Pediatric Urology Curriculum and Research

Throughout the pediatric urology fellowship program at Indiana University School of Medicine, fellows obtain a thorough knowledge in pediatric urology. A structured curriculum is provided with weekly conferences, including regular multi-disciplinary conferences, indications conferences, complex case conferences, journal club, and morbidity and mortality conferences.

Research conferences are held monthly with all staff, and bimonthly research meetings are held to present progress on research. Fellows are expected to participate in research projects during both years of the fellowship. A dedicated list of research projects and timelines are created to ensure productivity.

Learning objectives include performing bladder reconstruction, bowel continence surgery, complex genital reconstruction, endourology procedures, neurourology and urodynamics procedures, robotic upper and lower urinary tract reconstruction, and ureteral reconstruction. Fellows also learn to care for patients experiencing conditions such as hypospadias, undescended testicles, spina bifida and more.

Bladder and Ureteral Reconstruction

Fellows learn management of neurogenic bladder issues, including sacral neuromodulation, botox, catheterizable channels, bladder augmentation and bladder neck reconstruction. They also learn management of ureteral reconstruction, including intravesical ureteral reimplantation, extravesical ureteral reimplantation, uretero-ureterostomy and pyeloplasty (both open and robotic).
Complex Urologic Conditions

Fellows gain significant experience in complex genital reconstruction and female genital restoration surgery, as Riley Hospital for Children is one of the centers of excellence for congenital adrenal hyperplasia (CAH). They also learn management of congenital urologic conditions, including bladder exstrophy, cloaca and disorders of sex development.
Genital Reconstruction

Fellows learn about all ranges in penile reconstruction, including circumcisions, chordee repair, penoplasty, scrotoplasty and hypospadias repair (both single and staged procedures). They also study orchiopexy management from bianchi orchiopexy, inguinal and abdominal, including one stage and Fowler-Stevens as well as testicular auto-transplantation.
Robotic Reconstructive Urology

Fellows have the opportunity to log 50-75 robotic cases in a single year.
Transitional Care

Fellows help care for adolescents and adults through specialized spina bifida and adult spina bifida clinics as well as travel to other hospitals to assist in their care, including with cesarean sections, reconstruction procedures and more.

Duration

The fellowship is divided into two years. The clinical year comprises the first 12 months of the fellowship. Involvement in clinical research activities is encouraged during this year.

The second year is a research year. Fellows have weekly opportunities to participate in clinical activities. During the second year, in addition to research, the fellow will spend one day a week in clinical practice. This fosters independence and more autonomy, but with attending back up immediately available. This also facilitates the transition from fellow to attending physician.

Funding

Support is provided for fellows to travel to the Pediatric Fall Congress and the annual meeting of the American Urological Association to present research findings. A pediatric urology educational fund enhances educational activities for fellows demonstrating a commitment to academic pediatric urology.

Annual Case Mix for Index Cases	Number of cases (percentile)
Endourology	28 (68)
Ureterocele incision	8 (86)
Posterior valve ablation	10 (87)
Scrotal/Inguinal Surgery	170 (55)
Hernia Repair/Orchiopexy	146 (58)
Varicocelectomy	5 (46)
Penile Surgery	209 (93)
Distal Hypospadias	70 (93)
Proximal Hypospadias	26 (80)
Hypospadias Complication Repair	13 (49)
Epispadias	3 (70)
Bladder/Urethral Surgery	165 (94)
Ureteroneocystotomy	137 (95)
Cysto with subureteric injection	15 (72)
Major Reconstructive Surgery	150 (94)
Pyeloplasty	42 (91)
Nephrectomy	22 (86)
DSD Surgery	32 (92)
Appendicovesicostomy	28 (90)
Enterocystoplasty	13 (87)
Exstrophy closure	3 (71)
Urodynamics	13 (72)
Total Index Cases	696 (94)