Journal of Pediatric Urology最新文献

{"title":"Postoperative chemoradiotherapy in Wilms tumor with concurrent lung and lymph node metastasis.","authors":"Kongfeng Shao, Xijin Lin, Zhuhong Chen, Haojie Zhu","doi":"10.1016/j.jpurol.2026.105977","DOIUrl":"https://doi.org/10.1016/j.jpurol.2026.105977","url":null,"abstract":"<p><strong>Background: </strong>An effective treatment strategy is essential for metastatic Wilms tumor (WT) management. To improve prognostic accuracy, this study examined metastatic patterns and key prognostic factors.</p><p><strong>Methods: </strong>Children diagnosed with WT from 2010 to 2021 were identified from the SEER database. All patients underwent chemotherapy and surgical resection. Metastatic patterns, metastasis-related predictors, and prognostic factors were evaluated.</p><p><strong>Results: </strong>Of the 1040 patients analyzed, 226 (21.7%) experienced lung metastasis, 31 (3.0%) liver metastasis, 6 (0.6%) bone metastasis, and 220 (21.2%) regional lymph node metastasis. Distant metastasis was associated with a higher incidence of lymph node metastasis (OR = 1.506, 95% CI 1.346-1.685, p < 0.001). Age 3-17 years (OR = 1.933, 95% CI 1.406-2.680, p < 0.001), left-sided (OR = 1.383, 95% CI 1.016-1.890, p = 0.040), bilateral (OR = 2.303, 95% CI 1.215-4.243, p = 0.009), and tumor size ≥135 mm (OR = 2.020, 95% CI 1.481-2.749, p < 0.001) were identified as predictors of metastasis. Both lymph node (p < 0.001) and lung metastasis (p < 0.001) were high-risk factors for WT. Radiotherapy provided long-term survival benefits for the metastatic population (p = 0.027), while postoperative chemotherapy showed better outcomes than preoperative or other strategies (p < 0.001). Further analysis demonstrated that the concurrent lung and lymph node metastasis group benefited more from postoperative chemoradiotherapy, with HRs of 0.226 (p = 0.028) for overall survival and 0.255 (p = 0.048) for cancer-specific survival.</p><p><strong>Conclusion: </strong>WT with concurrent lung and lymph node metastasis represents a distinct and aggressive metastatic phenotype associated with a significantly poor prognosis. Postoperative chemoradiotherapy may provide superior survival benefits for this high-risk population.</p>","PeriodicalId":16747,"journal":{"name":"Journal of Pediatric Urology","volume":" ","pages":"105977"},"PeriodicalIF":1.9,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147856432","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":"Comparative outcomes of posterior sagittal anorecto-vagino-urethroplasty and total urogenital mobilization in cloacal malformations: A retrospective cohort study.","authors":"Mohammed Abdelmalak Abokandil, Mohammed Mansy, Mennatullah Saeed, Reham Ragab, Reem Saeed, Saber Waheeb, Ahmed Khairi, Mostafa Kotb","doi":"10.1016/j.jpurol.2026.105975","DOIUrl":"https://doi.org/10.1016/j.jpurol.2026.105975","url":null,"abstract":"<p><strong>Objective: </strong>To compare the surgical and functional outcomes of PSARVUP and TUM in a contemporary cohort of patients with cloacal malformations, with particular emphasis on urological results and the influence of individual patient anatomy on these outcomes.</p><p><strong>Methods: </strong>A retrospective cohort study of patients with cloacal malformations who underwent definitive repair between 2020 and 2023. Inclusion criteria were confirmed cloacal malformation with prior colostomy and definitive repair by PSARVUP or TUM, whilst cases with complex sacral and spinal anomalies were excluded. Preoperative workup included cystoscopy, pelvic and spinal MRI, renal ultrasound, and voiding cystourethrography. Outcome measures included postoperative complications, ability to void spontaneously, requirements for clean intermittent catheterization (CIC), status of urinary continence, incidence of febrile urinary tract infections (UTIs), and urodynamic findings.</p><p><strong>Results: </strong>A total of 27 patients with confirmed cloacal malformations were included. Of these, 16 patients (59.3%) underwent PSARVUP and 11 patients (40.7%) underwent TUM. Within the PSARVUP cohort, wound dehiscence represented the most frequent complication compared to vaginal stenosis in TUM group. As regards recurrent frequent UTIs, the overall incidence of infection was lower in PSARVUP as compared to TUM. Overall, approximately two-thirds of all evaluated patients demonstrated abnormal findings on urodynamic assessment with neurogenic bladder patterns were the most common.</p><p><strong>Conclusion: </strong>PSARVUP and TUM are effective techniques for repairing long common channel cloaca, each with distinct advantages and limitations. TUM offers an improved cosmetic outcome but can result in long-term urological complications. On the other hand, PSARVUP yields an improved functional outcome despite a more complex operative course and higher rates of vesicourethral fistulas. Longer follow-up and multicenter studies are required to refine surgical planning and optimize outcomes.</p>","PeriodicalId":16747,"journal":{"name":"Journal of Pediatric Urology","volume":" ","pages":"105975"},"PeriodicalIF":1.9,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147856364","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":"Feasibility of the TAIPEI procedure for penile straightening in hypospadias: Insights from families.","authors":"Cynthia Sze-Ya Ting, Sze-Wen Ting, Min-Hua Tseng, Li-Ping Tsai, Siew-Yin Chee, Pei-Yeh Chang","doi":"10.1016/j.jpurol.2026.105965","DOIUrl":"https://doi.org/10.1016/j.jpurol.2026.105965","url":null,"abstract":"<p><strong>Background: </strong>Persistent penile curvature remains a major challenge in proximal hypospadias repair. The TAIPEI (Taping In Between Penile Incisions) procedure is a novel postoperative rehabilitation strategy that maintains penile straightening through caregiver-applied taping between staged repairs. Despite promising surgical outcomes, the real-world feasibility of long-term home taping and family adherence has not been systematically evaluated.</p><p><strong>Objective: </strong>To assess the feasibility of the TAIPEI procedure based on caregiver-reported experience and to identify factors associated with perceived difficulty in performing taping.</p><p><strong>Study design: </strong>A cross-sectional, anonymous online questionnaire was distributed to families of patients who underwent staged hypospadias repair at a single tertiary institution between 2020 and 2024. Eligible participants were caregivers who had performed penile taping for at least three months. The survey evaluated ease of taping, time requirement, retaping frequency, financial burden, child adaptation, and potential side effects.</p><p><strong>Results: </strong>A total of 95 caregivers completed the questionnaire (response rate: 95/129, 73.6%). Most respondents (90%) rated taping as easy or moderately easy to perform, and 55% reported adaptation within three months. On average, 59% maintained taping for over 14 h per day, and 80% re-applied tape fewer than five times daily, with each session lasting under 5 min. Perceived taping challenges were significantly associated with shorter daily taping duration, more frequent retaping, longer taping sessions, and difficulty with child cooperation. No significant associations were found between difficulty and tape consumption, cost, or skin irritation.</p><p><strong>Discussion: </strong>These findings indicate that with proper instruction and follow-up support, most families can successfully implement the TAIPEI procedure at home. While compliance and adaptation vary, key challenges are behavioral rather than procedural or financial. Limitations include potential response bias and the single-center design.</p><p><strong>Conclusions: </strong>The TAIPEI procedure is a feasible and manageable family-centered postoperative rehabilitation strategy to correct penile curvature between staged repairs. Early caregiver education, clear demonstration of technique, and structured follow-up support appear critical for success.</p><p><strong>Clinical/translational applicability: </strong>This study provides the first quantitative assessment of caregiver experience with the TAIPEI procedure. The results support its use as a practical, low-cost, family-integrated rehabilitation method and may inform postoperative protocols and counseling in pediatric urology.</p>","PeriodicalId":16747,"journal":{"name":"Journal of Pediatric Urology","volume":" ","pages":"105965"},"PeriodicalIF":1.9,"publicationDate":"2026-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147816561","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: \"A contemporary analysis of single- and multi-stage hypospadias repair in the United States\".","authors":"Cayde Ritchie, Selin S Everett, Kathleen M Kan","doi":"10.1016/j.jpurol.2026.105967","DOIUrl":"https://doi.org/10.1016/j.jpurol.2026.105967","url":null,"abstract":"","PeriodicalId":16747,"journal":{"name":"Journal of Pediatric Urology","volume":" ","pages":"105967"},"PeriodicalIF":1.9,"publicationDate":"2026-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147839366","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":"RUBACE profile of pediatric patients with prune belly syndrome undergoing renal transplantation: Findings from a case series.","authors":"Priscila Cardoso Braz Ascar, Marcelo Costamilan Rombaldi, Camila Penteado Genzani, Mariana Janiques Barcia Magalhães Fonseca, Vanessa Scaranti, Eduardo Freitas Hatanaka, Luciana Santis Feltran, Maria Fernanda Carvalho de Camargo, Jovelino Quintino de Souza Leão, Paulo Cesar Koch Nogueira","doi":"10.1016/j.jpurol.2026.105959","DOIUrl":"https://doi.org/10.1016/j.jpurol.2026.105959","url":null,"abstract":"<p><strong>Introduction: </strong>Prune Belly Syndrome extends beyond the classical triad of deficient abdominal wall musculature, urinary tract anomalies, and cryptorchidism. Urological abnormalities may be severe enough to require renal transplantation during their lifetime. The RUBACE score is currently the most comprehensive tool for categorising the multisystem manifestations of the syndrome. We hypothesized that higher RUBACE scores would be associated with poorer post renal transplantation outcomes.</p><p><strong>Patients and methods: </strong>We conducted a retrospective review of 500 paediatric renal transplantations performed between April 2008 and October 2021, identifying all patients with Prune Belly Syndrome undergoing their first transplant. Demographic variables were collected, and RUBACE scores were assigned based on clinical assessment and physical examination prior to renal transplantation. Descriptive analyses were performed using the software R 4.4.3. Qualitative variables were expressed as percentages, and numeric variables as medians and interquartile (IQR 25-75). Associations between RUBACE scores graft loss or mortality were evaluated using a permutation test with 100.000 simulations, adopting a level of significance of 5%.</p><p><strong>Results: </strong>In the period of the study, 22 patients with Prune Belly Syndrome underwent their first renal transplantation. During follow-up, 11 patients (50%) experienced at least one febrile urinary tract infection, 3 (14%) had graft loss, and 2 (9%) died. Those with graft loss had higher RUBACE scores than those without, although this difference was not statistically significant (p = 0.16). RUBACE scores were higher among patients who died (p = 0.03).</p><p><strong>Discussion: </strong>Intestinal, osteoarticular, neurologic, pulmonary and cardiac manifestations impact the quality of life and survival of patients with Prune Belly Syndrome and should be considered in multidisciplinary care when preparing these patients for renal transplantation. Many of the patients in the present study needed procedures to allow adequate bladder emptying and to reduce complications such as recurrent urinary tract infections. Until now, no previous study has evaluated RUBACE score with renal outcomes in paediatric Prune Belly patients that received renal transplantation.</p><p><strong>Conclusions: </strong>Renal transplantation in children with Prune Belly Syndrome presents unique clinical challenges. RUBACE score may assist in risk stratification, helping to identify patients at higher risk of graft loss and mortality after transplantation.</p>","PeriodicalId":16747,"journal":{"name":"Journal of Pediatric Urology","volume":" ","pages":"105959"},"PeriodicalIF":1.9,"publicationDate":"2026-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147774741","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: \"Efficacy of three corporotomies to correct ventral penile curvature. Experience in 400 patients with severe hypospadias\".","authors":"Warren Snodgrass, Nicol Bush","doi":"10.1016/j.jpurol.2026.105957","DOIUrl":"https://doi.org/10.1016/j.jpurol.2026.105957","url":null,"abstract":"","PeriodicalId":16747,"journal":{"name":"Journal of Pediatric Urology","volume":" ","pages":"105957"},"PeriodicalIF":1.9,"publicationDate":"2026-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147774669","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":"Pre- and postoperative urodynamic risk stratification in infants and young children undergoing tethered cord release.","authors":"Taylor L Hughes, Ashley Phord-Toy, Daniel S Han, Kathleen M Kan","doi":"10.1016/j.jpurol.2026.105929","DOIUrl":"https://doi.org/10.1016/j.jpurol.2026.105929","url":null,"abstract":"<p><strong>Introduction and objectives: </strong>Primary tethered cord syndrome (TCS) can lead to neurological and urologic dysfunction. While postoperative urodynamic studies (UDS) are standard for evaluating bladder function after spinal cord detethering (SCD), the role of preoperative UDS remains unclear, particularly in non-toilet trained (NTT) infants and children. This study assesses the utility of preoperative UDS by 1) comparing pre- and postoperative findings and risk stratification, and 2) examining correlations with long-term urologic outcomes.</p><p><strong>Study design: </strong>We retrospectively reviewed records of children who underwent SCD between 2009 and 2022 and had UDS within one year before and after surgery. Patients were included if they were not toilet trained at time of preoperative UDS. Exclusion criteria included secondary SCD, incomplete UDS documentation, and prior urinary diversion. UDS tracings were independently reviewed by two pediatric urologists categorized as low-, intermediate-, and high-risk based on end-fill pressure (EFP) and detrusor overactivity (DO).</p><p><strong>Results: </strong>Forty-eight children met inclusion criteria. Median (IQR) age at preoperative UDS, SCD, and postoperative UDS was 7.7 (4.2-11.1), 8 (5-12), and 16.1 (12.7-20.5) months, respectively. Neurosurgeons had scheduled or definitively recommended surgery for 81.3% of patients prior to preoperative UDS. One child started CIC prior to SCD based on UDS findings of large capacity bladder and poor emptying; 97% of children had no preoperative change in urologic management. There was no significant difference in any individual urodynamic parameter pre- and postoperatively. Preoperatively, 34 (70.8%) children were low-risk, 14 (29.2%) intermediate-risk, and none high-risk. Change in risk categorization was observed in 16 (33.3%) children-11 (22.9%) improved and 5 (10.4%) worsened. At median follow-up of 5.4 years, children with intermediate- or high-risk postoperative UDS were 23.3 times more likely to require CIC at most recent follow-up than low-risk children (p = 0.010); no such association was found with preoperative risk status.</p><p><strong>Conclusion: </strong>Among NTT infants and young children with TCS, preoperative UDS findings did not differ significantly from postoperative findings and were not associated with long-term bladder outcomes. These data suggest limited utility of routine baseline preoperative UDS and support reserving preoperative UDS for select cases where results are expected to provide clinically actionable information. Interdisciplinary collaboration is needed to refine testing protocols and promote high-value, patient-centered care.</p>","PeriodicalId":16747,"journal":{"name":"Journal of Pediatric Urology","volume":" ","pages":"105929"},"PeriodicalIF":1.9,"publicationDate":"2026-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147839421","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":"Artificial intelligence in pediatric urology: Opportunities, limitations, and the need for methodological rigor.","authors":"Hsin-Hsiao Scott Wang, Michael Lingzhi Li","doi":"10.1016/j.jpurol.2026.105963","DOIUrl":"https://doi.org/10.1016/j.jpurol.2026.105963","url":null,"abstract":"","PeriodicalId":16747,"journal":{"name":"Journal of Pediatric Urology","volume":" ","pages":"105963"},"PeriodicalIF":1.9,"publicationDate":"2026-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147839399","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":"Utility of the 3-months post-operative ultrasound and percent reduction in antero-posterior diameter of renal pelvis to identify success, early failures and those at risk for late failures after pediatric dismembered pyeloplasty: an analysis of 359 cases.","authors":"Zita Hornok, V V S Chandrasekharam","doi":"10.1016/j.jpurol.2026.105951","DOIUrl":"https://doi.org/10.1016/j.jpurol.2026.105951","url":null,"abstract":"<p><strong>Background: </strong>There is no consensus on the ideal follow-up testing after pyeloplasty for ureteropelvic junction obstruction (UPJO) in children. Although diuretic renogram (DR) is considered the gold standard to define successful pyeloplasty, percent reduction in antero-posterior diameter (PR-APD) on post-operative ultrasound (USG) has been reported to be useful to identify successful pyeloplasty. We sought to further explore PR-APD ranges in the first post-operative USG that would have high specificity to identify successful and failed pyeloplasty.</p><p><strong>Methods: </strong>From a 10-year database of pediatric pyeloplasties performed in 4 centers, cases with follow-up USG at 3 months post-pyeloplasty and follow-up DR were selected for analysis. On the basis of drainage on follow-up DR, the patients were divided into group 1 (successful) and group 2 (failures). PR-APD was compared between the two groups, and receiver operating curve (ROC) analysis was performed to assess the cutoff value of PR-APD that had the best discriminative ability to predict success. Further, within group 2, PR-APD was compared between early (2a) and late (2b) failures.</p><p><strong>Results: </strong>Three hundred and fifty-nine children (323 group 1, 36 group 2) who underwent primary dismembered pyeloplasty for unilateral UPJO were included. Both groups were comparable for demographic parameters and mean pre-operative APD. On the 3-months post-operative USG, group 1 had significantly lower post-operative APD (p = 0.0001) and higher PR-APD (62.8% vs 24.6%, p < 0.001) than group 2. On ROC analysis, PR-APD of 42% had 91% sensitivity and 100% specificity for predicting success of pyeloplasty. PR-APD <15% predicted early failures with 100% specificity, while PR-APD between 16 and 42% was associated with 45% risk of late pyeloplasty failure.</p><p><strong>Discussion: </strong>We identified the cut-off values of PR-APD that could predict success and early failure of pyeloplasty with high specificity. While earlier reports had limited number of failed cases, our data was unique that we had a sizable number of failed pyeloplasty cases, thus enabling meaningful comparison of PR-APD between successes and failures. In addition, we identified a subgroup at risk of late failure. These findings might be useful to avoid routine post-operative DR studies after pyeloplasty, detect early failures and identify the few patients who benefit from long-term follow-up.</p><p><strong>Conclusions: </strong>On the 3-month post-operative USG after pyeloplasty, PR-APD 42% or more predicted success with 100% specificity, while PR-APD <15% was 100% specific in predicting early failures. Those with PR-APD 16-42% may be at risk for late failures and may benefit from long-term follow-up.</p>","PeriodicalId":16747,"journal":{"name":"Journal of Pediatric Urology","volume":" ","pages":"105951"},"PeriodicalIF":1.9,"publicationDate":"2026-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147774713","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":"Chronic kidney disease in classic bladder exstrophy following primary closure and then isolated bladder neck repair.","authors":"Nikhil V Batra, Kirstan K Meldrum, Rosalia Misseri, Mark P Cain, Pankaj P Dangle, Joshua D Roth, Benjamin M Whittam, Richard C Rink, Martin Kaefer, Konrad M Szymanski","doi":"10.1016/j.jpurol.2026.105952","DOIUrl":"https://doi.org/10.1016/j.jpurol.2026.105952","url":null,"abstract":"<p><strong>Introduction: </strong>We reviewed our data to evaluate changes in estimated glomerular filtration rates (eGFR) and chronic kidney disease (CKD) status in pediatric patients with classic bladder exstrophy (CBE) that have previously undergone staged repairs with primary closure followed by isolated bladder neck repair (BNR).</p><p><strong>Methods and materials: </strong>Medical records of patients with CBE (1986-2020) were retrospectively reviewed and included if the patient had undergone a staged repair without bladder augmentation and creatinine measurements were obtained prior to 18 years of age. Schwartz formula was used to calculate eGFRs and CKD status as determined by nephrology evaluations. Non-parametric statistical analysis was performed.</p><p><strong>Results: </strong>Twenty-two children (68% male) underwent primary closure (94% immediate neonatal) followed by BNR at median age of 5.1 years. At median follow-up after BNR of 16 years, 16 (73%) were augmented or diverted primarily for urodynamic deterioration or upper tract changes (81%). Mean preoperative eGFR was 109 ml/min/1.73 m² at which time no patient had a CKD classification based on eGFR criteria. Ninety-two percent had a decline in eGFR with mean change of -30 ml/min/1.73 m² (p < 0.001) observed prior to 18 years of age, corresponding to a -2.2 ml/min/1.73 m² (p = 0.02) annual rate of decline. A significant difference in eGFR between the two time points (before BNR and prior to age 18) was observed in male (p < 0.001) but not female (p = 0.29) patients. Prior to age 18, five patients met CKD criteria and one had CKD3+ at a median age of 14 years; all followed with a nephrologist.</p><p><strong>Conclusions: </strong>Renal outcomes data following exstrophy repairs continue to be sobering, with nearly a 2-point annual decline in eGFR in patients undergoing staged repair including isolated BNR. We did note a significantly higher risk of renal functional decline during childhood in boys. More attention to the early surveillance of renal function following exstrophy repair is needed.</p>","PeriodicalId":16747,"journal":{"name":"Journal of Pediatric Urology","volume":" ","pages":"105952"},"PeriodicalIF":1.9,"publicationDate":"2026-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147774751","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}