Pediatric

Local Pediatrics: Urinary Frequency

Pollakiuria, more commonly known as urinary frequency, is when a previously toilet trained child shows a sudden increase in frequency of needing to urinate throughout the day. These frequent bathroom trips will be partnered with much smaller amounts of urine expelled than normal.

Children ranging from 3-14 years old may suffer from pollakiuria, and those ages 5-6 are the most likely to have symptoms. Urinary frequency is self-limited, meaning it eventually resolves itself on its own and has no long-term health risks. The average case of urinary frequency will last approximately 7-12 months.  

Symptoms and Signs

  • Increased frequency of urination, often ranging from 15-20 minutes, though the window can be as small as 5-minute intervals between bathroom visits
  • Small amounts of urine loss
  • Normal urine color, odor and stream
  • No change in bowel movements or health
  • Able to sleep through the night without accidents
    • Approximately 25% of children suffering from pollakiuria will experience urgency at night
  • No abnormal sensations or pain

Diagnosis and Next Steps

Even though urinary frequency in children has no long-term ill effects, parents often feel distress due to their child’s discomfort and concern over how constant interruptions to urinate may affect school and other daily activities. Upon contacting their pediatrician or pediatric urologist, parents should be prepared to discuss medical history, including if the child has suffered from urinary tract infections. Parents can also expect doctors to perform a few tests in order to rule out more serious urological problems.

There are no known causes of pollakiuria, though stress is considered the most likely trigger. Children experiencing significant social or emotional stressors at home or school are the most likely to suffer from urinary frequency. Fortunately, improvement is often seen when the stressor is addressed, be it through therapy or some other intervention.

The main treatments for urinary frequency are simple. The first is to reassure the child (and parents) that there is nothing abnormal about the situation and that it will resolve itself, usually within weeks or one or two months. The second is to attempt to discern the emotional trigger and allow the child to address that trigger with his or her parents and possibly a therapist.

If your child is showing signs of urinary frequency or any other urological issues, AUNC offers personalized pediatric services and can help bring comfort to your child and to you. Our main branch and administrative office is located at 3821 Ed Drive, Raleigh, NC 27612 and can be reached at 919-758-8677. We have eight clinics conveniently located throughout the region, and their contact information, including driving directions, can be found on our “Contact Us” page on our website.

Local Pediatric Information: Undescended Testicles

Cryptorchidism – the condition known as undescended testicles – is the most common genital abnormality in boys. While growing in his mother’s womb, a baby boy’s testicles normally form within the abdomen and later descend into the scrotum just before he is born. Cryptorchidism takes place when that movement does not occur.

Symptoms and Statistics

The health condition of undescended testicles affects approximately 4% of baby boys born at term and 30% of boys born prematurely. Of those, most of their testicles will descend naturally within the first three months of life. If, however, the testicles do not descend within those three months, treatment will be required, as the testicles will no longer naturally descend after that point. 1 or 2 boys out of 100 will end up needing treatment

The symptom of cryptorchidism is not seeing a testicle where one would normally “expect” to find it – in the scrotum

Diagnosis, Next Steps and When to Seek Medical Treatment

Typically, an undescended testicle will be noticed by the doctor providing the examination after birth. Parents should ask their doctor how often they need to check to see if the testicle descends on its own.

It is crucial to treat undescended testicles early in life, as cryptorchidism has been linked to such health risks as infertility and testicular cancer later in life.

Some older boys, ages 4 months through pre-adolescence, may seem to “lose” a testicle that was previously visible. This can be a symptom of either:

  • Retracted Testicle – a testicle that moves between the scrotum and the groin and can be guided into the scrotum during a physical exam. This condition is not abnormal or considered a health risk.
  • Ascending Testicle – a testicle that has moved back into the groin and cannot easily be moved back into the scrotum by hand. This condition requires medical attention.

Parents who notice a change in their son’s genitals or are concerned about the development of his genital organs are urged to contact their family pediatrician or urologist.

Potential causes or contributing factors to undescended testicles include:

  • Low birth weight
  • Family history of testicular problems
  • Alcohol or tobacco use by the mother while pregnant
  • Premature birth
  • Parental exposure to some chemicals and pesticides before conception

Parents seeking medical attention for their son in regards to cryptorchidism should notify their provider if they experienced any of these conditions.

Associated Urologists of North Carolina is committed to providing exceptional pediatric care, and if your child is experiencing symptoms related to organ development or other urological problems, our board certified specialists can bring your family and child peace of mind. Our main branch and administrative office, located at 3821 Ed Drive, Raleigh, NC 27612, can be reached at 919-758-8677, and the contact information and driving directions for all eight regional AUNC clinics can be found at our contact page.

Inguinal Hernia in NC Children

A hernia is when an organ within the abdominal cavity breaks through a weakness in the abdominal wall. This can happen to adults from straining during lifting weights, for example. But the most common type of surgical problem experienced by children is a specific kind of hernia involving the groin. An inguinal hernia occurs when the intestines or fluid make their way through the inguinal opening into the groin area.

The inguinal opening is present in the womb during development, but the opening is meant to close by the time the baby is born. The opening is there to allow the testes to descend through for boys and for a smaller part of the girls’ reproductive structure to descend for females. Because the boys have a larger opening to make room for the testes, most of the problems with infants whose inguinal opening has not properly closed are males. In fact, 90% of those with inguinal hernias are male.

If the opening is smaller, nothing may come through and it may not be discovered until later in childhood. But an inguinal hernia will not heal itself and does need to be treated. Larger openings will allow the intestines to come through and create a bulge in the lower abdomen that will be more noticeable during strain. Usually, the opening allows the intestines to come through and then slide back out as the child moves, making it not very painful.

In more serious cases, the intestines can become trapped in the inguinal opening. If an emergency surgery is not done, this could lead to permanent damage to the intestines as they are choked off. The only treatment available for an inguinal hernia is surgery. The surgeon must remove the intestines from the hole and seal the opening so the hernia will not recur. The surgery itself is a fairly short – usually done in under an hour. The child will need to be given an anesthetic that leaves them unconscious during the procedure. There do not tend to be problems with recovery or complications after the inguinal opening is closed.

An inguinal hernia may be a fairly common problem for newborns, but left untreated it can cause very serious problems. It is important to have any protrusions in the abdomen inspected by a pediatric urologist in case an inguinal hernia is present. Associated Urologists of North Carolina have offices in Raleigh, Brier Creek, Apex, Durham, Chapel Hill, Cary, Wake Forest, Clayton, Dunn, Clinton and have successfully performed many surgeries on infants suffering from inguinal hernias. To set up an appointment today, please call 919-758-8677.

More Information on Pediatric Hypospadias

Hypospadias is a fairly common birth defect in boys, affecting one in every 200 male newborns. The condition describes when the urethral opening is not in the center of the tip of the penis, but is instead somewhere on the underside of the penis. There is no known cause or risk factors connected to the behavior of the parents but there do seem to be genetic links since infants are more likely to have hypospadias if someone in their family also had it.

This defect will not prevent urine from being expelled so there isn’t any immediate danger. It is however, a long-term issue for a number of reasons. If the boy isn’t treated before he is bathroom trained and out of diapers, then he will have trouble directing his urine flow and would need to sit down to urinate. Also, he would end up having painful erections later in life and other sexual functioning issues. Cosmetics are another common reason for having it corrected.

Hypospadias can be of varying severity. The least worrying variety is when the opening is underneath the tip of the penis or very close to the tip. Most will still want to have this operated on but it isn’t as serious. Then there is a moderate severity of hypospadias with the urethral opening somewhere near mid shaft and the most severe, where it opens near the scrotum. None of these should be confused with epispadias, a separate medical condition where the opening of the urethra is on top of the shaft. Hypospadias is always on the underside. They may seem similar, but are considered separate conditions and have different treatments.

Treatment for hypospadias involves surgery to correct the problem. Parents who wish to circumcise their child should not do so until this surgery is done because the extra foreskin is used to construct the functioning organ. Typically, the surgery is performed after three months and before 18 months. The child may need to be on a catheter or stent for a period until it heals but if there is a successful surgery there shouldn’t be long-term complications.

Hypospadias surgery is very technical and should only be done by experienced pediatric urologists. Associated Urologists of North Carolina’s 15 board certified urologists have a great reputation for successfully performing these surgeries. We have offices in Raleigh, Brier Creek, Apex, Durham, Chapel Hill, Cary, Wake Forest, Clayton, Dunn, Clinton and can be reached at 919-758-8677.

A Urologist for Men, Women and Children

Associated Urologists of North Carolina is one of the largest practices in the state. We have offices in Raleigh, Cary, Wake Forest, Clayton, Dunn, and Clinton and more than a dozen board-certified urologists on staff. Whether you are seeking urology care for a man, woman, or child, our practice has the expertise to diagnose and treat you.

There are many areas that urologists cover. Generally, if it is a medical issue relating to the bladder, kidney, prostate, or male sexual functioning, it will likely fall under the urology practice. For men, the most common problems for which they may see a urologist would be bladder infections, kidney stones, incontinence, infertility, erectile dysfunction, prostate cancer, testicular cancer, and vasectomies. We understand that these are all very sensitive issues to men and we treat them with nothing but the discretion and professionalism they deserve.

We also cover women’s urology concerns at Associated Urologists of North Carolina. Women tend to see obstetricians and gynecologists for their reproductive health, so unlike male patients, we do not deal as much with fertility and sexual functioning with women. However, women’s issues relating to the bladder, kidneys, and the pelvis are covered by urologists just like with men. Women’s most common concerns that may lead to them seeing a urologist include bladder infections, kidney infections, and pelvic organ prolapse. Women are more likely than men to experience infections in their bladder and kidney because their urethras are shorter, creating a shorter path for bacteria to travel.  For this reason urinary tract health is an important issue for our female patients.

Children often have a need to see a urologist as well. Obviously, male children will have similar potential issues to what was described above for males, and female children for what was described for females. However, age does play a role in many medical issues, so for an obvious example, prostate exams and fertility screenings are not pursued at this age. Children usually instead are given care for issues like undescended testicles, hernias, or urinary tract infections. Even though the health concerns are different for children, these are still important reasons to see a urologist.

So, as you can see, urologists can perform important care for every person here in North Carolina. Men, women, and children all have potential medical issues that need to be treated by a urologist. Associated Urologists of North Carolina can treat concerns of this kind for anyone, including low testosterone in older men, undescended testicles in young boys, pelvic organ prolapse in older women, and urinary tract infections in girls. If you suspect you have symptoms relating to anything discussed above, like urinary tract health or men’s sexual health, and live near Raleigh, Cary, Wake Forest, Clayton, Dunn, or Clinton, North Carolina, please give our office a call to schedule an appointment.