Division Focus: Pediatric Urology

UNC’s Children’s pediatric urology service is a small program with a big reach. The division's three providers offer a wide range of services to children with simple to complex medical conditions through approximately 3,000 outpatient clinic visits and 400 surgeries each year.

Division Focus: Pediatric Urology click to enlarge Dr. Sherry Ross performs surgery as part of a team from UNC Children's who provided care to children in Guatemala.

UNC Children’s is one of only four medical centers in North Carolina able to treat a range of genitourinary problems in children from simple to very complex. UNC’s three Board-certified pediatric urologists, Timothy P. Bukowski, MD, Sherry S. Ross, MD, and Richard W. Sutherland, MD, offer decades of combined clinic and surgical experience, including state-of-the-art, minimally invasive surgeries.

“We manage complex genitourinary tract abnormalities and also provide consultation services for fetal uropathies,” says Dr. Ross. “When surgery is required, we join with specialty-trained pediatric anesthesiologists and pediatric surgical specialists to provide a child-focused surgical experience.”

“Children are not small adults,” adds Dr. Ross. “They require doctors and surgeons who understand the critical and very unique aspects of caring for a child. Our caregivers are dedicated to creating a child- and family-friendly atmosphere where families can feel safe during their experience.”

UNC’s pediatric urology program also help children who experience persistent wetting and soiling incidents through its voiding dysfunction clinic.

“Bedwetting is a common problem among children and may be due to a medical condition, such as a urinary tract infection, but it is most often is associated with family history,” explains Dr. Ross. “In either case, it can be devastating for the family and a great source of anxiety for child and parent alike. Our physicians consider all possible causes before providing steps to treat the condition in a positive and productive manner.”

“Patients are thoroughly, evaluated by our pediatric urologist and, when warranted, by additional pediatric experts at UNC,” says Dr. Ross. “Parents are counseled on options and provided with expert advice on the current standard of care, so they can make the best medical decisions for their children.”


Research & medical education

Dr. Sutherland is a leader in the NIH supported the Randomized Intervention for Vesicoureteral Reflux (RIVUR) study with Dr. Bukowski and colleagues in UNC Division of Pediatric Nephrology. The groundbreaking research project provided physicians insights into the efficacy of antibiotic prophylaxis in children with the condition.

In addition, Dr. Sutherland has a great interest in the use of interactive classroom techniques during the first year of medical school. His interactive group learning format involves breaking the class down into small groups and letting them solve a clinical problem via today’s technology.

“Clinicians present real medical problems to the medical students which add variety and flavor to the classroom,” explains Sutherland. “My small group technique uses chat rooms on the internet, termed ‘CHARMS.’  Since students now routinely bring computers and smart phones to class, my technique allows them to meet in a chat room and text each other to solve the case.”

Dr. Ross has a special interest in spina bifida and better understanding the high rate of urinary tract infections in patients with spina bifida, spinal cord injuries, and other diseases that affect bladder function in order to develop preventive methods. She works with colleagues in orthopedics, physical medicine and rehabilitation, neurosurgery and others to provide urological care.

“A multi-disciplinary approach to these children with complex issues is necessary to ensure that all areas of concern are addressed,” says Dr. Ross of the UNC Children’s spina bifida clinic.

Dr. Ross and her research partners have also developed a novel animal model to study infections in the neurogenic bladder and are dedicated to better understanding this disease process. They are studying the processes behind the increasing incidence of stone disease in children.

Dr. Bukowski, a participant in the RIVUR study, has been affiliated with UNC since 1995. Dr. Bukowski has extensive experience in bladder exstrophy and reconstruction of children born with genitourinary abnormalities, in addition to general pediatric urology. He is well known and respected for his ability to provide excellent surgical reconstruction for this complex group of children.

Community involvement

Since 2011, the Division of Pediatric Urology has offered international trips to enrich resident education and to help underserved communities. The most recent trip, in November, had UNC Children’s specialists working alongside specialists from Duke Children’s in Guatemala City, Guatemala, where they evaluated approximately 200 patients in one week and performed 48 surgeries.

The team works closely with Mending Kids International, the Shalom Foundation, and the Moore Pediatric Surgery Center, and with colleagues at Duke to schedule both simple and complex missions which offer surgical care to children in developing countries.

On the horizon

Additionally, Dr. Ross and Matthew Raynor, MD, an adult urologist at UNC with expertise in robotic surgery, are collaborating to develop a pediatric urology robotic surgery program for UNC Children’s.

“Robotic surgery is a minimally invasive surgical approach to treat children with complex urological abnormalities,” she says. “When appropriate, children can receive minimally invasive surgical intervention by utilization of a high-tech laparoscopic robotic device that allows precise surgery without large, painful, and ugly scars.”

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