Exstrophy and epispadias are rare birth defects. Exstrophy means the bladder is open and outside the body, often with epispadias, where the urethra is also open. Surgical reconstruction is needed, and with ongoing specialized care, children can lead healthy, active lives.

Pediatrics: Exstrophy & Epispadias

Podcast: Exstrophy

Exstrophy overview

**Reimplante Ureteral (Ureteral Reimplantation)** is a surgical procedure to reattach the ureter, the tube carrying urine from the kidney, to the bladder. It's performed to correct issues like urine flowing backward (reflux) or blockages, ensuring healthy kidney function and proper urine drainage.

Reimplante Ureteral

Un testículo no descendido (o criptorquidia) ocurre cuando uno o ambos testículos no han bajado a su posición normal en el escroto. Es común en bebés varones y a menudo se resuelve solo en el primer año. Si no desciende, se puede recomendar un procedimiento quirúrgico sencillo para ayudar a prevenir posibles problemas de salud futuros.

Testiculo no descendido

An inguinal hernia occurs when a small part of your intestine or fatty tissue pushes through a weak spot in your lower abdominal muscle wall, often appearing as a bulge in the groin area. This bulge may become more noticeable with coughing or straining, and can cause discomfort or a dull ache. While common, it typically requires surgery to repair and prevent complications.

Hernia inguinal

Kidney stones (piedras renales/ureterales) are hard deposits that form in your kidneys and can travel to the ureters. They often cause severe pain in your back or side, and sometimes blood in the urine. Often linked to dehydration or diet, stones may pass naturally with pain management, or require medical procedures. Staying well-hydrated is crucial for prevention and management.

Piedras Renal/ Ureteral

La cirugía laparoscópica o robótica renal es un procedimiento mínimamente invasivo para tratar diversas afecciones del riñón, como tumores, cálculos, bloqueos o para donación. Se realiza a través de pequeñas incisiones usando una cámara y herramientas especiales. Este enfoque suele implicar menos dolor, cicatrices más pequeñas y una recuperación más rápida que la cirugía abierta tradicional.

Cirugia laparoscopica o robotica renal

La cirugía escrotal se refiere a procedimientos médicos realizados en el escroto o sus contenidos. Estas cirugías abordan diversas afecciones como hinchazón, dolor o masas, buscando resolver problemas y mejorar el bienestar. La recuperación generalmente requiere reposo y seguir las instrucciones postoperatorias para una curación óptima.

Cirugia escrotal

Hypospadias and chordee are birth differences in boys where the urine tube (urethra) opens on the underside of the penis instead of the tip, and the penis may have a downward curve. These common conditions develop before birth and are typically corrected with surgery, often in infancy, to allow for normal urination and appearance.

Hipospadias y chordee

Circumcision is a surgical procedure to remove the foreskin from the tip of the penis. It's often performed on newborns for religious or cultural reasons, or later in life due to medical needs like recurrent infections or trouble retracting the foreskin. Care typically involves keeping the area clean for proper healing.

Circuncision

Newborn circumcision (circuncision neonatal) is a common surgical procedure where the foreskin is removed from a baby boy's penis. It's often chosen for religious, cultural, personal, or potential health reasons. The procedure is typically quick, and parents receive instructions for simple wound care afterward. Decisions are best made after discussing with your healthcare provider.

Circuncision Neonatal

Varicocele is a common condition where veins within the scrotum become enlarged, similar to varicose veins in the leg. It often causes no symptoms, but can sometimes lead to a dull ache, a feeling of heaviness, or contribute to male infertility. Treatment, if necessary, may involve observation, pain management, or minor procedures, typically to address discomfort or fertility concerns.

Varicocele

Vesicoureteral Reflux (VUR) occurs when urine flows backward from the bladder towards the kidneys, often due to a natural valve weakness. This condition, commonly seen in children, can increase the risk of urinary tract infections (UTIs). Many children outgrow VUR, while some may benefit from monitoring, medication, or in rare cases, a minor procedure to protect kidney health.

Pediatrics: Vesicoureteral Reflux

Pediatric UPJ obstruction is a blockage at the junction where a child's kidney connects to the ureter (the tube carrying urine to the bladder). This can cause urine to back up, potentially affecting kidney function. Often detected before birth or due to symptoms like pain or UTIs, it may require monitoring or surgery to relieve the obstruction and protect kidney health.

Pediatrics: UPJ Obstruction

Undescended testis means a baby boy's testicle hasn't moved into its proper place in the scrotum. This is often noticed at birth and, while some descend naturally, treatment like surgery is common if needed to help prevent future health issues.

Pediatrics: Undescended Testis

Testicular torsion is an urgent condition where a testicle twists, cutting off its blood supply. It causes sudden, severe pain, swelling, and often nausea. Immediate medical attention and emergency surgery are crucial to restore blood flow and save the testicle. If you suspect this, seek care right away.

Pediatrics: Testicular Torsion

Neonatal hydronephrosis means a baby's kidney(s) are swollen because urine isn't draining properly, often due to a blockage or reflux. It's usually found on prenatal ultrasounds and often causes no symptoms. Many cases improve on their own, while others require monitoring or simple treatments to protect kidney health. Regular follow-up appointments are important for your baby's care.

Pediatrics: Neonatal Hydronephrosis

Kidney cysts in children are fluid-filled sacs on the kidneys. Often harmless and found incidentally, they usually cause no symptoms but can sometimes lead to pain or high blood pressure if large. Causes can be genetic or unknown. Most require only monitoring; rarely, intervention is needed. Staying well-hydrated supports kidney health.

Pediatrics: Kidney Cysts

Hypospadias is a common birth condition where a boy's urethra (the tube carrying urine) opens on the underside of the penis, not at the tip. It occurs due to incomplete development during pregnancy. This condition is usually corrected with surgery to ensure normal function, and families should discuss care with a pediatric urologist.

Pediatrics: Hypospadias

Bedwetting (nocturnal enuresis) refers to involuntary urination during sleep in children past the age when they're typically dry. This common issue often relates to bladder development, deep sleep, or genetics. Most children outgrow it; lifestyle adjustments like managing fluids before bed and regular bathroom habits, along with patience and support, are often beneficial.

Pediatrics: Bedwetting

Ambiguous genitalia in newborns means the external genitals don't clearly appear male or female. This rare condition often stems from genetic or hormonal differences during development. A specialized medical team will carefully evaluate to determine the underlying cause and help families navigate the best path forward for their child's health and well-being.

Pediatrics: Ambiguous Genitalia

Marcos Perez-Brayfield

San Jorge

Dorado

HIMA Caguas

Call Center Todas las Oficinas

Pediatric Urologist, Urology Residency Program Director University of Puerto Rico

Surgery (Urology)

Facebook   @perezbrayfieldmd

Conditions affecting male and female reproductive organs and private areas.

Genital Conditions

Urinary and genital issues in babies, children, and teenagers.

Pediatric Urology Conditions

Conditions affecting your bladder, kidneys, and how you urinate.

Bladder and Urinary Issues

Conditions affecting your kidneys and the tubes that carry urine.

Kidney & Ureter Conditions

Conditions affecting male organs, fertility, and sexual health.

Men's Reproductive Health

Conditions about getting pregnant, preventing it, and reproductive health.

Fertility and Family Planning

Conditions that don't fit into other main groups. A mixed collection of health issues.

Other

Medical procedures are planned steps healthcare professionals take to diagnose, treat, or manage various health conditions. These can include diagnostic tests like imaging, therapeutic interventions, or surgical operations, all aimed at improving your health.

Procedures

Conditions that doctors fix, remove, or repair using an operation.

Common Surgical Procedures

Health conditions affecting sex organs, fertility, & sexual well-being.

Sexual and Reproductive Health

Health issues treated by operations and care for healing.

Surgical and Post-Surgical Care

Conditions from hard, stone-like deposits in kidneys and urinary tract.

Kidney Stones

Problems that stop urine from flowing freely from your kidneys, bladder, or tubes.

Marcos Perez-Brayfield, MD

Pediatrics: Exstrophy & Epispadias

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