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What We Treat

At Pediatric Urology of Western New York, we specialize in treating an array of pediatric urologic conditions.

We provide comprehensive evaluation and treatment of pediatric problems related to the urinary and reproductive tracts. 

These include such conditions as:

  • Bedwetting (Enuresis)
  • Complex Urinary Reconstruction  
  • Hernia 
  • Hydrocele 
  • Hypospadias 
  • Genitourinary Malignancies 
  • Kidney, Bladder and Genital Abnomalities 
  • Neurogenic Bladder 
  • Testicular Torsion 
  • Urinary Tract Infections
  • Undescended Testicles 
  • Varicocele 
  • Vesicoureteral Reflux (VUR)
  • Voiding Dysfunction

 

Surgical Procedures

Our physicians provide surgical intervention for a variety of diagnosis.  Some of the common surgical procedures handled by our practice include:

Circumcisions and circumcision revisions
Continent urinary diversion 

Endoscopic injections to correct Vesicoureteral Reflux
Genitoplasty/vaginoplasty
Hernia repairs
Hydrocele repairs
Hypospadias repairs - to reconstruct an incompletely formed urethra
Laparoscopy - endoscopic examination of the abdomen for diagnosis

Lithotripsy - to break up a stone in the urinary tract
Lower urinary tract reconstruction
 
Microscopic varicocele ligation 
Orchidopexy - to place an undescended testis in the scrotum
Penooplasty - to correct an abnormal angulation of the penis
Pyeloplasty - to relieve the obstruction of a kidney
Reconstruction of ambiguous genitalia
 Ureteral reimplantation - open surgery to correct vesicoureteral reflux



Ultrasound:  Bladder and Renal


 We are performing screening ultrasound examinations of the bladder and kidneys at all of our locations. It is our hope that this "point of service" will be more convenient for families and enhance the efficiency of diagnosis and care. Our patients are able to schedule their office visit, and ultrasound appointment, with one phone call. This is particularly useful for the evaluation of children with voiding dysfunction and enuresis.

If other radiologic examinations are concurrently required, we may still ask that the ultrasound be performed along with those tests at a radiology facility, such as Women's and Children's Hospital or DIA Invision Health. An example is a child who needs a voiding cystourethrogram (VCUG) and a bladder ultrasound. 

How to prepare your child for an ultrasound:
Your child will be taken to an ultrasound room and asked to lie on their back on a bed. A blue jelly will be applied to your child's abdomen. This may feel cold. A scanner is then placed on top of the jelly and is moved around the skin. An image will be seen on the screen and a technologist will take pictures. The technologist will scan near the ribs on both sides.  A picture of the bladder is obtained and your child may need to lower his/her pants slightly to obtain this film. Your child will then be asked to roll over onto his stomach and more pictures of the kidneys will be taken in this position. This examination does not hurt.  It is IMPORTANT that your child lie still during the scanning.  Your child will then be able to empty their bladder and return to the room for a couple more pictures.
       You
Please make sure your child arrives for their appointment with a full bladder.  The best way to ensure they have a full bladder is to have them drink water:
    1-10 year olds need 16 ounces 1 hour prior to the exam.
    10+ year olds need 24 ounces 1 hour prior to the exam.

Uroflow Rate with Post Void Residual


A Uroflow rate is a quick and easy study done in our office.  Your child will need to arrive with a full bladder.  They will have a bladder scan done.  A bladder scan is where a small amount of blue gel is placed on the lower pelvis and a small wand is rubbed over that site.  This wand is able to identify how much urine is in the bladder.  Once we know the starting amount of urine in the bladder, the child will void on a special toilet that measures the velocity of their urinary stream.  Then we will repeat the bladder scan to see how much urine is left in the bladder.  The pre-void volume, void pattern and post-void volume will be given to your child's provider to review during your visit.

Please make sure your child arrives for their appointment with a full bladder.  The best way to ensure they have a full bladder is to have them drink water:
    1-10 year olds need 16 ounces 1 hour prior to the exam.
    10+ year olds need 24 ounces 1 hour prior to the exam.


Urotherapy
This is a conservative, non-surgical therapy used to treat bladder dysfunction, incontinence and urgency. Children with toileting difficulties are often anxious and are unable to relax the muscles needed for effective elimination of urine and stool. Pelvic floor retraining offers clear visual reinforcement on how to use pelvic floor muscles by using video games. This training helps the child identify pelvic floor muscles and teaches them how to relax these muscles during voiding. The nurse practitioner works with the children, coaching them on how to use their muscles.  These sessions are an hour long and occur at our Amherst and Orchard Park offices only.  The sesssions require the child to arrive with a FULL bladder. 

Urodynamics

 The test will be preformed by Dr. Greenfield or Dr. Williot and our urology nurse in the Radiology department of the Women and Children's Hospital of Buffalo.  This study involves placing a small catheter into the bladder by passing it through the urethra. A jelly with numbing medication will be used to pass this tube which is about the size of a cooked spaghetti noodle. Fluid is injected through the catheter until the bladder is full or until the child urinates.  In addition, a small balloon catheter may be placed in the child's rectum to monitor straining or movement, which can create false bladder measurements.  Small stick-on patch electrodes will be placed on your child's buttocks, which allow us to check the control of the urinary sphincter muscles.  While the bladder fills, X-rays will be taken to see how the bladder looks and behaves.
The test is done in the X-ray Dept. of the hospital.  You will be able to stay with your child for the testing, but you will need to sign a release form to stay in the room.  You will not be allowed in the room during x-rays if you are pregnant or receiving radiation therapy yourself, so plan on bringing a substitute who has a positive relationship with your child.  It is helpful to bring a bottle, pacifier, or favorite toy to help comfort your child during the study.  The test take about 20-30 minutes.
Afterward, your child may complain of some burning or irritation upon urination. This is normal and usually clears up after a couple voids. They can have Tylenol for the discomfort and encourage your child to drink plenty of liquids following the test. 

 

 



 


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