Journal of Pediatric Urology最新文献

{"title":"Commentary on socioeconomic and demographic factors predict post-surgical follow-up.","authors":"Ruohui Huang, Liqin Gu","doi":"10.1016/j.jpurol.2025.04.028","DOIUrl":"https://doi.org/10.1016/j.jpurol.2025.04.028","url":null,"abstract":"","PeriodicalId":16747,"journal":{"name":"Journal of Pediatric Urology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144094115","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":"\"Simple Anatomical Closure-SAC\" for distal hypospadias repair without glans wings dissection: Technical description and preliminary results.","authors":"Ali Ekber Hakalmaz, Ali Sezer, Ayşe Karagöz Hakalmaz, Haluk Emir","doi":"10.1016/j.jpurol.2025.04.036","DOIUrl":"https://doi.org/10.1016/j.jpurol.2025.04.036","url":null,"abstract":"<p><strong>Introduction: </strong>Glans wings dissection is an important part of hypospadias repair to ensure safe coverage of the neourethra. We here describe our technique entitled \"Simple Anatomical Closure (SAC)\" procedure, without extensive glans wings dissection, to preserve the distal continuity of spongious tissues and their glanular attachments.</p><p><strong>Objective: </strong>Our aim is to evaluate the clinical results of the SAC procedure, while questioning the absolute necessity of glans wings dissection.</p><p><strong>Patients and method: </strong>Cases that underwent SAC procedure between 2018 and 2023 were retrospectively analyzed for demographic data, perioperative findings, and clinical outcomes. Anatomical inclusion criteria for performing SAC procedure were: primary distal hypospadias cases with a wide glans penis, wide ventral periurethral triangles and well-developed distal periurethral spongious tissues. Cases with more than 30 degrees of ventral curvature and/or dysplastic urethral plate were excluded. For the SAC technique: following total penile degloving and exposure of distal penile structures, the urethral plate mucosa is separated from glanular mucosa while ventral glanular periurethral triangles are deepithelialized. Urethral plate incision with or without inlay grafting is applied if indicated. A limited distal urethral spongious tissue dissection is performed towards the glans penis while preserving spongious continuity and glanular attachments. Dorsal midline plication and/or complete urethral dissection with ventral corporotomies are applied if necessary for correction of ventral curvature. Penile structures are then closed according to their anatomical order.</p><p><strong>Results: </strong>SAC procedure was applied in 43 (2 glanular, 18 coronal, 23 subcoronal) primary distal hypospadias cases between 2018 and 2023. The median operation age was 25 months. Urethral plate incision was done in 39 cases and preputial inlay grafting added in 18. Ventral curvature was present in 34 cases (15-30°), which was corrected with penile degloving, dorsal midline plication, urethral dissection/separation and superficial ventral corporotomies, when necessary. Mean follow-up period was 32.5 months. Late term results revealed 1 fistula, 1 glanular tilt, and 2 mild distal glans dehiscences with no ventral curvature recurrence, penile rotation, diverticula, or stenosis.</p><p><strong>Discussion: </strong>Glans wings dissection is a commonly used technique during hypospadias repair that possibly increases success rates. However, in selected cases, reconstruction of penile structures without extensive glans wings dissection is possible. Recently described surgical modifications also have similar principles and recommend glanuloplasty without extensive glans wings dissection.</p><p><strong>Conclusion: </strong>\"Simple Anatomical Closure\" procedure without glans wings dissection is a safe method for primary distal hypospadias repair,","PeriodicalId":16747,"journal":{"name":"Journal of Pediatric Urology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144159565","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":"Early spontaneous resolution of vesicoureteral reflux from voiding cystourethrogram: A comparison of contemporary prediction models.","authors":"Adree Khondker, Jin Kyu Kim, Angela M Arlen, Mandy Rickard, Michael E Chua, Andrew J Kirsch, Armando J Lorenzo, Christopher S Cooper","doi":"10.1016/j.jpurol.2025.04.030","DOIUrl":"https://doi.org/10.1016/j.jpurol.2025.04.030","url":null,"abstract":"<p><strong>Background: </strong>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 risk stratification and guide decision-making. Here, we incorporated these measures to improve prediction of VUR resolution.</p><p><strong>Methods: </strong>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 logistic regression analyzed resolution, measured by odds ratios and area-under-the-receiver-operator characteristic (AUROC).</p><p><strong>Results: </strong>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).</p><p><strong>Discussion: </strong>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.</p><p><strong>Conclusion: </strong>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.</p>","PeriodicalId":16747,"journal":{"name":"Journal of Pediatric Urology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-05-02","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":"Strategies to reduce bleeding risk in office Gomco circumcisions for babies ≥ 5.5 kg.","authors":"Carlos Villanueva, Stephen Leahy","doi":"10.1016/j.jpurol.2025.04.032","DOIUrl":"https://doi.org/10.1016/j.jpurol.2025.04.032","url":null,"abstract":"<p><strong>Introduction: </strong>We sought to investigate whether some modifications to the office Gomco circumcision (OGC) result in reduced bleeding.</p><p><strong>Methods: </strong>Boys ≥5.5 kg had 6-8 interrupted sutures placed around the circumcision and had a specialized dressing. Boys <5.5 Kg had the standard OGC.</p><p><strong>Results: </strong>Out of 325 boys undergoing OGC, 125 were ≥5.5 kg, and 200 < 5.5 kg. Bleeding that required intervention occurred in 1 (0.5 %) infant weighing <5.5 kg, with no cases in the ≥5.5 kg group (p = 0.4285).</p><p><strong>Conclusion: </strong>These findings indicate that a modified OGC protocol can effectively mitigate bleeding risks for infants ≥5.5 kg.</p>","PeriodicalId":16747,"journal":{"name":"Journal of Pediatric Urology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144142814","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":"Pediatric sacral neuromodulation: A step-by-step tined lead placement technique and clinical outcomes.","authors":"A Faure, C Giannopoulou, M Haddad","doi":"10.1016/j.jpurol.2025.04.019","DOIUrl":"https://doi.org/10.1016/j.jpurol.2025.04.019","url":null,"abstract":"<p><strong>Introduction: </strong>Chronic stimulation of the sacral nerves has become one of the most accepted non-invasive treatments for non-neurogenic lower urinary tract dysfunction in children. The International Children's Continence Society recently recognized sacral neuromodulation (SNM) as a viable option for treating urinary incontinence related to overactive bladder (OAB) and urgency. Proper placement of the electrodes is a key factor in optimizing clinical outcomes.</p><p><strong>Objective: </strong>We present a video that offers a step-by-step demonstration of the tined lead placement technique in children and share our experience with this procedure in a pediatric cohort.</p><p><strong>Study design: </strong>Retrospective, non-randomized study.</p><p><strong>Results: </strong>Since 2020, seven children have undergone SNM for idiopathic OAB (n = 4, median age: 8.5 years) and chronic non-neurogenic urinary retention (n = 3, median age: 16 years). Six of the seven children progressed to permanent implantation after a successful test phase. The median follow-up duration was 39 months (8-48) and 18 months (18-42) respectively in the OAB and urinary retention group. All children were successfully treated. Two patients required surgical revision due to wound infection and device dysfunction. The SNM device was removed in one patient, with no recurrence of OAB symptoms.</p><p><strong>Discussion: </strong>Key elements of tined lead placement include identifying radiological landmarks, guiding the electrode into the sacral foramen, and ensuring its correct progression. Placement is based on fluoroscopic appearance of the electrodes and achieving motor and sensory responses during stimulation. These factors contribute to the positive clinical outcomes seen in our pediatric cohort.</p><p><strong>Conclusion: </strong>SNM appears to be an effective and minimally invasive treatment option for pediatric patients with non-neurogenic vesico-sphincter disorders that are resistant to first-line therapies. Standardization of the surgical technique is essential for optimizing patient outcomes and maximizing the therapeutic potential of SNM.</p>","PeriodicalId":16747,"journal":{"name":"Journal of Pediatric Urology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144142813","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":"Authors' response to Editorial Comment on \"Decision Aid Development for Shared Surgical Decision-Making in Differences of Sex Development: A Review of Existing Aids\".","authors":"Aalaa S Abdallah, Adam Davies, Emma Trasatti, Emilie K Johnson, Jax Whitehead","doi":"10.1016/j.jpurol.2025.04.034","DOIUrl":"https://doi.org/10.1016/j.jpurol.2025.04.034","url":null,"abstract":"","PeriodicalId":16747,"journal":{"name":"Journal of Pediatric Urology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144078499","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":"Comperative analysis of three chatbot responses on pediatric primary nocturnal enuresis.","authors":"Asya Eylem Boztas, Esra Ensari","doi":"10.1016/j.jpurol.2025.04.031","DOIUrl":"https://doi.org/10.1016/j.jpurol.2025.04.031","url":null,"abstract":"<p><strong>Background: </strong>The purpose of the study was to evaluate both the accuracy and reproducibility of the answers given by ChatGPT-4o®, Gemini® and Copilot® to frequently asked questions about pediatric primary enuresis nocturna.</p><p><strong>Methods: </strong>Forty frequently asked questions about primary nocturnal enuresis were asked 2 times, one week apart, on ChatGPT-4o, Gemini and Copilot. One of each pediatric surgeon and nephrologist independently scored the answers into 4 groups: comprehensive/correct (1), incomplete/partially correct (2), a mix of accurate and inaccurate/misleading (3), and completely inaccurate/irrelevant (4). The accuracy and reproducibility of each chatbots answers were evaluated.</p><p><strong>Results: </strong>In comparison of these most common used chatbots, the order of completely correct response rates from highest to lowest was Chat GPT-4o and followed by Copilot and Gemini. With an accuracy percentage of 92.5 %, ChatGPT-4o gave the most accurate responses of any AI chatbot. Gemini answered 50 % of questions correctly. Copilot was the weakest successful chatbot in answering questions about enuresis nocturna with 45 % of completely accurate answer ratio. Besides Copilot has a ratio of 2.5 % for completely inaccurate/irrelevant response. Reproducibility of ChatGPT-4o, Gemini and Copilots were 85 %, 77.5 %, 70 % respectively.</p><p><strong>Conclusion: </strong>ChatGPT-4o is more successful in providing a high percentage of accurate responses regarding nocturnal enuresis. Both patients and their parents can use it, especially for simple, low-complexity medical questions. However, it should be used alongside expert healthcare proffesional.</p>","PeriodicalId":16747,"journal":{"name":"Journal of Pediatric Urology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143970720","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":"Augmentation cystoplasty and continent catheterizable channels in the bladder exstrophy-epispadias complex: A 20-year experience.","authors":"Victoria Maxon, Carolyn Im, Ahmad Haffar, Alexander Hirsch, David Heap, Chad Crigger, Heather Di Carlo, John Gearhart","doi":"10.1016/j.jpurol.2025.04.033","DOIUrl":"https://doi.org/10.1016/j.jpurol.2025.04.033","url":null,"abstract":"<p><strong>Introduction: </strong>The variable presentation of the exstrophy-epispadias complex (EEC) has led to a variety of surgical and medical care practices for management of the condition. Augmentation cystoplasty (AC) is a procedure that can be used to increase the volume and compliance of the bladder to facilitate a functional storage vessel for urine that does not put the upper urinary tract under high pressure.</p><p><strong>Objective: </strong>To determine risk factors for complications after augmentation cystoplasty (AC) with continent catheterizable channel (CCC) in the EEC.</p><p><strong>Study design: </strong>An IRB approved institutional database of EEC patients was reviewed retrospectively. Patients that had primary augmentation performed at our institution between 2003 and 2023 were included. Gender, race, primary closure outcome, bowel segment choice for augmentation and stoma, preoperative bladder capacity, bladder neck status, age at augmentation, 30- and 90-day complications, number of stomal revisions, and length of longer term follow-ups were reviewed. Comparisons were made among different risk factors and complications across AC type and CCC type.</p><p><strong>Results: </strong>186 patients underwent primary AC with CCC at our institution and 157 met final inclusion criteria (Table 1). The patients included 148 (94.3 %) classic bladder exstrophy, 6 (3.8 %) male epispadias and 3 (1.9 %) female epispadias. The mean age at time of AC was 11.3 years with a median follow up of 6.46 years. There was no significant difference in the length of bowel harvested by the ileum and colon groups (p = 0.0836) or closure outcome (p = 0.3013). There was increased usage of Monti stoma in patients with an ileum AC (p = 0.0034). Stomal revisions were also significantly more common in the ileum group (p = 0.0392). Closure outcome did not influence the rate of 30- and 90-day complications (p = 0.6560, p = 0.6761) or stoma choice (p = 0.7384). There was no significant difference between the ileum and colon augment groups in terms of 30- and 90-day complications (p = 0.8329, p = 0.2923, respectively). Multivariate Cox regression showed no significant association between stoma or augmentation type and time to postoperative complication (p = 0.94 and p = 0.77, respectively). Patients with a history of primary successful closure had a shorter hospital stay (p = 0.0042) but there was no difference in hospital stay between the ileum and colon groups (p = 0.6632).</p><p><strong>Discussion: </strong>Bowel segment choice for AC does not influence the risk for complications in the EEC population. History of a failed primary closure leads to a longer hospital stay after AC, but there is no increased risk for complications.</p><p><strong>Conclusion: </strong>Risks factors in the EEC population for complications after AC with CCC remain unknown.</p>","PeriodicalId":16747,"journal":{"name":"Journal of Pediatric Urology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143968365","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 editor re: \"A single center, pilot study to compare the efficacy of an instructional male genital exam video to no prior education in the quality of telemedicine consultations in pediatric urology\".","authors":"Nilsun Kuas","doi":"10.1016/j.jpurol.2025.03.032","DOIUrl":"https://doi.org/10.1016/j.jpurol.2025.03.032","url":null,"abstract":"","PeriodicalId":16747,"journal":{"name":"Journal of Pediatric Urology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143977561","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":"Reply to Letter to editor for the paper titled - Intraoperative urinary ACR as a prognostic biomarker in unilateral pelviureteric junction obstruction in paediatric population- an observational study.","authors":"Keerthana Bachala, Amit Kumar Sinha, Bindey Kumar, Mala Mahto, Amit Kumar, Rashi Rashi","doi":"10.1016/j.jpurol.2025.04.025","DOIUrl":"https://doi.org/10.1016/j.jpurol.2025.04.025","url":null,"abstract":"","PeriodicalId":16747,"journal":{"name":"Journal of Pediatric Urology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144078526","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}