Each year, one in every 5,000 males in the United States is born with posterior urethral valves (PUV) disorder, which can cause serious complications affecting urination, fertility and quality of life. Sometimes overlooked is the fact that, like many children with a chronic illness, those with PUV are at elevated risk for developmental and behavioral health issues. This can be especially true for children with severe PUV who need a kidney transplant.

The PUV Center at Cincinnati Children’s is addressing this concern by partnering with clinical psychologists at the medical center to create a safety net for these children and their families.

“A kidney transplant creates unique stressors for patients and upends the family dynamic before and after surgery,” says Pramod Reddy, MD, director of the Division of Pediatric Urology. “And children with severe PUV have a higher incidence of attention deficit-hyperactivity disorder and learning disabilities than children in the general population. By providing proactive, focused care, our clinical psychologists can help identify concerns and connect families with the resources they need to navigate the challenges ahead.”

An Opportunity to Learn More About PUV and Mental Health

The psychologists at Cincinnati Children’s will provide a behavioral health assessment six months before and six months after transplant and tailor the treatment plan accordingly. Reddy hopes the assessment will help the entire care team better understand what these children—along with their parents and siblings—need from a behavioral health standpoint.

“Mental health and PUV is an understudied area, and we are curious to learn more,” Reddy says. “For example, do children with PUV who are developmentally delayed tend to catch up post-transplant? How do children’s behavioral health needs change after transplant? How are siblings impacted by the unique stressors of living with a brother with PUV? What can we do to support parents struggling to cope with the burden of caring for a child with PUV?”

Behavioral medicine is one of many services available to children and families through the PUV Center, which opened in June 2020. The center formalizes the hospital’s long-standing commitment to providing comprehensive, multidisciplinary care for patients with PUV disorder. The core team, led by Reddy, includes urology, nephrology, pulmonology, developmental pediatrics, nutrition, and behavioral medicine/clinical psychology specialists. Together, these providers offer a monthly clinic for patients with PUV disorder to preserve patients’ renal-bladder function and improve overall physical and mental wellness.

As a passionate proponent of cura personalis, the Jesuit principle of caring for the whole person, Reddy says his team wants to lessen the burden of PUV as much as possible for families. He says, “Providing behavioral medicine care is one more way we are helping patients be as independent as possible so they can live their lives to the fullest.”

For more information, contact Pramod.Reddy@cchmc.org.