As a parent, it can be worrying to see your child struggle with urinary or genital problems. Many children occasionally complain of pain while peeing or bedwetting, but when do these signs point to something more serious? Understanding when to consult a pediatric urologist can help you get the right care for your child at the right time.
This guide explains the most common signs that your child may need a pediatric urologist, what these symptoms could mean, and how early treatment can protect their long-term health.
Who Is a Pediatric Urologist?
A pediatric urologist is a specialist doctor who diagnoses and treats urinary and genital problems in babies, children, and teenagers. This includes conditions affecting:
- Kidneys
- Ureters (tubes that carry urine from the kidneys to the bladder)
- Bladder
- Urethra (tube that carries urine out of the body)
- Genitals (penis, testicles, scrotum in boys; and related structures in girls)
Unlike general urologists, pediatric urologists are trained to work specifically with children. They understand children’s unique anatomy, growth patterns, and emotional needs, and they use child-friendly techniques to make kids feel comfortable during evaluation and treatment.
1. Pain or Burning While Urinating
What you may notice:
- Your child says, “It hurts when I pee.”
- Crying or screaming during urination (common in toddlers and younger children).
- Refusing to use the toilet because of pain.
What it could mean:
- Urinary tract infection (UTI)
- Bladder or urethral irritation
- Narrowing of the urethra
- Stones in the urinary tract, in rare cases
If your child often complains of pain while peeing, or if this symptom keeps coming back despite treatment, it’s important to consult a pediatric urologist. Persistent pain during urination should never be ignored, especially when combined with fever, blood in urine, or abdominal pain.
2. Frequent Urination or Sudden Urgency
Signs to watch for:
- Needing to pee very often, even if only a small amount of urine comes out
- Rushing to the bathroom urgently and sometimes not making it in time
- Waking up many times at night to urinate
Possible causes:
- Overactive bladder
- Urinary tract infection
- Bladder dysfunction or incomplete bladder emptying
- Constipation-related bladder issues
Frequent urination can disrupt your child’s sleep and school life. If lifestyle changes and basic treatment are not helping, a pediatric urologist can perform detailed tests to check bladder function and suggest targeted therapies.
3. Bedwetting Beyond the Usual Age
Bedwetting (nocturnal enuresis) is very common in young children. Many children outgrow it naturally. However, you should consider seeing a pediatric urologist if:
- Bedwetting continues beyond 6–7 years of age on a regular basis
- Your child was dry at night earlier but has started bedwetting again
- Bedwetting is associated with daytime accidents, pain, or frequent urination
What could be going on:
- Bladder capacity or control issues
- Overactive bladder
- Structural abnormalities in the urinary tract
- In rare cases, neurological or hormonal problems
A pediatric urologist can help identify whether the bedwetting is simply developmental or a sign of an underlying medical condition. They can also guide you on lifestyle measures, alarm therapy, medications, and bladder training techniques if needed.
4. Blood in the Urine (Hematuria)
Seeing blood in your child’s urine can be frightening. It may appear as:
- Pink, red, or brownish urine
- Small blood clots in urine
- Blood seen only on a urine test (microscopic hematuria)
Possible reasons include:
- Urinary tract infection
- Kidney stones
- Injury to the kidney or urinary tract
- Structural abnormalities
- Certain kidney diseases
Any episode of blood in the urine should be evaluated promptly. A pediatric urologist can perform urine tests, imaging (such as ultrasound), and other studies to find the cause and start the right treatment early.
5. Recurrent Urinary Tract Infections (UTIs)
UTIs are more common in children than many parents realize, especially in girls and in uncircumcised boys. Signs of a UTI include:
- Fever without obvious cause
- Pain or burning during urination
- Foul-smelling or cloudy urine
- Abdominal or back pain
- Irritability or feeding issues in infants
If your child gets UTIs repeatedly, this could point to:
- Vesicoureteral reflux (VUR) – urine flowing back from bladder to kidneys
- Obstruction in the urinary tract
- Functional bladder issues (not emptying completely)
Recurrent UTIs can damage the kidneys over time if not treated correctly. A pediatric urologist can perform specialized tests to look for reflux, blockages, or other abnormalities and plan appropriate treatment to protect kidney health.
6. Swelling or Pain in the Testicles or Groin (in Boys)
For boys, some genital symptoms require urgent attention. You should seek immediate medical evaluation – preferably by a pediatric urologist or emergency department – if you notice:
- Sudden, severe pain in one testicle
- Swelling, redness, or hardness of the scrotum
- One testicle appearing much higher than the other
- Nausea, vomiting, or crying with scrotal pain
These may be signs of:
- Testicular torsion (twisting of the testicle) – a surgical emergency
- Infection or inflammation of the testicle or epididymis
- Trauma-related injury
Other non-urgent concerns that still need pediatric urology evaluation include:
- Undescended testicles (testicles not present in the scrotum) after 6 months of age
- Hydrocele (fluid-filled swelling around the testicle)
- Hernia in the groin
- Noticeable difference in testicle size
These problems may affect fertility and hormone function later in life if not treated at the right time.
7. Abnormalities in the Penis or Genitals
Some genital differences are visible soon after birth, while others become noticeable as the child grows. Reasons to see a pediatric urologist include:
- Hypospadias – opening of the urethra is not at the tip of the penis but on the underside
- Chordee – bent or curved penis, especially during erection
- Foreskin that cannot be retracted (phimosis) with pain, infections, or ballooning while urinating
- Recurrent redness, swelling, or infections of the foreskin
- Very small opening for urine, causing a thin or forceful stream
Many of these conditions can be corrected with safe surgical procedures when done by a trained pediatric urologist. Early evaluation helps in planning surgery at the best age and reducing emotional stress for both child and parents.
8. Abdominal, Side, or Back Pain Related to Urination
Unexplained pain in the side, back, or lower abdomen that seems connected to urination should never be ignored. You may notice:
- Your child complaining of “tummy pain” while or after peeing
- Holding the side or back during painful episodes
- Nausea or vomiting along with pain
This could be related to:
- Kidney stones
- Blockage in the ureter
- Swelling of the kidneys due to obstruction (hydronephrosis)
A pediatric urologist will typically recommend imaging tests like ultrasound to find the cause and will guide you about medication, dietary changes, or surgery if required.
9. Difficulty Starting or Stopping Urine Flow
If your child struggles to start urinating, has a weak stream, or dribbles urine after finishing, it may indicate:
- Narrowing of the urethra
- Bladder outlet obstruction
- Functional voiding problems
In boys, straining or a very thin urine stream can also be a sign of structural issues requiring detailed evaluation and sometimes surgical correction. Early intervention can prevent future bladder and kidney damage.
10. Congenital (Birth) Abnormalities Detected on Ultrasound
Sometimes, abnormalities in the kidneys or urinary tract are first noticed during pregnancy or soon after birth, such as:
- Dilated kidney (antenatal hydronephrosis)
- Duplicate collecting systems (double ureters)
- Structural abnormalities of the bladder or urethra
When Should Parents Not Delay?
You should seek prompt advice from a pediatric urologist if you notice:
- Persistent or recurrent urinary symptoms (pain, frequency, urgency)
- Bedwetting with other urinary complaints or behavioral changes
- Any visible blood in urine
- Recurrent fever suspected to be from urinary infections
- Swelling, pain, or redness of the genitals, especially sudden testicular pain in boys
- Noticeable abnormalities of the penis, testicles, or urinary opening
Early diagnosis can:
- Prevent long-term kidney damage
- Reduce the need for major surgeries later
- Improve bladder control and quality of life
- Reduce emotional stress and embarrassment for your child
How a Pediatric Urologist Evaluates Your Child
A typical visit may include:
- Detailed history
- Symptoms, duration, toilet habits, past infections, family history.
- Physical examination
- Abdomen, back, external genitalia, and sometimes a gentle rectal exam in older children if needed.
- Tests and imaging
- Urine tests and cultures
- Ultrasound of kidneys and bladder
- Special imaging like MCU/VCUG, nuclear scans, or uroflowmetry (to study urine flow), when indicated.
- Management plan
- Lifestyle and dietary changes
- Medications
- Bladder training, physiotherapy, or behavior therapy
- Minimally invasive or open surgery for structural problems, when required
Pediatric urologists focus on both physical and emotional comfort. Many clinics are designed to be child-friendly, helping kids feel relaxed during visits and procedures.
Supporting Your Child Emotionally
Urinary and genital problems can be embarrassing or frightening for children. As a parent, you can help by:
- Staying calm and reassuring – avoid shaming or blaming the child.
- Explaining that many kids have similar problems and that doctors can help.
- Encouraging them to talk openly about their symptoms.
- Respecting their privacy, especially in older children and teens.
When you choose a qualified pediatric urologist, you get a partner who not only treats the condition but also understands your child’s emotional needs. Symptoms like repeated pain while urinating, frequent UTIs, persistent bedwetting, blood in urine, or visible genital abnormalities should never be ignored. Early evaluation and treatment can prevent complications. If you are a parent looking for expert, child-friendly care, do not hesitate to consult a pediatric urologist in Pune.
