Programs & Services
Reconstructive Urology Program
Our team regularly treats complex reconstructive urologic conditions including:
- Newborn exstrophy/epispadias complex
- Failed exstophy closure
- Cloacal exstrophy
- Cloacal malformations
- Severe hypospadias
- Failed hypospadias
Supported by sophisticated pediatric video urodynamics suite, Connecticut Children’s urologists provide medical and surgical management for patients with neurogenic bladder and posterior urethral valves, including bladder augmentation and bladder outlet procedures, such as slings and bladder neck reconstruction, bladder neck closure and catheterizable stoma creation including Mitrofanoff catheterizable channels or antegrade continence enema procedures. Benchmarked against national data, our surgical outcomes are among the best.
Solid Tumor Program
The solid tumor program at Connecticut Children’s is nationally recognized for its clinical expertise along with its basic science and clinical research efforts. As part of the Children’s Oncology Group the world’s largest organization devoted exclusively to childhood and adolescent cancer research, Connecticut Children’s collaborates with regional and national committees to develop novel therapies for children with solid tumor malignancies.
Our surgeons have extensive experiences in treating children affected by urological conditions such as renal (Wilms, renal cell carcinoma, cystic masses), bladder, prostate and vaginal (rhabdomysarcoma), and testicular tumors and masses.
As part of a highly specialized, multidisciplinary team that includes oncology and general surgeons, Connecticut Children’s urologic surgeons have significant clinical experience treating pediatric patients diagnosed with solid tumors and are particularly focused on using organ-sparing surgical technique whenever possible.
Our surgical experts have authored multiple basic science and clinical research papers and several book chapters on the subjects of pediatric renal and bladder cancers.
Clinic for Variations of Sexual Development
The Clinic for Variations of Sexual Development provides multidisciplinary, highly specialized care to patients with disorders of sexual development such as ambiguous genitalia and gender identity disorders in infants, children and teens. Overseen by medical directors from urology and endocrinology, Connecticut Children’s program has been touted as best-in-class by patient advocacy groups.
Maternal-Fetal Urology Program
Antenatal urologic abnormalities are co-managed with the maternal-fetal medicine team with care coordinated at the University of Connecticut Health Center, Hartford Hospital and Danbury Hospital. Maternal-fetal medicine specialists, neonatologists and other pediatric subspecialists collaborate closely on patient care, with Jill Bernstein, MD, coordinating pre- and post-natal patient care. Advanced diagnostic techniques such as fetal MRI are available to improve prenatal diagnoses and preparation for neonatal care.
Children and parents benefit from our multidisciplinary Myelomeningocele Program where they are cared for by urologists, neurosurgeons and orthopedic surgeons in a single setting. Supported by a sophisticated video-urodynamics and voiding dysfunction laboratory, our reconstructive team provides medical and surgical treatment to ensure long-term kidney health and an improved quality of life through bowl and bladder functionality.
In our state-of-the-art video-urodynamics and voiding dysfunction laboratory directed by Phillip Smith, MD, Connecticut Children’s urologists perform studies to evaluate voiding dysfunction such as urinary incontinence, urinary retention, overactive bladder, and urinary tract infection. Urodynamic testing is frequently recommended annually for children with spina bifida or spinal cord injuries.
Urodynamic testing shows:
- How much urine a child’s bladder holds
- How to best manage problems with wetting
- What happens in a child’s bladder as it fills with urine
- What happens in a bladder as the child urinates
- Changes in bladder function from year to year
- Risks for developing kidney problems in the future
- How the muscles that help hold urine in the bladder and help control urination work
Testing may also include Uroflow evaluation, in which a pediatric patient is asked to use a special toilet that is connected to a computer to measure his or her urinary flow rate and voiding pattern. Additional innovative techniques include computer-assisted biofeedback and botulinum toxin treatments to aid with lower urinary tract dysfunction.
An important component of treating children with complex genitourinary conditions is recognizing and treating any associated anxiety and psychological distress.
Connecticut Children’s Division of Urology integrates psychological counseling with Matthew Malouf, PhD, and Barbara Rzepski, PhD, who have expertise in addressing the issues unique to our patient population. They are supported by Lisa Namerow, MD, a psychiatrist with extensive experience working with children and young adults affected by genitourinary disease.
Using a variety of approaches, our uro-psychology team counsels children and families regarding issues such as disorders of sexual development, preparing for surgery, and the importance of health maintenance for young adults.