The Division of Urology is nationally and internationally recognized for its long-standing commitment to and expertise in the care of children with complex genitourinary anomalies. Our tradition of innovative clinical research and surgical techniques dates back to Dr. Julian Ansell’s seminal work in primary repair of exstrophy over 30 years ago. Since then, we have pioneered other approaches, including the complete primary repair of exstrophy (originated by our former division chief, Dr. Michael Mitchell, and current division chief, Dr. Paul Merguerian). We continue to embrace the concepts of minimally invasive open, laparoscopic and robotic pediatric urological surgery.

Complex patients are treated in collaborative multispecialty programs with colleagues in nephrology, transplant, oncology, endocrinology, genetics, gynecology, general surgery, gastroenterology and neurodevelopmental medicine.

• The Disorders of Sex Development (DSD) clinic, developed under the guidance of Dr. Margarett Shnorhavorian, involves providers from specialties including endocrinology, gynecology, genetics, social work and psychology. This clinic cares for children born with disorders of sexual differentiation.

• The Reconstructive Pelvic Medicine Clinic, developed under the guidance of Drs. Richard Grady and Paul Merguerian, involves providers from specialties including general surgery, gynecology and gastroenterology. This clinic cares for children born with intestinal, urological and gynecological anomalies (such as patients with cloacal anomalies or imperforate anus). A subset of this clinic also includes patients born with bladder exstrophy.

• A new Urology, Infectious Disease Clinic involves Infectious Disease and Urology. This clinic provides multidisciplinary service to children with urological anomalies that have developed resistant urinary tract infections.

• The Stones Clinic, currently in development under the guidance of Dr. Thomas Lendvay, will include nephrology providers and a dietitian. This clinic will evaluate and treat children who have developed kidney stones.

To evaluate new approaches to medical and surgical treatment of pediatric urologic conditions, faculty members have jointly created clinical research protocols and are involved in large-scale relational, multiplatform and multi-institutional databases to track children with a variety of conditions.

Current research efforts include the evaluation of complementary medical therapies (e.g., cranberries) to treat urinary tract infections in children, new approaches to robotic surgery, use of crowdsourcing in evaluating surgical skills, genetic markers in common urological conditions such as hypospadias, undescended testicles, clinical standard work and its effect on outcomes and research to reduce cost of delivering pediatric urological care.

Dr. Richard Grady is nationally and internationally known for management of patients with bladder exstrophy. Grady’s career has melded an interest in the care of children with complex urologic conditions with a passion for service and social justice. Having had the good fortune to train under an internationally regarded reconstructive surgeon at a program with a longstanding interest in the management of exstrophy, he is now recognized as an international expert on the management of this condition. He has regularly and consistently participated and played a key role in surgical training programs in Zambia, Zimbabwe, Mozambique, the Gaza Strip and India over the last decade. In addition to being invited as a consulting surgeon and a visiting professor throughout the United States and globally, he represents Seattle Children’s Urology in Alaska and Montana at clinical outreach programs where he has worked collaboratively with the pediatric urologists and urologists in those regions over the last 15 years. His current research interests focus on exstrophy and the impact of environmental toxicants on genitourinary development as a co-investigator on the NIH-funded TIDES study.

The urology division’s teaching commitment includes an ACGME-approved, nationally respected two-year fellowship in pediatric urology and active roles in University of Washington and Madigan Army Medical Center urology residency programs. Dr. Byron Joyner continues as director of the University of Washington Urology Residency Program and associate dean for graduate medical education at the University of Washington. Dr. Richard Grady continues as fellowship director with Dr. Thomas Lendvay as associate director.

Future division plans include expansion of clinical and research faculty as well as an increased presence in Children’s-sponsored satellite clinics in order to meet the growing needs of local, regional and national communities. On the global health platform we will continue to provide help to underserved communities worldwide and create pediatric urology training curricula and introduce the concepts of quality and safety to these communities.

Leadership and Faculty


  • Ardavan Akhavan, MD
  • Johnathan Ellison, MD