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
Present at birth.
The accumulation of urine in a kidney.
Into a vein (in this case, inserting a dye into the bloodstream through a vein).
Relating to the kidney.
Tube that carries urine from the kidney to the bladder.
The canal through which urine is discharged from the bladder.
Normally, the kidneys produce urine by filtering the blood and removing waste. The urine drains from each kidney through a collection system that ends in a funnel-shaped structure known as the renal pelvis. It then travels through the ureter to the bladder before traveling through the urethra to exit the body.
However, when there is an obstruction in the ureteropelvic junction (the area in which the ureter joins the renal pelvis), urine builds up in the kidney. Most often a congenital defect, it is usually detected during routine ultrasound exams during pregnancy. It occurs in approximately 1 out of every 1,500 children.
Although prenatal ultrasounds may indicate the likelihood of hydronephrosis (accumulation of urine in the kidney), actual diagnosis is made using one of two different exams.
During a furosemides renal scan, a radioactive material is injected into the bloodstream so a special camera can provide detailed information about kidney function and drainage.
Another diagnostic procedure that may be performed is called an intravenous pyelogram (IVP). During this procedure, dye is injected into the bloodstream and the kidneys extract the dye from the blood. Using an X-ray, your child’s healthcare professional can see the kidney, renal pelvis and ureter.
While your child is under general anesthesia (completely asleep), the surgeon makes a 2-3 inch incision just below the ribs on the side of the body. During the procedure, which takes about 2 hours, the physician removes the UPJ and reattaches the ureter to the renal pelvis. In most cases, one surgery relieves the problem and establishes urine flow through the ureter. Your child will have a drainage tube to help remove fluids and promote healing. The surgeon or nurses will provide you with guidelines for your child’s recovery.
This procedure is designed to accomplish the same result as open repair, but approaches surgery in a different manner. Laparoscopic surgery is performed using several small incisions in the abdomen — one for a laparoscope that enables the surgeon to visualize his work with fiber optic light and a video camera. The remaining incisions are for instruments used in completing the operation.
In order for the surgeon to be able to see and maneuver the instruments, carbon dioxide is used to inflate the abdomen creating space between the abdominal wall and organs. After the procedure is completed, the carbon dioxide is released.
Some patients may benefit from robotic-assisted minimally invasive surgery. In this case, the physician uses the innovative daVinci™ Surgical System to perform the various actions and manipulations of procedure.
During the weeks after the surgery, your child will have follow-up tests to evaluate kidney function. Although the child may have pain for a few days after the procedure, most patients recover quickly and do not suffer a relapse. However, there is a slightly increased risk of kidney stones or infection due to the fact that the patient’s kidney may still have some pooled urine in spite of the removed obstruction.