Urologic Surgery

father and son

Surgery for children is different from surgery for adults, especially urologic surgery which involves a child’s reproductive system and urinary tract. That’s why our surgical teams include highly trained pediatric specialists who are sensitive to the physical and emotional needs of children. We use the latest minimally invasive treatments and techniques that help kids heal faster and get back to their lives sooner.

 
Read More About Pediatric Urologic Surgery

Nemours pediatric urologists are board-certified specialists who perform a variety of state-of-the-art surgical interventions for urologic conditions such as pyeloplasty in infants.

Our surgeons perform a wide range of procedures, including:
  • pediatric pyeloplasty (correction of kidney obstruction in children)
  • hydrocele surgery and hernia repair
  • hypospadias repair
  • varicocele correction
  • orchiectomy (removal of testis) and orchidopexy (fastening of an undescended testis inside the scrotum)
  • partial and total nephrectomy (kidney removal)
  • bladder augmentation (increasing the size of the bladder)
  • extrophy repair (closure of the bladder)
  • genital reconstructive surgery
  • circumcision
  • correction of disorders of sexual differentiation (ambiguous genitalia)
Minimally Invasive Surgical Expertise

Nemours urologic surgeons perform a number of minimally invasive procedures, which use smaller incisions or a child’s natural openings – resulting in less scarring, a faster healing time, fewer infections, and
less pain.

Depending on the specific procedure and the location where your child receives care, minimally invasive procedures available may include laparoscopic techniques (the use of a scope and sometimes other instruments to diagnose, inspect, and/or treat a problem) and robotic-
assisted laparoscopic surgery (in which surgeons use a robot to assist
in performing very precise movements through small openings or ports in
the body).

Nemours Children's Hospital, Orlando


13535 Nemours Parkway
Orlando, FL 32827
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For Appointments: (407) 650-7715

 
What to Bring
  • photo ID
  • medical and pharmacy insurance cards
  • preferred pharmacy name and phone number
  • names and dosage of all medications, including over-the-counter medication, your child is currently taking
  • guardianship and custody papers, if a legal guardian rather than a parent accompanies your child
  • any forms required for school, camp, sports, etc.
  • a list of prior immunizations
New Patients

Bring these forms for your first appointment:

Returning Patients
 
Forms & Resources
New Patient Forms
Returning Patient Forms
Resources for Patients & Families

Urology specialists at the Nemours Children’s Hospital (NCH) regularly perform robotic surgery and lecture throughout the country on advanced techniques for urologic surgery for children. This means we bring extensive knowledge and expertise to performing both simple and complex pediatric urological procedures, including pyeloplasty in infants (correcting kidney obstruction) and hydrocele surgery (removing fluid from the scrotum).

At Nemours, we understand the unique needs of children and the concerns of parents, especially when a urologic surgical procedure may be necessary. That’s why we do our best to clearly explain treatment options, answer your questions, and address all of your concerns completely and compassionately. If your child needs urologic surgery, you can trust that we’re looking for the least invasive method possible for faster healing and return to normal activities.

Special Expertise in Minimally Invasive Surgery

Nemours pediatric urologists have been selected as some of the "Best Doctors in America®" year after year. As board-certified specialists, our surgeons utilize the latest treatments and techniques, including minimally invasive procedures — performed through tiny incisions or by using natural body openings. Less invasive procedures are often easier on the body, which means your child can get back to being a kid again as soon as possible.

Minimally invasive procedures include laparoscopic or endoscopic techniques (the use of a scope and sometimes other instruments to diagnose, inspect and/or treat a problem) and robotic-assisted laparoscopic surgery (in which surgeons use a robot to assist in performing very exact movements with a surgical precision beyond the abilities of the human hand).

Minimally invasive procedures offer benefits that may include:
  • smaller incisions and scars
  • faster healing time
  • less risk of infection
  • less pain
  • faster healing time
  • shorter hospital stays
 
Learn More About Minimally Invasive Surgery for Children

Some operations that used to be done as open surgery (requiring larger “open” incisions) can now be performed in a “minimally invasive” way using a patient’s natural openings (for example, the urethra, which is the tube that connects the bladder to the genitals) or tiny incisions an inch or smaller.

Whenever you see or hear “oscopy” or “oscopic” at the end of a procedure’s name, it means “use of a scope” and sometimes other instruments to diagnose, inspect, and/or treat a problem. Minimally invasive surgery refers to:

Laparoscopy: A procedure that allows us to diagnose and/or repair or treat a problem using one or more small incisions rather than a large open incision. One small incision is used for a tiny camera, which gives the surgeon a magnified view inside the body. The other incisions are used for inserting surgical instruments. The surgeon also inflates the abdomen with gas in order to see the inside of the body more clearly. Laparoscopy is often called “band-aid surgery” because the incisions are small enough that they can be covered with small bandages after surgery instead of a large dressing.

Endoscopy: A procedure that includes passing a small lighted telescope through a body opening to examine the inside of the body. Instruments can also be passed through the scope to remove small objects or to take biopsies (when a piece of tissue is obtained for close examination). This means some procedures can be done without any cut at all — and a child can go home the very same day. Many urologic endoscopic procedures use an ureterscope, a thin tube that’s passed through the urethra (which connects the bladder to the genitals), the bladder, and the ureter (which propels urine from the kidney to the bladder) to view and treat urologic conditions such as kidney stones.

Performing the Most Advanced Robotic-Assisted Procedures for Pediatric Surgery

NCH pediatric urologic surgeons use the most advanced version of the da Vinci® robotic-assisted surgical technology which provides 3-D imagery and views at 15-times magnification. Robotic-assisted surgery is less invasive than traditional, open surgery and offers several potential benefits like reduced risk of bleeding and quicker recovery.


Types of Pediatric Urologic Procedures Performed by Our Surgeons

Nemours pediatric urologists perform a variety of state-of-the-art surgical interventions for urologic conditions, such as pyeloplasty (correction of kidney obstruction) in infants.

Other pediatric urologic surgical procedures include:
  • hydrocele surgery and hernia repair (closure of the inguinal, or groin, canal)
  • hypospadias repair (relocating the urethra, or the opening that carries urine out of the body)
  • varicocele correction (correcting the backwards flow of urine)
  • orchiectomy (removal of the testis)
  • orchidopexy (fastening of an undescended testis inside the scrotum)
  • partial and total nephrectomy (kidney removal)
  • bladder augmentation (increasing the size of the bladder)
  • extrophy repair (closure of the bladder)
  • genitourinary reconstructive surgery (correction of urethral abnormalities that are acquired or present at birth)
  • circumcision (surgical removal of the foreskin from the penis)
  • correction of disorders of sexual differentiation (ambiguous genitalia, when an infant’s genitals are not well formed)
  • ureteroscopy and Holmium laser lithotripsy (use of a scope to deliver laser pulses to break up kidney stones)
  • extracorporeal shock wave lithotripsy (use of high-energy sound waves to break up kidney stones)
  • endoscopic management of vesicoureteral reflux (alternative to surgical correction for abnormal urine flow)

We also offer special testing, including video fluoroscopic urodynamic testing (using low dose X-ray imaging) and non-invasive uroflowmetry (a special funnel connected to a measuring instrument) to assess urinary function.

 
About Anesthesia: Urologic Surgery for Children

When your child needs anesthesia or sedation for a surgical procedure, it’s natural to be concerned. Rest assured that our board-certified pediatric anesthesiologists are right here to make decisions on the best types of medicine to keep your child comfortable — and to answer any questions or concerns you may have about medication safety.

Learn More About Pediatric Anesthesiology at Nemours Children’s Hospital »

 
Family-centered Care Means We're Here for You

At Nemours, we want to hear your concerns and share with you everything we can about your child’s condition and treatment. If English is not your first language, we’ll make sure you understand what to expect — in your language. Several of our urology team members and surgeons are bilingual and can speak with you in English or Spanish. We also offer translation services for other languages.

Learn More About Interpreter Services at Nemours Children’s Hospital »


Surgical Center of Excellence: Patient Care, Research, and Education

Located in the heart of Lake Nona Medical City, NCH is a dedicated home for science, teaching, and training. Our surgeons (who do not have private practices) are here full-time, developing cures, teaching tomorrow’s leaders in pediatric health care, and bringing the most advanced treatments to bedside, faster.

 
Nemours Partnerships in Orlando — and Beyond

We’re forming relationships with our Medical City neighbors — and the international medical community — to further groundbreaking advancements in research and education. For example, we’re:

  • conducting joint research with Sanford-Burnham Medical Research Institute to study the role stem cells and gene therapy have in treating wounds (funded by the National Institutes of Health)
  • forging academic partnerships with the University of Central Florida, University of Florida and University of South Florida colleges of medicine
  • bringing in world-renowned pediatric surgical specialists to share their research, knowledge, and expertise with our physicians who are teaching future pediatric specialists

What to Expect With Pediatric Surgery

If your child needs surgery, you can trust the highly trained pediatric surgical team at Nemours Children’s Hospital. Our pediatric surgical specialists (surgeons, anesthesiologists, and nurses) understand what kids (and families) need, psychologically, and physically.

Because we truly believe in family-centered care, we invite you (one parent or guardian) to the operating room to be with your child until just after sedation. We also provide our families with a peaceful place to wait without leaving the surgical floor, in our beautiful rooftop garden.

 
What Happens During the Pre-Surgical Visit

Before any type of surgical procedure, your child will require a pre-surgical visit. At this visit, you and your child will meet your surgeon, discuss the diagnosis and details of the operation, and get answers to all of your questions or concerns. You may also meet with an anesthesiologist if necessary.

We’ll call you before your visit so you'll know what to bring, like:
  • any medications your child is currently taking
  • your ID
  • insurance and/or Medicaid cards
  • proof of guardianship, if applicable

When you arrive for a pre-surgical visit, go directly to the pre-surgical clinic area on the second floor. There, the patient service representative will review and verify your information and insurance. You will also complete a medical history form.

A nurse practitioner will assist with the visit and order any necessary tests. She or he will also inform you about what to expect the day of the surgery, including:

  • how your family will be kept updated during the procedure
  • when you can expect the surgeon to come out and speak with you
  • when you can join your child in the recovery room

EmmiKids Programs: Online Educational Videos for Families

At the end of the pre-surgical visit, you and your child may have the option to view an online educational program from EmmiKids about the upcoming surgical procedure and the anesthesia. You can watch these programs at the hospital or you may choose to watch them at home or in your local library. We’ll give you an access code to view the program(s).

Learn More About EmmiKids at Nemours »

 
How to Prepare the Day Before Surgery

The day before surgery, the surgical services staff will call you to check on your child’s health status, give you a time of arrival for the next day, update you on feeding instructions, and answer any questions.

General Feeding/Drinking Instructions

No food, milk, formula or breast milk may be consumed after a specific time (provided by your surgeon) on the day of the surgery. Your child may only have apple juice, electrolyte replenishing/sports drinks or water up to four hours prior to scheduled surgery time. These are considered “clear liquids.” We ask that you do not substitute other juices. Special Note: Infants 11 months or younger may have breast milk, but only up to six hours prior to surgery.

Suggested items to pack for your child:
  • empty baby bottle or cup
  • special feeding or suction equipment (if needed)
  • bathrobe
  • slippers
  • socks
  • favorite stuffed animal and/or blanket
  • loose-fitting clothes
  • eyeglasses (if needed)
Please remove the following items from your child:
  • all jewelry — including earrings
  • fingernail polish
  • hair accessories
  • contact lenses
  • retainers

 
What Happens the Day of Surgery

On the day of surgery, we ask that you be here at the time instructed so your child’s surgery won’t be delayed. We encourage you to allow extra time in your travel plans in case of traffic or unexpected delays.

Parking and Where to Go in the Hospital

When you arrive at the hospital on the day of surgery, you can use our complimentary valet parking, or you can self-park in the garage near the outpatient entrance. Valet services are located at the outpatient entrance and are available Monday through Friday, from 8 a.m. to 6 p.m.

Once inside the hospital, go straight to the surgical services desk on the second floor. There, the patient service representative will greet you, review your child’s information and insurance status, and check your child in. We’ll give you a case number, as well as a pamphlet with instructions about where to go and what to do during the waiting period. We’ll ask your child to change into a hospital gown and will then check vital signs: temperature, pulse, blood pressure and weight.

Just Before Surgery

While waiting for surgery, your child can play in our colorful, relaxing surgical commons area featuring many interactive games and activities to help reduce anxiety and pass the time. We also have a “toy store” where your child or teen can choose from a variety of gifts like stuffed animals, ball caps, and electronic items to keep.

When it’s close to the time for surgery, we’ll escort you and your child to an exam room, where you’ll meet the anesthesiologist and operating room nurse. As part of our unique family-centered model of care, our anesthesiologists may allow one parent to accompany your child to the operating room and stay until just after the anesthesia is administered.

During and Just After Surgery

You’ll be asked to stay in the surgical waiting area while your child is in the operating room. A nurse liaison or a trained volunteer will keep you updated during the procedure. If you need to leave the area for any reason, please inform a staff member.

After surgery, your child’s surgeon will come out to discuss the procedure and answer any questions you may have. We’ll inform you as soon as you can join your child in the recovery area or “wake up” room.

Patients must be fully awake before discharge. You should plan to stay in the recovery area for at least one hour (or longer, depending on your child). It’s very common for children to experience nausea and/or vomiting just after surgery, and also have a flushed face. We’ll offer clear liquids to drink when your child is ready. If your child will be admitted to the hospital after surgery, you’ll be given instructions ahead of time.

Once your child is ready for discharge, a nurse will review instructions with you regarding diet, wound care, medication, activity, and when your child should return to see the doctor. You may also be given prescriptions.

 
What to Expect During and Just After Surgery

You’ll be asked to stay in the surgical waiting area while your child is in the operating room. A nurse liaison or a trained volunteer will keep you updated during the procedure. If you need to leave the area for any reason, please inform a staff member.

After surgery, your child’s surgeon will come out to discuss the procedure and answer any questions you may have. We’ll inform you as soon as you can join your child in the recovery area or “wake up” room.

Patients must be fully awake before discharge. You should plan to stay in the recovery area for at least one hour (or longer, depending on your child). It’s very common for children to experience nausea and/or vomiting just after surgery, and also have a flushed face. We’ll offer clear liquids to drink when your child is ready. If your child will be admitted to the hospital after surgery, you’ll be given instructions ahead of time.

Once your child is ready for discharge, a nurse will review instructions with you regarding diet, wound care, medication, activity, and when your child should return to see the doctor. You may also be given prescriptions.

 
What to Expect the Day After Surgery

Make sure your child rests as much as possible after surgery. Temporary nausea or vomiting is quite common after discharge. But if your child experiences any of the symptoms below, call your surgeon or the nursing staff immediately:

  • a fever of more than 101 degrees Fahrenheit
  • persistent nausea or vomiting
  • severe pain that’s not relieved by prescribed medication
  • excessive bleeding from an incision

A nurse will call to check on your child’s recovery and to address any questions or concerns. We’re committed to making your child’s surgical visit as pleasant and safe as possible – before, during and after the procedure.

  

 

 
Managing Pain After Surgery: Nemours Pain Management Program

If your child is experiencing post-surgical pain, we can help. Nemours Children’s Hospital has one of the only pediatric pain management programs in the country that provides holistic, whole-child — and whole family — healing for children and teens experiencing acute (temporary) or chronic (ongoing) pain. Our integrated program is led by a world-renowned pediatric anesthesiologist who is also board-certified in pain management. We focus on relieving the physical, mental, and emotional aspects of pain using a variety of therapies in an outpatient or inpatient (day stay hospital program) setting.

Learn More About Pediatric Pain Management at Nemours Children’s Hospital »


A Hospital Designed by Families, for Families

At Nemours Children’s Hospital, family-centered care is at the heart of everything we do. In fact, families helped shape the unique amenities and convenient services that make our hospital like no other in the region.

 
If Your Child Needs to Stay Overnight in Our Hospital

You’ll feel right at home in one of our private patient rooms designed with input from families who understand what it’s like to have a child in the hospital.

Our large, comfortable, single-patient rooms have sleeping accommodations for parents, a private bathroom, wireless internet access, connections for DVD players and game systems, and flat-screen TVs.

Other in-room features include:
  • full floor-to-ceiling windows for natural light
  • LED lighting controls for patients to “paint” the room with color
  • refrigerator for family meals and snacks
  • wardrobe storage for personal items and a hotel-style safe
  • GetWellNetwork interactive television (uniquely based on your child’s age, medical condition and more) so your child can watch TV, surf the web, check e-mail, play music and games, and learn about your Nemours health care team
We have many more comforts and amenities such as:
  • complimentary valet and parking
  • kid-friendly commons areas for siblings
  • cafe and coffee shop
  • gift shop
  • non-denominational chapel
  • concierge services

Learn More About Nemours Children’s Hospital »

 
Advanced Pediatric Medical Imaging Services Available Onsite

If your child needs medical imaging, we offer some of the area’s most advanced pediatric radiology services here on campus at Nemours Children’s Hospital.

Our unique services include:
  • interventional radiology: Our team of experts uses image guidance to diagnose and treat diseases and tumors throughout the body. Certain conditions that previously required open surgery can now be treated by Nemours pediatric interventional radiologists. We are very fortunate to have the only dual-trained pediatric diagnostic and interventional radiologist in the state.
  • neuroradiological or cardiovascular imaging, and fetal MRI (magnetic resonance imaging): Our subspecialty-trained pediatric radiologists see children with complex conditions who require this highly specialized imaging.
  • Central Florida’s only 256-slice Brilliance iCT Scanner: We are one of only a handful of children’s hospitals in the country to have this latest generation CAT (or CT) scanner that scans faster than most machines and produces excellent images in a much shorter time with much less radiation exposure for the child.

Our team of board-certified pediatric radiologists and pediatric radiologic technologists are experts in the safe medical imaging of children of every age, even newborns.

We have also pledged our commitment to the “Image Gently” campaign of the Alliance for Radiation Safety in Pediatric Imaging, which is increasing awareness of the opportunities to promote radiation protection in the imaging of children.

Learn More About Medical Imaging at Nemours Children's Hospital »

 
With Your Family From Clinic and Hospital to Home – KidsTRACK

If your child has a complex or chronic condition, we encourage you to take advantage of KidsTRACK, a unique service of Nemours Children’s Hospital. Located on the first floor of our hospital, KidsTRACK is designed to help families by providing expert assistance and information on all aspects of your child’s care, even before you leave our hospital or clinic.

A KidsTRACK care coordinator is available during every step of diagnosis, treatment, and healing — helping your family make a smooth transition from Nemours Children's Hospital to home. Your coordinator works alongside the nursing /case managers in our subspecialty areas and acts as a single point of contact connecting you to medical and community resources. Simply ask your physician for a referral to KidsTRACK or call (407) 650-7715.

Learn More About KidsTRACK at Nemours Children’s Hospital »