Children are not small adults. This concept is the foundation of the mission of Shriners Hospitals for Children — Springfield and for the pediatric specialty care provided in the 22 Shriners Hospitals for Children across the United States, Canada and Mexico.
The Springfield Shriners Hospital initiated its newest program, a pediatric urology program, in February. Pediatric urology relates to conditions affecting the reproductive system and urinary tract, including the kidneys, ureter, bladder, urethra, penis and testes. In children, these systems continue to develop until puberty is reached. However, in many children, there are complications or injuries that can cause problems that require consultation with and treatment from a specialist in pediatric urology, dedicated to the care of infants and children.
The pediatric urologist has specialized training and experience that includes two years of general surgery residency, four years of adult and pediatric urology residency and an additional two-year pediatric urology fellowship to become certified by the American Academy of Pediatrics and the American Board of Urology.
Most care is provided on an outpatient basis through appointments in an outpatient clinic. However, some outpatient and inpatient surgical procedures are also performed when necessary. Some of the most common conditions treated by a pediatric urologist include hypospadias, undescended testes and complex urological care of children with spina bifida.
Hypospadias is a congenital abnormality of the penis in which the opening of the urethra is in the wrong place, most often somewhere between the tip and the base of the penis. This condition occurs in between one in 250 and one in 500 male births and is most common when a father or brother has the condition. Boys with a moderate or severe condition may have difficulty with urination and functional impairment with fertility later in life. This condition will not go away on its own; therefore, intervention by a pediatric specialist is important to repair the condition during a surgery that can take one to three hours on an outpatient basis.
Another common pediatric urological condition is undescended testes, which occurs in about three of every 100 boys. While most of these will correct by the age of 6 months, when they do not, surgery is indicated to prevent future complications, including infertility. For children with conditions such as spina bifida, a birth defect where there is incomplete closing of the spine around the spinal cord, urological problems are a major concern.Care of the kidneys and bladder are important to maintain health. However, many children with spina bifida have very poorly functioning bladders that do not grow with them and the bladder will need to be enlarged by a bladder augmentation procedure. The procedure is performed by a pediatric urologist to protect the kidneys, achieve bladder and stool control and promote independence.
Pediatric urology is a new specialty program at Shriners Hospitals for Children — Springfield with outpatient clinics and surgical appointments available weekly with one of two board-certified, fellowship-trained pediatric urologists. This program was developed in response to an area need identified for pediatric urology services and is one way Shriners Hospitals for Children meets its vision of transforming the lives of children and families by providing exceptional health care through innovative research in a patient and family-centered environment.
A collaborative effort
Shriners Hospitals for Children — Springfield is partnering with Pediatric Urology Associates, P.C., the largest provider of pediatric urology services in the Northeast, to provide specialized care to children from birth through adolescence with a wide range of urologic conditions. Pediatric Urology Associates provides services in the New York City metropolitan area, New Jersey, Connecticut and from Shriners Hospitals for Children — Springfield. John Makari, M.D., and Christina Kim, M.D., are both actively involved in clinical care, education and research, and provide comprehensive inpatient and outpatient pediatric urology care at the Springfield Shriners Hospital for conditions of the bladder, kidneys and disorders of sexual development. For an appointment, call 413-735-1234.
Pictured: John Makari, M.D., a fellowship trained specialist in pediatric urology, examines Florimar at her outpatient clinic appointment in our pediatric urology clinic.