Enuresis (Bedwetting)

• Another type of incontinence is Enuresis (Bedwetting), the involuntary urine loss in bed during the night, and we refer to persons of 3 years of age and older. In 50% of the cases, the cause of this phenomenon is a developmental delay or a neurogenic bladder dysfunction. In 30% of the cases there is a psychogenic cause and the remaining 20% is the result of another condition. 
  Women are more prone to developing incontinence than men, with the possibilities to increase with age.
  Urine incontinence also has a psychological and social impact on the people who face this problem and has a negative effect in their quality of life. There is a decrease in their social activities, decreased sexual desire, shame, lack of self-confidence, and in many cases depression.
  Urine incontinence can be cured, and the therapeutic methods vary according to the type of the incontinence and the disease that causes it. video

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  Phimosis
  It is a condition in which the glans penis cannot be revealed due to preputial stenosis (stenosis or narrowness of the foreskin) that prevents retraction. The most usual cause of the condition is the chronic infection of the glans penis and the prepuce due to poor local hygiene and can occur at any age. Also people suffering from diabetes mellitus are likely to develop chronic balanoposthitis which will result in phimosis. The condition may cause problems with urination, pain during sexual intercourse, premature ejaculation, short erection, paraphimosis (inability to retract the foreskin in position over the head of the penis). Treatment is achieved through surgical operation. video

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  Microphallia
  It is a condition in which the length of the penis is abnormally small. The condition may be caused by hereditary predisposition, hormonal disorders or genetic abnormalities and may cause impotency and serious social and psychological problems and disorders. The treatment of this problem consists of surgical operation, medication and proper psychotherapeutic support.

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  Hypospadias - Epispadias
  It is the most common congenital abnormality of the penis. In this condition, the urinary meatus (opening) is abnormally located on the ventral aspect of the shaft (the scrotum or the perineum) rather than at the tip of the glans of the penis. It causes problems during urination, difficulty in sexual intercourse which may result to psychological problems. Restoration of hypospadias is achieved with surgical operation and the age of 4 years is consider the most appropriate, because at this age the penis has developed sufficiently and cooperation and communication with the child is more feasible. A similar type of congenital anomaly is “Epispadias” which can be observed to people regardless of sex. In men, the only difference with hypospadias is that the urinary meatus is located on the dorsal aspect of the shaft.

• • •Congenital Urethral Valves

  The congenital urethral valves cause obstruction of the prostatic urethra. This means that during urination these valves fall on the urethral tube causing valve obstruction of the urethra and allowing urine outlet only through the narrow opening they create. This obstruction results in the appearance of disorders in the operation of the bladder and the kidneys, and, at an older age, of sexual dysfunction. It is one of the severest diseases of pediatric urology. It is observed only in male babies and infants. Its treatment is surgical

  • •Urethral Diverticula

  The congenital urethral diverticula is a rare condition observed to both boys and girls. They are divided into sacular and spherical and cause urethral obstruction. They must be surgically removed.

  • •Double Urethra

  Double urethra is a very rare condition. It can be complete or incomplete and in some cases it can be accompanied by duplication of the penis and the urinary bladder. Its treatment is surgical and depends of the type of duplication.

  • •Bladder exstrophy

  It is the severest congenital urinary tract anomaly. It is characterized by a group of urinary tract, genetic, myosceletic and sometimes gastroenteric systems anomalies. One of the most serious types of bladder exstrophy is “cloacal exstrophy”. The treatment of these conditions is surgical and includes a series of corrective operations.

  • •Urachal anomalies

  This anomaly is accompanied by a partial bladder distention and its clinical manifestation is urine leakage from the navel, in parallel with the normal urination through the urethra. It requires surgical treatment.

  • •Cystic-Urethral retrogression

  It is a pathological condition, in which during urination or filling of the bladder, there is urine retrogression from the bladder back to the ureter and the corresponding kidney.

  • •Bladder Neck Stenosis (Marion Disease)

  This condition is rarely observed and there is doubt whether bladder neck stenosis really exists. It is considered to be caused by the development of a fibrous plexus on the bladder neck and is observed more often in boys. Treatment is surgical.

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  Cryptorhidism
  It is the condition when the testicle is not located in its regular position within the cavity of the scrotum, but in some other place of its normal descent from the kidney to the respective semi-scrotum. Anatomical, functional and hormonal disorders have been proposed at times as possible causes of the incomplete descent of the testicles. The absence of the testicle from the scrotum (the sac or pouch that contains the testes) can be easily identified during the clinical examination of the patient. The treatment is mainly surgical and the appropriate age recommended for the operation is the age of 2 years, since the early treatment of cryptorchidism is considered to be restricting the complications which ectopic testicles may present.

   

• Hydrocele
  Hydrocele is the collection of fluid between the petals of the tunica albuginea of the testicle (pre-formed fibrous capsule covering the testes), which results in a, usually painless, swelling of the scrotum. In many cases the etiological factor cannot be identified, therefore it is an idiopathic hydrocele, while there are cases when the collection of fluid is a reactive manifestation of some testicular disease, in which case it is a secondary hydrocele (possibly existing testicular cancer). It requires surgical treatment. video

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  Varicocele
  It is the varicose dilatation of the veins of the spermatic cord which results in the formation of a soft mass above the testicle (this is the stagnation of blood around the testis and is caused by the failing or insufficient function of some of the valves along the internal spermatic vein). Varicocele is usually asymptomatic unless it is very large, in which case the patient may experience pain or burden in the testis. Varicocele usually affects people of young age and requires surgical treatment. video

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  Spermatocele
  It is a small, soft cyst which contains accumulated fluid (mostly sperm) on the upper and rear part of the testis and is treated surgically. video

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  Testicular Torsion
  It is the contortion of the spermatic tone, the area which the nerves and veins ending to the testis go through (rotation of the testis around its axis). It is usually observed with children and adolescents of up to 18 years of age, it can, however, occur at older ages too. The symptoms are intense: pain, swelling of the testicle, as well as redness of the scrotum. Testicular torsion is a surgical emergency that needs immediate intervention. Severe implications of this condition are the loss (death) of the testicle and sterility. Immediate surgical treatment is required. video

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