Journal of Pediatric Urology最新文献

{"title":"Early spontaneous resolution of vesicoureteral reflux from voiding cystourethrogram: A comparison of contemporary prediction models","authors":"Adree Khondker ,&nbsp;Jin Kyu Kim ,&nbsp;Angela M. Arlen ,&nbsp;Mandy Rickard ,&nbsp;Michael E. Chua ,&nbsp;Andrew J. Kirsch ,&nbsp;Armando J. Lorenzo ,&nbsp;Christopher S. Cooper","doi":"10.1016/j.jpurol.2025.04.030","DOIUrl":"10.1016/j.jpurol.2025.04.030","url":null,"abstract":"<div><h3>Background</h3><div><span>Spontaneous resolution in vesicoureteral reflux (VUR) is an important clinical outcome. Patients with unresolved VUR are at risk for infection and renal scarring. Contemporary predictive models, such as VURx, ureteral diameter ratio (UDR), and qVUR have been developed to improve </span>risk stratification and guide decision-making. Here, we incorporated these measures to improve prediction of VUR resolution.</div></div><div><h3>Methods</h3><div><span>We performed a retrospective study on children from a single center with primary VUR who underwent repeat VCUG 1 year from an index VCUG. We assessed spontaneous complete resolution at follow-up VCUG, that were conducted. Patients were included if they had a 1-year follow-up VCUG or underwent surgery for breakthrough UTI within a year of the VCUG. Patients were excluded if they underwent surgery for patient/parent preference within one year of the VCUG. Multivariable models including age, sex, laterality and one of: VUR grade, modified VURx score (mVURx), UDR, and qVUR features were created. Multivariable </span>logistic regression analyzed resolution, measured by odds ratios and area-under-the-receiver-operator characteristic (AUROC).</div></div><div><h3>Results</h3><div>In 141 children with VUR, 29 (21 %) resolved VUR within 1 year. Older age was negatively associated with resolution, while sex, VUR laterality, and VUR grade were not significantly associated with resolution. On multivariable analysis, higher maximum UDR (OR 0.02, 95%CI 0.001, 0.60; p = 0.04) and ureteral width (OR 0.79, 95%CI 0.66, 0.91; p = 0.003) were associated with lower odds of resolution. Among predictive models, qVUR-based models demonstrated the highest performance (AUROC = 0.79), followed by mVURx (AUROC = 0.77) and UDR (AUROC = 0.75), while traditional VUR grading was the least predictive (AUROC = 0.74).</div></div><div><h3>Discussion</h3><div>This study demonstrated that incorporating measures of VUR severity from qVUR or UDR, as well as incorporating additional factors such as gender, timing of the onset of reflux, and ureteral anomalies as done with mVURx, offers improved prediction of VUR resolution.</div></div><div><h3>Conclusion</h3><div>Incorporation of more objective radiographic measurements of the degree of VUR over grade alone, as well additional factors such as gender, age, and timing of onset of VUR improves predictive ability of VUR resolution.</div></div>","PeriodicalId":16747,"journal":{"name":"Journal of Pediatric Urology","volume":"21 4","pages":"Pages 999-1004"},"PeriodicalIF":1.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144078501","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":"Two-flip Mathieu's technique in distal hypospadias with small glans","authors":"Vikesh Agrawal ,&nbsp;Ramesh Babu","doi":"10.1016/j.jpurol.2025.02.035","DOIUrl":"10.1016/j.jpurol.2025.02.035","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Introduction&lt;/h3&gt;&lt;div&gt;Hypospadias repair can be complicated, especially with poorly developed glans. This study evaluates the outcomes of the Two-Flip Mathieu (TFM) procedure, which aims to reinforce the glans and reduce dehiscence in patients with small glans, comparing it to conventional Mathieu's repair.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;&lt;span&gt;This retrospective study analyzed case records of patients with distal hypospadias and minimal ventral curvature. Preoperative evaluations&lt;span&gt; included assessments of meatal location, glans and urethral plate width, perimeatal skin quality, and presence of chordee&lt;span&gt;&lt;span&gt;. Patients with small glans (&lt;14 mm) received hormonal stimulation using intramuscular testosterone. Surgical choices were based on urethral plate and glans morphology: patients with good urethral plates and glans underwent TIP repair (excluded), those with poor urethral plates and good glans widths underwent conventional Mathieu repair (Group 1), and those with both poor urethral plates and glans widths received TFM repair (Group 2). Postoperative assessments focused on meatal position, &lt;/span&gt;fistula&lt;span&gt; formation, glans dehiscence at regular intervals, and patient satisfaction, which was measured using a 5-point Likert scale covering meatal appearance, glans aesthetics, &lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;urinary stream, and overall cosmetic satisfaction at 6 month follow-ups.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;During the two-year study period (2021–2023), 73 patients with distal hypospadias were treated. After excluding 22 patients who underwent TIP repair, 51 were divided into two groups. Group 1 (20 patients) underwent conventional Mathieu repair, while Group 2 (28 patients) received TFM repair. In the TFM group, 2 patients (7.1 %) developed urethrocutaneous fistulas, with one requiring surgery. Three patients (10.7 %) experienced superficial necrosis, managed conservatively. TFM had no cases of glans dehiscence, whereas conventional Mathieu repair showed significant dehiscence (&lt;em&gt;p&lt;/em&gt; = 0.0343). Re-operation rates were lower in TFM (&lt;em&gt;p&lt;/em&gt; = 0.0148). Patient satisfaction was significantly higher in TFM for glans aesthetics and overall appearance.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Discussion&lt;/h3&gt;&lt;div&gt;&lt;span&gt;Glans size and urethral plate quality are key factors in hypospadias repair. The TFM technique addresses limitations in conventional Mathieu repair by reinforcing the glans, reducing tension on the neo-urethra, and improving outcomes. Though initial color mismatch between the V-flap and glans is a limitation, cosmetic satisfaction was excellent at 6 month follow-up. TFM is unsuitable for patients with distal urethral hypoplasia and thin perimeatal skin but enhances the versatility of Mathieu repair in cases with poor glans quality.&lt;/span&gt;&lt;span&gt;&lt;figure&gt;&lt;span&gt;&lt;img&gt;&lt;ol&gt;&lt;li&gt;&lt;span&gt;&lt;span&gt;Download: &lt;span&gt;Download high-res image (232KB)&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/li&gt;&lt;li&gt;&lt;span&gt;&lt;span&gt;Download: &lt;span&gt;Download full-size image&lt;/span&gt;&lt;/s","PeriodicalId":16747,"journal":{"name":"Journal of Pediatric Urology","volume":"21 4","pages":"Pages 874-880"},"PeriodicalIF":1.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143630583","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":"Editorial commentary on “Comparing clinical and radiological success in open versus endoscopic surgery of primary vesicoureteral reflux”","authors":"Yuval Bar-Yosef","doi":"10.1016/j.jpurol.2025.02.046","DOIUrl":"10.1016/j.jpurol.2025.02.046","url":null,"abstract":"","PeriodicalId":16747,"journal":{"name":"Journal of Pediatric Urology","volume":"21 4","pages":"Pages 992-993"},"PeriodicalIF":1.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143719774","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 effect of preoperative ureteral stenting on the outcomes and complications of pediatric ureteroscopy: A systematic review and meta-analysis","authors":"Baha’ Aldeen Bani Irshid ,&nbsp;Tarek Mohamed ,&nbsp;Mohammad Ghassab Deameh ,&nbsp;Hamza Elhashamy ,&nbsp;Mohamed Ramez ,&nbsp;Ahmed Abdelhalim","doi":"10.1016/j.jpurol.2025.04.012","DOIUrl":"10.1016/j.jpurol.2025.04.012","url":null,"abstract":"<div><h3>Introduction</h3><div>Small ureteral caliber may prohibit<span> safe primary ureteroscopy<span> (URS), particularly in children. Pre-stenting was proposed to passively dilate the ureter for later safer ureteral access. This meta-analysis aims to analyze outcomes of both primary and deferred ureteroscopy after a period of pre-stenting.</span></span></div></div><div><h3>Methods</h3><div><span><span><span>PubMed, Scopus, Cochrane Library, and Web of Science were searched for studies comparing outcomes of primary and deferred ureteroscopy in children younger than 18 years with ureteral and/or </span>renal stones. Outcomes of interest were stone free rate (SFR), complication rates, </span>ureteral injury, </span>urinary tract infection (UTI), operative time, stone migration, postoperative stenting use and ureteral access sheath use.</div></div><div><h3>Results</h3><div>Four studies encompassing 826 patients were included. When attempted, primary ureteroscopic access was successful in 69–83 % of patients. SFR was higher in the pre-stenting group (OR 0.87, 95 % CI [0.81–0.94], <em>P</em> = 0.0005). No significant difference was found between the two groups in terms of the overall complications rate (RR 1.66, 95 % CI [0.93–2.96], <em>P</em><span> = 0.09), ureteral injury (RR 3.67, 95 % CI [0.43–31.66], </span><em>P</em> = 0.24) febrile UTI (RR 0.62 (95 % CI [0.15 to 2.5], <em>P</em> = 0.5), use of postoperative stent (OR 0.86, 95 % CI [0.52–1.44], <em>P</em> = 0.58), use of ureteral access sheath (RR 0.94 (95 % CI [0.73 to 1.22], <em>P</em> = 0.65), or stone migration (RR 2.28 (95 % CI [0.48 to 10.80], <em>P</em> = 0.30).</div></div><div><h3>Conclusion</h3><div>Although pre-stenting is associated with a relatively higher SFR, primary URS is successful in most pediatric patients without increased complication risk. We advocate primary URS whenever possible to allow stone treatment under a single anesthetic and minimize healthcare costs.</div></div>","PeriodicalId":16747,"journal":{"name":"Journal of Pediatric Urology","volume":"21 4","pages":"Pages 844-854"},"PeriodicalIF":1.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143987521","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 American Association of Pediatric Urologists (AAPU) 2025 annual meeting - Beaver Creek, Colorado","authors":"Martin Koyle,&nbsp;Brian Vanderbrink,&nbsp;Christopher Roth,&nbsp;Joseph Ortenberg,&nbsp;Hal Scherz,&nbsp;Richard Hurwitz","doi":"10.1016/j.jpurol.2025.03.018","DOIUrl":"10.1016/j.jpurol.2025.03.018","url":null,"abstract":"","PeriodicalId":16747,"journal":{"name":"Journal of Pediatric Urology","volume":"21 4","pages":"Pages 821-822"},"PeriodicalIF":1.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144025726","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":"Commentary to “Robotically procured living donor kidneys transplanted into pediatric recipients”","authors":"Antonio Macedo Jr,&nbsp;José Osmar Medina Pestana","doi":"10.1016/j.jpurol.2025.03.029","DOIUrl":"10.1016/j.jpurol.2025.03.029","url":null,"abstract":"","PeriodicalId":16747,"journal":{"name":"Journal of Pediatric Urology","volume":"21 4","pages":"Page 982"},"PeriodicalIF":1.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144026560","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":"Commentary to “Early spontaneous resolution of vesicoureteral reflux from voiding cystourethrogram: A comparison of contemporary prediction models”","authors":"Hans G. Pohl","doi":"10.1016/j.jpurol.2025.04.041","DOIUrl":"10.1016/j.jpurol.2025.04.041","url":null,"abstract":"","PeriodicalId":16747,"journal":{"name":"Journal of Pediatric Urology","volume":"21 4","pages":"Pages 1005-1006"},"PeriodicalIF":1.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144094118","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: “Increased risk of chronic kidney disease in children with anorectal malformations”","authors":"Haluk Emir,&nbsp;Ali Ekber Hakalmaz,&nbsp;Esra Karabağ Yılmaz","doi":"10.1016/j.jpurol.2025.05.009","DOIUrl":"10.1016/j.jpurol.2025.05.009","url":null,"abstract":"","PeriodicalId":16747,"journal":{"name":"Journal of Pediatric Urology","volume":"21 4","pages":"Pages 917-918"},"PeriodicalIF":1.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144142817","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: “Increased risk of chronic kidney disease in children with anorectal malformations”","authors":"Isabel Planas Díaz,&nbsp;Isabel Casal-Beloy,&nbsp;María José Moya Jiménez,&nbsp;Rosa María Romero Ruíz","doi":"10.1016/j.jpurol.2025.04.042","DOIUrl":"10.1016/j.jpurol.2025.04.042","url":null,"abstract":"","PeriodicalId":16747,"journal":{"name":"Journal of Pediatric Urology","volume":"21 4","pages":"Pages 915-916"},"PeriodicalIF":1.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144132580","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":"Summer 2025 edition of dialogues in pediatric urology - The young urologists issue","authors":"Albert Lee,&nbsp;Carmen Tong","doi":"10.1016/j.jpurol.2025.07.019","DOIUrl":"10.1016/j.jpurol.2025.07.019","url":null,"abstract":"","PeriodicalId":16747,"journal":{"name":"Journal of Pediatric Urology","volume":"21 4","pages":"Pages 832-833"},"PeriodicalIF":1.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144830699","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}