The pediatric urology team at Children’s Hospital has the expertise and training to successfully diagnose and treat disorders of both the genitals and urinary tract. We treat everything from bedwetting to urinary tract infections to birth defects requiring reconstructive surgery.

Dr. Elizabeth Malm-Buatsi, at MU Women's and Children's Hospital.

Young children sometimes have difficulty telling adults what is troubling them, and as they grow older, many find it difficult to discuss the awkward topics of genitals and urinary problems. Our team overcomes these challenges by providing a comfortable, relaxed environment for your child. We are trained to care for kids of all ages, and we use equipment specially designed to ensure their comfort and safety.

Although many pediatric urology problems do not require surgery, some are best managed this way. If our team recommends surgery, be sure to closely follow the pre- and post-operative instructions provided by your child’s doctor and nurses, and visit this page for helpful resources.

Conditions We Treat

Kidney and bladder disorders:

  • Hydronephrosis. Buildup of urine in the kidney, usually due to blockage, a congenital birth defect or backwards flow of urine. Our team will identify the cause and severity of this condition to determine whether surgery is necessary.
  • Vesicoureteral reflux (VUR). VUR occurs when urine flows backwards from the bladder into the ureter, the tube which connects the kidney to the bladder. Some children outgrow mild VUR cases without treatment, but surgery is sometimes necessary.
  • Ureteropelvic junction obstruction (UPJO). When the connection between the kidney and ureter is too narrow, urine cannot drain from the kidney. This results in a blockage called UPJO. If this condition does not improve on its own, it might require surgery.
  • Ureterovesical junction obstruction (UVJO) and megaureter. When the connection between the ureter and the bladder is too narrow, urine cannot drain into the bladder. This causes buildup of urine in the ureter, and the resulting swollen ureter is sometimes called a megaureter. If this condition does not improve on its own, your child might require surgery.
  • Kidney stones. Also called nephrolithiasis, kidney stones occur when solid material forms in the kidneys. In addition to causing sudden and severe pain, kidney stones can cause blood in the urine and persistent urinary tract infection. Treatment depends on the size of the kidney stone and if there is blockage of the urinary tract.
  • Kidney transplant. When children are diagnosed with end-stage renal disease, they may require dialysis when their kidneys no longer function well. These children may be interested in kidney transplantation as an alternative to dialysis. Pediatric kidney transplants can be from living donors or deceased donors; patients will be evaluated for transplantation eligibility by our transplant team.
  • Urinary tract infections. Urinary tract infections are common infections in children that can either be in the bladder (cystitis) or the kidney (pyelonephritis). Recurrent infections can be due to many different reasons, and the source of the problem determines how it is treated. Treatment can range from behavioral changes to surgery depending on the source of infections.

Conditions of the male reproductive system:

  • Hydrocele and inguinal hernia. Hydroceles and inguinal hernias occur when the connection between the abdomen and the scrotum does not close normally. This allows fluid to collect in the child’s scrotum and appear as swelling.
  • Undescended testes. Also known as cryptorchidism, this condition occurs when one or both testicles fail to move from the abdomen into the scrotum. Undescended testes increase the risk of infertility, testicular cancer and torsion. Testicular torsion is painful twisting of the blood supply of the testicle that can lead to permanent testicular damage if not treated in a timely manner.
  • Hypospadias. This occurs when your child’s urethra does not open at the tip of the penis. Instead, the opening is often on the underside of the penis, or in severe cases, located behind the scrotum. Reconstructive surgery allows the opening to be moved.
  • Chordee. This is a congenital downward bend of the penis that can cause painful erections and difficulty with intercourse as an adult. Reconstructive surgery allows for straightening of the penis.
  • Phimosis and Paraphimosis. Phimosis is the inability to retract the foreskin away from the head of the penis, and paraphimosis occurs when the foreskin is stuck in a retracted state. In many children, phimosis can be present until the age of 7. If it does not resolve on its own or causes difficulty with urination or infection, treatment is recommended. Paraphimosis can lead to irritation and swelling, when can lead to damage of the head of the penis if not addressed in a timely manner.

Our Clinics:

Our team is active in the following multidisciplinary clinics at Children’s Hospital:

Voiding Dysfunction Clinic. This clinic helps children and caregivers manage daytime and nighttime wetting, urinary tract infections, urinary frequency/urgency and other issues. Most patients are successfully treated with behavior modification, including managing coexisting constipation, timed voiding, limiting fluids before sleep and bedwetting alarms. A wide variety of medications can also be used to help prevent accidents and establish a normal urinary routine.

Spina Bifida Clinic. Patients with spina bifida often have coexisting urologic conditions including hydronephrosis, vesicoureteral reflux and recurrent urinary tract infections. Our team focuses on preventing urinary tract damage caused by these common issues. We monitor spina bifida patients with the latest technology, looking for signs of kidney damage and other problems.

Pediatric Kidney Transplant Clinic. Children with end-stage renal disease are evaluated for kidney transplantation eligibility and also are monitored by the transplant team regularly after they receive their transplant. The team is comprised of urological surgeons, pediatric nephrologists, specialty nurses and social workers who ensure your child has all aspects of transplant care provided.

Prenatal Counseling. Expecting mothers whose babies are found to have hydronephrosis are evaluated by the maternal fetal medicine team as well as in our pediatric urology clinic prior to delivery to discuss diagnosis and expectations after delivery. After the baby is delivered, he or she will usually be evaluated in the hospital and will then follow up in pediatric urology clinic.