The physicians and staff of the Pediatric Urology Group evaluate and treat your child’s pediatric urological condition with the expertise of a skilled professional and the compassion of a caring parent.
Posterior Urethral Valves (PUV) Repair
Pyeloplasty, daVinci Robotic Assisted
Undescended Testis (Orchiopexy)
Urinary Tract Infection (UTI) Treatment
Vesicoureteral Reflux (VUR) Treatment
Removal.
Present at birth.
Using a small, flexible tube with a tiny camera and light on the end to examine the urinary tract.
Accumulation of urine in a kidney.
Dye is injected into the bloodstream and the kidneys extract the dye from the blood. An X-ray shows function of the kidney and related organs.
Relating to the kidney.
Dye is injected into the bloodstream and the kidneys absorb the dye from the blood. A special camera is then able to evaluate kidney function.
Infection of the bloodstream characterized by fever, chills and possible mental changes.
Long, narrow ducts that carry urine from the kidney to the bladder.
The canal through which urine is discharged from the bladder.
Series of exams used to assess how the bladder and urethral sphincter function in relationship to the brain and spinal cord when the bladder fills and empties.
When urine travels backward from the bladder toward the kidney; it may affect one or both ureters.
Using a catheter, dye is inserted into the urethra where it travels to the bladder. X-rays are taken while the bladder fills. The catheter is removed and the patient voids (urinates) into a container.
This congenital condition occurs only in boys and is seen in approximately 1 in 8,000 males. Posterior Urethral Valves (PUV) are excess flaps of tissue in the urethra. The excess tissue can block or reverse the flow of urine, causing damage to not only the urethra, but also to the bladder, ureters and kidneys.
Although severe degrees of PUV can be diagnosed during prenatal ultrasounds, others aren’t identified until the child experiences symptoms at an older age. Because of this, it’s important to bring to your physician’s attention any of the following symptoms your child may be experiencing:
• painful, difficult or frequent urination
• weak urine stream
• unexplained accidents or bedwetting (after successful toilet training)
In addition to these symptoms which parents are likely to notice, your physician may identify other possible symptoms including an enlarged bladder (which may be detected during a routine exam) or a Urinary Tract Infection (UTI).
Diagnosis may be made using an abdominal ultrasound, a voiding cystourethrogram (VCUG) or endoscopy. In addition, blood and urine is usually evaluated. Your healthcare provider may also perform intravenous pyelogram (IVP), a renal scan and/or urodynamics testing. (See sidebar for definitions.)
Treatment varies based on the severity of PUV, your child’s overall health, age and other factors as determined by your physician.
If the child is in severe pain or distress, the first step is to insert a catheter to reduce discomfort. Then, while the child is under general anesthesia (asleep), the physician performs a minimally invasive procedure called valve ablation or transurethral incision of PUV. Using an endoscope (small, flexible tube with a tiny camera and light on the end) inserted into the urethra, the surgeon is able to remove (ablate) the valves. The child will not have an external incision.
Some cases of PUV may require a vesicotomy. This procedure is performed under general anesthesia and is the surgical creation of a stoma between the anterior bladder wall and the skin of the lower abdomen.
PUV patients must have both post-op and long-term follow-up exams to ensure ongoing health and to prevent or detect any other potential problems. Children with PUV are more susceptible to vesicouretal reflux (VUR), bladder problems and renal (kidney) function issues. They may require additional procedures to correct damage caused by the PUV.