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Name of Treatment Program: Pediatric Urology
Short description: The Pediatric Urology Service at MassGeneral Hospital for Children provides care ranging from simple circumcisions to the most complex of urinary and genital anomalies in children from birth to young adulthood.
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The Pediatric Urology Service at MassGeneral Hospital for Children provides state-of-the-art urologic care ranging from very simple circumcisions to the most complex urinary and genital anomalies encountered in children from birth to young adulthood.
Through a number of specialized clinics, we provide comprehensive diagnostic and therapeutic services for the broad spectrum of surgical diseases affecting the urinary and genital tracts:
Our clinic is backed by more than 40 years of experience in this field, beginning with the seminal contributions of William Hardy Hendren, MD, and Patricia Donahoe, MD.
Rafael Pieretti, MD, has significant interest and experience in the surgical treatment of these conditions. Research work produced by the Pediatric Surgery Research Laboratories, headed by Dr. Donahoe and David MacLaughlin, PhD, has resulted in numerous publications dealing with the molecular mechanisms causing intersex abnormalities. Based on this combination of clinical and research experience, MassGeneral Hospital for Children has become a recognized referral center for ambiguous genitalia. In our clinic, patients are evaluated by a multidisciplinary team of pediatric urologists, pediatric endocrinologists, geneticists, psychiatrists and basic science investigators, who strive to provide our patients and their families with state-of-the-art medical and surgical treatment.
This clinic is devoted to the management of complex urological and surgical cases such as imperforate anus, persistence of the cloaca, bladder exstrophy, cloacal exstrophy, urinary diversions and undiversions, Prune Belly Syndrome, and tumors of the genitourinary system.
The complexity of these conditions requires the involvement of highly experienced surgeons, with a thorough understanding of its embryology, anatomy and resulting functional problems. Our surgeons use their background and experience in pediatric urology and pediatric general surgery to provide their patients with state-of-the-art surgical treatment.
Hypospadias is a very common condition, in which the male urethral opening (urethral meatus) does not reach the tip of the penis. Hypospadias occurs in about 1 in 200-300 male births and presents in a broad clinical spectrum. Surgical repairs require considerable experience and the use of a meticulous technique to achieve good results.
The vast majority of cases can be repaired in a single-stage procedure using local tissues. The use of newer surgical techniques, fine absorbable suture material and visual magnification has significantly improved the success rate in hypospadias surgery. Complex cases might require the use of grafts; these may be taken from sites such as the buccal mucosa, bladder mucosa or skin.
Our pediatric urologists run a busy hypospadias clinic and when indicated, our patients are evaluated by a team expanded to include pediatric endocrinologists and geneticists.
The family should bring relevant medical records, test results, and X-rays to the appointment to avoid duplications. A recent urinalysis and urine culture is convenient in cases of urinary tract infection.
Instructions for specific tests may be provided when an appointment is scheduled.
Treatment is provided in close communication and cooperation with the patient's referring physician.
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Condition: Exstrophy of the Bladder and Epispadias - 608,Hypospadias - 617,Megaureter - 626,Micropenis - 628,Neurogenic Bladder - 321,Pheochromocytoma - 635,Posterior Urethral Valves (PUV) - 640,Testicular Torsion - 652,Ureterocele and Ureteral Duplication - 658,Urinary Incontinence - 488,Urinary Tract Infection - 489,Vesicoureteral Reflux - 498
Multidisciplinary Care Center:
Spotlights: Checking in for Surgery - 1272, Partners HealthCare Patient Gateway - 1311
Contact: MGHfC Urology - 1722
tab2_label: Meet the Team
tab2_content: <p> </p> <ul> <li><a href="/children/doctors/doctor.aspx?id=19666">Jack Elder, MD</a></li> <li><a href="/children/doctors/doctor.aspx?id=18014">Dicken Ko, MD</a></li> <li><a href="/children/doctors/doctor.aspx?id=17558">Rafael Pieretti, MD</a></li> <li><a title="Jaclyn McGowan, NP profile page" href="http://massgeneral.photobooks.com/directory/profile.asp?dbase=main&pict_id=0451166">Jaclyn McGowan, NP</a></li> </ul> <p> </p>
tab3_label: Conditions & Diseases
tab4_label: Patient Education
tab5_label: Clinical Trials