Often in my practice I question my decision to offer surgery as the only treatment option to kids suffering from urological or surgical problem. While on one hand I wish to avoid pain and hospitalisation for the child on the other hand I hope that my decision not to offer surgery may itself should not harm the child. These blogs are a reflection of these thought processes and questions which I often ask myself.
Pelvi-ureteric junction obstruction remains one of the most common causes of fetal or antenatal hydronephrosis. Almost 1% of the pregnant mothers when subjected to antenatal ultrasound during pregnancy will be found to have some form of kidney swelling and the most common cause for this is pelvi-ureteric junction obstruction.
A good clinical examination should be done at 6 months of age to check if the testis is present or not. If the testis is present, it may have descended incompletely and may lie within the inguinal canal (just above the scrotum). Such a testis may be felt by the examining Pediatric Surgeon or a Pediatric urologist doctor. The testicle may have not descended properly, but remains within the tummy or it may be absent. In such a case a testis may not be felt by the doctor.
Our first choice nowadays for treatment of children who come with phimosis or tight foreskin is local steroid therapy using betamethasone. More than 1000 children have been treated by Dr A.K.Singal in his pediatric urology clinic all over Navi Mumbai and in Mumbai, India preventing unnecessary surgery (circumcision) in more than 800 children. This is particularly gratifying as circumcision has its own risks of infection, bleeding and anesthesia related complications.
In my practice at hypospadias foundation and MITR Hospital and other hospitals in Navi Mumbai and Mumbai, India, we have been operating children around the age of 6-9 months for the last few years with excellent surgical results and happy parents. Once the surgery and the post operative recovery period is over, parents often come and tell us that it was a good decision that they got their kid operated at this early age and now all their worries are over.
At Pediatric Urology division at MITR Hospital at Kharghar, Navi Mumbai and at MGM Hospital at Vashi, Navi Mumbai, we see about 20-30 kids with urinary stones/ kidney stones every year for the last few years. Dr A.K.Singal, Pediatric Urologist is well trained in managing the children with kidney stones using non-invasive means such as medications, extra-corporeal shock wave lithotripsy and sometimes endoscopic surgeries using lasers.
Though fetal hydronephrosis is very common and may be alarming, the good part is that in up to 70% cases, this may go away by itself either before or after birth. A regular checkup with a Pediatric urologist is a must to ensure and confirm that this has happened.
Almost 50% of the surgical problems in children are urological in nature and the most common ones are hypospadias, undescended testis, phimosis, hydronephrosis due to pelvi-ureteric junction obstruction or reflux and urinary infections. Dr A.K.Singal, a top Pediatric Urology expert talks about how Pediatric urology offers the best care for children with urinary problems.
Dr A.K.Singal, Pediatric Urologist & Hypospadias Surgeon, Mumbai, India 