Stories about: Urology

What value does urology bring to multidisciplinary cancer care? Q&A with a pediatric urologist

Richard Lee pediatric urologic oncology urology multidisciplinary cancer care
Richard Lee, MD

Cancer affects more than just the tissue or organ in which a tumor starts — it affects the whole patient. This is as much the case with children as adults, if not more so, and can have greater consequences. With survival rates for childhood cancers constantly on the rise, the long-term effects of cancer care on nearly every organ system are coming under increasing scrutiny, as are ways of reducing those effects.

A multidisciplinary approach to cancer care is the best way to keep cancer treatment’s side effects as low as possible while keeping a patient’s quality of life high, both during and after treatment. In this context, pediatric urologists bring a unique perspective, one that combines techniques that can help a child’s care team evade or alleviate continence and voiding issues during treatment and address options for maintaining urologic, sexual and reproductive function down the road.

Notes talked to Richard S. Lee, MD, director of pediatric urologic oncology for Dana-Farber/Boston Children’s Cancer and Blood Disorders Center and a physician in Boston Children’s Hospital’s Department of Urology, about the expertise a pediatric urologist brings to a multidisciplinary pediatric cancer care team. …Read More

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Challenging Case: UTI and undetected genitourinary anomalies

MRI solid kidney vesicoureteral reflux hydronephrosis
MRI revealing the lack of a right kidney, as well as hydronephrosis of the left kidney.

A 3-year-old boy initially presented with a 10-day history of intermittent fevers—fluctuating as high as 105°F—and abdominal pain. His abdominal pain was episodic (lasting 30-60 minutes and occurring 2-3 times per day) fairly severe, peri-umbilical, non-radiating, and worsened with fevers. Initial evaluation revealed largely unremarkable labs (wbc 11.3, urinalysis normal). The patient was admitted to the hospital overnight but cultures and other workup were negative. No imaging was obtained at that time. As his fevers and abdominal pain resolved during the hospital stay, he was discharged home with presumed diagnosis of sequential viral infections.

Three days later he presented again a fever of 104°F and recurrent abdominal pain. Urinalysis and cultures were again negative. This time, abdominal sonography was obtained, showing a solitary left kidney with hydroureteronephrosis and a cystic area posterior to the bladder. The Boston Children’s Hospital Department of Urology was called into consult, after which an MRI confirmed right renal agenensis, left hydroureteronephrosis and a presumed right seminal vesicle cyst. …Read More

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