In the 21st century, access to quality medical care is all too often dictated by where people live. Pediatric urologists at Cincinnati Children’s are working to change that reality for children with complex urological conditions.

One strategy is to create lasting partnerships with hospitals around the world. In 2018, Division Director Pramod Reddy, MD, once again traveled to India as part of a multi-institutional collaboration to promote a long-term, sustainable model to address the surgical burden of patients with bladder exstrophy and penopubic epispadias. Called the International Bladder Exstrophy Consortium, this collaboration provides intensive training for Pediatric Surgeons at a host hospital in India and ensures rigorous post-surgical follow-up for every patient cared for year over year, among other commitments. Preliminary data suggest that this model can help achieve surgical outcomes on par with those reported by academic research centers from higher-income countries.

Building Expertise in Israel Similarly, pediatric urologist Eugene Minevich, MD, has developed a strong connection with urologists in Israel over the past decade. He typically travels to the country twice a year to perform surgery on children with complex urological conditions. While there, he may speak at symposiums, serve as a visiting professor or provide training for local physicians. “Israel is a relatively small country, and therefore physicians have limited exposure to rare pathology,” Minevich says. “Previously, we would recommend that patients needing complex reconstructive surgery come to the United States for their entire scope of treatment. This made it very difficult for physicians in Israel to develop their surgical skills. Now, thanks in part to physicians who travel from the U.S. and Europe to provide training, the Israeli care teams can care for complex patients in their own country.”

Partnering with Hospitals in Abu Dhabi The hospital’s pediatric urologists are members of a larger surgical team participating in a new collaboration between Cincinnati Children’s and NMC Healthcare, located in Abu Dhabi, United Arab Emirates. The agreement brings highly specialized, pediatric surgical expertise to NMC Royal Hospital, the largest private healthcare provider in the UAE. In 2018, Reddy traveled to Abu Dhabi and provided surgical care at NMC Royal. He later initiated a quality improvement project between the clinical laboratory teams at NMC Royal and Cincinnati Children’s that will help the two hospitals provide well-coordinated, high-quality care for patients.

Closer to home, the division continues to grow its international pediatric urology fellowship program. In 2018, two fellows—from Mexico and Jordan—graduated from the program. Other graduates have come from Egypt, Germany, India, Israel, Japan, Lebanon, Pakistan and Syria. Participants (who include pediatric surgeons and adult urologists) typically spend up to two years training at Cincinnati Children’s, with the commitment of practicing in their home country for at least three years after that.

“In a perfect world, every child with a complex urological condition would receive specialized medical care close to home,” Reddy says. “We are doing what we can to extend the reach of our program and help physicians around the world make that possible.”