Urologic Reconstructive Surgery

Treatment & Procedures

Comprehensive Reconstructive Surgery for the Most Complex Disorders

Bladder and cloacal exstrophy: Exstrophy is a rare and complex disorder in which the abdominal wall fails to close during fetal development, the intestine may be abnormally connected to the bladder, and the urethra and genitals are not completely formed. Surgery must be performed in the first 24 hours of your baby's life. We are one of only a few medical centers on the East Coast with an interdisciplinary program in place to treat exstrophy.

Bladder problems related to spina bifida and anorectal malformations:  Our pediatric urologists have experience in "appendicovesicostomy," a procedure in which a channel is constructed out of your child's appendix to make is easier to insert a urinary catheter to empty the bladder. Children with neurogenic bladder also often require a Malone procedure to facilitate emptying of the colon. We can use the appendix to create both channels — something that is not done in many other institutions.

Disorders of sexual development: We are home to the first Center of Excellence for congenital adrenal hyperplasia (CAH). We provide surgical consultations and treatment for families who wish to learn about genital reconstruction for girls with severe CAH. In addition, we have developed a surgical "vaginal replacement" technique for girls born with an abnormality known as "Mullerian failure," or Mayer-Rokitansky syndrome, and we have more experience with this type of abnormality than many other centers around the world.

End-stage kidney disease: One in four children who need a kidney transplant or dialysis due to end-stage renal disease needs surgery to correct urologic issues. We work with the transplant team and perform surgery before and after transplant to enhance the survival of a transplanted kidney, reduce the risk of infections, and improve the urinary function of these children.

Hypospadias: In boys with hypospadias, the urine tube (urethra) is short and does not come out to the end of the penis. We perform reconstructive surgery for hypospadias to restore both cosmetic appearance and optimal function in your child. We also have a special practice devoted to boys with hypospadias that have been repaired and need additional surgery. Our surgeons have streamlined hypospadias surgery to reduce the risk of complications after surgery and to get boys back to their regular activities sooner.