The Scope of Paediatric Urology Practice

This is by no means an exhaustive list, but the most common problems seen in a children's urology clinic:

Hypospadias   Pelvi-Ureteric Obstruction
Phimosis   Dysplastic Kidneys
Buried Penis   Urinary Tract Infection
Incontinence   Duplex Kidneys
Vesicoureteric Reflux   Undescended Testicle

Paediatric Urology is a sub-speciality encompassing a range of congenital and acquired conditions of the genitourinary tract in children. Although it has been recognised as a sub-speciality for over 25 years, in the grand scheme of the medical world it is a relatively young and maturing sub-speciality.

The practice range covers hydronephrosis due to obstructive or refluxing pathologies, multicystic dyplastic kidney, posterior urethral valves, urinary incontinence, disorders of sexual differentiation (DSD), Genital surgery for boys including circumcision, hypospadias and buried penis, bladder exstrophy, neurogenic bladder, undescended testes and urological conditions associated with anorectal malformations.

Minimally invasive or keyhole surgery including Robotics is defining its place in some of these conditions which were traditionally managed by open operations and this has meant that children are being treated with less invasive approach, early recovery in the postoperative period and certainly greater emphasis on cosmetic outcomes.

Paediatric Urology is a Unique sub-speciality and its scope in terms of practice is immense, covering a wide range of medical problems in childhood related to the urinary tract. Children are not young adults; their physiology is very different when it comes to management of their problems, a different spectrum from adult practice. A large subset of the problems seen in Paediatric urology is congenital and developmental in origin. Moreover, the advent of antenatal diagnosis in the last 20 years has changed the outlook towards the management of certain conditions.

The majority of our children are expected to outlive their physicians by a good few years and therefore there rests a huge responsibility with us as Paediatric urologists when it comes to decision-making. Our actions today have consequences, which could last a lifetime.

Most Paediatric urologists come from a Paediatric surgical background and training and is often recognised as a sub-speciality of Paediatric Surgery in the United Kingdom and many other countries. One of the other significant links is with Adult Urology, which is the background from which practitioners can sub-specialise into Paediatric Urology and is certainly true in the USA.

The practice of Paediatric Urology is closely linked with various other disciplines including Paediatric Nephrology, Paediatric Radiology, Paediatric Endocrinology and Paediatric Oncology and transplant surgery. It is extremely important to savour a good working relationship with our colleagues from other disciplines in order to provide comprehensive care for children, who are the future of mankind.