Pediatric surgeon names common urologic conditions in boys

Boys often have urological diseases that require proper attention and timely treatment. About the most common diseases, causes of their development, symptoms, diagnosis and treatment told "Izvestia" on December 28, children's surgeon, pediatric urologist andrologist "SM-Clinica", candidate of medical sciences Victor Gubarev.

The doctor named phimosis as one of the widespread diseases - the inability to withdraw the head of the penis due to the narrowing of the foreskin. At the same time, he noted that all boys are born with physiological phimosis, that is, the narrowing of the foreskin at an early age is normal.

"According to various authors, physiological phimosis independently can be resolved by the age of five to seven years with the correct performance of hygienic procedures by parents and subsequently by the child himself. However, scarring of the foreskin (scar phimosis) or hypertrophic phimosis (congenital changes in the foreskin in the form of its hypertrophy) may appear at an earlier age. Most urologists agree that the issue with the opening of the head should be solved as early as possible, "- said a pediatric urologist andrologist.

According to him, phimosis complicates genital hygiene, which can lead to inflammation in the area of the penis head and foreskin (balanitis/balanopostitis). A pronounced scar deformity of the foreskin makes it difficult to urinate and can also lead to acute urinary retention, which requires the urologist to take emergency measures.

Therefore, it is important to undergo timely medical examination. According to the order of the Ministry of Health of the Russian Federation on medical examination, at the age of three years, the child should be examined by a pediatric urologist for the first time.

Treatment of phimosis is currently carried out in two ways: conservative (in physiological phimosis or synechia) and surgical (in pathological forms, as well as in cases of ineffective treatment of physiological phimosis by conservative methods).

"It is important to note that circumcision of the foreskin is contraindicated in congenital malformations of the genital organs (hypospadias, epispadias, etc.), since the foreskin is used as a plastic material in the treatment of these malformations," - emphasized the specialist.

The second disease, which the doctor told about, is bladder-ureteral reflux (VUR), in which there is urine diversion from the bladder to the upper parts (ureter, pelvis and calyx of the kidney). In some cases, PMR can be asymptomatic.

"With PMR, during each urination, the kidney receives a hydrodynamic shock that does not exist in the norm. By simple mathematical calculations, we find that for a year the kidney of a child with DMR receives an average of 2.5 thousand such blows. Excessive pressure in the ureter and collecting system of the kidney leads to deformation of the kidney, resulting in impaired microcirculation in the kidney tissue, which in combination with hydrodynamic shocks leads to deterioration of kidney function. In addition PMR is a substrate for infection of the urinary system, by which in some cases it can be suspected," explained Gubarev.

According to him, treatment depends on the degree of DMR. In the case of the first to third degree, a surgery called "endoscopic reflux correction" can be performed.

The third common urologic condition in boys is cryptorchidism (absence of the testicle in the scrotum). In this disease, the testicle may be located in the inguinal canal (inguinal form) or in the abdomen (abdominal form).

"Most often cryptorchidism is a congenital disease. In some cases, the testicles descend into the scrotum on their own by six months of age, but if cryptorchidism persists longer, surgical treatment is recommended. In the process of surgery, the testicle and the vessels feeding it are separated from the surrounding adhesions and fix the testicle in the scrotum," the pediatric surgeon noted.

According to him, the disease is dangerous because the testicle, which is outside the scrotum, is in unfavorable conditions for development and functioning, which leads to its hypotrophy and impairment of its functions both in childhood and in the future. And also with the passage of time can occur malignization of testicular tissue - the formation of malignant tumors.

"Currently, the treatment of all these diseases is carried out according to time-tested methods that have proven their effectiveness and safety. The scope of diagnosis and treatment methodology is chosen by the attending physician in a dialog with the patient's parents", - summarized the specialist.

Earlier, orthodontist, head of the orthodontic department of the scientific and clinical center EUROKAPPA clinic Victoria Radko told "Izvestia" that if you do not wean a child from the habit of sucking a pacifier, it can lead to a violation of normal jaw growth. The upper jaw will gradually narrow and the lower jaw will shift backwards, which will cause a distal bite.