Urologist, Pediatric Specialist
28 years of experience
Video profile
Accepting new patients
West Seventh
Pediatric Surgical Associates Ltd
347 Smith Ave N
Ste 502
Saint Paul, MN 55102
651-220-6040
Locations and availability (5)

Education ?

Medical School Score
Creighton University (1982)
  • Currently 2 of 4 apples

Awards & Distinctions ?

Awards  
Patients' Choice Award (2009 - 2010)
Compassionate Doctor Recognition (2010 - 2011)
Top 10 Doctor - State (2014)
Minnesota
Urologist
Top 10 Doctor - Metro Area (2014)
Twin Cities
Urologist
Associations
American Urological Association
American Board of Urology

Affiliations ?

Dr. Wolpert is affiliated with 17 hospitals.

Hospital Affilations

Score

Rankings

  • Healtheast Woodwinds Hospital
    1925 Woodwinds Dr, Saint Paul, MN 55125
    • Currently 4 of 4 crosses
    Top 25%
  • Fairview Ridges Hospital
    201 E Nicollet Blvd, Burnsville, MN 55337
    • Currently 3 of 4 crosses
    Top 50%
  • United Hospital
    Urology
    333 Smith Ave N, Saint Paul, MN 55102
    • Currently 2 of 4 crosses
  • Hennepin County Medical Center
    701 Park Ave, Minneapolis, MN 55415
    • Currently 2 of 4 crosses
  • HealthEast St. Joseph`s
  • Abbott - Northwestern Hospital Inc
  • Childrens at Scottish Rite
  • Childrens St. Paul
  • Abbott Northwestern Hospital Minneapolis, Minnesota
  • Gillette Children's Specialty Healthcare
  • Childrens Hospitals and Clinics
  • Childrens Health Care-St Paul
  • Park Nicollet Methodist Hospital
  • United Hospital St. Paul, Minnesota
  • Gillette Childrens Hospital
  • HealthEast St. John`s
  • Sister Kenny Rehabilitation Institute
    800 E 28th St, Minneapolis, MN 55407
  • Publications & Research

    Dr. Wolpert has contributed to 12 publications.
    Title Utility of Dextranomer/hyaluronic Acid Injection in Setting of Bladder and Ureteral Anomalies.
    Date May 2008
    Journal Urology
    Excerpt

    OBJECTIVES: Previous studies have shown that the cure rates after dextranomer/hyaluronic acid (Dx/HA) injection can be decreased in patients with neurogenic bladder, previous ureteroneocystostomy, duplicated ureters, or periureteral diverticula. We attempted to determine whether these factors reduce the efficacy of Dx/HA injection compared with that in otherwise normal patients. METHODS: All children with vesicoureteral reflux (VUR) undergoing Dx/HA injection from April 2002 to March 2006 at two institutions were eligible for this study. Multivariate logistic regression models were built to assess the effect of bladder/ureteral anomalies on the success of Dx/HA injection. We adjusted for previously described predictors of injection success, including VUR grade, sex, age, surgeon experience, and injection technique. RESULTS: A total of 543 refluxing ureters (373 patients) were included, of which 145 (27%) had persistent VUR on postoperative voiding cystourethrography; 86 ureters (16%) had anatomic anomalies. On univariate analysis, the most important predictors of injection failure were increasing VUR grade, male sex, younger age, subureteral injection, ureteral duplication anomaly, increasing Dx/HA volume, and surgeon experience. On multivariate analysis, however, the only significant predictors of injection failure were increasing VUR grade, subureteral injection technique, and surgeon experience. No anatomic or functional abnormalities, considered individually or grouped, significantly affected the probability of injection failure. CONCLUSIONS: In our experience, children with functional and anatomic bladder/ureteral anomalies were no more likely to have Dx/HA injection fail than were children with uncomplicated VUR. The most important predictors of Dx/HA success remained VUR grade, injection technique, and surgeon experience. Dx/HA injection in patients with complex bladders could be a reasonable therapeutic option.

    Title Multivariate Comparison of the Efficacy of Intraureteral Versus Subtrigonal Techniques of Dextranomer/hyaluronic Acid Injection.
    Date November 2007
    Journal The Journal of Urology
    Excerpt

    PURPOSE: Numerous factors have been postulated to increase success rates for dextranomer/hyaluronic acid injection for vesicoureteral reflux. Ureteral hydrodistention combined with intraureteral injection reportedly improves injection success rates. We combined the results of 5 pediatric urologists to evaluate the efficacy of this technique compared to that of subtrigonal-only injection in relation to other factors. MATERIALS AND METHODS: Patients with primary vesicoureteral reflux undergoing dextranomer/hyaluronic acid injection from April 2002 to December 2005 at 2 institutions were eligible. Only patients with primary vesicoureteral reflux were included in the study. Injection success was defined as the complete absence of reflux on followup voiding cystourethrogram or radionuclide cystogram. Predictors of a successful outcome were analyzed statistically with logistic regression. Factors included in our analysis were gender, age, vesicoureteral reflux grade, dysfunctional voiding, amount of injected dextranomer/hyaluronic acid, injection technique (intraureteral vs subureteral) and surgeon. RESULTS: A total of 301 patients (453 ureters) with a median age of 5.5 years met inclusion criteria, of whom 199 (66%) were cured at 3 months of followup. Of the patients 145 (48%) underwent subureteral injection and 156 (52%) underwent ureteral hydrodistention combined with intraureteral injection. On multivariate analysis only vesicoureteral reflux grade (p <0.001) and surgeon (p = 0.01) were significantly predictive of injection success. There was a trend toward significance with ureteral hydrodistention combined with intraureteral injection (p = 0.056). CONCLUSIONS: In our multivariate model only vesicoureteral reflux grade and surgeon were independently predictive of injection success in patients with primary, uncomplicated vesicoureteral reflux. There was a trend toward improved results with ureteral hydrodistention combined with intraureteral injection, although this did not achieve statistical significance.

    Title Tunneled Tunica Vaginalis Flap is an Effective Technique for Recurrent Urethrocutaneous Fistulas Following Tubularized Incised Plate Urethroplasty.
    Date October 2006
    Journal The Journal of Urology
    Excerpt

    PURPOSE: In the last several years the use of the tubularized incised plate hypospadias repair has greatly increased. The most significant complication after this mode of urethroplasty is urethrocutaneous fistula development. Tunneled tunica vaginalis flap is a well described technique for repair of urethrocutaneous fistula. However, to our knowledge its use after tubularized incised plate repair has not yet been described. We present our results with this technique. MATERIALS AND METHODS: We retrospectively reviewed all patients undergoing repair of urethrocutaneous fistula after initial tubularized incised plate repair between January 2001 and December 2005. We analyzed the initial number and location of fistulas, number of previous urethrocutaneous fistula repairs, duration of surgery, and intraoperative and postoperative complications. RESULTS: A total of 16 boys (median age 2.2 years) underwent tunica vaginalis flap repair at our institution for urethrocutaneous fistula following initial failed tubularized incised plate repair. Of these patients 4 had not previously undergone urethrocutaneous fistula repair and 12 had undergone 1 to 4 failed repair attempts. All boys had a subcoronal fistula and 8 had additional fistulas along the penile shaft, 4 each with 3 and 4 fistulas, including 1 penoscrotal fistula. Mean surgical time was 45 minutes, and no intraoperative or postoperative complications occurred. After a mean followup of 18 months (range 4 to 36) no patient had recurrence of urethrocutaneous fistula. CONCLUSIONS: Tunneled tunica vaginalis flap repair is a highly successful technique for the treatment of urethrocutaneous fistula after initial failed tubularized incised plate repair. The technique is technically simple to perform, and we encountered no complications. Tunneled tunica vaginalis flap repair should be considered for treating urethrocutaneous fistula following initial failed tubularized incised plate hypospadias surgery, particularly in a repeat surgical setting.

    Title Postoperative Ureteral Obstruction After Subureteral Injection of Dextranomer/hyaluronic Acid Copolymer.
    Date October 2006
    Journal The Journal of Urology
    Excerpt

    PURPOSE: Subureteral injection of dextranomer/hyaluronic acid copolymer is widely accepted for the treatment of primary vesicoureteral reflux. Few studies document the incidence of surgically relevant postoperative obstruction or the characteristics of patients at risk. MATERIALS AND METHODS: Four institutions had reported surgically relevant postoperative obstruction to representatives of Q-Med Scandinavia, the manufacturers of Deflux (dextranomer/hyaluronic acid). All children undergoing dextranomer/hyaluronic acid injection at these institutions were evaluated in this study. Patients requiring postoperative stenting were retrospectively reviewed for pertinent history, volume injected, technique of injection, duration of symptoms before intervention, duration of intervention and final outcome. RESULTS: A total of 745 patients (1,155 ureters) underwent injection. Five patients (6 renal units, 7 ureters) required stenting for obstructive symptoms and hydronephrosis, of whom 4 immediately became symptomatic. All patients had been injected with up to 1 ml dextranomer/hyaluronic acid. Four patients (80%) had either a neurogenic bladder or dysfunctional voiding. All stents were placed and removed without complications, with complete resolution of symptoms in all patients. Length of stenting ranged from 2 to 6 weeks. No patient required open surgery. One of 2 patients undergoing postoperative voiding studies had development of recurrent vesicoureteral reflux. CONCLUSIONS: Dextranomer/hyaluronic acid injection is associated with a small risk of postoperative ureteral obstruction requiring endoscopic intervention, with an overall incidence of less than 0.7% of patients injected. Patients with voiding dysfunction or neurogenic bladder may be at increased risk. Intervention with temporary ureteral stenting is effective, technically simple and curative.

    Title Single Center Experience with Endoscopic Management of Vesicoureteral Reflux in Children.
    Date June 2006
    Journal The Journal of Urology
    Excerpt

    PURPOSE: Dx/HA copolymer was approved by the Food and Drug Administration in 2001 for the treatment of VUR in children. Published results have varied widely, prompting us to report our single center experience with 300 consecutive patients. MATERIALS AND METHODS: All patients undergoing Dx/HA injection (300 children, median age 5.4 years) at our institution were eligible for this study. We examined several parameters to determine which variables influence the success of Dx/HA injection, including preoperative reflux grade, bladder diverticula, neurogenic bladder, ureteral duplication, perioperative urinary tract infection, dysfunctional voiding, laterality of reflux and amount of Dx/HA injected. RESULTS: A total of 225 patients (75%) underwent postoperative studies, and, thus, were eligible for study inclusion. Reflux was cured in 144 patients (64%) and improved in 44 (20%). A total of 20 patients had ureteral duplication anomalies. Cure rates in this subgroup were significantly decreased compared to nonduplicated cases (40% vs 66%). Injection in low grade (I to II) reflux was significantly more successful than in high grade (III to IV) reflux (72% vs 54%). A total of 10 patients (8.3%) with unilateral reflux had development of de novo contralateral reflux. Of the patients who failed initial injection 10 (4%) underwent repeat injection, of whom 5 (50%) were cured after the second injection. Two patients (0.9%) had development of temporary ureteral obstruction. CONCLUSIONS: We report a large short-term single center experience with endoscopically injected Dx/HA. Although our cure rate of 64% was less than published rates for open surgery, the minimal morbidity and low complication rate of endoscopic treatment make it an attractive first line therapy for patients with VUR. Longer followup is required to better evaluate this technique.

    Title Misleading Leads: Wilms Tumor with a Metachronous Lesion Appearing in the Remaining Kidney.
    Date January 1998
    Journal Medical and Pediatric Oncology
    Excerpt

    Medullary dysplasia may be present in the kidneys of children with the Beckwith-Wiedemann Syndrome (BWS). This is usually visible only at the microscopic level, but superimposed pyelonephritis in a child with the BWS led to gross changes that produced a filling defect on CT scanning of the remaining kidney. The finding could have been misinterpreted as a metachronous wilms tumor.

    Title Ureteral Tailoring: a Comparison of Wedge Resection with Infolding.
    Date August 1990
    Journal The Journal of Urology
    Excerpt

    A retrospective analysis of 44 consecutive pediatric ureteral reimplantations in 42 patients (51 ureters reimplanted) is presented, in which the ureter was tapered by infolding or wedge resection. Few postoperative complications occurred and the results were essentially comparable for the 2 groups, although slightly more postoperative ureteral obstruction occurred in the wedge resection group. Over-all success rate (no postoperative reflux and no obstruction) was 95% for the infolded group and 90% for wedge resection group. Stent time and hospital stay were significantly less for the infolded group.

    Title Pyeloplasty in the Young Infant.
    Date August 1989
    Journal The Journal of Urology
    Excerpt

    The urgency, safety and benefits of performing pyeloplasty during the first weeks of life currently are being questioned. We reviewed our experience with 114 pyeloplasties in 103 infants and young children performed between 1983 and 1987. The 34 patients who underwent an operation before they were 3 months old were compared to 69 operated upon after 3 months. The surgical results in the 2 groups were equally good, with 90 per cent of the cases having an improved or stable postoperative excretory urogram or renal scan. Complications were few and were more common in the older age group, in which 7 children required a secondary procedure, including 2 for recurrent obstruction at the ureteropelvic junction. No patient in the younger age group required a secondary procedure for treatment of a complication or recurrent obstruction. Our findings indicate that the success of pyeloplasty performed during the first weeks of life is equal to that performed at a later patient age and were not more likely to be followed by a complication.

    Title Cystic Dysplasia of Testis Associated With Ectopic Ureter Causing Chronic Orchalgia.
    Date
    Journal Urology
    Excerpt

    Cystic dysplasia of the testis (CDT) is a rare entity that typically does not present with orchalgia in affected patients. Most patients with CDT are asymptomatic and have ipsilateral renal malformations. Our patient with CDT was referred because of prolonged unilateral orchalgia. Computed tomography demonstrated an ipsilateral atrophic kidney and hydro-ureter traveling posterior to the bladder. Orchalgia resolved with resection of the dysplastic kidney and ectopic ureter, which drained to an enlarged seminal vesicle. Atypical symptoms associated with CDT, such as chronic orchalgia, should prompt additional investigation to rule out concomitant malformations. This is the first report of an ectopic ureter associated with CDT.

    Title Unilateral Vesicoureteral Reflux: Does Endoscopic Injection Based on the Cystoscopic Appearance of the Ureteral Orifice Decrease the Incidence of De-novo Contralateral Reflux?
    Date
    Journal Journal of Pediatric Urology
    Excerpt

    OBJECTIVE: In patients with unilateral vesicoureteral reflux (VUR), it has been suggested that injection of a non-refluxing but cystoscopically abnormal contralateral ureteral orifice (UO) with dextranomer/hyaluronic acid (Dx/HA) should be performed to prevent the development of de-novo contralateral VUR. We evaluate the effectiveness of this practice. PATIENTS AND METHODS: Patients with primary unilateral VUR undergoing injection of Dx/HA from 2002 to 2005 at two institutions were eligible. Patients with unilateral VUR with cystoscopically abnormal contralateral UOs were injected with Dx/HA, while patients with normal appearing UOs received no treatment. Multivariate logistic regression models were used to estimate the impact of prophylactic injection on the development of de-novo contralateral VUR. RESULTS: In total, 101 patients with unilateral VUR and an abnormal appearing contralateral UO underwent prophylactic injection of Dx/HA while 45 patients with a normal appearing contralateral UO were untreated. In patients receiving prophylactic Dx/HA, 9% (9/101) of the previously non-refluxing ureters developed de-novo VUR. Similarly, 13% (6/45) of patients with a normal appearing UO treated by observation alone developed de-novo VUR (P=0.55). The overall incidence of 10% (15/146) de-novo contralateral VUR matches published results where this protocol was not followed. CONCLUSIONS: Our findings suggest that cystoscopic assessment and prophylactic treatment of an abnormal appearing, non-refluxing contralateral UO with Dx/HA is of little clinical benefit and should be abandoned.

    Title Acute Renal Infarction Due to Fungal Vascular Invasion in Disseminated Candidiasis.
    Date
    Journal Urology
    Excerpt

    Disseminated candidiasis occurs almost exclusively in leukemic patients recovering from neutropenia. Although renal involvement can be a sequela of disseminated candidiasis, acute renal infarction secondary to Candida invading the renal vasculature has not previously been reported. Our patient, who was being treated for acute myelogenous leukemia, developed complete obstruction of the right renal vessels during the course of 36 hours as documented by serial renal ultrasound scans with Doppler investigation of the vasculature. Histopathologic examination of the nephrectomy specimen revealed complete infarction of the kidney secondary to Candida spp. infiltrating the parenchyma and occluding the hilar vessels.

    Title Tunneled Tunica Vaginalis Flap for Recurrent Urethrocutaneous Fistulae.
    Date
    Journal Advances in Urology
    Excerpt

    The tubularized incised plate (TIP) hypospadias repair is currently the most widely used urethroplasty technique. The most significant post-TIP complication is urethrocutaneous fistula (UCF) development. Tunneled tunica vaginalis flap (TVF) is a well-described technique for the repair of UCF. We retrospectively reviewed all patients undergoing repeat repair of UCF after TIP repair from 2001 to 2005. Twelve boys underwent TVF repair at our institution for recurrent UCF. Fistulae ranged from distal penile to penoscrotal in location. Median surgical time was 45 minutes and no postoperative complications occurred. After a median follow-up of 32 months (range 16-48 months), no patient has yet had a recurrence of UCF. In conclusion, TVF repair is a successful technique for the treatment of UCF after previous failed repair. TVF is technically simple to perform and should be considered for treating UCF following TIP urethroplasty, particularly in a repeat surgical setting.

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