Orthotopic neobladder reconstruction is becoming the diversion procedure of choice for female cystectomy patients due to recent advances in care for female urology patients
MGHfC Pediatric Urology Service
Warren Building, 11th floor
55 Fruit Street
Boston, MA 02114
Near public transit
International and Non-English-Speaking Patients
Families and patients enjoy expert and prompt assistance from our International Patient Center regarding multilingual translation services, appointments, transportation, hotel accommodations, and health costs.
We have particular expertise in caring for international patients and their families. Several of our surgeons and office staff are fluent in Spanish and have a Hispanic family background.
Explore This Treatment Program
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:
- Vesicoureteral reflux (including minimally invasive endoscopic treatment with Deflux), urinary tract infection
- Voiding dysfunction, enuresis, urinary incontinence
- Neurogenic bladder
- Obstructive uropathies: congenital hydronephrosis, congenital megaureter, ureteral duplication/ureterocele, posterior urethral valves
- Prenatal consultation for antenatal hydronephrosis and other obstructive uropathies
- Inguinal hernia, hydrocele, undescended testicle (including laparoscopy for diagnosis and treatment of nonpalpable testis), varicocele
- Disorders of sex development, genital reconstruction in males and females
- Bladder exstrophy, cloacal exstrophy, epispadias
- Anorectal malformations: imperforate anus and persistence of the cloaca
- Complex urinary tract reconstruction (undiversion, bladder augmentation, incontinence procedures)
- Prune belly syndrome, posterior urethral valves
- Ectopic ureter/ureterocele
- Hidden penis/webbed penis
- Ectopic kidney, horseshoe kidney, crossed fused ectopia
- Multicystic dysplastic kidney
- Testicular torsion
- Tumors: renal, retroperitoneal, bladder, prostate and testicular
- Renal transplantation including minimally invasive nephrectomy for organ donation
- Kidney stones
Minimally Invasive Pediatric Urology
Endoscopic treatment of vesicoureteral reflux: the use of a tissue bulking agent, in particular dextranomer/hyaluronic acid, has resulted in a minimally invasive alternative to the open surgical and medical treatment of vesicoureteral reflux. We have been performing this technique as an outpatient procedure in selected patients with a high success rate.
Laparoscopic surgery: laparoscopic procedures have resulted in faster recovery time, less pain and better cosmetic results. We are performing laparoscopic procedures in an increasing number of conditions.
Disorders of Sex Development Clinic
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.
Clinic for Complex Reconstructive Pediatric Urology
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.
Preparing for Your Appointment
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.
Getting Your Child Ready for Surgery
These videos and PDFs give you age-appropriate advice for getting your child ready for surgery.
Getting Ready for Surgery
Learn what to expect when you come in for surgery at MassGeneral Hospital for Children.
- Jul | 25 | 2018
Complete removal of a tumor thrombus resulting from venous tumor invasion is essential for eliminating the cancer in patients with advanced renal cell carcinoma (RCC). A multispecialty tumor thrombus team within an integrated practice can improve the safety of this intricate and extensive procedure.
- Press Release
- Feb | 8 | 2018
A clinical trial led by investigators at Massachusetts General Hospital and University of California, San Francisco found that treatment with an investigational androgen receptor inhibitor significantly delayed the development of metastasis in patients with prostate cancer that had become resistant to standard androgen-deprivation therapy.
- Jan | 31 | 2018
The Massachusetts General Hospital Department of Urology looks back at five of our top research contributions published in 2017.
- Jan | 25 | 2018
Robotic surgery can decrease blood loss and patient pain, lead to a shorter recovery time than a traditional laparoscopic approach, and offers surgeons a shorter learning curve.
- Nov | 27 | 2017
The Massachusetts General Hospital Department of Urology is pleased to welcome three new doctors to its clinical practice.