May 13, 2019

Last month, Texas Children’s Department of Surgery leadership announced that Dr. Paul Austin was named Texas Children’s new chief of Urology, the third Urology chief in the hospital’s 65-year history.

“I’m excited that Dr. Austin has accepted the position of chief of Urology at Texas Children’s,” said Surgeon-in-Chief Dr. Larry Hollier. “His clinical experience, combined with a successful research program, provides a wonderful foundation for the future of Pediatric Urology at Texas Children’s.”

Austin assumes the helm of the division from Dr. David Roth, who has served as chief of Urology for the past seven years and helped recruit Austin nearly two years ago. Under Roth’s leadership, Texas Children’s Division of Urology grew from three physicians and an advanced practice provider (APP) to one of the largest programs in the country, with 10 urologists, two research PhDs and six APPs. During this time, the division of Urology’s national status steadily improved and the program is currently ranked No. 4 in country according to U.S. News & World Report.

“I have enjoyed the growth of our division and appreciate the support of our leadership and administration,” Roth said. “I am excited that Dr. Austin is continuing the tradition of leadership for the Division of Urology that began with Dr. Edmond Gonzales over 40 years ago. He is an internationally recognized leader in pediatric pelvic health and is the right person to lead our division for years to come.”

Austin currently serves as Director of Texas Children’s Complex Urologic Reconstruction Program and Director of the Pediatric Urology Basic Science Research Program. He has co-authored more than a hundred articles and 25 book chapters, has edited four textbooks, and has three grants totaling more than $2.5 million in National Institutes of Health R01 funding.

Austin is also the current president of the American Association of Pediatric Urologists (AAPU) – one of the best-respected and most important societies for pediatric urologists in the United States – an organization that Roth co-founded more than 30 years ago.

“Since I first attended AAPU with a mentor of mine in 1996, it has been my favorite conference of the year,” Austin said. “It’s always a special time of learning, networking and collaboration. The sheer variety of talks and topics is always amazing, and the way these experts challenge each other, but in a respectful way, has always been a hallmark of the event. That is thanks to Dr. Roth’s vision, and it’s my honor to serve as AAPU president this year.”

Austin brings a bright and multifaceted vision for the future to the Division of Urology. In addition to keeping our clinical care at the forefront of pediatric urology on a national level, he wants to enhance the division’s capabilities in the treatment of complex urologic conditions and in research.

“Everyone has their niche, and you have to be aware of your team members’ passions and think about how you can help them grow and develop their talents, whether that be in patient care, education and teaching, or research,” Austin said. “My main goals are to grow our basic and clinical research enterprise, to provide encouragement, motivation and support that will lead our people to continued excellence and achievement in patient care, basic and clinical research, in competition for research prizes, and in leadership roles in the greater field of pediatric urology, and to foster multidisciplinary collaboration between Urology and other divisions and services across the Texas Children’s system.”

About Pediatric Urology at Texas Children’s

The Division of Urology at Texas Children’s Hospital offers the most advanced surgical care for routine urological needs as well as genitourinary problems related to congenital birth defects, trauma and a range of other medical conditions.

The division provides specialized, multidisciplinary care and expertise in fetal medicine, spina bifida, renal stone disease, gender medicine and complex urologic care. The division has also established a transition urologic care process that allows adolescent patients to transfer care to adult care providers.

We work closely with child-life specialists, who provide support to help patients and their families cope with the challenges frequently presented by urological disorders. Transitional follow-up care is provided for adolescent patients as they progress to adult care.

Learn more about Urology at Texas Children’s.

March 25, 2019

In this month’s episode of Medically Speaking, you’ll hear from Texas Children’s urologist, Dr. Ming-Hsien Wang. In her talk, Wang discusses best practices in the treatment of pediatric urinary tract infections (UTIs) and also shares the differing views between American Academy of Pediatrics guidelines and findings from a recent double-blind study on the use of prophylactic antibiotics to treat UTIs.

Learn more about the services provided and conditions treated by Texas Children’s Division of Urology.

Medically Speaking features some of the brightest minds from several Texas Children’s specialty and subspecialty areas. The series is meant to be a helpful educational resource for parents and a convenient way for physicians and other caregivers to stay up-to-date on the latest in pediatric medicine. Viewers can watch talks on a variety of interesting topics, including advancements in surgery, breakthroughs in research, new clinical trials, and novel and back-practice treatments for specific conditions.

Be on the lookout for more Medically Speaking episodes here on Connect, or view additional episodes now.

PLEASE NOTE:
This presentation is not intended to present medical advice or individual treatment recommendations, and does not supplant the practitioner’s independent clinical judgment. Practitioners are advised to consider the management of each patient in view of the clinical information. All content is shared for informational purposes only, and reflects the thoughts and opinions of the original author. No physician-patient relationship is being created by the use of this presentation. The presentation sets out recommendations based upon similar circumstances and is provided as an educational tool. The presenters are not attorneys, and to the extent this presentation provides commentary on current laws and regulations affecting health care activities, it is not intended as legal advice.

December 18, 2018

For Lauren Meredith and her family, this holiday season has been a time of joy and gratefulness after the care and expertise they received from the experts in Texas Children’s Colorectal and Pelvic Health Program. It stands in sharp contrast to the nightmare she and husband, Ryan, experienced a year ago when their third child, Ava, was born with a rare congenital disorder of the colon that doctors thought would make her unable to pass stool. With sparse information and little time to weigh their options, the anxious parents had to make the quick decision to have Ava transported to a hospital in the Texas Medical Center for surgery – a colostomy – which she underwent at just 12 hours old.

Unfortunately, their long, hard journey was only beginning.

“We were sent home with relatively little information on how to properly care for her,” Meredith said. “I was making 10 to 15 calls a day to the doctor’s office, the insurance company and the medical supply company, but no one was helping. We felt completely alone and unprepared to tackle this complex medical issue.”

At a breaking point, Lauren began a search for help and answers online, where she first read about Texas Children’s Colorectal and Pelvic Health Program. On Christmas Eve 2017, she sent an email to Dr. Timothy Lee, pediatric surgeon and program director, explaining their ordeal.

The next day, the Merediths got their own holiday miracle.

“Dr. Lee emailed me back – on Christmas Day – and three days later we had our first appointment,” Meredith said. “The care, from the minute we walked in, was like stepping into a different world. The communication was incredible. I really felt like I was being heard for the first time.”

In August 2018, the colorectal and pelvic health team performed an operation to repair Ava’s initial defect and assess her gynecologic anatomy. And this past November, Ava had her colostomy reversal. Her prognosis is excellent.

Today, Ava – who turned one year old on December 13 – is a happy, healthy little girl who loves when her older brothers, Jackson and Greyson, sing to her and build forts for her to play in. She loves to snack, especially tacos. And she loves cuddles with her dad when he gets home from work.

“The team at Texas Children’s has given us so much to be thankful for,” Meredith said. “They took the burden off us and made us feel like they were on our side. We could tell from the very beginning that the entire Colorectal and Pelvic Health Program cared about Ava and wanted the best outcome.”

The full spectrum of care

A child’s diagnosis with a congenital disorder of the colorectal and urogenital system can be a heartbreaking and trying ordeal for families. Since these conditions are rare and often complex – and because no two cases are exactly alike – some institutions may lack the expertise necessary to provide effective treatment.

Fortunately, a highly skilled, multidisciplinary team of specialists at Texas Children’s Hospital offers patients and families the full spectrum of care for these disorders in our Colorectal and Pelvic Health Program.

Watch the video to learn more.

The Colorectal and Pelvic Health Program comprises four different specialties – pediatric surgery, pediatric urology, pediatric and adolescent gynecology, and gastroenterology – and provides treatment for several disorders and developmental anomalies, including imperforate anus, hirschsprung’s disease, cloacal malformation, cloacal exstrophy, and severe idiopathic constipation.

Regardless of the disorder, the team works together to develop a customized approach to care for these complex, and often sensitive, medical issues.

“Many of these conditions can have an extreme negative impact on the self-esteem of a child,” said Dr. Paul Austin, director of Texas Children’s Complex Urologic Reconstruction Program. “Knowing that we can make a positive difference through the care that we provide is extremely rewarding.”

Specialists collaborate to identify the patient’s specific issues and determine the best path to a positive outcome and improved quality of life, whether through surgery, medication or some combination of treatments. Additionally, the team has focused on improving patient care through clinical research and development of best practice pathways to standardize and streamline clinical care for this complex patient population.

“This hallmark of the program is providing multi-disciplinary collaborative care,” said Lee, pediatric surgeon and program director. “Even though these conditions aren’t common, we’ve seen more and more of them at Texas Children’s as our patient volume has grown. Parents can be confident when they come to us that they will be receiving truly comprehensive, collaborative care delivered by experts who have been treating these kinds of patients for years.”

Learn more about the Colorectal and Pelvic Health Program.

September 4, 2018

The Southwest Pediatric Device Consortium (SWPDC), anchored at Texas Children’s Hospital and Baylor College of Medicine, recently received a prestigious P50 grant from the U.S. Food and Drug Administration. The five-year, $6.75 million grant will begin on September 1 and will allow SWPDC to leverage ongoing activities to expand and accelerate the development of much-needed pediatric medical devices. The five principal investigators include Drs. Chester Koh and Henri Justino of Texas Children’s and Baylor, Dr. Balakrishna Haridas of Texas A&M University, Dr. Maria Oden of Rice University, and Dr. Michael Heffernan of Fannin Innovation Studio.

SWPDC supports pediatric device innovators with the goal of addressing the shortage of needed novel medical devices for children, a public health problem that has been acknowledged by the FDA.

“A great need currently exists for medical devices designed specifically for children,” said Koh, founder of SWPDC and lead principal investigator, as well as a pediatric urologist at Texas Children’s and professor of urology, pediatrics and Ob/Gyn at Baylor. “Pediatric device development is challenging, but with this support from the FDA, our consortium will continue to assist pediatric device innovators along all stages of development with the goal of improving our care of pediatric patients.”

The past decade has been a period of growth in adult medical device innovation. Advances in devices for children, however, have lagged far behind. Why the disparity? Economics are partially to blame. The market for pediatric devices is smaller, and thus the return on investment lower. Then there are the clinical and regulatory challenges. Pediatric device projects may need an extended life cycle before they can be approved and exposed to the external market. As a result, pediatric surgeons and pediatricians have had to make do with what’s available, often using retooled adult medical devices, and without adequate testing in children.

“Significant technical (design and manufacturing), preclinical testing, clinical and regulatory testing challenges exist in the field of pediatric devices,” said Haridas, co-founder and co-PI of SWPDC (lead PI at Texas A&M) and professor of practice in biomedical engineering at Texas A&M. “This FDA-funded SWPDC is uniquely positioned to address these challenges across the pediatric device development and clinical translational cycle to deliver significant advances in treatments tailored for pediatric patients.”

Support from the P50 grant will enable SWPDC to provide services in several areas: unmet needs assessment, prototype development, product and technology acceleration services, and business acceleration services. Consortium members will evaluate and support projects, as well as advise innovators throughout the total product life cycle. Based on individual project needs, the consortium will direct investigators to specific resources, collaborators and industry experts, and will coordinate the services offered by its member programs to identify, evaluate and assist pediatric device projects.

SWPDC includes clinical, scientific/engineering, investment, regulatory and academic partners in the Texas Medical Center, the Greater Houston area and the southwestern U.S. Primary partners include Texas A&M University, Rice University, University of Houston and Fannin Innovation Studio, and includes others such as Biotex Inc., Children’s Hospital of San Antonio, Children’s Health in Dallas and Phoenix Children’s Hospital, with additional future sites. SWPDC was selected as one of five national consortia that are addressing the shortage of pediatric devices.

To learn more about the Southwest Pediatric Device Consortium, visit swpdc.org.

June 26, 2018

Texas Children’s Hospital has once again been named as a national leader among pediatric institutions by U.S. News & World Report in their recently published 2018-19 edition of Best Children’s Hospitals.

Ranked fourth among all children’s hospitals nationally and one of only 10 hospitals to achieve the Honor Roll designation for the tenth straight year, Texas Children’s is the only hospital in Texas – and the entire Southern region of the U.S. – awarded this coveted distinction.

“Each year, our Texas Children’s team exhibits incredible strength and kindness, as well as passion, caring for the inspirational children and families we serve,” said Texas Children’s President and CEO Mark Wallace. “I believe this is one reason why we continue to maintain the respect and reputation as one of the best hospitals in the nation, and the destination for pediatric care in Texas.”

In addition to ranking children’s hospitals overall, U.S. News & World Report also ranks the top 50 pediatric hospitals in 10 major sub-specialty areas. To be considered for the honor roll distinction, a hospital must have high rankings in at least three sub-specialties. For the second straight year, Texas Children’s Heart Center ranks No. 1 in the nation for pediatric cardiology and heart surgery. Texas Children’s Pulmonology ranks as the best program in the country for children with lung diseases.

Texas Children’s has 8 subspecialties ranked in the top 10, and the hospital improved outcomes across all sub-specialties. There are approximately 190 children’s hospitals in the U.S. and this year, 86 of the 189 surveyed hospitals were ranked among the top 50 in at least one sub-specialty. The 2018-19 Best Children’s Hospitals Honor Roll recognizes the 10 hospitals with the highest rankings across all sub-specialties. Here are a few highlights of this year’s rankings for Texas Children’s:

  • Cardiology and Congenital Heart Surgery is again no. 1 in the nation and received the top score in externally reported risk-adjusted operative mortality for congenital heart surgery.
  • Pulmonology, which first debuted in the top spot in the 2016 rankings, is now again ranked no. 1 in the nation. We received the top score in several asthma outcomes and structure metrics, such as mean LOS for asthma patients.
  • Neurology and Neurosurgery moved from no. 4 to no. 3, receiving the top score in several outcomes metrics, such as 30-day readmissions for craniotomy and Chiari decompression and complication rate for epilepsy surgical procedures.
  • Nephrology also moved from no. 4 to no. 3, with the top score in one-year kidney transplant graft survival and hemodialysis catheter-associated bloodstream infections.
  • Urology moved from no. 6 to no. 4, propelled by the top score in unplanned hospital admission for urologic issues within 30 days of surgery, as well as significant improvements in hypospadias and revision surgeries.

Texas Children’s, working closely with our academic partner Baylor College of Medicine, continues to pioneer advancements in pediatric health care and earns the U.S. News honor roll distinction by being ranked among America’s best in:

  • #1 Cardiology and Congenital Heart Surgery
  • #1 Pulmonology
  • #3 Neurology and Neurosurgery
  • #3 Nephrology
  • #4 Gastroenterology and GI surgery
  • #4 Urology
  • #6 Cancer
  • #6 Diabetes and Endocrinology
  • #15 Orthopedics
  • #21 Neonatology

This year’s rankings are the results of a methodology that weighs a combination of outcome and care-related measures such as nursing care, advanced technology, credentialing, outcomes, best practices, infection prevention and reputation, among others.

“From a measurement perspective, our survey results demonstrate how hard we’re working as an organization to deliver high quality care to our patients,” Wallace said. “The more consistently we deliver high quality care and the safer we deliver that care to our patients, the better their outcomes are, and the better our overall numbers are.”

Our results continue to reflect the diligent efforts of a solid structure focused on the U.S. News survey. The process of compiling and refining our data is an ongoing challenge, which will continue to improve under the excellent leadership of Trudy Leidich, Elizabeth Pham and the entire USNWR team.

The 2018-19 edition of Best Children’s Hospitals is available online at www.usnews.com/childrenshospitals.

August 22, 2017

Texas Children’s work to develop a novel non-invasive device for pediatric ureteral stent removal after a urinary tract procedure, with Baylor College of Medicine, Rice University’s Oshman Engineering Design Kitchen (OEDK) and Department of Bioengineering, as well as local life sciences commercialization firm Fannin Innovation Studio, was recently funded by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) of the National Institutes of Health (NIH). The $225,000 Small Business Innovation Research (SBIR) grant will be used to conduct further development of an electromagnetic device for removal of ureteral stents in pediatric patients.

Through the Rice undergraduate design program, a group of Rice University engineering students collaborated with Dr. Chester Koh, a pediatric urologist and surgeon at Texas Children’s and Baylor College of Medicine, to create the device in 2015, after Koh challenged the students to develop an innovative tool that would simplify ureteral stent removals, a fairly common procedure that is performed on more than 2,000 pediatric patients nationwide each year.

After extensively collaborating with Texas Children’s surgeons to better understand the challenges of the current procedure and the need for refinement, the collaborative team developed a non-invasive device to remove ureteral stents from children using a small magnetic bead and a powerful custom-built electromagnet that was designed with the assistance of 3-D printing at Rice’s OEDK labs. The electromagnet safely pulls on the tiny metallic bead that is attached to the ureteral stent to allow passage through the urethra without the need for an invasive procedure or general anesthesia.

This new innovation in pediatric ureteral stent removal is less painful and costs two-thirds less than the standard procedure because it avoids general anesthesia and the time and equipment necessary for a surgical procedure. The team’s invention has won two significant awards: the top prize at Rice University’s 2016 annual Engineering Design Showcase and the Grand Prize for Student Design at the 2016 annual Design of Medical Devices conference in Minneapolis.

“The development of pediatric medical devices lags adult device development by more than 10 years,” said Koh, who has a mechanical engineering degree from the University of California, Berkeley. “This is an important example of why academic partnerships are needed to advance pediatric medical device projects, since the pediatric medical device pipeline is currently limited. I applaud the Rice and Fannin Innovation Studio team members for showing their dedication and passion to the kids under our care at Texas Children’s.”

Prior to coming to Texas Children’s to establish the robotic surgery program in 2013, Koh co-founded a U.S. Food and Drug Administration-supported pediatric device consortium based in Southern California. He is creating a similar initiative at Texas Children’s, drawing on the top engineering and device development talent in the region.

The early work for this project was supported by the Denton A. Cooley Fellowship for Surgical Innovation of the Texas Children’s Auxiliary and by the Texas Children’s Department of Surgery, which continues to support the pursuit of innovation solutions to the unmet surgical needs of children.

The SBIR Phase I grant from the NIDDK will allow the team to implement design modifications to further refine the device as well as perform benchtop and pre-clinical studies with a target goal of larger SBIR Phase II grants.

July 11, 2017

Texas Children’s Hospital’s Kidney Stone Clinic has expanded to Texas Children’s Hospital West Campus.

In addition to once monthly clinics at Main Campus in the Medical Center, patients can now access multi-disciplinary stone treatment at West Campus on the first Wednesday of each month.

During each visit, patients and families will meet with a urologist, a nephrologist, and a dietitian to better understand what’s causing the stones and how to manage or prevent them.

To make an appointment, simply place a referral order in Epic or contact Central Scheduling at ext. 2-2778.