Urinary System Birth Defects in Grand Rapids, Michigan

The urinary system plays a critical role in filtering waste and maintaining fluid balance. In most people, this system includes:

  • Two kidneys (located on either side of the middle back)
  • Two ureters (tubes that carry urine from each kidney to the bladder)
  • The bladder (which stores urine)
  • The urethra (the tube that carries urine out of the body)

In Grand Rapids, Michigan, pediatric urologists at Spectrum Health Helen DeVos Children’s Hospital, Trinity Health Grand Rapids, Metro Health, and Mercy Health frequently diagnose and treat congenital (present at birth) urinary system differences, including:

  • Hypospadias
  • Obstruction of the renal pelvis (ureteropelvic junction obstruction)
  • Renal agenesis (missing one or both kidneys)

These conditions are often found during routine newborn exams or prenatal ultrasounds, and families in the Grand Rapids area have access to specialized care and support.

Understanding Hypospadias

Hypospadias is a genital variation of the penis where the urethral opening is not at the tip of the penis. Instead, the opening is located on the underside and may be:

  • Just below the tip of the penis
  • Along the shaft
  • Near the base of the penis
  • As far back as the scrotum

Hypospadias is one of the most common genital variations in Michigan, occurring in about 1 in 150 births. Pediatric specialists in Grand Rapids commonly see and treat this condition.

How Hypospadias Is Detected

  • Most cases are noticed at birth during the newborn physical exam.
  • Very mild forms may be diagnosed later in childhood or even adulthood, especially if the urine stream is unusual or there are cosmetic concerns.

Common features can include:

  • Hooded foreskin (the foreskin is not fully formed on the underside)
  • Ventral penile curvature (chordee) – the penis curves downward, especially during erection
  • Urethral opening located on the underside, not at the tip

Causes of Hypospadias

The exact cause of hypospadias is unknown. Research suggests:

  • There may be a genetic component – boys with a family history of hypospadias have a slightly higher risk.
  • Environmental and hormonal factors during pregnancy may also play a role, though these are not fully understood.

Nothing a parent did or did not do during pregnancy is known to directly cause hypospadias.

Does Hypospadias Need Urgent Treatment?

Hypospadias does not usually require emergency surgery. Most families in Grand Rapids are referred to a pediatric urologist for evaluation and planning.

However, further testing and prompt specialist evaluation are important when:

  • Hypospadias is severe (opening is far from the tip)
  • There is significant chordee (curvature)
  • There are other genital differences, such as undescended testicles
  • There are concerns about urinary function (difficulty urinating, very abnormal stream)

In these situations, your child’s doctor may recommend:

  • Ultrasound of the kidneys and urinary tract
  • Hormonal or genetic testing, if indicated
  • Close follow-up with a pediatric urology team

Psychosocial Support and Normalizing Genital Variations

For families in Grand Rapids, it is helpful to know that:

  • Hypospadias is common and treatable.
  • Many boys grow up with normal urinary function, sexual function, and fertility after appropriate care.

Psychosocial support can include:

  • Speaking with a pediatric urologist who explains the condition clearly
  • Access to counseling or child psychologists, often available through major health systems like Spectrum Health or Trinity Health Grand Rapids
  • Support from local or online parent groups who have children with similar conditions

Normalizing genital differences and providing age-appropriate explanations to your child can support healthy body image and emotional well-being.

Hypospadias Surgery in Grand Rapids

Timing of Surgery

Hypospadias surgery is most commonly performed between 6 and 18 months of age. This timing:

  • Allows the child to be big enough for safe anesthesia
  • Is early enough that the child is unlikely to remember the procedure

Goals of Surgery

The main goals of hypospadias repair are:

  • Repositioning the urethral opening to the tip of the penis
  • Straightening the penis if chordee is present
  • Improving both function and appearance

Surgical Approaches

  • Mild hypospadias

    • Often repaired in one stage
    • Repositioning the urethral opening is usually straightforward
    • The foreskin can be:
      • Reconstructed, or
      • Removed (resulting in a circumcised appearance), based on parent preference

  • Moderate to severe hypospadias

    • May require a two-stage procedure
    • A skin graft using the foreskin is often needed to create or lengthen the urethra

Important: Do Not Circumcise Before Evaluation

If your son is suspected to have hypospadias:

  • Do not have him circumcised before seeing a pediatric urologist.
  • The foreskin may be needed for the repair, especially in moderate or severe cases.

Obstruction of the Renal Pelvis (Ureteropelvic Junction Obstruction)

An obstruction of the renal pelvis (also called ureteropelvic junction obstruction or pelvi-ureteric junction obstruction) occurs when:

  • Urine cannot drain properly from the kidney into the ureter and down to the bladder.

This can lead to:

  • Kidney swelling (hydronephrosis)
  • Increased risk of urinary tract infections (UTIs)
  • Possible impact on kidney growth and function

How Common Is It?

This condition occurs in about 1 in 350 babies. Pediatric kidney and urology specialists in Grand Rapids see these cases regularly, often referred from prenatal ultrasound findings.

Symptoms and Signs

In babies and children, signs may include:

  • Recurrent urinary tract infections (UTIs)
  • Poor or impaired growth
  • Abdominal or flank pain (in older children)
  • Nausea or vomiting during episodes of blockage

Sometimes, there are no symptoms, and the issue is first seen on an ultrasound.

Causes of Renal Pelvis Obstruction

The exact cause is not always clear, but factors can include:

  • Muscle abnormalities in the ureter wall that interfere with normal urine flow
  • Unusual twists or bends in the ureter
  • A blood vessel compressing the ureter, narrowing the passage for urine

Genetic factors may also contribute in some children.

Diagnosis and Treatment of Renal Pelvis Obstruction in Grand Rapids

How It Is Diagnosed

  • Prenatal ultrasounds often detect kidney dilation (hydronephrosis) before birth.
  • After birth, your baby may have:
    • Follow-up ultrasounds to monitor kidney size and drainage
    • Specialized imaging studies such as:
      • A renal scan to measure kidney function and drainage
      • A voiding cystourethrogram (VCUG) if reflux or other issues are suspected

Treatment Options

Treatment depends on:

  • Severity of the obstruction
  • Impact on kidney function
  • Presence of symptoms (such as frequent UTIs or pain)

Possible approaches include:

  • Watchful waiting with regular ultrasounds if drainage is only mildly affected and kidney function is stable
  • Antibiotic prophylaxis in certain cases to reduce UTI risk
  • Surgical correction (pyeloplasty) if:
    • Kidney function is declining
    • Obstruction is severe
    • The child has repeated infections or significant symptoms

Pediatric urology and nephrology teams at Grand Rapids hospitals work together to create an individualized care plan.

Renal Agenesis (Missing One or Both Kidneys)

Renal agenesis means that one or both kidneys did not develop.

  • Unilateral renal agenesis: One kidney is missing

    • A baby can usually live a healthy life with one functioning kidney.
    • The remaining kidney often enlarges to handle the extra workload.
    • Regular monitoring of blood pressure and kidney function is important.

  • Bilateral renal agenesis: Both kidneys are missing

    • Unfortunately, this condition is not compatible with life, as the body cannot filter waste or maintain fluid balance without kidneys.
    • This is typically detected on prenatal ultrasound, and families are offered counseling and support.

In Grand Rapids, maternal-fetal medicine specialists and neonatologists provide detailed information and emotional support for families facing these diagnoses.

Seasonal and Local Health Considerations in Grand Rapids

Living in Grand Rapids and the broader West Michigan region brings some specific health considerations:

  • Cold winters and icy conditions can increase the risk of falls and injuries in pregnant individuals, making regular prenatal care and safe mobility important.
  • Dehydration can occur in both hot, humid summers and dry, heated indoor environments in winter. Adequate hydration supports kidney health, especially in children with existing urinary tract differences.
  • Access to major health systems like Spectrum Health, Trinity Health Grand Rapids, Metro Health, and Mercy Health ensures that most urinary system birth defects can be evaluated and managed locally, without needing to travel far.

When to Call a Doctor in Grand Rapids

Contact your child’s doctor or pediatrician if you notice:

  • Abnormal appearance of the penis or foreskin at birth
  • A urinary stream that seems weak, sprays, or comes from an unusual location
  • Frequent urinary tract infections (fever, pain with urination, foul-smelling urine)
  • Poor weight gain or growth
  • Belly or side pain, especially with nausea or vomiting

Your pediatrician can refer you to a pediatric urologist at a Grand Rapids hospital for further evaluation.

Local Resources and Where to Get Help

Families in Grand Rapids, MI, can access care and information through:

  • Your GP or pediatrician – first point of contact for concerns and referrals
  • Spectrum Health Helen DeVos Children’s Hospital – pediatric urology and nephrology services
  • Trinity Health Grand Rapids – pediatric and family urology care
  • Metro Health – University of Michigan Health – specialty pediatric services
  • Mercy Health – pediatric and family medicine services

Public health resources:

  • Kent County Health Department – information on child health, immunizations, and local clinics
  • Grand Rapids Public Health programs – support for families, prenatal care connections, and child development services

Key Points for Grand Rapids Families

  • Hypospadias is one of the most common genital variations in Michigan, occurring in about 1 in 150 births.
  • The causes of hypospadias are not fully known, but family history can increase risk.
  • Hypospadias surgery is usually done between 6 and 18 months of age to improve function and appearance.
  • It is important not to circumcise your son before evaluation for hypospadias, as the foreskin may be needed for surgery.
  • Obstruction of the renal pelvis can cause recurrent urinary tract infections and impaired growth if not treated.
  • Most urinary system birth defects can be diagnosed early and managed effectively with the help of pediatric specialists in Grand Rapids, Michigan.