Dedicated pediatric urology experts

The Division of Urology here at Children’s Hospital of Philadelphia (CHOP) is consistently ranked as one of the top pediatric urology programs in the nation. Our team is comprised of world leaders in pediatric urology who offer the full range of surgical approaches to make sure your child achieves the best results for their condition.

A team approach to advancing bladder care

Bladder exstrophy, cloacal exstrophy, epispadias (the bladder exstrophy-epispadias complex, or BEEC) are rare and complex disorders. Many physicians see only one or two cases in their career. We have of one of the largest and most accomplished teams of pediatric urology experts in the world working in our Bladder Exstrophy Program. Our urologists work as a team with other CHOP specialists including orthopedic surgeons, anesthesiologists, gastroenterologists, physical therapists, urology psychologists and nurses to help ensure the best outcomes for your child. In addition, we partner with doctors around the country to provide expert care that improves the quality of life, bladder control (continence) and body image for children who live with these disorders. 

The Multi-Institutional Bladder Exstrophy Consortium

The Multi-Institutional Bladder Exstrophy Consortium (MIBEC) is a collaboration among three world-renowned institutions — Children’s Hospital of Philadelphia, Boston Children’s Hospital and Children’s Hospital of Wisconsin — dedicated to improving care and functional and cosmetic outcomes of children with all forms of bladder exstrophy. 

The MIBEC team brings together some of the most experienced pediatric urologists in the nation who have more than 200 collective years of surgical experience. By working together, we have four times the experience and have gained unmatched expertise in treating these rare conditions. Our team works closely together to plan each child’s surgery and make it as safe and successful as possible. We also keep a detailed, ongoing record of our patients’ results so we can learn from every case and continue to improve the care we provide.

Physical therapy and psychology services

Children born with bladder exstrophy, or those recovering from reconstructive surgery, often face challenges with bladder control, movement and confidence. Here at CHOP, we use physical therapy as an important part of care. Before and after surgery, pelvic health physical therapists evaluate and help children strengthen and coordinate their core and pelvic floor muscles. This training supports bladder control, improves movement, reduces discomfort and helps kids feel more confident returning to school, sports and everyday life.

Our urology psychologists work closely with our clinical team to offer specialized support to children and families, and to help care for your child’s emotional and behavioral health. They can help ease worries about medical care, assist with toilet training and treatment routines, and work with your child to build coping skills for living with a chronic condition. They also support you as parents and caregivers as you adjust and advocate for your child’s needs.

Together, physical therapy and psychology services help children heal physically, emotionally and socially, so they can move forward with strength, confidence and hope. 

Dedicated to surgical safety

For every child we treat, our goal is to fully close and rebuild the areas affected by bladder exstrophy and epispadias so the bladder and nearby organs can work as they should. We follow a careful, step-by-step surgical process — from the very first incision to the final stitch — to make sure the repair is strong, safe and gives the best long-term results. We constantly evaluate our outcomes and make adjustments to the way we operate, and care for children after surgery, to make sure that each child receives the best care.

A focus on the future

After surgical repair, your child will require lifelong follow up. Your child’s care team will schedule regular follow-up clinic visits and ultrasounds at the institution where their surgery was performed so we can monitor their bladder and kidneys as they grow.

Our team’s goal is to help each child have the best possible bladder (urinary) control, kidneys that safely filter waste from the body and keep it healthy, natural appearance and healthy function of the urinary and reproductive organs (genitalia). 

As children grow, some may need another surgery to help them stay dry (achieve continence) or to complete the reconstruction of the genital area. These follow-up procedures help support healthy body function and confidence as each child develops.

Details of all patients’ operations are recorded and reviewed by the MIBEC team to continually guide and help us refine our approach to long-term care for patients recovering from bladder exstrophy and reconstruction surgery.