Pediatric urology is focused on the specialized medical and surgical treatment of children with conditions related to the urinary and reproductive tract – congenital and acquired. Some of these problems are quite simple while others are among the most complex anomalies.
We offer a team of fellowship trained, full-time pediatric urologists who have earned the American Board of Urology Certificate of Sub-specialization in Pediatric Urology. We work closely with pediatricians and all pediatric specialists, including pediatric nephrologists, oncologists, endocrinologists, geneticists, radiologists and gynecologists to provide wide-ranging and innovative treatment for our young patients.
The pediatric urologic surgeons at Cohen Children's provide state-of-the-art minimally invasive surgery for infants, children and adolescents. Using laparoscopic and robotic technology, children experience less pain and complications by performing surgery through very small incisions with little or no scarring, a faster recovery time, and a shorter stay in the hospital.
Outpatient surgery for healthy children undergoing urologic surgery takes place at the Center for Advanced Medicine or in the main hospital operating rooms when there is potential need for an overnight admission (more complex surgery or children with significant medical problems). These child-friendly environments are staffed by pediatric anesthesiologists and nurses who care for children before, during and after surgery. Patients recover from surgery in the dedicated pediatric recovery rooms staffed by pediatric nurses who are trained in all aspects of postoperative care.
Children requiring hospitalization will have surgery in the main hospital operating rooms. Parents are allowed to be with their child in the recovery room shortly after surgery and one parent may sleep in the room with his or her child. For those children from out of town or from foreign countries, families may stay at the Ronald McDonald House located one block from the hospital at very low cost.
What we treat
The Division of Pediatric Urology at Cohen Children’s provides diagnosis and treatment for a wide variety of urological medical conditions, including:
Chordee - A condition of the penis where there is a bend, usually toward the bottom. This condition sometimes needs surgery to improve penis function and appearance.
Disorders of sexual differentiation (ambiguous genitalia or intersexuality) - Sometimes doctors cannot be certain whether a child is a male or a female at time of birth. Special genetic tests and hormone studies, as well as ultrasounds and x-rays are required to diagnoses this condition properly and to assign the proper sexual identify to the baby. Surgery is usually required to correct the genital appearance.
Hematuria - This can be caused by many conditions. These may be conditions that affect the kidney, the ureter or tube draining the kidney, the bladder or the urethra tube through which we urinate. These conditions include infections, blockages in the kidney or ureter or urethra, cysts of the kidney, kidney stones or kidney tumors. Special tests such as ultrasounds, voiding cystourethrograms or X-rays of the bladder and urethra, CTs and MRIs allow the specific diagnosis to be made and the treatment can then be selected.
Hernia or hydrocele – This is communication between the abdomen and scrotum, or in girls between the abdomen and labia, resulting in fluid or abdominal content moving through the groin into the scrotum, or labia in female children.
Hydronephrosis - This condition means that there is dilation of the kidney. Hydronephrosis is commonly detected by ultrasound. The causes may be obstructed urine flow, reflux of urine, or may be a temporary condition or normal finding.
Hypospadias – This is the failure of the urethral tube in boys to develop all the way to the tip of the penis. It is frequently associated with a downward bend of the penis and less penile skin on the undersurface of the penis.
Incontinence or enuresis - This is the failure to gain control of urination beyond the age that this is expected. This condition may only be a problem at nighttime or may occur both during the day and at nighttime.
Kidney stones - These usually cause back pain or abdominal pain together with hematuria (blood in the urine). In some children, fever may also occur.
Phimosis – This is a condition causing an inability to retract the penile skin back over the glans penis. Phimosis may require "freeing up" of the excess penile skin or circumcision removal of the extra skin.
Undescended testes - The failure of complete descent of the testes. Failure to recognize this condition or treat it in a timely fashion can result in later infertility and cancer. Depending on the location of the undescended testes, groin surgery or laparoscopy can be used to treat this condition.
Urinary tract infection (UTI) – This is an infection of the bladder or kidneys. UTIs may be simple or associated with significant dysfunction of the urinary system. Common symptoms of a UTI include pain with urination, urinating frequently, a compelling feeling to urinate and the loss of previously established urinary control like bedwetting. Kidney infections are associated with fever and back pain
Varicocele – These are abnormal swollen scrotal veins. This condition is usually discovered just before or during puberty. The large veins can sometimes affect the growth and maturation of the testicles resulting in infertility. Treatment may simply require observation, in order to monitor growth of the testicle. In more severe cases, surgery is the procedure of choice.
Vesicoureteral reflux (VUR) - This is an abnormal condition where urine goes back up to the kidneys from the bladder that is frequently discovered in children who develop urinary infections. In some children, antibiotic treatment and observation is all that is required for treatment, whereas in other children surgery is required
Wilms' tumor – This is kidney cancer in childhood. It occurs typically in younger children. It has become a very curable cancer when surgery is coupled with other treatments such as chemotherapy and radiation therapy.
Fetal hydronephrosis – This is when urine is visible within the kidney during pregnancy. This may represent a significant problem such as obstruction or vesicoureteral reflux that needs to be evaluated after birth.
Polycystic kidney disease – This is an inherited condition where many fluid-filled cysts develop in both kidneys. These cysts can multiply and expand leading to kidney failure.
Multicystic kidney disease – Multiple cysts develop in a kidney that hasn't developed properly, eventually causing it to stop functioning.