When you have a new baby, the biggest hope you have as a mother or father is to see your baby healthy. But sometimes, we have to worry a little because of some problems that arise while the baby is still in the womb. Today, we are going to talk about some changes or defects in the baby's urinary system that are born from birth. In medical terms, we call these 'Congenital Urinary Abnormalities'. Don't be afraid when you hear the name, if you are well aware of this, it will be easier for us to face anything.
Simply put, what are these congenital urinary system problems?
The word 'congenital' means 'from birth'. This means that these conditions are present while the baby is still in the womb or at birth. They can affect the urinary system and sometimes the reproductive system.
Think of the urinary system in our body as a system that filters water, collects it in a tank, and then releases it through a pipe. There are a few main parts to this system:
- Kidneys: These are the two super filters in our body. The main function of the kidneys is to filter out unnecessary salts, water, toxins, and waste products from the blood and produce urine . Normally, everyone has two kidneys.
- Urinary Bladder: This is a small, elastic sac that temporarily stores urine produced by the kidneys.
- Ureters: These are the two tubes that carry urine from the kidneys to the bladder.
So, these congenital abnormalities we're talking about are certain changes or defects that occur in parts like the kidneys, bladder, or urethra when they're formed.
What are the most common congenital problems of the urinary system?
There are several types of such conditions. Some are very common, while others are very rare. Let's simply understand the main types. I have put this information in a table for easy understanding.
| Name of Condition | What happens in this condition? |
|---|---|
| Hydronephrosis | Simply put, kidney stones are swelling. Because of a blockage somewhere in the urinary tract, urine cannot flow from the kidneys to the bladder. Then, urine fills up inside the kidneys, causing the kidneys to swell. This can happen to one or both kidneys. |
| Undescended Testicles (Cryptorchidism) | This is a condition that affects boys. The testicles usually develop inside the baby's abdomen. They then gradually descend into the scrotum, a sac behind the penis. In this condition, one or both testicles are stuck in the upper part of the body instead of descending. |
| Hypospadias | This also affects boys. The urethra is the tube through which urine and semen exit the body. Normally, the opening in this tube is at the tip of the penis. But in boys with this condition, the opening is on the underside of the penis. |
| Spina Bifida | This happens because the brain, spinal cord, and surrounding membranes do not fully close while the baby is growing in the womb. In severe cases, this can damage the nerves and cause conditions like paralysis. This can lead to problems with bladder control (neurogenic bladder). |
| Vesicoureteral Reflux (VUR) | Normally, urine flows from the kidneys to the bladder. But in this condition, urine from the bladder flows backwards, up the ureters, and into the kidneys. Like water flowing up a river. This can lead to frequent urinary tract infections (UTIs) and kidney damage. |
| Bladder Exstrophy | This is a very rare condition. What happens here is that the baby's bladder turns inside out, leaving an opening on the skin of the abdomen. So, instead of leaving through the normal urethra, urine flows out through this opening in the abdomen. |
| Prune Belly Syndrome | This is also a rare condition. The main feature of this is that the abdominal muscles are very weak or absent. As a result, the skin on the abdomen looks wrinkled like a raisin. In addition, the testicles do not descend and other problems with the urinary system are also seen. |
| Posterior Urethral Valve (PUV) | This is also something that only happens to male babies. At the back of the urethra, something like an extra membrane forms, blocking the passage of urine. Then, urine cannot flow out and flows backward, causing the bladder to swell. This can also damage the urethra and kidneys. |
The most common condition seen in male children is undescended testicles .
Vesicoureteral reflux (VUR) is a common condition in girls .
What are the symptoms of this?
The symptoms that arise with these conditions vary. Some conditions do not cause any pain or visible signs. They can only be detected through tests such as scans. However, there are a few common symptoms that can be seen.
- Pain in the abdomen, stomach, or back.
- Burning or pain when urinating (dysuria).
- The urine stream is diverted to another direction instead of flowing straight.
- Passing more or less urine than normal.
- Blood in the urine (hematuria).
- Nausea and vomiting.
- Hernia conditions.
- Frequent urinary tract infections (UTIs).
- The child is not developing as expected.
Why do situations like this occur?
It's really hard to pinpoint a single cause. It's a bit complicated. Doctors believe it's often caused by a combination of environmental factors and genetic influences .
Environmental factors that can affect:
- The mother has diabetes during pregnancy.
- Insufficient intake of essential vitamins and minerals like folate and iron during pregnancy.
- Some medications taken during pregnancy, especially those for epilepsy, can damage the kidneys.
Genetically, this could be caused by certain changes (mutations) in genes that affect the child's development. But you don't need to worry too much about these. The important thing is to understand that this is not your fault or something else.
How to recognize these conditions?
These types of congenital problems are often detected during prenatal ultrasounds . When looking at a baby's development, doctors also look at the amniotic fluid that surrounds the baby. After 20 weeks of pregnancy, most of this amniotic fluid is made up of the baby's urine. So, if there is a low amount of this fluid, doctors may suspect a problem with the urinary system.
If not diagnosed before birth, doctors may suspect this during infancy or early childhood based on the child's symptoms. Then, various tests are performed to confirm the condition.
- Ultrasound Scan: This takes pictures of the body's organs.
- Urinalysis: Check for urinary tract infections.
- Blood Tests: Measure how well the kidneys are filtering blood.
- CT Scan: Uses a large number of X-rays to create detailed three-dimensional images of the inside of the body.
- MRI Scan: Uses magnets and radio waves to produce very clear images of organs.
- VCUG (Voiding Cystourethrogram): This is a special X-ray test. It helps to see what happens when the bladder fills and empties. This is especially important to check for VUR.
- Renal Scan: A small amount of radioactive material is injected into the kidneys to provide a detailed look at kidney function and urine flow.
How is it treated?
Treatment options depend on the child's specific condition and its severity.
Not all conditions require treatment. Some minor problems may resolve on their own over time, or may only require regular medical attention.
On the other hand, some conditions require treatment. These may include:
- Antibiotics: Prevent or treat urinary tract infections.
- Surgery: Surgery may be needed to remove blockages, repair the urethra, or correct other defects.
- Dialysis: If the kidneys are severely dysfunctional (kidney failure), a machine must be used to remove waste products from the body.
- Kidney Transplant: In end-stage renal failure, a healthy kidney transplant may be a solution.
The medical team treating your child will carefully examine your child's condition and develop the most appropriate treatment plan for them.
What can you expect for your child's future?
This depends entirely on the child's condition and how it affects them. Some children may need medical care for the rest of their lives. But don't worry. The medical team will work with you to develop a plan to help your child live a safe, healthy, and independent life .
As the child grows older, problems such as difficulty controlling urine and stool, frequent urinary tract infections, and kidney damage may arise. There is also a risk of kidney failure due to severe kidney damage.
Also, these conditions can affect the child's mental health. The child may feel anxious about their body and what others think of them. Therefore, it is very important to provide the child with the necessary psychological support and seek help from the medical team.
When should I see a doctor? When should I go to the ETU?
If your child has this condition, be sure to attend the clinic dates provided by the doctor. It is essential to monitor the child's development and condition.
Also, if any of the following emergency symptoms appear, immediately take the child to the nearest Emergency Treatment Unit (ETU) .
- Sudden or unbearable pain in the stomach, flank, or back.
- A fever of more than 100.5 Fahrenheit (38 Celsius).
- Changes in urination: passing urine more or less than usual, inability to urinate, pain when urinating, or blood in the urine .
In such cases, do not wait at home. Prompt medical attention can prevent serious complications.
Take-Home Message
- 'Congenital urinary tract abnormalities' are conditions that occur while the baby is developing in the mother's womb. This is not the parents' fault at all.
- Many of these can be detected early through scans during pregnancy.
- If your child is having difficulty urinating, has frequent infections, or is showing other unusual symptoms, don't ignore it. Take your child to a doctor right away.
- Not all conditions require surgery or aggressive treatment. The treatment method depends on the child's specific condition.
- With the right treatment and long-term medical care, most children with these conditions can live healthy and normal lives. Your medical team will help you do that.
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