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Urology

Center for Urodynamics and Incontinence

Andrew Combs, RPA-C
Director
Kenneth I. Glassberg, MD
Medical Director

The Division of Pediatric Urology offers a state-of-the-art Center for Urodynamics and Incontinence at NewYork-Presbyterian Morgan Stanley Children's Hospital to treat children with incontinence as well as other conditions that affect bladder function. The Center provides more than 1,400 urodynamic studies each year. Demand has risen so dramatically that the Division now offers two active urodynamic laboratories -- one with fluoroscopy and one without.

The Center for Urodynamics and Incontinence has become internationally recognized, training clinicians to develop units at other institutions and continually hosting visitors from similar laboratories that have been established all over the world. Most recently, the Center has welcomed visitors from the Hospital for Sick Children in Ontario, the Great Ormond Street Hospital in England, and the University of Ghent in Belgium.

The Division's physicians, physician assistant and nurse practitioners often contribute to the literature, present at national conferences and participate on international committees devoted to the treatment of children with voiding dysfunction and incontinence. In 2010, Dr. Glassberg and Andrew Combs, RPA-C, presented their findings on primary bladder neck dysfunction in children and adolescents at the American Academy of Pediatrics. Their findings were also published in the Journal of Urology.Primary bladder neck dysfunction is a nonneurogenic voiding disorder that is frequently overlooked in pediatrics. The diagnosis classically is made by videourodynamics, but can also be made with noninvasive uroflow studies with pelvic floor electromyography. Dr. Glassberg and Mr. Combs have found that the non-invasive method provides the same findings as the invasive method. On the basis of test results, it can be determined which patient would benefit from medication, biofeedback, or a combination of both.

Dr. Glassberg and Mr. Combs are also studying data on children with abnormal urological conditions who require intermittent catheterization and are on high doses of medication. According to Dr. Glassberg, by being proactive and investigating patients very early, they have been able to prevent their bladders from deteriorating over time, thereby avoiding bladder augmentation, a procedure in which a piece of the bowel, stomach or ureter (the tube that carries urine from the kidney to the bladder) is used to enlarge the bladder. Dr. Glassberg and Mr. Combs will be presenting their findings at the American Urological Association on the use of overnight catheterization, a protocol that they believe will help to normalize the bladder and avoid the need for bladder augmentation in the future.