Experienced Pediatric Urology Teams
The pediatric urology specialists at NewYork-Presbyterian provide therapies based on the results of the latest research, customized to your child's needs. From advanced diagnostics to medical and surgical treatments, we provide all the care your child requires. Here we describe how we treat three common issues: adolescent varicocele, kidney stones, and urinary tract infections.
Minimally invasive treatment for adolescent varicocele
Varicocele is the presence of varicose veins in the testicles and occurs in up to 15 percent of adolescent males. It's usually found during routine school or camp examinations and typically does not cause any symptoms. NewYork-Presbyterian's pediatric urologic surgeons have advanced the knowledge of adolescent varicocele and pioneered minimally invasive approaches to treating this disorder.
- Does your child need treatment? Not all boys with varicocele need surgery. In many cases, however, an untreated varicocele can lead to impaired growth of the affected testicle and infertility in adulthood. Repair of a varicocele when your child is an adolescent can prevent further growth delays of the affected testicle and enhance his likelihood of being fertile as an adult.
- Predicting the need for surgery. We use Doppler ultrasound to help determine if your child needs surgery ("varicocelectomy"). This test can help predict the significance of your child's varicocele in the future. Surgery may be more effective when it's performed during adolescence, rather than later in life.
- Leaders in varicocele surgery. Our surgeons have performed hundreds of varicocelectomies. These operations can be performed laparoscopically or via a microsurgical technique. Both approaches are performed in the outpatient setting and achieve excellent success rates.
Relief for children with kidney stones
Kidney stones can be painful and debilitating. Our goal is to treat your child's kidney stones as quickly and with as little discomfort as possible. We also provide education about how to reduce the chances of kidney stones developing again. Our teams include clinicians with expertise in urology, nephrology, metabolism, radiology, and genetics. We have all the specialists onsite that your child may need, depending on the cause of the stones and offer nonsurgical and surgical treatments depending on the type and size of the stones. If your child's kidney stone does not move through the ureter on its own, if fever develops, or if his or her pain doesn't improve, he or she may need treatment to break up, remove, or bypass the kidney stone, such as:
- Extracorporeal shock wave lithotripsy. We use sound waves to break the stone into tiny particles that can be passed. This outpatient procedure is effective for stones in the kidney or upper ureter, but not if your child has very large stones or other medical conditions.
- Ureteroscopy. We insert a fiberoptic telescope (ureteroscope) through your child's urethra and pass it through the bladder to remove or break up the stones with a laser. We complete this treatment as an outpatient procedure.
- Percutaneous nephrolithotomy (PCNL). We thread catheters through guide wires that pass through your child's skin and into the kidney. We manipulate surgical instruments through the catheters to break up and remove kidney stones. This procedure usually requires a stay in the hospital. Your child will most likely get back to his or her normal activities within two weeks.
- Laparoscopic surgery. We make three small (3 to 5 mm) incisions, and your child's abdomen is distended with gas. We remove the stone through an incision in the ureter or kidney, which we then repair. Most children need to stay in the hospital overnight.
The Center for Kidney Stone Care at NewYork-Presbyterian Morgan Stanley Children’s Hospital is one of the few comprehensive centers focused on the detection and management of kidney stones in children and adolescents. Pediatric urologists here offer incision-free endoscopic approaches for breaking up kidney stones and treatment for patients with complex medical and genetic disorders, including those who are wheelchair-bound. NewYork-Presbyterian Komansky has a very active stone center as well.
Evaluating and treating urinary tract infections
If your child has a urinary tract infection (UTI) and a fever, you should take him or her to a urologist to see if there is an anatomical abnormality that may be predisposing your child to these infections. In children, particularly those under age 6, UTIs can cause kidney damage. Left untreated, and in the most severe cases, they can cause kidney failure that requires your child to receive dialysis or have a kidney transplant. We'll provide all the care needed to diagnose the infection, treat it, and try to prevent it from happening again.
- Treatment of vesicoureteral reflux (VUR). In children with recurring UTIs, we routinely look for VUR — a condition where the urine backs up into the ureters and possibly up to the kidneys, exposing the kidneys to infection and causing hydronephrosis (a swelling of the kidneys). Our surgeons use minimally invasive surgical approaches, including robotic surgery, to correct the anatomical problem causing VUR.
- Education to prevent UTIs. If your child gets UTIs without a fever, he or she may not be drinking enough water, may be holding onto urine, or may be constipated or have other behaviors. We'll work with you to help your child develop good water drinking habits and learn to urinate and empty the bowels more frequently.
Why Choose Us
Pediatric urologic problems range from those that are easily treatable, such as UTIs due to not drinking enough water, to more complex conditions that may require surgery, such as VUR. When you bring your child to our children's hospitals, you can take comfort knowing you'll have access to whatever care your child needs, all in one medical center. Make an appointment with one of our pediatric urologists or specialized nurse practitioners to learn how we can help your child.