Multidisciplinary Valves Program

Lurie Children’s Multidisciplinary Valves Program (MVP) Clinic, launched in 2019 with patient family-centered care in mind, is the most experienced comprehensive pediatric clinic in the region treating this rare urological condition in infants and children.

Lurie Children’s MVP provides individualized care to each patient family they meet with, from before birth through adulthood. Our care team offers initial assessments, comprehensive surgical and medical treatment and ongoing managed care for patients with posterior urethral valves (PUV). Our specialists also welcome patients previously treated for PUV at other institutions and can help ensure and streamline transition of care.

Our team includes specialists in both urology and nephrology (kidney disease), allowing patients and their families to get the unified care they need for this condition during the same appointment.  

What is Posterior Urethral Valves (PUV)?

Posterior urethral valves are abnormal leaflets of tissue that prevent the normal release of urine, causing the bladder and kidneys to become overfilled and expanded. Affecting only boys, PUV affects about 1 in 5,000 births. 
In most cases, a child is diagnosed with PUV before they are born by prenatal ultrasound.

Some children may not be identified with PUV before they are born and can go years before an accurate diagnosis. Children diagnosed later in life often present with toilet training and kidney functional issues.

The condition is caused by small flaps of tissue in the posterior urethra that blocks urine from coming out. These tiny flaps can cause tremendous damage to the bladder, thickening it and making it function poorly. This pressure can be passed up to the kidney, leading to problems with kidney function. 

What is Treatment Like for PUV?

Patients with PUV require a surgical procedure shortly after they are diagnosed. In most cases, a telescoping camera will be placed into the urethra and the valve leaflets will be identified and cut. This procedure is needed to remove the blockage to urine flow out of the bladder. Some of the injury to the urinary tract may be reversed with this procedure, but some injury—from the kidneys to the bladder—may be permanent.

Because of this, most of the treatment for PUV following the initial surgery is about managing the condition. Regular ultrasound, bladder function, and kidney function tests are typically performed to track the patient’s progress. Medications may be necessary to support bladder and kidney function. On occasion, further surgeries of the urinary tract may be necessary to prevent problems with kidney function or urinary tract infections.

Even with treatment, some children with PUV may have worsening kidney and bladder function over time. Some may need dialysis or a kidney transplant. Many children with PUV have bladder function issues, including delayed toilet training, nighttime or daytime wetting, and urinary tract infections. In some cases, children with PUV will need a catheter to empty their bladder.

Our team will help ensure the best possible care to potentially prevent these complications and proactively manage them if they occur. 

The Lurie Children’s Difference

The PUV team at Lurie Children’s is comprised of specialists from our nationally ranked Divisions of Urology and Pediatric Nephrology (kidney).

The Division of Urology is ranked 6th in the nation by U.S. News & World Report and is the largest pediatric urology department in the region with more than 18,000 pediatric visits each year for both common and complex conditions.

Meanwhile, The Division of Nephrology (Kidney Disease) is ranked 14th in the nation by U.S. News & World Report for pediatric kidney disorders. We have the region’s largest pediatric kidney diseases (pediatric nephrology) team.

Our approach is thorough, family-centered and team oriented. Based on their needs, your child will have access to a skilled and coordinated team of doctors, nurses, therapists and technicians from many specialties. Together, our specialists offer comprehensive and compassionate surgical and medical care for your child.

Our Specialists

The PUV Clinic was established in 2019, co-led by pediatric nephrologist Kavita Hodgkins, MD, and pediatric urologist Edward Gong, MD. 

Kavita Hodgkins, MD

Attending Physician, Nephrology (Kidney Diseases), Urology

Dr. Hodgkins has been a pediatric nephrologist at Lurie Children’s since 2013 after completing fellowship in pediatric nephrology at Lurie Children’s. She is an Assistant Professor of Pediatrics at Northwestern University Feinberg School of Medicine and serves as the Director of Resident and Medical Student Education for the Division of Pediatric Nephrology as well as College Mentor for the Feinberg School of Medicine. She is a published author, publishing research related to kidney disease in children. Dr. Hodgkins truly enjoys working in multidisciplinary teams and the tremendous benefits this offers to patients and families. 

Edward Gong, MD

Attending Physician, Urology; Co-Director, Fetal Urology, The Chicago Institute for Fetal Health; Member, Lurie Children's Surgical Foundation

Dr. Gong is an attending physician in urology at Lurie Children’s and the Co-Director of Fetal Urology at The Chicago Institute for Fetal Health. He is an Assistant Professor of Urology at Northwestern University Feinberg School of Medicine. He has been a pediatric urologist at Lurie Children’s since 2011, following a fellowship in pediatric urology at Boston Children’s Hospital. He is a published author of numerous scientific articles related to posterior urethral valves and other pediatric urologic conditions. He has a particular interest in developing standardized management guidelines for patients with this challenging diagnosis. 

Melissa Sawyer, RN

Melissa received her Bachelor’s in Nursing at Loyola University-Chicago. She is a certified pediatric nurse and has worked at Lurie Children’s since 2018. Melissa adores children and enjoys the fact that there is always something new to learn and understand in Nephrology, making every day interesting. 

Desiree Murray, RN

Sue Purol, RN

Christine Santos

What to Expect

Our treatment begins with an initial assessment of your child. 

At most appointments, your child with meet for about 30 minutes each with both a pediatric nephrologist and a pediatric urologist. The appointment may involve imaging or scans, lab work (a blood draw) and other testing in advance.

Our specialists review each patient individually, and then discuss each patient’s needs together to ensure each patient is receiving comprehensive care from all experts involved.

Our team will help children with PUV and their families manage their condition with the best possible support throughout their journey. 

Make an Appointment

Please call 312.227.6340 if you would like to schedule an appointment with the PUV team. Please ask to speak to Christine.