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Urology

Compassionately managing conditions affecting the kidneys, bladder, urethra or genital tract in pediatric patients.


Disorders of the urinary tract and genital organs among infants, children, and adolescents can impair normal function and affect health, quality of life, self-esteem, and sexuality. The pediatric urology team at Duke Children’s understands the impact that these disorders can have on young patients and their families and offers prompt and accurate diagnosis combined with state-of-the-art medical and surgical treatment in a family-friendly setting.

Our team includes three fellowship-trained, board-certified pediatric urologic surgeons along with two experienced nurse practitioners and a nurse clinician/urotherapist to provide expert care for all urologic disorders. We know that diagnosis and treatment for a urologic condition can be challenging for you, your child, and your family, so we provide guidance and support to help get you through this process. In addition, we are backed by the entire Duke Children’s group. This allows us to create a first-class, multidisciplinary team with specialists in nephrology, endocrinology, developmental pediatrics, hematology/oncology, neurology, neurosurgery, and orthopaedics to ensure that your child receives the best and most comprehensive, individualized care possible for his or her condition.

We treat the full range of pediatric urologic disorders, from common conditions such as bed-wetting to rare birth defects of the urinary and reproductive systems. Our diagnostic tools include an exclusively pediatric urodynamic and pelvic floor retraining center for voiding disorders, and we work closely with specialists in pediatric radiology to provide the most accurate and gentle imaging available. When a child needs surgery, our pediatric urologists use minimally invasive approaches, such as endoscopic, laparoscopic, and robotic urologic surgery, whenever possible. Our surgeons perform simple common corrective procedures to complex reconstructive surgery for abnormalities of the bladder, kidneys, urethra, and genitalia. We are also specialists in the care of urologic disorders diagnosed during pregnancy and provide prenatal consultations for bladder exstrophy, urinary obstructions, and other genital and urinary tract conditions in the developing fetus.

Recognized for Excellence

Our pediatric urology program is the only one in North Carolina to have been ranked every year among the nation’s best by U.S. News & World Report. Our doctors and nurses are recognized leaders in pediatric urology by their work with the American Urological Association, Society for Pediatric Urology, Society of Fetal Urology, Pediatric Urology Nurse Specialists, Children’s Oncology Group, and the Centers for Disease Control and Prevention. 

Duke Children’s is the only pediatric urology program in the nation where all of its pediatric urologists have received highly competitive research grants from the National Institutes of Health (NIH). This means that at Duke, we are able to offer you and your child the newest, most innovative, and most impactful research discoveries in pediatric urology. 


Treatments

Commonly Performed Procedures

Common conditions we treat include:

  • Hypospadias (urethra opens on penis along the bottom of the shaft instead of at the end)
  • Undescended testes (boy’s testicles not in the scrotum), hydroceles, and inguinal Hernias
  • Hydronephrosis (swelling of the kidney) and other obstructive disorders of the urinary tract
  • Vesicoureteral reflux (when urine backs up into the kidneys)
  • Kidney stones
  • Urinary tract infections
  • Voiding dysfunction (bladder control problems)
  • Foreskin problems
  • Neurogenic bladder (from spinal cord injuries and disorders, such as spina bifida)

We also treat less common urologic conditions, such as:

  • Tumors of the kidneys (such as Wilms tumor), bladder (such as rhabdomyosarcoma), and testicles (such as germ cell tumors)
  • Posterior urethral valves and prune belly syndrome (blockage of the bladder in boys)
  • Bladder exstrophy and cloacal exstrophy
  • Disorders of sex development (ambiguous genitalia or intersex)

Some of these conditions can require multiple, extensive surgeries to reconstruct the urinary and genital tracts so that children can live normal or near-normal lives. Our pediatric urology team is there for you and your child every step of the way.

Disease-Specific Programs

We offer several specialty clinics including:

  • ABCD (Achieving Bladder Control at Duke) Clinic
    This clinic provides specialized care and individualized attention to children with bladder control problems such as enuresis (bed-wetting), urinary frequency, and daytime incontinence. Our comprehensive therapy includes behavioral therapy, enuresis alarms, and medications. Evaluation and treatment with pelvic floor biofeedback and urodynamics are utilized when indicated.
  • Duke Comprehensive Spina Bifida Clinic, Lenox Baker Children's Hospital
    This clinic was developed over 30 years ago to provide complete care to children with spina bifida and other spinal cord disorders. In one visit, you will instantly have access to an entire panel of specialists who can diagnose and treat all aspects of this complicated condition.  Pediatric urology works collaboratively with teams from neurosurgery, orthopaedics, developmental pediatrics, and physical therapy to care for these children. This clinic is recognized for its excellence by its selection by the U.S. Centers for Disease Control and Prevention to participate in multiple national collaborative studies.
  • Fetal Urology Clinic
    This clinic is coordinated with specialists in maternal-fetal medicine at Duke Perinatal of Durham and Raleigh for pregnant women whose unborn children are found to have urologic or genital anomalies on sonography (ultrasound).
  • Pediatric Kidney Stone Clinic 
    This multidisciplinary clinic is conducted with nephrologists and a dietician for comprehensive care of kidney stones including diagnosis, treatment (surgical and non-surgical), and prevention.
  • Duke Center for Child and Adolescent Gender Care
    This multidisciplinary clinic allows our pediatric urologists to work side-by-side with pediatric endocrinologists, psychiatrists, psychologists, pediatric surgeons, adolescent medicine specialists, and social workers to provide the best possible care (surgical and non-surgical) for children with sexual development and/or gender disorders.

Physicians and Staff

Physicians

Name Areas of Special Interest
Jonathan C. Routh, MD, MPH Robotic and laparoscopic kidney and bladder surgery in children; urologic neoplasms in children; reconstructive surgery of congenital anomalies of the genitourinary tract (hypospadias, cryptorchidism, intersex, obstructive uropathies [hydronephrosis], vesicoureteral reflux, exstrophy); management of urinary-tract infections, incontinence, and enuresis in children; management of neurogenic bladders in children; general pediatric urology; consultation for fetal uropathies
John S. Wiener, MD Reconstructive surgery of congenital anomalies of the genitourinary tract (hypospadias, cryptorchidism, intersex, obstructive uropathies [hydronephrosis], vesicoureteral reflux, exstrophy); management of urinary-tract infections, incontinence, and enuresis in children; management of neurogenic bladders in children; urologic care of spina bifida patients; general pediatric urology; consultation for fetal uropathies; urologic neoplasms in children
J. Todd Purves, MD, PhD Kidney and bladder stones; bladder exstrophy and epispadias; management of neurogenic bladders in children; urologic care of spina bifida patients; reconstructive surgery for congenital anomalies of the urinary tract (hypospadias, undescended testicles, vesicoureteral reflux); hernias and hydroceles; bladder inflammation and infection; prenatal consultation for fetal uropathies; general pediatric urology

Nurse Practitioner

NameAreas of Special Interest
Cynthia Camille, CPNP, FNP Voiding dysfunction; vesicoureteral reflux; recurrent urinary tract infections; incontinence; enuresis; neurogenic bladder and bowel management; prenatal consultation for fetal uropathies; postnatal management of hydronephrosis; general pediatric urology
Maryellen Kelly, DNP, CPNP Voiding dysfunction; vesicoureteral reflux; recurrent urinary tract infections; incontinence; enuresis; neurogenic bladder and bowel management; prenatal consultation for fetal uropathies; postnatal management of hydronephrosis; general pediatric urology


Clinic Hours and Location

Duke Children's Hospital & Health Center
General Pediatric Urology Clinic
ABCD (Achieving Bladder Control at Duke Clinic)
Pediatric Kidney Stone Clinic
Duke Center for Child and Adolescent Gender Care

Duke Children's Hospital & Health Center
Third Floor
2301 Erwin Road
Durham, NC 27710
Clinic Days: Monday, Tuesday, Wednesday, Friday (not all clinics meet each day)
Appointments: 919-684-6994

Lenox Baker Children's Hospital
Duke Comprehensive Spina Bifida Clinic
3000 Erwin Road
Durham, NC 27705
Clinic Days: Fourth and Fifth Thursday of every month
Appointments: 919-681-5456

Duke Children’s and WakeMed Children's Specialty Services
General Pediatric Urology Clinic
ABCD (Achieving Bladder Control at Duke) Clinic
23 Sunnybrook Road, Suite 200
Raleigh, NC 27610
Tel: 919-862-1200
Clinic Days: Monday and Thursday (not every week)

Duke Health Center at Southpoint
General Pediatric Urology Clinic
ABCD (Achieving Bladder Control at Duke) Clinic
6301 Herndon Road
Durham, NC 27713
Tel: 919-572-9905
Clinic Days: First and third Thursdays
Appointments: 919-684-6994

Duke Children's Specialties of Greensboro
General Pediatric Urology Clinic
1126 N. Church St., Suite 203
Greensboro, NC 27401
Tel: 336-235-0944
Clinic Days: Second Friday of every month 
Appointments: 919-684-6994