Journal of Pediatric Urology最新文献

{"title":"Commentary: “The mini-flank lumbotomy for pyeloplasty in association with the Ottoni pyelostent: An inexpensive and efficient combination”","authors":"Christa Gernhold","doi":"10.1016/j.jpurol.2025.01.019","DOIUrl":"10.1016/j.jpurol.2025.01.019","url":null,"abstract":"","PeriodicalId":16747,"journal":{"name":"Journal of Pediatric Urology","volume":"21 3","pages":"Pages 785-786"},"PeriodicalIF":2.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143468260","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":"Author reply to Letter to the Editor, Re: Adherence to follow-up ten years after hypospadias repair","authors":"Nikhil V. Batra, Rosalia Misseri, Joshua D. Roth","doi":"10.1016/j.jpurol.2025.02.019","DOIUrl":"10.1016/j.jpurol.2025.02.019","url":null,"abstract":"","PeriodicalId":16747,"journal":{"name":"Journal of Pediatric Urology","volume":"21 3","pages":"Page 626"},"PeriodicalIF":2.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143557181","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":"Initial puncture vs observational management of ureteroceles","authors":"H. Gil Rushton, Hans Pohl","doi":"10.1016/j.jpurol.2025.02.037","DOIUrl":"10.1016/j.jpurol.2025.02.037","url":null,"abstract":"","PeriodicalId":16747,"journal":{"name":"Journal of Pediatric Urology","volume":"21 3","pages":"Page 817"},"PeriodicalIF":2.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143674097","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":"Parameatal based flip flap urethroplasty as a salvage procedure for management of graft fibrosis following first stage of staged free graft hypospadias repair","authors":"P. Ashwin Shekar,&nbsp;Girraj Sharma,&nbsp;Anuj Yadav","doi":"10.1016/j.jpurol.2024.12.019","DOIUrl":"10.1016/j.jpurol.2024.12.019","url":null,"abstract":"<div><h3>Introduction</h3><div>Graft fibrosis following the first stage of a free graft staged hypospadias repair is a difficult scenario where the management has traditionally been to excise the graft and replace it with a new graft. However, still the risk of recurrent fibrosis remains making it difficult to proceed to the second stage and tubularising a fibrosed graft practically ensures a breakdown. Herein, we present our way of using parameatal based flip flap urethroplasty as a salvage procedure in this situation.</div></div><div><h3>Patients and methods</h3><div>This video is a step by step description of the parameatal based flip flap urethroplasty technique used in our center in patients who returned with graft fibrosis following first stage repair with a graft. Operative details and post-operative management in an index case are described.</div></div><div><h3>Results</h3><div>We have utilized this technique in 5 patients who had developed graft fibrosis after the first stage of a free graft staged repair. One patient had a small urethrocutaneous fistula which was subsequently closed. At a median follow-up of 34 months, all patients are voiding well from the glanular tip.</div></div><div><h3>Conclusions</h3><div>Our experiences demonstrates that Parameatal based flip flap urethroplasty can be an effective salvage technique for managing graft fibrosis following the first stage of a free graft staged hypospadias repair. This technique leverages available local tissue, even in complex scenarios where previous repairs and grafting have failed. The satisfactory outcomes in these complex cases highlight its potential as a valuable tool for pediatric urologists.</div></div>","PeriodicalId":16747,"journal":{"name":"Journal of Pediatric Urology","volume":"21 3","pages":"Pages 777-778"},"PeriodicalIF":2.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142950525","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 Commentary regarding “Adherence to Follow-up Ten Years after Hypospadias Repair”","authors":"Nikhil V. Batra,&nbsp;Joshua Heiman,&nbsp;Jeremy Koehlinger,&nbsp;Pankaj Dangle,&nbsp;Kirstan K. Meldrum,&nbsp;Benjamin M. Whittam,&nbsp;Konrad M. Szymanski,&nbsp;Richard C. Rink,&nbsp;Martin Kaefer,&nbsp;Mark P. Cain,&nbsp;Rosalia Misseri,&nbsp;Joshua D. Roth","doi":"10.1016/j.jpurol.2024.12.026","DOIUrl":"10.1016/j.jpurol.2024.12.026","url":null,"abstract":"","PeriodicalId":16747,"journal":{"name":"Journal of Pediatric Urology","volume":"21 3","pages":"Pages 622-623"},"PeriodicalIF":2.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143007170","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":"Novel CO2 loaded nanoparticle ultrasound-activated contrast agent: A potential urinary catheter-free modality to detect vesicoureteral reflux","authors":"Callum Lavoie ,&nbsp;Zoe Nussbaum ,&nbsp;Helal Syed ,&nbsp;Brian Chun ,&nbsp;Van Do ,&nbsp;Davin Nguyen ,&nbsp;Anvi Surapaneni ,&nbsp;Ethan Hamid ,&nbsp;Adnan Rayes ,&nbsp;Dominic De La Torre ,&nbsp;Oliver Ramirez ,&nbsp;Eduardo Rosales ,&nbsp;Travis J. Williams ,&nbsp;Jesse T. Yen ,&nbsp;Andy Y. Chang","doi":"10.1016/j.jpurol.2025.01.003","DOIUrl":"10.1016/j.jpurol.2025.01.003","url":null,"abstract":"<div><h3>Background</h3><div>The current gold-standard for detecting vesicoureteral reflux (VUR) is the voiding cystourethrogram (VCUG). However, VCUGs require ionizing radiation and bladder catheterization that can be challenging to perform and traumatic for pediatric patients and their parents.</div></div><div><h3>Objective</h3><div>To investigate the feasibility of a novel urinary catheter-free modality for diagnosing VUR using in vitro and ex vivo models.</div></div><div><h3>Design, setting, and participants</h3><div>Polyethyleneimine (PEI) and pressurized CO₂ gas were utilized to formulate our polymer in a standardized and reproducible method. The CO₂-loaded PEI solution was stimulated using moderate intensity ultrasound in latex balloons and ev-vivo porcine bladders. Degassed, deionized water served as the control.</div></div><div><h3>Outcome measurements and statistical analysis</h3><div>A Butterfly iQ ultrasound imaging system connected to a 9th generation iPad was utilized to observe any effervescence (bubbles).</div></div><div><h3>Results</h3><div>In both the balloon and ex vivo bladder models, CO₂ effervescence is reproducible and visualizable from the CO₂-loaded polymer solution under US imaging after stimulation.</div></div><div><h3>Conclusions</h3><div>We have demonstrated the ability to selectively release CO₂ from CO₂-loaded PEI nanoparticles to serve as an ultrasound contrast agent in both in vitro and ex vivo models. Future combined kidney-bladder porcine model experiments will be a critical step as we work towards validating and translating this agent as an effective modality for the diagnosis of VUR.</div></div><div><h3>Patient summary</h3><div>In this feasibility study, we evaluated early pre-clinical models of a urinary catheter-free modality for the diagnosis of vesicoureteral reflux. We utilized a novel CO₂-loaded nanoparticle solution that creates bubbles when activated with moderate intensity ultrasound. These bubbles were clearly visualizable with regular diagnostic ultrasound imaging in both a latex balloon and porcine bladder model.</div></div>","PeriodicalId":16747,"journal":{"name":"Journal of Pediatric Urology","volume":"21 3","pages":"Pages 743-748"},"PeriodicalIF":2.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143007180","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 utilization of a spare ureter to create a continent catheterizable channel to the bladder in pediatric patients","authors":"Fabian Frank,&nbsp;Bernd Wullich,&nbsp;Karin Hirsch-Koch,&nbsp;Marios Marcou","doi":"10.1016/j.jpurol.2025.01.007","DOIUrl":"10.1016/j.jpurol.2025.01.007","url":null,"abstract":"<div><h3>Introduction</h3><div>Clean intermittent catheterization (CIC) has significant advantages over indwelling catheters. To facilitate CIC, a continent catheterizable channel (CCC) to the bladder is required in some cases. The Mitrofanoff appendicovesicostomy (APV) is considered the gold standard for pediatric CCC creation. However, when the appendix is unavailable or unsuitable for the creation of a CCC alternatives are required.</div></div><div><h3>Objective</h3><div>This study aims to share our single-center experience with using a spare ureter as a CCC in pediatric patients and compare its advantages and complications to those of APV and the use of bowel segments.</div></div><div><h3>Study design</h3><div>A retrospective review of the medical records of all pediatric patients who underwent CCC creation between 2001 and 2023 was performed. The inclusion criteria were age younger than 18 years at surgery and the use of an appendix, ileal segment, or ureter for CCC creation.</div></div><div><h3>Results</h3><div>A total of 108 pediatric patients underwent CCC creation. Of these, 90 had an APV, 5 had an ileal segment CCC, and 13 had a ureteral CCC. Operating times were not significantly different among the groups. The median follow-up was 78 months for the ureter group, 66 months for the APV groups and 13 months for the ileal group. The stomal continence rates were 92 % for the ureter group, 97 % for the APV group, and 100 % for the ileal group. Stomal complications occurred in 15.4 % of ureter CCCs, 25.6 % of APVs, and 40 % of ileal CCCs. No significant differences in complication rates were observed among the groups.</div></div><div><h3>Discussion</h3><div>Our findings demonstrate that ureteral CCCs have acceptable complication rates and functional outcomes comparable to those of APVs and ileal CCCs. The limitations of this study include its retrospective design and small sample size, especially in the ureteral and ileal groups. Future prospective studies with larger cohorts are recommended to further validate these findings.</div></div><div><h3>Conclusion</h3><div>Our study indicates that the utilizazion of a spare ureter for CCC creation is a feasible and effective alternative in pediatric patients with a nonfunctioning kidney.</div></div>","PeriodicalId":16747,"journal":{"name":"Journal of Pediatric Urology","volume":"21 3","pages":"Pages 651-658"},"PeriodicalIF":2.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143028959","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":"Vaginoplasty in female bladder exstrophy–epispadias complex: Analysis of operative technique, outcomes, and complications","authors":"Logan Galansky,&nbsp;Andrew T. Gabrielson,&nbsp;Joseph Cheaib,&nbsp;Victoria Maxon,&nbsp;Ahmad Haffar,&nbsp;Alex Hirsch,&nbsp;Chad B. Crigger,&nbsp;John P. Gearhart,&nbsp;Heather N. Di Carlo","doi":"10.1016/j.jpurol.2025.02.005","DOIUrl":"10.1016/j.jpurol.2025.02.005","url":null,"abstract":"<div><h3>Introduction and objective</h3><div>Bladder exstrophy–epispadias complex (BEEC) is a rare, but serious congenital malformation. After achieving urinary continence and upper tract preservation, genital reconstruction is performed for function and cosmesis. We evaluated our institutional experience with vaginoplasty, including technical considerations and post-operative outcomes.</div></div><div><h3>Patients and methods</h3><div>An IRB-approved database was used to conduct an institutional retrospective review of BEEC patients undergoing vaginoplasty from 2000 to 2024. Patients with XY karyotype, primary vaginoplasty during BEEC closure or at another institution, or no urologic follow-up visits at least six months post-vaginoplasty were excluded. Data on age, reconstructive method, and suture type was collected. Post-operative complications were analyzed with the primary surgical outcome of vaginal stenosis requiring re-operation (VS) and secondary surgical outcomes including urinary tract infection (UTI), surgical site infection (SSI), dehiscence, rectal injury, fistula, and symptomatic pelvic organ prolapse (POP) after vaginoplasty.</div></div><div><h3>Results</h3><div>A total of 240 female BEEC patients were identified with 54 (22.5 %) undergoing vaginoplasty. Median age at vaginoplasty was 15.6 years old. The majority of cases were perineal flap vaginoplasty (88.9 %). Nylon suture was most commonly used (46.3 %), with Vicryl and PDS used in 31.5 % and 22.2 % of cases, respectively. Median follow-up time was 55.2 months. Post-operative complication rates were VS 14.8 %, UTI 3.7 %, SSI 7.4 %, dehiscence 3.7 %, rectal injuries 0 %, fistula 0 %, and symptomatic POP 12.9 % (Table 1). The perioperative complication rate per-patient from post-operative day 1–90 was 20.4 % and the overall lifetime complication rate per-patient was 33.3 %. We found no significant association between reconstructive method and VS (p = 0.2). Among VS events, PDS was used in 50 % of cases (p = 0.041). On univariable analysis, PDS use was significantly associated with VS (OR 4.75, 95 % CI [1.02–23.1], p = 0.042). This finding remained significant when adjusting for reconstructive method on multivariable analysis (OR 5.83, 95 % CI [1.06–32.3], p = 0.043) (Table 2).</div></div><div><h3>Conclusions</h3><div>As children with BEEC mature into adulthood, optimizing surgical outcomes for genital reconstruction is critical. In this large retrospective cohort of BEEC patients undergoing vaginoplasty, we observed that VS was the most common post-operative complication. Symptomatic POP was the second most common post-operative complication, but of these patients, the majority were managed conservatively. Use of PDS during vaginoplasty was significantly associated with VS, suggesting that other suture types may be more advantageous for successful surgical outcomes, but further investigation into the clinical significance of this finding is warranted.</div></div>","PeriodicalId":16747,"journal":{"name":"Journal of Pediatric Urology","volume":"21 3","pages":"Pages 567-573"},"PeriodicalIF":2.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143458397","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":"Contralateral orchiopexy during pediatric testicular torsion management: What are the national practice patterns?","authors":"Allison Grant ,&nbsp;Justin A. Lee ,&nbsp;Joseph Marte ,&nbsp;Belinda Li ,&nbsp;Soo Jeong Kim ,&nbsp;Christopher B. Anderson ,&nbsp;Christina P. Carpenter","doi":"10.1016/j.jpurol.2025.02.004","DOIUrl":"10.1016/j.jpurol.2025.02.004","url":null,"abstract":"<div><h3>Purpose</h3><div>Evidence-based guidelines for contralateral orchiopexy during testicular torsion surgery are lacking. We aim to evaluate the rates of contralateral orchiopexy at time of testicular torsion surgery.</div></div><div><h3>Material and methods</h3><div>Utilizing Kids Inpatient Database, we performed a retrospective cohort study of children &lt;18 years old who had surgery for testicular torsion from 2016 to 2019. Patients were identified using the ICD10 testicular torsion diagnosis code. Primary outcome was the rate of contralateral orchiopexy. Multivariable logistic regression evaluated patient and hospital factors associated with contralateral orchiopexy.</div></div><div><h3>Results</h3><div>We identified 1544 children who had surgery for testicular torsion. Of the 531 patients who underwent ipsilateral orchiopexy, 170 (32 %) did not have concurrent contralateral orchiopexy. Of the 528 patients who underwent orchiectomy, 186 patients (35 %) did not have concurrent contralateral orchiopexy. Overall, 1188/1544 (76.9 %) children underwent bilateral orchiopexy, and 356/1544 (23.1 %) did not undergo contralateral fixation.</div><div>Multivariable logistic regression analysis showed that increased patient age was associated with decreased likelihood of having a contralateral orchiopexy (OR = 0.96, 95 % CI [0.94–0.98], p &lt; 0.01). Patients having surgery at Western region (OR = 0.50, 95 % CI [0.34–0.73], p &lt; 0.01), private non-profit (OR = 0.60, 95 % CI [0.39–0.92], p &lt; 0.02) and private investor owned (OR = 0.58, 95 % CI [0.35–0.95], p &lt; 0.03) hospitals were less likely to have a contralateral orchiopexy.</div></div><div><h3>Conclusions</h3><div>We observed that roughly a quarter of children having surgery for testicular torsion do not undergo a contralateral orchiopexy. Increasing patient age, surgery in Western region hospital, and private hospital, were associated with decreased likelihood of contralateral orchiopexy.</div></div>","PeriodicalId":16747,"journal":{"name":"Journal of Pediatric Urology","volume":"21 3","pages":"Pages 725-731"},"PeriodicalIF":2.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143502041","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 to CASR, CLDN 14, ALPL & SLC34A1 genes are associated with the risk of nephrolithiasis in Egyptian children","authors":"Yuval Bar-Yosef","doi":"10.1016/j.jpurol.2025.01.038","DOIUrl":"10.1016/j.jpurol.2025.01.038","url":null,"abstract":"","PeriodicalId":16747,"journal":{"name":"Journal of Pediatric Urology","volume":"21 3","pages":"Page 583"},"PeriodicalIF":2.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143537283","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}