Pediatric urologists, such as Dr. Herz and Dr. Walker, are surgeons who can diagnose, treat, and manage children’s urinary and genital problems. This is a surgical subspecialty that focuses exclusively on disorders of children’s genitourinary systems. Pediatric urologists provide care for both boys and girls from birth up until early adulthood.
What kind of training do pediatric urologists have?
These are the qualifications that Dr. Herz and Dr. Walker had to attain to be our pediatric urologists at UT Urology:
- Complete at least 4 years of medical school
- Complete a 1- to 2-year surgical residency
- Spend at least 4 additional years of residency training in general urology
- Spend an additional 2-3 years of fellowship training in pediatric urology
A pediatric urologist must devote a minimum of 75 percent of his or her practice to the urologic problems of infants, children, and adolescents.
What are the most common conditions treated by a pediatric urologist?
The most common health issue seen by pediatric urologists is a urinary tract infection (UTI). These are more prevalent in girls than in boys. Roughly 8 percent of girls and 1 to 2 percent of boys have had a UTI by the time they are 5 years old.
This is the range of our most addressed health conditions:
- Evaluation and management of voiding disorders, vesicoureteral reflux, and urinary tract infections that require surgery
- Surgical reconstruction of the urinary tract (kidneys, ureters, and bladder) including genital abnormalities, hypospadias, and disorders of sex development
- Surgery for groin conditions in childhood and adolescence (undescended testes, hydrocele/hernia, varicocele)
- Evaluation and surgical management of kidney stone disease
- Surgical management of tumors and malignancies of the kidney, bladder, and testis
- Evaluation and management of urological tract problems identified before birth
- Evaluation and management of urinary tract problems associated with neurological conditions such as spina bifida
What causes nighttime bedwetting/incontinence?
Bed-wetting before the age of 7 is not unusual. Although most children are fully toilet trained by age 5, they still may be developing nighttime bladder control.
However, bed-wetting may be a sign of underlying conditions that may require evaluation by one of our pediatric urologists at UT Urology.
- Inability to recognize a full bladder — Sometimes the nerves that control the bladder are slow maturing, so a full bladder may not wake the child.
- Urinary tract infection — These infections make it difficult for children to control urination. Signs and symptoms of UTIs may include bed-wetting, daytime accidents, frequent urination, red or pink urine, and pain during urination.
- A structural problem with the urinary tract
- A small bladder — if the bladder is not fully developed and cannot hold the amount of urine produced during the night, bed-wetting can occur.
- Hormone imbalance — Some children don’t produce enough anti-diuretic hormone to slow nighttime urine production.
When should a child see a pediatric urologist?
Minor pediatric urology problems, such as a urinary tract infection, can be treated by your child’s pediatrician or primary care doctor. But when the issues are more serious, then it’s time for a pediatric urologist to take over.
You should come see our pediatric urologists at UT Urology for ongoing, urgent, and issues outside of routine health. These would be problems with the kidneys, urethra, testicles, and genitalia.
These are common conditions that would need a pediatric urologist:
- Hernias (bulging in the groin or scrotum)
- Hydroceles (swelling around a testicle)
- Undescended testicles
- Varicoceles (enlarged veins in the scrotum)
- Vesicoureteral reflux (reflux of urine from the bladder back into the kidneys)
- Hypospadias (abnormal development of the opening of the urethra in boys)
- Ureteropelvic junction obstruction (blockage of the kidneys)
- Recurrent urinary tract infections
- Kidney or bladder stones
- Swelling of the kidneys
- Neurologic disorders of the bladder
What sorts of signs or symptoms would I watch for?
With many urologic problems, the child has discomfort, but there isn’t an immediate need for intervention by a pediatric urologist. Urinary tract infections are the second most common bacterial infection in children. These infections will show themselves in a frequent need to urinate and pain during urination. These will require treatment, but it is not an emergency situation.
But there are times when immediate treatment is necessary:
- You notice a mass in a testicle
- You notice the bulge of a hernia that is painful but can be pushed back inside the body
What is the process during my child’s first visit with a UT Urology pediatric urologist?
We’ll start the appointment by gathering your child’s vital signs, height, and weight. We’ll go through his or her medical history with you. Then your child and you will meet with Dr. Herz or Dr. Walker.
They will perform a physical examination focusing on the problem area. This may include:
- Pressing on your child’s belly and back to check for abdominal pain or back pain.
- Examining your child’s genital area.
- Examining the area immediately above the buttocks to check the spine.
At this point, we’ll discuss what we see going on with you. We’ll answer the questions you have. If we need more information, we may recommend tests or imaging that could include:
- Ultrasound of the kidneys and/or bladder to look for blockage
- X-rays of the internal urinary tract to look for blockage of urine outflow or urine reflux
- Low-dose radiation imaging of the kidneys to ascertain function
- Testing of the speed of the urine stream, how much the bladder is able to be cleared, and pressure inside the bladder
Why is a pediatric urologist a better option for treating my child’s condition?
Pediatric urologists, such as Drs. Herz and Walker, are trained to understand problems and pain in children that can’t be easily expressed by the child. They examine, diagnose, and treat urology and genital problems in children in a comforting and relaxing environment to help put your child at ease.
What are the next steps if issues persist after my visit?
Our first treatment approaches, as long as the situation is not an emergency, are always the most conservative. However, in some cases these aren’t adequately impacting the problem, so surgery may be necessary.
Are boys or girls more likely to develop urology problems?
During the first year of life, boys are more likely than girls to have a structural/anatomic reason for urinary problems. Girls are more likely to develop urinary tract infections.
Why should I trust UT Urology for pediatric urology problems with my child?
Dr. Herz has worked to create our pediatric urology practice at UT Urology. As one of the only board-certified, fellowship-trained pediatric urologists in Chattanooga, Dr. Herz has extensive training in open, robotic, and minimally invasive surgical techniques necessary for treating a variety of pediatric urologic conditions.
Dr. Walker joined UT Urology in 2019 and became, along with Dr. Herz, only the second fellowship-trained pediatric urologist in Chattanooga. Dr. Walker specializes in a variety of complex congenital and acquired urologic conditions, which he treats through open, laparoscopic, and robotic surgical techniques.
It’s this kind of training, experience, and overall expertise that makes our Pediatric Urology Department at UT Urology the leader in this region, providing the most comprehensive pediatric urologic care.
Schedule Your Consultation Today
If you’re interested in learning more about pediatric urology please contact us for a consultation at (423) 778-5910 or fill out our contact us form. We will discuss your needs and concerns, and determine your best course of action.