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
A triangle-shaped, hollow organ located in the lower abdomen that holds urine.
A term used for a procedure that utilizes a cystoscope, a thin, tube-like instrument used to look inside the bladder and urethra.
A term used for a procedure that utilizes an endoscope, a small, flexible tube with a light and a lens on the end used to examine the inside of the body.
A kidney that becomes distended (enlarged) with urine to the point where its function is impaired.
In this case, the backward flow of urine from the bladder back through the ureters and sometimes into the kidneys.
One of a pair of tubes that caries urine from each kidney to the bladder.
Vesicoureteral reflux (VUR) is the backward flow of urine from the bladder into the kidneys and is present in 1% of healthy children.
This condition is usually a congenital deformity in which there is an abnormal attachment between the ureter and bladder with a short, ineffective flap valve. Infants and children who are predisposed to VUR include: children born with neural tube defects, children whose parents or siblings have the irregularity, or those who have other urinary tract abnormalities. Most of the children who suffer from VUR are Caucasian and 75% are female.
VUR is measured using a grading system called the International Study Classification and includes 5 grades:
Grade I results in urine reflux in to the ureter only.
Grade II results in urine reflux into the ureter and the renal pelvis, without distention (hydronephrosis).
Grade III results in reflux into the ureter and the renal pelvis, causing mild hydronephrosis.
Grade IV results in moderate hydronephrosis.
Grade V results in severe hydronephrosis and twisting of the ureter.
The treatment for VUR depends on the grade. Lower grade conditions may often gradually disappear on their own. In many children, the junction between the bladder and the ureter develops and increases in length as a child grows, relieving the condition.
Low dosage antibiotics may be administered to prevent infection. Other medications, as well as bladder training may be effective. Occasionally, the child may undergo X-ray studies of the bladder and/or kidneys to monitor kidney growth as well as the status of the reflux.
Higher-grade conditions may require a surgical procedure known as ureteral re-implantation. This surgical therapy is performed under general anesthesia through an incision in the lower abdomen. The procedure can be performed as conventional surgery or, in appropriate cases, using minimally invasive techniques. The operation corrects the flap-valve attachment to the ureter to the bladder to prevent reflux from occurring. Usually, a catheter is used to drain the bladder for a few days after the operation. An X-ray evaluation is performed several months later to ensure that the condition has been alleviated.
Cystoscopy with Injection of DeFlux is another corrective procedure that can be performed. This is an endoscopic surgery, where the surgeon inserts an instrument called a cystoscope into the urethral opening in order to view the bladder. A substance called DeFlux, which is a gel-based material composed of dextranomer and hyaluronic acid, is injected into the area where the ureter enters the bladder in an attempt to repair the reflux. This technique is performed under general anesthesia as an outpatient procedure.