As a pediatric urologist at Cincinnati Children’s, I treat all conditions pertaining to the urinary tract in children. As co-director of the Pediatric Stone Center, I focus heavily on the surgical and medical management of children with kidney stones, a condition that is becoming much more common in the United States. I also treat tumors of the urinary tract and birth defects of the genitalia including hypospadias and undescended testicles. I perform robotic-assisted laparoscopic surgery on kidneys. Along with my partners, I see and treat patients from all over the world who have complex bladder abnormalities requiring surgical reconstruction.
When I entered medical school back in 1992, I was initially attracted to primary care and wanted to go back to my small town in Kentucky and be a family doctor. However, after my surgery rotations, I found a different calling. Urology as a specialty is a good mix of medical treatment and surgical procedures and presents different challenges every day. When I was exposed to pediatric urology as a resident, I found my true passion.
Pediatric urology allows me not only to correct urgent problems, such as hernias and kidney stones, but also to manage patients with chronic diseases of the urinary tract that need ongoing, lifelong care. Following these patients from birth is extremely rewarding. It’s amazing to watch children grow up under your care and see them blossom into young adults.
Every patient and family should be treated as individuals with a treatment plan specific to their needs. All factors – medical, behavioral and social – need to be carefully considered. Even though two patients can have nearly identical conditions, based on the whole picture, they may need a different plan of care. A surgeon can perform a technically successful operation, but if it doesn’t meet the patient’s needs and expectations, there may still be an unsatisfactory outcome.
My main goal with every patient encounter is to ensure that the voice of the patient and family is heard. I take my time to listen to what brought the family to me. I review all available test results, including X-ray images, with the family in the office. At the end of the visit, I address all of their questions and concerns. If needed, I will arrange a follow-up phone or in-person consultation after the appointment to further discuss complex issues. This gives them a chance to consider the options and do their own research. I do this to make sure our course of action is comfortable for the patient, family and surgical team.
I was honored to have been awarded an endowed chair in Clinical Outcomes Research at Cincinnati Children’s Hospital in 2018. I was also named Educator of the Year in the Division of Urology at the University of Cincinnati College of Medicine the same year. I serve on multiple national and international executive boards. These have included the American Academy of Pediatrics Section on Urology Executive Committee and the Pediatric Urology Fellowship Directors Committee, of which I was vice chair and am now chair-elect. I’m also past president and education chair of the American Association of Pediatric Urologists, a national organization of specialists in our field.
In addition to clinical care, I conduct research to study diseases of the urinary tract and determine optimum treatments for our patients. In pediatric urology, we often deal with rare conditions for which there are few randomized clinical trials. These trials are considered the highest level of evidence in medical research and are critical to determining the best course of action.
Recently, Cincinnati Children’s participated in the largest trial of children with vesicoureteral reflux (RIVUR study), and the findings were published in the New England Journal of Medicine. Due to the large volume of complex and rare conditions we see at Cincinnati Children’s, we are in a unique position to add our experience and knowledge to the world’s medical research literature.
In my spare time, I love to run half marathons and coach recreational league youth basketball. As a graduate of the University of Kentucky Medical School, I’m a huge college basketball fan, of course. I was recently elected to be an elder at my church, and I’m an avid reader of both fiction and nonfiction. My wife, a general pediatrician, and I have three teenagers as well as a 120-pound Great Dane, which leads to lots of fun and chaos at our house!
BS: Georgia Institute of Technology, Atlanta, GA, 1991.
Fulbright Fellowship: Universite' Rene' Descartes, Paris, France, 1992.
MD: University of Kentucky, Lexington, KY, 1996.
Residency: Medical University of South Carolina, Charleston, SC, 2001.
Fellowship: Cincinnati Children's Hospital, Cincinnati, OH, 2003.
MPH: Harvard University, Boston, Massachusetts, School of Public Health, 2005.
Complex genitourinary reconstruction; clinical outcomes research; clinical trials; urolithiasis; uro-oncology; laparoscopic-assisted; robotic-assisted surgery; vesicoureteral reflux
Colorectal Disorders, Urology, Kidney Stones
Modulation of apoptosis in cryptorchidism (undescended testes) with anti-oxidant pharmacotherapy; pediatric urologic surgical outcomes analysis using an evidence based medicine approach
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Kidney function outcomes in patients after complete primary repair of bladder exstrophy and penopubic epispadias: Results from the international bladder exstrophy consortium. Journal of Pediatric Urology. 2023; 19:34.e1-34.e9.
Enteral nutrition and the risk of nephrolithiasis in complex pediatric patients. Journal of Pediatric Urology. 2022; 18:743.e1-743.e6.
International Pediatric Multidisciplinary Management Using Telemedicine to Promote Equitable Care. Telemedicine Journal and e-Health. 2022.
Renal Transplantation. Pediatric Surgery. 2022.
Diagnosis, management and recurrence rates of Mitrofanoff polyps. Journal of Pediatric Urology. 2021; 17:855.e1-855.e4.
Outcomes according to channel type for continent catheterizable channels in patients undergoing simultaneous urinary and fecal reconstruction. Journal of Pediatric Surgery. 2021; 56:1335-1341.
Comparison of risk of anticholinergic utilization for treatment of neurogenic bladder between in utero or postnatal myelomeningocele repair. Journal of Pediatric Urology. 2021; 17:525.e1-525.e7.
Endoscopic-assisted robotic pyelolithotomy: a viable treatment option for complex pediatric nephrolithiasis. Journal of Pediatric Urology. 2020; 16:192.e1-192.e5.
Need for botulinum toxin injection and bladder augmentation after isolated bladder outlet procedure in pediatric patients with myelomeningocele. Journal of Pediatric Urology. 2020; 16:32.e1-32.e8.
Impact of body mass index on 30-day postoperative morbidity in pediatric and adolescent patients undergoing continent urinary tract reconstruction. Journal of Pediatric Urology. 2019; 15:521.e1-521.e7.
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