Journal of Pediatric Urology最新文献

{"title":"Renal parenchymal thickness measurements on initial sonogram are associated with spontaneous resolution of isolated SFU grade 3 hydronephrosis.","authors":"Chris Staniorski, Hassan Aboughalia, Jane Kim, Tiffany Myint, Briony K Varda, H Gil Rushton, Hans G Pohl, Aaron Krill","doi":"10.1016/j.jpurol.2026.106317","DOIUrl":"https://doi.org/10.1016/j.jpurol.2026.106317","url":null,"abstract":"<p><strong>Background: </strong>Measurements of the renal parenchyma have been associated with risk for undergoing pyeloplasty in children with antenatally diagnosed isolated hydronephrosis.</p><p><strong>Objective: </strong>To evaluate the association of renal parenchymal measurements and spontaneous resolution of isolated SFU grade 3 hydronephrosis.</p><p><strong>Methods: </strong>A retrospective single-institution cohort of patients with antenatally diagnosed SFU grade 3 hydronephrosis without hydroureter from 2000 to 2016 was identified. Those with adequate follow-up, defined as two sonograms, and renal measurements performed were included for analysis. Final hydronephrosis grade prior to 5 years of age was the primary outcome; resolution was defined as SFU grade 0-1 and improvement as SFU grade 2. Logistic regression and time-to-event analysis were performed.</p><p><strong>Results: </strong>In all, 107 patients were included in the final analysis with the first sonogram performed at a median of 33 days of age (IQR 18-50) and median follow-up age of 2.6 years (IQR 1.2-6.7). The majority were male (n = 85, 79%). The median anterior-posterior renal pelvis diameter (APRPD) was 11.6 mm (IQR 9.2-14.9) and median minimal parenchymal thickness (MPT) was 5.2 mm (IQR 4.0-6.8). Diuresis renography showed a median differential function of 50% (IQR 48-53) in the affected kidney and median T1/2 was 6 min (IQR 4-11). Twenty-nine patients (27%) experienced resolution while 23 additional patients demonstrated improvement to SFU grade 2 (21%). On univariate analyses, MPT, MPT as a ratio to the contralateral measurement (MPTR) and as a ratio to age-based normal values (nMPTR) were associated with any improvement as well as complete resolution while APRPD was associated with resolution alone. On multivariate logistic regression including APRPD and MPT, each millimeter increase in MPT was independently associated with 33% increase in odds of resolution (aOR 1.33, 95%CI 1.05-1.71, p = 0.02) and 26% increase in odds of improvement to at least SFU grade 2 (aOR 1.26, 95%CI 1.02-1.59, p = 0.04). Median time to improvement was 1.8 years and to resolution was 1.6 years. Time-to-event analysis considering competing risk of pyeloplasty demonstrated a significantly higher cumulative incidence of resolution with increasing MPT (sHR 1.41, 95%CI 1.13-1.77, p = 0.003) on initial sonogram. Over time, the minimal parenchymal thickness correlated with the outcome; cases of resolution commonly recovered parenchymal thickness to within one standard deviation of an age-based normal value by one year of age.</p><p><strong>Conclusions: </strong>Objective measurements of minimal renal parenchymal thickness are independently associated with spontaneous resolution and improvement of isolated SFU grade 3 hydronephrosis prior to age 5 in patients with antenatally diagnosed hydronephrosis.</p>","PeriodicalId":16747,"journal":{"name":"Journal of Pediatric Urology","volume":" ","pages":"106317"},"PeriodicalIF":2.2,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149216358","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Defining imaging parameters to guide selection of cases for ureterocele surveillance.","authors":"Zack Majd, Christopher Staniorski, Bruce M Sprague, Butool Hisam, Hassan Aboughalia, Briony K Varda, Hans G Pohl","doi":"10.1016/j.jpurol.2026.106314","DOIUrl":"https://doi.org/10.1016/j.jpurol.2026.106314","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Selection criteria for surveillance in patients with ureteroceles are ill-defined.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To evaluate the outcomes of surveillance in patients meeting functional imaging criteria hypothesized to be associated with low rates of surveillance failure.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We performed a single institution retrospective cohort study of infants with ureterocele evaluated from 2015 to 2020. Patients were classified according to imaging criteria into group 1 (non-functional moieties or preserved function with prompt drainage) or group 2 (impaired function or drainage). The primary outcome was surveillance failure defined as urinary tract infection (UTI), new high-grade vesicoureteral reflux (VUR), new high-grade hydronephrosis or intervention for persistent high-grade VUR or hydronephrosis. Descriptive statistics and time-to-event analysis were performed.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Among 73 patients with a median follow-up interval of 2.7 years (IQR 1.4-4.8), 85% were diagnosed prenatally, and 62% were female. Collecting system duplication (74%) and high-grade hydronephrosis (71%) were common. Diuresis renography was performed in 61 patients (84%). Group 1 included 42 patients (57%) and group 2 included 31 (43%). Patients in group 1 were more likely to be male (50% v. 23%, p = 0.02) and have a non-duplex collecting system (28% v. 10%, p &lt; 0.01). Thirty-five patients in group 1 (83%) and 13 in Group 2 (42%) underwent surveillance (48 total). Among Group 1 patients who underwent surveillance, 34% developed surveillance failure (12/35), 20% experienced UTI (7/35), and 14% underwent intervention (5/35); these outcome rates were not significantly different from Group 2. Three group 1 patients underwent intervention primarily for management of VUR while concern for obstructed infection drove intervention in two others. Group 1 patients with high-grade VUR on initial evaluation had significantly higher rates of surveillance failure (71% v. 25%, p = 0.03) and intervention (43% v. 7%, p = 0.04) compared to those with low-grade or absent VUR. Most failure events occurred within 2 years of initiating surveillance and group 1 was associated with lower risk of surveillance failure (HR 0.35, 95%CI 0.14-0.85, p = 0.02) and UTI (HR 0.30, 95%CI 0.10-0.89, p = 0.03).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Discussion: &lt;/strong&gt;Patients in group 1 had outcome rates on surveillance comparable to prior published studies. Few overall underwent intervention which was often for the management of VUR. High-grade VUR was associated with surveillance failure, even amongst patients meeting the proposed surveillance imaging parameters.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Imaging parameters supplemented by diuresis renography can aid clinical decision-making when selecting patients with ureteroceles for surveillance. VUR in duplex systems accounts for many outcomes in the identified group.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Irb approval: &lt;/strong&gt;STUDY000","PeriodicalId":16747,"journal":{"name":"Journal of Pediatric Urology","volume":"23 1","pages":"106314"},"PeriodicalIF":2.2,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149224257","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the Editor re: \"Risk of acute kidney injury after lower urinary tract reconstruction with early NSAID therapy: A propensity matched retrospective analysis\".","authors":"Vinod Kumar, Ravi Kant","doi":"10.1016/j.jpurol.2026.105912","DOIUrl":"10.1016/j.jpurol.2026.105912","url":null,"abstract":"","PeriodicalId":16747,"journal":{"name":"Journal of Pediatric Urology","volume":" ","pages":"105912"},"PeriodicalIF":2.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147973208","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the Editor re: \"Parental experiences with outpatient care for daytime urinary incontinence in children: a mixed methods study\".","authors":"Poornima Suryanath Singh, Akanksha Singh, Abhijeet Prasad Sinha","doi":"10.1016/j.jpurol.2026.106070","DOIUrl":"10.1016/j.jpurol.2026.106070","url":null,"abstract":"","PeriodicalId":16747,"journal":{"name":"Journal of Pediatric Urology","volume":" ","pages":"106070"},"PeriodicalIF":2.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148339048","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the Editor re: \"Comparative analysis of three chatbot responses on pediatric primary nocturnal enuresis\".","authors":"Ramadevi Arepalli, D Deepthi, Anandakumar Haldorai","doi":"10.1016/j.jpurol.2026.106089","DOIUrl":"10.1016/j.jpurol.2026.106089","url":null,"abstract":"","PeriodicalId":16747,"journal":{"name":"Journal of Pediatric Urology","volume":" ","pages":"106089"},"PeriodicalIF":2.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148376307","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response to Letter to the Editor re: \"Moving beyond meatal location: The case for a ten-point severity grading system in hypospadias\".","authors":"Ramesh Babu, Vikesh Agrawal","doi":"10.1016/j.jpurol.2026.106193","DOIUrl":"10.1016/j.jpurol.2026.106193","url":null,"abstract":"","PeriodicalId":16747,"journal":{"name":"Journal of Pediatric Urology","volume":" ","pages":"106193"},"PeriodicalIF":2.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148794669","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response to Letter to the Editor re: \"Risk of acute kidney injury after lower urinary tract reconstruction with early NSAID therapy: A propensity matched retrospective analysis\".","authors":"Kyle O Rove, Darren Ha","doi":"10.1016/j.jpurol.2026.105913","DOIUrl":"10.1016/j.jpurol.2026.105913","url":null,"abstract":"","PeriodicalId":16747,"journal":{"name":"Journal of Pediatric Urology","volume":" ","pages":"105913"},"PeriodicalIF":2.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147717089","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the Editor re: \"Opioid prescribing patterns and the effect of chronic kidney disease in pediatric urology population: A retrospective cohort analysis\".","authors":"Kexin Ji, Xiaozheng Duan","doi":"10.1016/j.jpurol.2026.106019","DOIUrl":"10.1016/j.jpurol.2026.106019","url":null,"abstract":"","PeriodicalId":16747,"journal":{"name":"Journal of Pediatric Urology","volume":" ","pages":"106019"},"PeriodicalIF":2.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148143745","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the Editor re: Moving beyond meatal location: The case for a ten-point severity grading system in hypospadias.","authors":"Ramesh Babu","doi":"10.1016/j.jpurol.2026.106041","DOIUrl":"10.1016/j.jpurol.2026.106041","url":null,"abstract":"","PeriodicalId":16747,"journal":{"name":"Journal of Pediatric Urology","volume":" ","pages":"106041"},"PeriodicalIF":2.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148176133","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the Editor re: \"ChatGPT-4o's performance on pediatric vesicoureteral reflux\".","authors":"B Aruna, Sarika Koluguri, Minu Balakrishnan","doi":"10.1016/j.jpurol.2026.106102","DOIUrl":"10.1016/j.jpurol.2026.106102","url":null,"abstract":"","PeriodicalId":16747,"journal":{"name":"Journal of Pediatric Urology","volume":" ","pages":"106102"},"PeriodicalIF":2.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148376221","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}