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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

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 (excess fluid within the kidney) and other obstructive disorders of the urinary tract
  • Vesicoureteral reflux (urine that travels from the bladder up to the kidney)
  • 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 Clinic (Achieving Bladder Control at Duke) 
    The ABCD Clinic provides specialized care and individualized attention for children with bladder control problems such as enuresis (bed wetting), urinary urgency and frequency, and daytime incontinence. We understand the frustrations that may result from these types of concerns for affected children and their families. According to the American Academy of Pediatrics, about 25% of school aged children have some form of voiding dysfunction, and bed wetting affects over five million children over the age of six in the United States. At the ABCD Clinic, we perform a thorough evaluation to help us create a treatment plan designed for your child with his or her individual needs in mind. We offer comprehensive therapies, including options for behavioral therapy, enuresis alarms, and medications. Evaluation and treatment with pelvic floor biofeedback, uroflowmetry, and urodynamics are also utilized when indicated.
     
  • Fetal Uropathy Clinic
    This clinic coordinates care with maternal-fetal medicine specialists at Duke Perinatal of Durham and Raleigh for pregnant women whose unborn children are diagnosed with urologic or genital anomalies on sonography (ultrasound). We provide comprehensive, compassionate care for expectant parents, including individualized counseling relative to the diagnosis, information about expected outcomes and options for management plans to ensure proper care when the child is born.
     
  • Duke Center for Child and Adolescent Gender Care
    In this clinic, our multidisciplinary team of specialists uses an integrative, holistic approach to provide comprehensive, compassionate, family-centered care to transgender youth, gender-expansive youth, and children with differences in sex development. Our clinic is staffed by experts in pediatric endocrinology and urology, in addition to clinical social workers and counselors in psychology/psychiatry and spiritual care. We also collaborate with doctors, surgeons and counselors in neonatology, genetics, family and community medicine, adolescent medicine, voice care services, fertility, and nutrition to provide all-inclusive treatment, support, and education to patients and their families. 
     
  • Duke Comprehensive Spina Bifida Clinic
    The Duke Comprehensive Spina Bifida Clinic was developed over 30 years ago to provide complete care to children with spina bifida and other spinal cord disorders. It is the region’s largest multidisciplinary program providing comprehensive evaluation and long-term management for infants, children, teens and adults. In a single visit, our patients have access to an entire team of specialists, who can diagnose and treat all aspects of these complicated conditions. Our pediatric urology specialists work collaboratively with specialists from neurosurgery, orthopaedics, neurodevelopmental pediatrics, and physical therapy, and additional staff specializing in wound care, nutrition, and social work are also available in the clinic. Together, this team works with the family to design a treatment and follow-up care plan that is tailored specifically to the needs of each patient. This clinic is recognized for excellence by its selection by the U.S. Centers for Disease Control and Prevention to participate in multiple national collaborative research studies.
  • Pediatric Kidney Stone Clinic
    This clinic comprises pediatric nephrology specialists and a dietician who provide comprehensive care, including diagnosis, treatment (surgical and non-surgical), and prevention, for children with kidney stones. We aim to alleviate acute symptoms and design follow-up care plans for our patients to minimize future recurrence of kidney stones. 

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 Practitioners

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

Locations

Duke Children's Hospital & Health Center
Third Floor
2301 Erwin Road
Durham, NC 27710

Clinics offered:

  • ABCD (Achieving Bladder Control at Duke) Clinic
  • Duke Center for Child and Adolescent Gender Care
  • Fetal Uropathy Clinic
  • General Pediatric Urology Clinic
  • Pediatric Kidney Stone Clinic 

Clinic days: Monday, Tuesday, Wednesday, Friday (not all clinics meet each day)


Lenox Baker Children's Hospital
3000 Erwin Road
Durham, NC 27705

Clinics offered:

  • Duke Comprehensive Spina Bifida Program 

Clinic days: Fourth and fifth Thursday of every month


Duke Children’s and WakeMed Children's Specialty Services
23 Sunnybrook Road, Suite 200
Raleigh, NC 27610
Tel: 919-862-1200

Clinics offered:

  • General Pediatric Urology Clinic
  • ABCD (Achieving Bladder Control at Duke) Clinic
  • Fetal Uropathy Clinic

Clinic days: First, third and fifth Monday*; second and fourth Wednesday; first, second and third Thursday

*extended hours available


Duke Health Center at Southpoint
6301 Herndon Road
Durham, NC 27713
Tel: 919-572-9905

Clinics offered:

  • General Pediatric Urology Clinic
  • ABCD (Achieving Bladder Control at Duke) Clinic
  • Fetal Uropathy Clinic

Clinic days: First and third Thursdays


Duke Children's Specialties of Greensboro
1126 N. Church St., Suite 203
Greensboro, NC 27401
Tel: 336-235-0944

Clinics offered:

  • General Pediatric Urology Clinic

Clinic days: Second Friday of every month 


Appointments

  • For new or follow-up appointments with the General Pediatric Urology, ABCD, Fetal Urology or Pediatric Urology Kidney Stone Clinics, please call 919-684-6994.
     
  • For new or follow-up appointments with the Duke Comprehensive Spina Bifida Clinic, please call 919-681-5456.
     
  • For new or follow-up appointments with the Duke Center for Child and Adolescent Gender Care, please call 919-684-8361.

In order to serve you better, please bring any associated medical records for review with you or fax them in advance of your visit to 919-681-5507.