Services and Innovations
The Children’s Hospital of Michigan Urology Department offers a number of unique services aimed at successfully treating a various pediatric urological conditions including:
Behavioral Modification Voiding Program (Be MVP):
The Behavioral Modification Voiding Program (BeMVP) is dedicated to the care of children with dysfunctional elimination syndrome (DES). This includes daytime wetting, painful voiding, dribbling, increased or decreased voiding frequency, hesitancy, recurrent urinary tract infections, bed wetting and constipation. A multidisciplinary approach is required when evaluating and treating patients with these conditions. The shame and humiliation of frequent “accidents” sometimes cause psychological problems for children. Children with DES may also suffer from frequent urinary tract infections. In severe cases, DES may lead to kidney failure and require surgical intervention. As a result, a wide variety of specialists may be involved in patient care — including a pediatric urologist, nephrologist, psychologist, biofeedback specialist and physical therapist. Working closely with patients, families and schools, the BeMVP team helps children learn healthy voiding habits.
During the clinic visit services include:
- Detailed history and physical examination;
- Urine examination;
- Bladder scan to measure the post void urine volume;
- Bladder and kidney ultrasound when indicated;
- Urodynamic evaluation (in selected patients) to assess bladder pressure, capacity, and voiding pressure;
- Behavioral techniques, dietary modifications, improved hydration, medications if needed, and Biofeedback for pelvic muscle retraining.
Nocturnal Enuresis (Bed Wetting)
The Pediatric Urology Department at the Children's Hospital of Michigan sees about several hundred patients a year with some form of enuresis, including nocturnal enuresis. About 70 percent of children who struggle with bed wetting will respond to some form of behavioral modification — biofeedback training, pelvic floor muscle relaxation or the use of a bed wetting alarm. About 30 percent of children don't respond to behavioral modification techniques. For these patients, it's important to identify the specific cause of the bed wetting. Medical causes might include polyuria, small bladder or obstructive sleep apnea (OSA) — each requiring a different approach to treatment. The multiple causes and treatments of bed wetting underscore the importance of a multidisciplinary approach to care. At the Children's Hospital of Michigan, several pediatric subspecialists may be involved in the evaluation and treatment of each patient — including a pediatric urologist, nephrologist, psychologist and biofeedback specialist. Get more information on bed wetting.
This conservative non-surgical therapy aims to teach children how to relax the muscles necessary for effective urination and bowel movements. Get more information on the study.
Bowel and Urinary Disorders Clinic
Researchers on the medical staff in the Department of Urology at the Children's Hospital of Michigan demonstrated a link between constipation and urinary incontinence in children. Treatment of children with complex bowel and urinary disorders requires a multidisciplinary approach offered at the Children's Hospital of Michigan. Pediatric urologists work closely with pediatric gastroenterologists on staff, as well as a psychologist, biofeedback specialists and physical therapist to care for patients with chronic bowel and urinary conditions.
Disorders of Sex Development (DSD) Clinic
The Disorders of Sex Development (DSD) clinic at the Children’s Hospital of Michigan is staffed by a pediatric urologist, endocrinologist and psychologist. Because these are rare disorders, researchers still have much to learn. This is why the DSD Clinic at the Children’s Hospital of Michigan has participated in research of the disorders.
Multidisciplinary Pediatric Kidney Stone Clinic:
The Multidisciplinary Pediatric Stone Clinic focuses on the prevention and treatment of kidney stones in children. All patients are evaluated by a multidisciplinary care team including a dietitian a pediatric nephrologist and a pediatric urologist.
The Stone Clinic offers comprehensive evaluation, medical and surgical management of children who currently have kidney stones, those who have previously had them and those who are at risk for developing them. Services may include a detailed history and physical examination, blood and urine testing, and chemical analysis of stone if passed or removed. The treatment is individualized in each patient, depending upon the stone composition and risk factors identified. It usually consists of optimal fluid management, dietary modification, and medication. The need for surgical removal of the stone, and the choice of the best surgical procedure is carefully assessed (such as extracorporeal shock wave lithotripsy (ESWL), percutaneous nephrolithotomy, ureteroscopy with laser lithotripsy.
Pediatric Urology Nephrology (PUN) Clinic
Children with complex urological disorders resulting in renal impairment and/or End Stage Renal Disease are best treated in combination with Pediatric Nephrology. The PUN Clinic serves to address the needs of these patients and those on dialysis and requiring renal transplant, with joint evaluation and management along with Pediatric Nephrology specialists. Get more information on the Nephrology Department.
Myelomeningocele Care Center
For more than 30 years, the Myelomeningocele Care Center at Children's Hospital of Michigan has provided multidisciplinary care to children with spina bifida, spinal cord birth defects, spinal cord injuries, spinal cord tumors and infections. The Center offers a one-stop medical care solution for children with multiple neurosurgical, urologic, orthopaedic and rehabilitative health issues. Additional clinic support services include nutrition, nursing, wound/ostomy/continence nursing, psychology, physical therapy, occupational therapy, therapeutic recreation and social work. The Center takes a family-centered care approach to treatment; family-centered discussions are held during annual multidisciplinary evaluations. Get more information on the Myelomeningocele Care Center.
This study assesses how the bladder and urethra are performing their job of storing and releasing urine. Get more information on the study.
To refer patients or make an appointment for these services please call (313) 745- 5588, (313) 745-KIDS or toll-free at (888) 362-2500.