Thursday 13 February 2020

Urinary tract problems in baby boys



How does your baby boy pee?
It’s interesting what you can learn from people waiting in hospital queues. I learned something so important at my last hospital visit, I just have to share with my readers – especially moms with baby boys. It’s this - please make sure that when your baby boy makes a pee, that it’s a strong flow that arches (like the picture … ok, not into his mouth!) because this is a good indication that all is well with his water-works; bladder, ureters, and penis. If he pees in an odd direction, or urine simply dribbles out, or the tip of his penis balloons, there’s a problem.

This is what a mother told me. When her son was a baby, his nappies were always wet, so nobody (even the paediatrician) suspected there was a problem. But there was. The tubes leading from his kidneys to his bladder (called the ureters) were partially blocked. This meant that his kidneys couldn’t empty properly and over the years, this led to chronic nephritis with severe implications.

Although her baby’s nappies were always wet, urine was constantly ‘dribbling’, and, as time went by, her son picked up repeated bladder (urinary tract) infections. This should have sounded warning bells, but repeated antibiotics always solved the problem.

As her son grew older, infections became more frequent and severe so that by the time he went to school, he was in trouble. Always sick and miserable, her son struggled to make friends, couldn’t play sport and often ‘wet his pants’. Constant ‘urine reflux’ meant that his kidneys became infected (called chronic nephritis) so that by the time he was a teenager, the damage was irreversible and he needed a transplant. His mother was his donor.

Her son’s health improved remarkably after the transplant, but this has meant constant follow-ups, life-long medications like cortisone (to prevent organ rejection) and an otherwise hospital-bound life-style for her son. If the problem had been picked up early, this may have been avoided.

Other things to look out for in your little boy:

Are his testicles in the scrotal sac? Preemie baby boys often have delayed descent. Undescended testicles may have to be corrected surgically if, by three months. there are no testicles in the sac.

Is his little penis straight? If it’s curved, this is called chordee and can be corrected.

Hypospadias is when the opening for the urethra (tube for the urine) from the bladder is not at the tip of the penis where it should be, but on the underside anywhere from just below the end of the penis to the scrotum. This can vary from minor to severe and depends on whether the urethra is near the head of the penis, along the shaft or where the penis and scrotum meet. Again, this can be picked up if the baby boy does not pee in an arch. 

Unfortunately, corrective surgery is very difficult if the baby has been circumcised because the foreskin is used in reconstructive surgery.

Epispadias is when the opening is on the front of the penis.

If the foreskin ‘balloons’ when the baby boy pees, this means that the foreskin is too tight or attached to the tip of the penis and must be corrected by circumcision. 

We tend to forget the importance of these ‘unmentionable’ organs, but if there is a problem, the sooner they are seen to the better. Men can struggle unnecessarily with life-long emotional, physical and sex-related problems because their parents were ‘ashamed’ about the way their son looked, and simply used the nappy to ‘keep it covered’.

I hope this advice helps. Please pass it onto a friend if she has a baby boy.

Photo from Amber Holley.