BRIDGE Program

Bladder Reconstruction, Independence Development & Diversions for Genitourinary Empowerment 

The BRIDGE Program at The Hospital for Sick Children (SickKids) in collaboration with Sunnybrook Health Science Centre, HollandBloorview Kids Rehabilitation Hospital, and University of Toronto-Division of Urology is a lifelong, multidisciplinary initiative dedicated to children and adolescents with complex bladder conditions. By uniting paediatric and adult urology, nephrology, neurosurgery, nursing, social work, and rehabilitation specialists, BRIDGE delivers seamless surgical planning, rehabilitation support and structured transition to adult care. 

Program Objectives

• Optimize bladder function & preserve renal health through evidence-based surgical and medical management. 
• Promote independence & continence via tailored reconstructive procedures (e.g., augmentation cystoplasty, Mitrofanoff, Monti) and continence training. 
• Bridge paediatric & adult care with dedicated transition protocols, joint clinics, and shared care pathways. 
• Empower patients & families through education, psychosocial support, peer networks, and community resources. 

Clinical Services & Operations

BRIDGE Multidisciplinary Clinic

• When: Last Monday of each month 
• Where: Atrium. 6D 
• What we offer: 
  • Collaborative surgical consultations with urology, nephrology, and neurosurgery
  • Video urodynamics (VUDS) interpretation and ambulatory UDS planning 
  • Botox and medical bladder management protocols 
  • Social work coordination, school reintegration planning, and transition navigation 

Surgical Reconstruction Blocks 

• Weekly OR Days: Tuesdays and/or Wednesdays
• Coordination: Integrated scheduling with adult reconstructive specialists and pelvic floor multidisciplinary team (MAGIC clinic) 
• Key Procedures: 
  • Bladder augmentation (enterocystoplasty) 
  • Urinary diversion techniques (Mitrofanoff catheterizable channels, Monti conduits) 
  • Bladder neck reconstruction and continent stoma creation 
  • Other necessary procedures that are relevant to help protect the kidneys/ upper tract.

Joint Paediatric–Adult Transition Clinic 

• When: Quarterly (first or last Monday clinic block) 
• Who: High risk adolescents with neurogenic bladder condition approaching transition 
• Partners: Adult urology leads from Sunnybrook Health Sciences and the transitional care team at Holland Bloorview Kids Rehabilitation Hospital 
• What: Shared consultations, individualized handover plans, and long-term followup strategies 

Education & training opportunities

Fellowship in Genitourinary Reconstruction & Functional Urology 

Canada’s first combined Paediatric–Adult Genitourinary Reconstructive & Functional Urology Fellowship equips surgeons with dual expertise in complex bladder reconstruction across the lifespan: 

• Duration & Rotations 
  • 12 months at SickKids: Paediatric reconstructive surgery for neurogenic and myogenic bladder management, videourodynamics, transitional care, and paediatric neurogenic bladder multidisciplinary clinics, research immersion 
  • 9 months at Sunnybrook: Adult complex reconstructive urology procedures,  
  • 3 months at Toronto Western Hospital: Specialized functional urology, sacral neuromodulation, pelvic floor disorders management  
• Curriculum Highlights 
  • Surgical Mastery: Handson training in augmentation cystoplasty, continent diversion channels, bladder neck procedures 
  • Neuro-Urology: Comprehensive assessment and management of neurogenic bladder, advanced urodynamic interpretation 
  • Research & Quality Improvement: Protected time to lead clinical trials, device development, and outcomes research 
  • Didactics & Simulation: Weekly case conferences; SimLab modules on paediatric VUDS and catheterization techniques 
  • Leadership & Teaching: Co-preceptorship of junior trainees; curriculum design for global capacity building 
• Application and Intake 
  • Program Launch: September 2025 
  • First Fellow Start Date: January 2026 

Global Surgery Capacity Building 

The BRIDGE Global Surgery Initiative extends our expertise to low and middle-income countries (LMICs) through ethical, sustainable partnerships. For those interested in the BRIDGE mission, we follow a unique three-phase program cycle that ensures meaninful engagement and long-term impact.

1. PreMission Virtual Prep: Needs assessment; codeveloped curricula 
2. OnSite Engagement: 2week intensive workshops; casebased coaching 
3. PostMission FollowUp: Outcome audits; telerounds; planning for subsequent visits 

Following are the sites we visit and the acitivities we focus on:

• Asia Site: 
  • Location: Manila, Philippines & Ho Chi Minh, Vietnam 
  • Activities: Handson surgical mentorship in paediatric and adult reconstruction; local provider workshops; telementoring sessions 
  • Focus Areas: Augmentation cystoplasty adaptations for resource limited settings; community outreach for followup care
• Africa Site:
  • Location: TBC 
  • Activities: Joint operating lists with local urologists; training in continent catheterizable stoma techniques; infrastructure strengthening 
  • Focus Areas: Capacity for long-term urodynamic monitoring; development of nurse-led continence clinics

Research activities 

• Clinical Trials:
  • Vibegron in Pediatric Neurogenic Detrusor Overactivity (site activation Fall 2025)
  • Pediatric Sacral Neuromodulation Feasibility Study (recruitment Q4 2025)
• Registries & Outcomes Research:
  • PanCanadian Neurogenic Bladder Registry with Pediatric Urologists of Canada (PUC)
  • Timing of CIC initiation in neonates and impact on renal outcomes
  • Patientreported outcome measures (PROMs) and decisional regret postdiversion
• Simulation Development: Pediatric VUDS training modules in SimLab (Q4 2026)

Address: 

Atrium 6D - Division of Urology, Department of Surgery,
Hospital for Sick Children,
555 University Ave,
Toronto, ON 
M5G 1X8