Pediatric Urologic Conditions We Treat
At Pediatric Urology of Western New York, we specialize in treating a wide range of pediatric urologic conditions. We provide comprehensive evaluation and treatment of pediatric problems and conditions related to the urinary and reproductive tracts, including several tests, treatments, and surgical procedures, allowing us to provide comprehensive care to our patients.
Some Conditions We Treat:
- Bedwetting (Enuresis)
- Complex Urinary Reconstruction
- Hernia
- Hydrocele
- Hypospadias
- Genitourinary Malignancies
- Kidney, Bladder and Genital Abnormalities
- Neurogenic Bladder
- Testicular Torsion
- Urinary Tract Infections
- Undescended Testicles
- Varicocele
- Vesicoureteral Reflux (VUR)
- Voiding Dysfunction
Surgical Procedures We Offer
Our physicians provide surgical intervention for a variety of diagnoses. We offer laparoscopic as well as robotic surgeries when indicated.
Some of the common surgical procedures handled by our pediatric practice include:
- Circumcisions and circumcision revisions
- Continent urinary diversion
- Deflux 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
- Penoplasty – 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
Urodynamics
The urodynamics test will be performed by our physicians and our urology nurse in the Radiology department of Oishei Children’s Hospital. 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 takes 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 of voids. They can have Tylenol for the discomfort, and encourage your child to drink plenty of liquids following the test.
Ultrasound: Bladder and Renal
We are performing screening ultrasound examinations of the bladder and kidneys at all of our locations. We hope this “point of service” will be more convenient for families and enhance the efficiency of diagnosis and care. Our patients can 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 J. Oishei Children’s Hospital. For example, a child who needs a voiding cystourethrogram (VCUG) in addition to 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 placed on top of the jelly and 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, and 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.
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:
- Age 1-3 years = 8 ounces
- Age 4-8 years = 12 ounces
- Age 8-12 years = 16-20 ounces
- Age 13+ years = 24 ounces
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:
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