Stories about: Dr. Carlos Estrada

What parents should know about hypospadias

cartoon birds talking about hypospadias
ILLUSTRATION: PATRICK BIBBINS/BOSTON CHILDREN’S HOSPITAL

It’s one of the most common birth defects, affecting an estimated 1 out of 200 boys. But most parents aren’t aware of hypospadias until their child is diagnosed with it. In this condition, the opening of a boy’s urethra (through which both urine and semen pass) is located on the underside of his penis rather than at the tip of it. In about 80 percent of boys with hypospadias, this opening is found near the end of the penis. Fifteen percent of those boys also have a condition called chordee, in which the penis curves downward to varying degrees. Hypospadias is usually diagnosed at birth, but severe cases are increasingly being diagnosed in utero with ultrasonography.

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Looking at the whole child: Coordinated care for spina bifida helps Jeffrey thrive

8-year-old boy with spina bifida smiles at the camera

Jeffrey Marotz and his family may have driven to Boston Children’s Hospital from their home in New York, but it was really the boy’s feet that brought him here.

Born with severe spina bifida, a complex birth defect that affects the development of a child’s spinal cord, spine and brain, Jeffrey had also been diagnosed with clubfoot, a related orthopedic condition that causes the foot to twist unnaturally.

Previous surgeries hadn’t worked and the braces that had been custom made for then three-year-old Jeffrey didn’t fit correctly. “Nothing was working,” says his mom, Michelle.

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Pushing past the pain: Morgan’s journey with spina bifida

Dr. Warf with Morgan, who has spina bifida.
“Be glad you can use your legs now. You might not always be able to.”

That’s what Morgan Gautreau was told by a neurosurgeon in Alabama six years ago, one of many doctors she had seen seeking a solution for her nearly constant back pain caused by a tethered spinal cord, a condition where the spinal cord is attached to tissue around the spine and can’t move freely within the spinal canal. Morgan’s tethered cord was due to spina bifida occulta, a type of neural tube defect where the spinal column doesn’t develop properly.

Luckily, she and her family didn’t take his words to heart, but kept looking for help.

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Tackling bedwetting: ‘Don’t be afraid to talk about it’

Bedwetting, otherwise known as urinary incontinence or enuresis, is fairly common, often embarrassing and sometimes difficult to talk about. It is estimated that about 20 percent of boys and 17 percent of girls, ages 6 to 7 years old have some problem with daytime or nighttime wetting. Still, many kids are reluctant to talk about wetting with parents, friends and teachers. Parents themselves often have a hard time confronting the issue.

The Voiding Improvement Program (VIP) at Boston Children’s Hospital offers a comprehensive approach to bedwetting tailored to each child’s individual needs. “Our program is driven by highly skilled and compassionate nurses who understand both the physiologic and emotional issues surrounding urinary issues,” says Pamela Kelly, the program’s nurse director. Treatment may include biofeedback training, relaxation therapy such as guided therapy and behavioral therapy.

Kelly and VIP’s director, Dr. Carlos Estrada, offer five tips for managing your child’s wetting issues.

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