function.
Bladder Exstrophy
Cause: A severe congenital anomaly where the bladder develops outside the abdominal wall.
Symptoms: Bladder plate visible outside body, continuous leakage of urine, associated pelvic bone deformities.
Treatment: Primary Bladder Closure and Staged Reconstruction – Performed in steps to close bladder, reconstruct urinary tract, and restore continence.
Posterior Urethral Valves (PUV)
Cause: Congenital obstructing flaps of tissue in the male posterior urethra.
Symptoms: Weak urine stream, straining, recurrent infections, progressive kidney damage.
Treatment: Endoscopic Valve Fulguration – A cystoscopic procedure where obstructing valves are ablated to relieve obstruction and protect kidneys.
Vesicoureteral Reflux (VUR)
Cause: Abnormal backward flow of urine from bladder into the ureters and kidneys due to defective ureteric valve mechanism.
Symptoms: Recurrent urinary tract infections, fever, flank pain, kidney scarring, risk of hypertension later.
Treatment: Ureteric Reimplantation – Surgical repositioning of ureter into bladder (open, laparoscopic, robotic). Endoscopic injection of bulking agent is a minimally invasive alternative.
Pelvi-Ureteric Junction (PUJ) Obstruction
Cause: Blockage at the junction between renal pelvis and ureter.
Symptoms: Flank pain, recurrent infection, hydronephrosis, deterioration of kidney function.
Treatment: Pyeloplasty – Surgical reconstruction of PUJ to relieve obstruction and save kidney function. Can be performed by open, laparoscopic or robotic approach.
Urolithiasis (Stones in Children)
Cause: Metabolic abnormalities, dehydration, infection, congenital urinary tract anomalies.
Symptoms: Flank pain, hematuria, urinary obstruction, recurrent infections.
Treatment: Mini-PCNL, Pediatric URS, Cystolithotripsy – Minimally invasive, size-appropriate procedures for stone clearance in children.
Undescended Testis (Cryptorchidism)
Cause: Failure of testis to descend into the scrotum during development.
Symptoms: Empty scrotum, infertility risk, increased malignancy risk.
Treatment: Orchidopexy – Surgical fixation of testis in scrotum, ideally before 1 year of age to preserve fertility potential.
Phimosis
Cause: Tight foreskin that cannot be retracted over glans.
Symptoms: Pain, ballooning during urination, recurrent balanitis, hygiene issues.
Treatment: Circumcision – Surgical removal of foreskin, simple and curative.
Neurogenic Bladder
Cause: Bladder dysfunction due to neurological conditions (spina bifida, spinal cord injury).
Symptoms: Incontinence, urinary retention, recurrent infections, kidney risk.
Treatment: Clean Intermittent Catheterization (CIC), Mitrofanoff procedure (continent catheterizable channel), Augmentation cystoplasty (increasing bladder capacity using bowel segment).
Exstrophy-Epispadias Complex
Cause: A severe congenital anomaly combining bladder exstrophy and epispadias.
Symptoms: Bladder outside body, urinary incontinence, genital malformations.
Treatment: Staged reconstruction with bladder closure, genital reconstruction, and augmentation cystoplasty if required.
Non-functioning / Dysplastic Kidney
Cause: Poorly formed or damaged kidney, often congenital.
Symptoms: Asymptomatic or recurrent infections, hypertension.
Treatment: Nephrectomy – Surgical removal of the non-functioning kidney (laparoscopic or open).
Congenital Ureterocele
Cause: Balloon-like swelling at the lower end of ureter inside bladder.
Symptoms: Urinary obstruction, infection, hydronephrosis.
Treatment: Endoscopic incision or ureteric reimplantation – Relieves obstruction and restores drainage.