How to find a Paediatric Urologist

Mr Robb - Paediatric Urologist - Operating

How to Find a Paediatric Urologist.

 

Paediatric Urology is a small speciality in the UK.  Not all hospitals provide a Paediatric Urology Service.  This post aims to provide advice on how to find paediatric urologist within the UK.  It is not intended to give details on how to find a pediatric urologist in other countries.

 

Paediatric Urologists are surgeons who manage problems with children’s waterworks and genitalia.

 

To find out more about Paediatric Urology please read my article “What is Paediatric Urology”.

 

So, how do you find a Paediatric Urologist?  There are a number of questions that you should ask:

 

  1. Do I need a Paediatric Urologist?
  2. Does my child have a condition that requires special expertise?
  3. Where is the closest Paediatric Urology Service?
  4. How do I find information about Consultant Paediatric Urologists?

 

 

Do I need a Paediatric Urologist?

 

This may seem like a stupid question as this post is titled "How to find a paediatric urologist."

 

There are some conditions that are also managed by other specialists, such as Paediatric Surgeons or Paediatric Nephrologists.  This may mean that you can be treated closer to home.

 

What other surgeons can operate on children?

 

There are a number of other specialists who operate on Children.

 

Paediatric Surgeons.  Paediatric Surgeons specialise in the surgical management of problems in children.  The majority of Paediatric Urologists originally trained as Paediatric Surgeons before undertaking more training.  There is a lot of cross over in what Paediatric Surgeons and Paediatric Urologists manage.

 

Adult Urologists.  Some Adult urologists also look children.  They tend to look after what is referred to as General Surgery of Childhood. This includes inguinal hernias, hydroceles, undescended testes and foreskin problems.  They may also look some children with UTIs or incontinence.

 

General Surgeons.  There are some Adult General Surgeons who also look after children with General Surgery of Childhood.  In order to look after children Adult General Surgeons will have spent time being trained in looking after children.

 

What other Specialists may be able to look after some of the conditions?

 

For a number of the conditions there are a number of other specialists that may be able to treat the child.

 

Paediatrician (including Community Paediatricians).  These are doctors who look after a child’s medical problems.    They may look after some problems such as urinary tract infections.

 

Paediatric Nephrologists.  These are Paediatricians who have specialised in problems of the kidneys.  They also look after conditions that may effect the kidney, such as Urinary Tract Infections (UTIs) or Vesico-Ureteric Reflux (VUR).

 

 

What Conditions Can be Looked After by Other Specialities?

 

Conditions that are looked after by other specialists include:

 

  • Inguinal Hernias and Hydroceles – As well as Paediatric Urologists, these can be looked after by both Paediatric Surgeons, some Adult Urologists and some General Surgeons.

 

  • Foreskin Problems – Simple foreskin problems such as phimosis may also be managed by Paediatric Surgeons, some Adult Urologists and some General Surgeons. More complicated problems with the foreskin are managed only by Paediatric Urologists.

 

  • Urinary Tract Infections – As well as Paediatric Urologists, some Adult Urologists, Paediatric Nephrologists and some Paediatricians may initially manage children with UTIs. These children may still be referred to a Paediatric Urologist for specialist investigations.

 

  • Incontinence – Like with UTIs, some Adult Urologists, Paediatric Nephrologists and some Paediatricians may also initially manage children with UTIs. These children may still need to be referred to a Paediatric Urologist for specialist investigations.  There are also certain causes of incontinence that will be managed by Paediatric Urologists.

 

  • Haematuria (blood in urine) – The initial investigation of haematuria can be performed by Paediatric Urologists or Paediatric Nephrologists. There are some causes of haematuria that are medical and these are managed by Paediatric Nephrologists.  Others causes are surgical and are looked after by Paediatric Urologists.

 

 

In the NHS there are some regions where GPs will refer children locally to one of these specialists because there is no local Paediatric Urologist.  After the child is seen it may be necessary for the child to be referred to a Paediatric Urologist.  This is called a Tertiary Referral.

 

Even if there is another specialist who can manage the condition, it may not be appropriate for you to see that specialist.  You may still need to see a Paediatric Urologist because of other medical conditions that your child has or because their condition needs more expertise to manage.

 

If you are unsure whether you need a Paediatric Urologist you should talk with your family doctor.

 

Assuming that you do need a Paediatric Urologist then the next question to ask is does My Child Have a Condition that Needs Special Expertise?

 

 

What conditions need special expertise?

 

There are a number of conditions that need special expertise to manage.  This may mean that to get the right treatment you child may require to travel further to see a Paediatric Urologist with the right expertise to look after their condition.

 

Within the UK, some of the conditions that require a Paediatric Urologist with special expertise include:

 

Bladder Exstrophy / Epispadias.  This is a very rare condition where the bladder develops on the outside of the body.  It is managed in only 2 centres in England – Manchester Children’s Centre and Great Ormond Street Hospital for Children.

 

Kidney Stones  Kidney stones in children are rare.  The correct management of stones requires access to a lot of equipment.  This means that not all Paediatric Urology Centres are able to kidney stones in children.  I have patients that travel over 100 miles for me to treat their kidney stones.

 

Disorders of Sex Development (DSD)  To manage children with DSD you need to have a specialist team made up of a number of specialists including Endocrinologists, Psychologists and Paediatric Urologists.  This limits the number of centres that can offer this treatment.

 

Cloaca  A cloaca is a condition found in girls where the pee tube, the vagina and rectum join together and come out as a single perineal opening (opening between the legs.)  This condition is managed by a specialist Paediatric Urologist and Paediatric Surgeon who operate together.

 

Many of these problems will be diagnosed by a neonatologist (doctor specialising in the treatment of newborn babies) or another specialist.  They will often not be an expert in the management of the condition.  They will, however, know someone who can treat it.  They will be able to give you advice on which centre or who you need to see.

 

 

Where is my closest Paediatric Urology Unit?

 

The Specialist Paediatric Urology Centres in the UK and Ireland are shown below, along with links to their respective websites.  Just click on the marker to access the details.

 

A number of centres also have outreach services.  This means that the Children's Urologists go out to District General Hospitals (DGHs) in their catchment area and do clinics.  Sometimes they also operate in these hospitals.  Outreach clinics mean that patients do not need to travel as far to see a Paediatric Urologist.

Paediatric Urology departments often have Urodynamics Nurses.  Urodynamics Nurses are equally as important in managing patients, but have different expertise.  Their roles may include:

  • Performing investigations such as bladder assessments and flow rates.
  • Video urodynamics.
  • Providing Education for patients about conditions and surgery
  • Teaching patients Clean Intermittent Catheterisation and giving them support
  • Providing Post Operative Care for patients.
  • Running some clinics - such as Nurse Led Wetting Clinics.

Some consultants also have a Private Practice and see patients at other hospitals.

 

How do I find Information about the Consultant Paediatric Urologists?

There are a number of ways that you can find out information about which consultants work in your closest Paediatric Urology Centre.  The easiest way to find this information is to search on the Hospital Website.  This will normally list the consultants working in that centre.  As an example click here to see the list of Consultants in the Paediatric Surgery & Urology Department at Birmingham Children's Hospital.

There are other places that you can look for more information.  These include:

British Association of Paediatric Surgeons (BAPS) Website.

British Association of Paediatric Urologists (BAPU) Website.

British Association of Urological Surgeons (BAUS) Website.

 

If you are wanting to find a Paediatric Urologist to see privately then there are other places to search for information.

Some Insurance Companies, such as BUPA hold a list of recognised consultants.  click here to see the list of Paediatric Urologists registered with BUPA.

Private Hospitals will have a list of Consultants which will allow you to search for Paediatric Urologists.  As many hospitals are owned by larger companies such as BMI or Spire, you can search via the company website.  Unfortunately these hospitals do not tend to have Paediatric Urology as a speciality - as it is not common.  You often have to search under Paediatrics to find the Paediatric Urologists.  Click here to open the Spire and BMI consultant lists in a new tab.

TopDoctors - This site holds a list of doctors, along with useful information about conditions they manage.

 

Many of us have sub-sub-speciality interests.  This means that although we are sub specialists as Paediatric Urologists, we have areas of special expertise.  For example I have a special interest in kidney stones and with bladder problems.  Not all of my colleagues manage kidney stones for example.  It also means there are some conditions, such as DSD that I will ask my colleagues to take over.  This is because I am not an expert in managing patients with DSD.   When I or any of my colleagues receive a referral that we feel would be better looked after by someone with a special interest, we will refer the patient to our colleague.

Why is this important?  For most common conditions, Paediatric Urologists are able to see and manage children.  You may however want to find someone who has special expertise in your child's condition.  Information about special interests or expertise should be available on their web profile.

It is also important to remember that in large Paediatric Urology Centres, such as Birmingham or GOS, Paediatric Urologists may have more opportunity to specialise and have more experience with some complex procedures.  This does not necessarily mean they are better.

 

So, How Do I Find a Paediatric Urologist?

After working out that you need to see a Paediatric Urologist, there are a large number of ways to find out information about who practices locally.

There are very few conditions that need specialist expertise to be managed.  If your child has one of these issues then you should talk with your paediatrician or neonatologist.  They will be able to guide you.

Most often the best thing to do is to use the map above to find your closest Paediatric Urology Centre.  You can then find out who the Paediatric Urologists are in that centre.

I hope that this guide will help you find a suitable specialist.