General Practitioners

• Pediatric Care
• Primary Care
• Constipation
• Urinary Incontinence

Gynecologists

• Female Infertility

Internists

• Urology
  Pediatric Urology Associates offers a broad range of services to its patients. We offer evaluation and treatment of problems such as the following...
• Testicular Cancer
  The most common type of testicular cancer–seminoma–has a survival rate approaching 100% in cases detected and treated early.
• Interstitial Cystitis
• Urinary Tract Infection
  Infants urinate in a very healthy way. The bladder will automatically contract, as a reflex, and the sphincters automatically relax. This is very healthy because the bladder pressure needed to empty the urine is low. However, it’s not very sociable! Some children are able to postpone urination in the same way as adults, but many cannot. This can be due to many of the factors mentioned above, but it can also be due to “immaturity” of their nervous system so that they recognize the urge to urinate before they have developed the ability to postpone urination. They feel the sudden need to urinate, but are unable to keep their bladders from trying to empty. They learn to stay dry by blocking the flow of urine because they are unable to postpone urination. Some of these children will dance (“pee-pee dance”), others will stand very still and some girls will even sit down on the heel of their foot in order to put pressure on the urethra and block urine flow (“curtsy sign”). Obstruction and incomplete emptying are bad for the bladder and can lead to an overactive bladder. This pattern of behavior can become the only way these children are able to control their overactive bladders. This is a common cause of what we call voiding dysfunction. Voiding dysfunction is also very frequently associated with constipation. Normal, low-pressure, complete emptying of the bladder is one of the best defenses against urinary tract infection. Because they do not urinate normally, these children have a much higher rate of urinary tract infections. Fortunately, biofeedback training can be used to teach these children how to relax their bladder sphincters during urination and, along with management of their constipation, we can help them become dry and reduce the rate of urine infections.

Psychiatrists

• Attention Deficit Hyperactivity Disorder (ADHD)
• Mental Health
  Until your older child outgrows bed-wetting, he/she will need a lot of emotional support from the family. Support from a pediatrician or a mental health professional can also help.

Endocrinologist

• Diabetes Care

Radiologist

• Ultrasound
  If your doctor suspects a problem, he/she may take a urine sample from your child to check for signs of infection or other problem. Your doctor may also order tests, such as ultrasound of the kidneys or bladder, if there are signs that wetting is due to more than just delayed development of bladder control. On occasion when a child wets day and night, then a voiding cystouretrogram is performed if it is deemed necessary.
• X-Rays

Surgeons

• Reconstructive Surgery
  The male may have a short, curved penis which may appear somewhat flat at the top. The urethral opening is epispadiac (on the upper surface of the penis). There is usually a space between the base of the penis and the scrotum. The patient may have bilateral inguinal hernias. The testes may be undescended (not in the scrotum) or retractile (capable of going back into the scrotum). If hernias are present they will be repaired. Reconstructive surgery will be done to repair the penis. This surgery will result in functional and cosmetically acceptable genitalia.

Plastic Surgeons

• Botox
  A variety of treatment approaches are available and are tailored to the individual needs of each child. Some of these treatments include medication, clean intermittent catheterization, bowel elimination programs, Botox injections, bladder reconstructive surgery and MACE procedures. Knowing which child needs which treatment is a special expertise of the doctors and nurses at Pediatric Urology Associates.
• Laparoscopic Surgery
  The object of treatment of a varicocele is to interrupt or block the vein that has been allowing the blood to go backward when a boy stands up. This prevents the veins around the testicle from becoming enlarged any more. The most common way a varicocele is corrected is by surgical division of the blood vessel somewhere above the scrotum. This is an outpatient procedure done either by an incision in the groin or lower abdomen or by laparoscopic surgery. In some instances, parents will elect to have the varicocele treated by having a catheter placed into the main vein to the heart (the inferior vena cava). The catheter is then fed back down the “bad” vein and solid material is injected down the vein to block it. Both of these are very effective at correcting the varicocele.