Dr. Prabhu Karunakaran, consultant pediatric urologist at the Asian Institute of Nephrology and Urology, Hyderabad, emphasizes the importance of understanding urinary tract infections (UTIs) in both adults and children, as there are differences in risk factors and prevalence. In children, repeated UTIs require evaluation by a pediatric urologist since approximately 30 percent may have anatomical abnormalities, such as vesicoureteric reflux (VUR). UTIs are more prevalent in male infants, particularly those who are uncircumcised.
However, after the first year, the risk shifts, with females becoming more susceptible due to anatomical factors, including their shorter urethra, which is closer to the anus and facilitates bacterial entry. Symptoms of UTIs vary by age; infants may show non-specific signs like fever, irritability, poor feeding, or vomiting, while older children might experience painful urination, frequent urges, lower abdominal pain, and foul-smelling or cloudy urine. Fever can occur if the infection reaches the kidneys. Risk factors for UTIs include congenital urinary tract abnormalities, dysfunctional voiding, constipation, and VUR.
Diagnosis involves urinalysis, urine culture, and kidney ultrasound, with treatment typically consisting of oral antibiotics; severe cases may require hospitalization with intravenous antibiotics. Surgical correction, such as ureteric reimplantation, may be necessary for conditions like VUR and other abnormalities that cause recurrent UTIs. Preventive measures include maintaining proper hygiene, treating constipation, and circumcision in males, which has been shown to reduce UTI risk in infancy. Long-term prophylactic antibiotics and surgical procedures may be needed for recurrent UTIs, especially in children with VUR.
Hyderabad, April 2024 – In a remarkable display of medical innovation, Dr. Prabhu Karunakaran, a Pediatric Urologist, successfully performed a no-scalpel cystolithotripsy procedure on a 5-month-old girl, removing a bladder stone without surgical incisions. The infant, from a farmer’s family in Nakarakal Mandal, Nalgonda district, Telangana, benefitted from this minimally invasive technique that uses advanced laser technology to break down the stone into tiny particles, which are then naturally passed through urination, reducing discomfort and speeding up recovery.
The baby presented with symptoms of passing small stones during urination and frequent fever episodes. An ultrasound revealed an 8 mm stone in her bladder and mild bladder wall thickening (cystitis), while her kidneys remained normal. After careful evaluation, Dr. Karunakaran and his team decided on cystolithotripsy under general anesthesia. They employed a Thulium Fiber laser to fragment the stone into particles smaller than 2 mm, which were successfully removed without complications.
Post-surgery, the focus shifted to pain management and preventive care, with regular follow-ups scheduled to monitor the baby’s kidney function and overall health to ensure smooth recovery. “Bladder stones in infants are rare and often challenging to diagnose early,”
explained Dr. Karunakaran. “They can be caused by factors like family history, concentrated urine, or urinary tract abnormalities. This case highlights the importance of early detection and timely intervention. Our aim was to minimize discomfort and provide a safe and effective solution.” The success of this procedure underscores the importance of advanced medical technology and specialized pediatric care in managing rare conditions like bladder stones in infants. Dr. Karunakaran’s expertise and dedication to utilizing innovative solutions have proven instrumental in delivering comprehensive care for pediatric patients. For more insights, watchDr. Karunakaran’s video on YouTube: https://youtu.be/bZy5p9cyv4Y?feature=shared
