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
The hollow organ in the lower abdomen that stores urine.
A thin flexible hollow tube used to drain fluids from body cavities; in this case, passed into the bladder through the urethra to draw off urine.
Using a catheter that has been gently inserted into the urethra, a liquid is introduced into the bladder. Images will be taken of the bladder and kidneys; and in some cases, additional images will be taken while urinating and with an empty bladder.
A special imaging test that involves placing radioactive material into the bladder then using a scanner to check bladder and urinary tract functions.
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.
Long, narrow ducts that carry urine from the kidney to the bladder.
The muscular mechanism that controls the retention and release of urine from the bladder. The internal sphincter is automatically controlled by the brain, while the external sphincter can be voluntarily controlled.
Laboratory analysis of urine, used to detect disease or abnormality.
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.
Voiding dysfunction is an abnormality in one of both phases of the voiding cycle. A normal voiding cycle requires a bladder that stretches easily when it fills with urine and contracts normally during voiding. During a normal voiding phase, there should be complete relaxation of the external urethral sphincter muscle so urine released from the bladder flows without interruption until the bladder empties itself.
Voiding dysfunction is caused by an interrupted or intermittent flow of urine or incomplete emptying. This can be caused by a neurological problem (an abnormality of the spinal cord or brain) that affects how nerves help control bladder function and the internal urethral sphincter.
In most cases, however, it is a learned problem where the child holds his or her urine for different reasons, such as not wanting to take a break to use the bathroom, fear of urinating due to a urinary tract infection, or abnormal urinating habits that go back to potty training. The learned dysfunction involves the external urethral sphincter, which can be controlled.
The urologist will take a history of your child’s voiding problems and may ask you to keep a diary, perhaps one of the most important diagnostic tools in the process. This is followed by a thorough physical examination, urinalysis and urine culture. Radiological and urodynamics testing may be used to confirm the diagnosis.
Further evaluation of the urinary tract will be dictated by the severity of the symptoms, and may include a specialized X-ray called a voiding cystourethrogram (VCUG) to check for possible vesicoureteral reflux (VUR). In some children, mainly girls, a similar test called a cystogram is performed. Other times a renal scan (DMSA) is done to test renal function and identify areas of kidney damage.
Treatment options include a timed voiding schedule (where the child is asked to go to the bathroom every two or three hours and monitored) and biofeedback (behavioral) therapy. Long-term evaluation is necessary to prevent urinary tract infection (UTI), and to manage any other conditions that may be associated with the voiding dysfunction. The goal is to identify the condition early, treat it proactively and evaluate the child’s response to the specific therapy in order to limit the potential long-term effects on bladder and kidney function.