Journal of Pediatric Urology最新文献

{"title":"Commentary - Management of paediatric urinary tract infections in 2025: Where do we go from here?","authors":"Jonathan S Ellison","doi":"10.1016/j.jpurol.2025.07.041","DOIUrl":"https://doi.org/10.1016/j.jpurol.2025.07.041","url":null,"abstract":"","PeriodicalId":16747,"journal":{"name":"Journal of Pediatric Urology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145206650","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 management of paediatric urinary tract infections in 2025: Where do we go from here? A commentary on \"Update and summary of the EAU/ESPU paediatric guidelines on urinary tract infection in children\" on behalf of the EAU/ESPU paediatric urology guidelines panel.","authors":"Michele Gnech, Anna Bujons, Christian Radmayr, Lisette 't Hoen, Guy Bogaert, Berk Burgu, Yazan F Rawashdeh, Selcuk Mesrur Silay, Fardod O'Kelly, Josine Quaedackers, Niklas Pakkasjärvi, Allon van Uitert, Martin Skott, Uchenna Kennedy, Yuhong Yuan, Alexandra Zachou, Marco Castagnetti","doi":"10.1016/j.jpurol.2025.08.041","DOIUrl":"https://doi.org/10.1016/j.jpurol.2025.08.041","url":null,"abstract":"","PeriodicalId":16747,"journal":{"name":"Journal of Pediatric Urology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145199797","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":"The wider erection angle in hypospadias: A neglected feature affecting surgical outcomes.","authors":"İbrahim Ulman, Sibel Tiryaki, Yusuf Atakan Baltrak, Ali Tekin","doi":"10.1016/j.jpurol.2025.09.002","DOIUrl":"https://doi.org/10.1016/j.jpurol.2025.09.002","url":null,"abstract":"<p><strong>Introduction: </strong>Penile curvature often accompanies hypospadias, and numerous techniques have been described for its correction; however, in some cases, an abnormal erection angle may also be present, further exacerbating the perception of curvature.</p><p><strong>Objective: </strong>This study investigates the significance of the erection angle in hypospadias cases and its correlation with the severity of the anomaly.</p><p><strong>Study design: </strong>A retrospective analysis of intraoperative photographs of hypospadias cases operated between 2019 and 2023 was performed. Erection angle was measured with a digital goniometer during a full artificial erection. Erection angles in proximal and distal hypospadias cases were analyzed and compared to data from Kinsey's subgroups representing healthy male erection angles.</p><p><strong>Results: </strong>This study involved images of 68 patients, with 31 having proximal and 37 distal hypospadias. The median age of the whole group was 11 months (6-156, IQR 9). Median erection angle was 91 (63-119, IQR 11) for distal cases, whereas it was 96 (75-138, IQR 21) for proximal cases. The difference was statistically significant (p = 0.009). The erection angle distribution in our cohort, including both proximal and distal hypospadias cases, skewed toward wider angles, highlighting a distinct pattern compared to data constituted by Kinsey and Sparling.</p><p><strong>Discussion: </strong>Our findings indicate that the erection angle in hypospadias is significantly wider in proximal cases, suggesting a correlation between erection angle and severity of the hypospadias. While we acknowledge the limitation of comparing our prepubertal cohort with Kinsey's adult data, the absence of evidence suggesting significant post-pubertal changes in erection angle justifies this approach. Additionally, the use of digital images for angle assessment is not a standardized technique in hypospadias evaluation; these images were initially captured for curvature assessment. Despite these limitations, our study provides novel insights into seldom mentioned association with hypospadias - a wide erection angle, emphasizing the need for further research on its implications for surgical planning and long-term outcomes.</p><p><strong>Conclusion: </strong>This study introduces a wider erection angle as an additional characteristic of hypospadias particularly pronounced in proximal cases. To our knowledge, this is the first focused investigation on addressing this aspect of the condition. It emphasizes the need for further research on adults with wide post-repair erection angles to explore its long-term impact on sexual function and aesthetics.</p>","PeriodicalId":16747,"journal":{"name":"Journal of Pediatric Urology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145113026","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":"The impact of medicaid circumcision coverage on pediatric urologists' practices.","authors":"Michael Sischka, Nicolette G Payne, Ryan J Hassen, Gwen M Grimsby, Carlos A Villanueva","doi":"10.1016/j.jpurol.2025.08.030","DOIUrl":"https://doi.org/10.1016/j.jpurol.2025.08.030","url":null,"abstract":"<p><strong>Introduction: </strong>Routine circumcisions are covered by Medicaid in some U.S. states and not others. Data on how this coverage impacts pediatric urologists' practices is limited.</p><p><strong>Objectives: </strong>This study aimed to compare urologists' practices regarding newborn and operative circumcisions, other penile surgeries, circumcision complication procedures, and foreskin related office visits in states with and without Medicaid coverage of newborn circumcision.</p><p><strong>Study design: </strong>American Board of Urology (ABU) physician case logs from 2003 to 2023 of CPT codes for newborn circumcision, operative circumcision, circumcision complication procedures, and other penile surgeries were reviewed. Clinic visits for foreskin related conditions were compared using ICD codes. States without newborn circumcision coverage by Medicaid were compared to states with newborn circumcision coverage by Medicaid. States where the coverage changed during the study period were excluded. The Kruskal-Wallis Test was used to compare the median number of procedures per surgeon and clinic visits per surgeon between covered and uncovered states.</p><p><strong>Results: </strong>No significant differences were found in the median number of newborn circumcisions, operative circumcisions, circumcision complication procedures, or other penile surgeries per urologist between states with and without Medicaid coverage of newborn circumcision. Urologists in states with Medicaid coverage of newborn circumcision reported more office visits for congenital chordee and hidden penis than states without coverage, but no other differences in clinic visits were observed for other foreskin related conditions.</p><p><strong>Discussion: </strong>Prior studies have suggested that states without Medicaid coverage of newborn circumcision have increased numbers of circumcisions and other foreskin related procedures done in the operating room compared with states without coverage of newborn circumcision which may adversely affect the training and practice of urologists. This study found no difference in the case volume of penile surgery between states with and without coverage. The main limitation of the study is the source of the data from the ABU for which no prior reports exist of its accuracy or limitations.</p><p><strong>Conclusions: </strong>This study suggests that Medicaid coverage of newborn circumcision does not significantly impact the practice patterns of pediatric urologists in either the operating room or clinic setting.</p>","PeriodicalId":16747,"journal":{"name":"Journal of Pediatric Urology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145113645","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":"Treatment outcomes of functional urinary incontinence in children after structured urotherapeutic training.","authors":"C M Schad, F Wachter, A M Schmidt, P Richert, S Hughes, M Stehr, F M Schäfer","doi":"10.1016/j.jpurol.2025.09.018","DOIUrl":"https://doi.org/10.1016/j.jpurol.2025.09.018","url":null,"abstract":"<p><strong>Purpose: </strong>Functional (Nonorganic) urinary incontinence (FUI) in children is a prevalent disorder and a common presenting symptom in clinical practice. Non-pharmaceutical urotherapeutic approaches are increasingly important treatment tools, but have not been studied for effectiveness. This study aims to evaluate the outcomes of children with FUI following Standardized Urinary Incontinence Training (SUIT) based on the guidelines of the German Consensus Group on Continence Training (KgKS) and to identify potential influencing factors that may hinder successful urotherapy.</p><p><strong>Material and methods: </strong>A retrospective analysis on 297 children aged 5-16 who underwent SUIT between 2017 and 2022 was conducted. Patient data were gathered from institutional records and a follow-up questionnaire. Participants were categorized according to their diagnosis and symptoms, including non-monosymptomatic enuresis nocturna (Non-MEN), daytime urinary incontinence (DUI), and dysfunctional voiding (DV) without incontinence. The outcomes were evaluated at early and late follow-ups using the criteria of the International Children's Continence Society (ICCS), with statistical analyses performed to identify significant predictors of success.</p><p><strong>Results: </strong>214 patients were available for the evaluation of initial success rate. Partial response or better was noted in 88.3 % while 44.4 % achieved complete response. 83.0 % of the 94 patients available for long-term follow-up maintained complete success over two years. Female patients showed significantly higher initial success rates compared to males (p = 0.028). Multiple logistic regression identified voiding postponement incontinence (VPI) as a positive predictor for success, while age, psychosocial stress (PSS) and attention deficit hyperactivity disorder (ADHD) were associated with lower success rates (p = 0.0002). Patients with VPI were 2.5 times more likely to achieve treatment success than those without VPI symptoms, while ADHD patients were five times less likely to achieve treatment success compared to individuals without ADHD. Overall, in patients without PSS or ADHD, the initial success rate was 94.8 %, incorporating the partial and complete response categories, while 88.0 % of those patients exhibited complete success in the long-term category.</p><p><strong>Conclusion: </strong>SUIT is an effective first-line treatment for FUI in children, with significant improvements observed in patients without comorbidities. The findings highlight the importance of tailored interventions and the potential benefits of multidisciplinary approaches that address behavioral factors in therapeutic protocols.</p>","PeriodicalId":16747,"journal":{"name":"Journal of Pediatric Urology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145206683","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":"Validation of the Turkish pediatric incontinence questionnaire (PinQ-TR): A reliable measure for assessing HRQoL in children with LUTD.","authors":"Ece Zeynep Saatçı, Halil Tuğtepe, Elif Elçin Dereli, W F Bower, Tuğba Kuru Çolak","doi":"10.1016/j.jpurol.2025.09.020","DOIUrl":"https://doi.org/10.1016/j.jpurol.2025.09.020","url":null,"abstract":"<p><strong>Background: </strong>Lower urinary tract dysfunction (LUTD) is a prevalent condition in childhood that adversely affects multiple dimensions of health-related quality of life (HRQoL). The Pediatric Incontinence Questionnaire (PinQ) is a widely used, disease-specific instrument for capturing the psychosocial impact of urinary incontinence in children. To date, no validated Turkish version of this tool has been available.</p><p><strong>Objectives: </strong>This study aimed to translate, culturally adapt, and psychometrically validate the Turkish version of the Pediatric Incontinence Questionnaire (PinQ-TR) for use in children with LUTD, ensuring its conceptual equivalence and measurement accuracy in the Turkish pediatric population.</p><p><strong>Methods: </strong>A methodological study was conducted with 120 children aged 6-16 years diagnosed with LUTD. The translation process followed internationally accepted guidelines for cross-cultural adaptation. Psychometric evaluation included internal consistency (Cronbach's alpha), test-retest reliability (intraclass correlation coefficient, ICC), and construct validity. Convergent and discriminant validity were tested through correlations with the Pediatric Quality of Life Inventory (PedsQL) and Dysfunctional Voiding and Incontinence Scoring System (DVISS), respectively.</p><p><strong>Results: </strong>The PinQ-TR demonstrated strong internal consistency (α = 0.79) and excellent test-retest reliability (ICC = 0.967). Moderate-to-strong correlations with PedsQL and DVISS scores confirmed its construct validity. Floor and ceiling effects were minimal, indicating a broad sensitivity to patient-reported outcomes.</p><p><strong>Conclusions: </strong>The PinQ-TR is a valid, reliable, and culturally appropriate instrument for assessing HRQoL in Turkish-speaking children with LUTD. Its integration into clinical and research contexts may enhance outcome tracking, patient-centered care, and cross-cultural comparability in pediatric urology.</p>","PeriodicalId":16747,"journal":{"name":"Journal of Pediatric Urology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145206717","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":"Expanding the clinical and translational role of antegrade genitography in obstructive Müllerian malformations.","authors":"Cherdpong Choenklang, Patpicha Arunsan, Schawanya K Rattanapitoon, Nathkapach K Rattanapitoon","doi":"10.1016/j.jpurol.2025.09.010","DOIUrl":"https://doi.org/10.1016/j.jpurol.2025.09.010","url":null,"abstract":"","PeriodicalId":16747,"journal":{"name":"Journal of Pediatric Urology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145186173","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 the letter to the editor: Expanding the clinical and translational role of antegrade genitography in obstructive Müllerian malformations.","authors":"Yitzhak Elkis, Guy Hidas","doi":"10.1016/j.jpurol.2025.09.011","DOIUrl":"https://doi.org/10.1016/j.jpurol.2025.09.011","url":null,"abstract":"","PeriodicalId":16747,"journal":{"name":"Journal of Pediatric Urology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145191830","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":"Systematic review and meta-analysis on the role of transcutaneous electrical nerve stimulation in children with overactive bladder - Pooled analysis of nine randomized controlled trials.","authors":"Sathyamurthy Arunaa, Ramesh Babu, Ramasundaram Madhu, Sambandan Kumaravel","doi":"10.1016/j.jpurol.2025.09.012","DOIUrl":"https://doi.org/10.1016/j.jpurol.2025.09.012","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the efficacy of transcutaneous electrical nerve stimulation (TENS) in the management of overactive bladder (OAB) in children by conducting a systematic review and meta-analysis of randomized controlled trials (RCTs).</p><p><strong>Methods: </strong>A systematic search of PubMed, Embase and the Cochrane Library was conducted to identify RCTs comparing TENS with standard therapies (urotherapy, sham TENS, or oxybutynin) in children with OAB. Inclusion criteria encompassed RCTs published between 2004 and 2024, reporting TENS as a primary intervention. Data were pooled using a meta-analysis framework, and heterogeneity was assessed using I² statistics. Risk of bias was evaluated using the ROBVIS tool.</p><p><strong>Results: </strong>Nine RCTs involving 382 children were included. Five studies compared active TENS with sham TENS, of which three reported superior efficacy for TENS, while two found no difference. Two studies compared TENS with oxybutynin; one demonstrated TENS superiority, while the other found comparable efficacy. One study showed TENS to be as effective as urotherapy, and another found that TENS combined with oxybutynin was superior to either treatment alone. The meta-analysis revealed that TENS significantly increased the likelihood of a full response compared to other treatments (OR 3.96, 95 % CI 2.46-6.38, p < 0.001). TENS was effective both as a standalone therapy (OR 4.34) and as an adjunct (OR 3.27). Parasacral TENS demonstrated a higher response rate than posterior tibial TENS.</p><p><strong>Conclusion: </strong>TENS is an effective, non-invasive therapy for pediatric OAB, either as monotherapy or in combination with urotherapy or medication. However, variability in study protocols and limited long-term follow-up data highlight the need for standardized treatment protocols and larger RCTs to assess long-term outcomes, including relapse rates.</p><p><strong>Prospero registration number: </strong>CRD420251114932.</p>","PeriodicalId":16747,"journal":{"name":"Journal of Pediatric Urology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145186207","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":"Post-pubertal outcomes of hypospadias surgery performed during infancy: High satisfaction with urinary function and minimal lower urinary tract symptoms.","authors":"Annaleena Anttila, Niklas Pakkasjärvi, Seppo Taskinen","doi":"10.1016/j.jpurol.2025.09.013","DOIUrl":"https://doi.org/10.1016/j.jpurol.2025.09.013","url":null,"abstract":"<p><strong>Objectives: </strong>To assess long-term lower urinary tract symptoms (LUTS) in post-pubertal patients operated on for hypospadias during infancy.</p><p><strong>Patients and methods: </strong>We analysed patient-reported LUTS in 176 post-pubertal patients born between 1991 and 2003, who underwent early hypospadias repair at a median age of 1.4 years (IQR 1.1-1.9). At their last follow-up visit, patients returned pre-mailed questionnaires evaluating LUTS before transitioning from the pediatric unit. The results were compared to a healthy control group. We also assessed the impact of hypospadias severity on voiding and storage symptoms.</p><p><strong>Results: </strong>At a median age of 16.3 years, 19 % of patients had undergone stricture treatment following hypospadias repair. Frequent (often/always) or severely disturbing (moderate/major) voiding or storage symptoms were rare and comparable to controls according to DAN-PSS questionnaire (p > 0.05 for all comparisons). Most symptoms were mild, and the occurrence of mild symptoms varied between patients and controls. The severity of hypospadias did not affect the occurrence of voiding or storage symptoms. The occurrence of bothersome LUTS was also similar between patients with and without prior stricture treatment (p > 0.5 for all).</p><p><strong>Conclusion: </strong>Most patients reported satisfaction with their urinary function after urethroplasty, indicating that long-term LUTS do not significantly increase following hypospadias when complications including strictures are identified and managed. To enable long-term outcomes after childhood hypospadias surgery, structured follow-up is essential to detect and treat such complications.</p>","PeriodicalId":16747,"journal":{"name":"Journal of Pediatric Urology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145186190","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}