Journal of Pediatric Urology最新文献

{"title":"Quality of information on hypospadias from artificial intelligence chatbots: How safe is AI for patient and family information?","authors":"Peter Stapleton, Jordan Santucci, Monica Thet, Nathan Lawrentschuk, Lachlan Dodds, Thomas Cundy, Niranjan Sathianathen","doi":"10.1016/j.jpurol.2025.08.029","DOIUrl":"https://doi.org/10.1016/j.jpurol.2025.08.029","url":null,"abstract":"<p><strong>Introduction: </strong>Hypospadias is the most prevalent congenital anomaly of the penis, with an estimated incidence of 0.4-8.2 cases per 1000 live births (1). However, most of the parents and families of those with hypospadias experience anxiety and uncertainty regarding the information about hypospadias (2, 3). Leading to many families conduct their own independent internet search for information to better understand a diagnosis. The reliability and quality of this information for patients and families has not previously been formally assessed. The objective of this study is to assess the ability of AI chatbots to provide accurate and readable information to patients and families on hypospadias.</p><p><strong>Methods: </strong>AI chatbot inputs were sourced from google trends and healthcare organisations. Google trends was used to identify the top 10 google search terms relating to 'Hypospadias' based on search volume. Royal Children Hospital in Melbourne (RCH) and the Urology Care Foundation American Urology Association - Hypospadias (AUA) headers were used as healthcare related hypospadias inputs4 different AI chatbot programs ChatGPT version 4.0, Perplexity, Chat Sonic, and Bing AI. Three urology consultants blinded to the AI chatbots assessed responses for accuracy and safety and a further two trained investigators, blinded to AI chatbot type and each other's evaluation scores, assessed AI chatbot responses using various evaluation instruments including PEMAT, DISCERN, misinfomration and Flesch-Kincaid readability formula as well as word count and citation.</p><p><strong>Results: </strong>As demonstrated in the 4 AI chatbots assessed contained high quality health consumer information median DISCERN 4 (IQR 3-5). The degree of misinformation was low overall and across all AI chatbot responses, with a median of 1 (IQR 1-1). The PEMAT Understandability scores was high overall with a median of 91.7 % (IQR 80-92.3). However, all AIs performed poorly in the actionability of their responses with an overall median of 40 % (20-80). The median word count per AI chatbot response was 213 (IQR 141-273).</p><p><strong>Conclusion: </strong>AI chatbots provided understandable, high level and accurate health information relating to hypospadias. However, the information was delivered at a reading level which may limit its use in a paediatric or general public setting, and only one chatbot gave clearly actionable interventions or direction. Overall, AI chatbots are a clinically safe and appropriate adjunct to face to face consultation for healthcare information delivery and will likely take a more prominent domain as technology advances.</p>","PeriodicalId":16747,"journal":{"name":"Journal of Pediatric Urology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145102912","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":"Urethrocutaneous fistula recurrence after hypospadias repair: Risk factors and recurrence rates in a 20-year single-center experience.","authors":"Sylvia Weis, Alaa El-Ghoneimi, Ugo Maria Pierucci, Amane A Lachkar, Valeska Bidault-Jourdainne, Annabel Paye, Matthieu Peycelon","doi":"10.1016/j.jpurol.2025.08.031","DOIUrl":"https://doi.org/10.1016/j.jpurol.2025.08.031","url":null,"abstract":"<p><strong>Purpose: </strong>To study the outcomes, risk factors, and timing of fistula recurrence after surgical repair of urethrocutaneous fistula (UCF) in children with hypospadias.</p><p><strong>Methods: </strong>102 patients with a complete follow-up (>5 months) who had a fistula repair after hypospadias surgery were retrospectively analyzed (2000-2023). Median (IQR) age and follow-up were 3.5 years (2-6) and 26 months (12-57), respectively. Analyzed data included demographics; type of hypospadias, urethroplasty and fistula repair; fistula characteristics, and complications.</p><p><strong>Statistical analysis: </strong>Mann-Whitney U, Fisher's exact, and Chi-square tests.</p><p><strong>Results: </strong>The 2-year fistula recurrence rate was 23.5 %. Significant risk factors for secondary fistula recurrence after repair included: fistula size of 2-4 mm, previous fistula repair performed at another center, and the total number of fistula recurrences. Fistula repair using a skin flap was associated with a lower rate of recurrence. The median (IQR) and mean time to fistula recurrence were 10 (5.5-40) and 30 months respectively. Fistula recurrence occurred in 54.2 % within the first 12 months post-surgery and in 45.8 % after 12 months. No significant differences were observed regarding the type of hypospadias, the technique used for hypospadias repair, single-stage versus two-stage surgery, postoperative complications (including meatal stenosis and urethral strictures), fistula characteristics (location and number), or different surgeons performing the hypospadias and fistula repairs.</p><p><strong>Conclusion: </strong>The risk of secondary fistula recurrence increased with a fistula size of 2-4 mm and the total number of recurrences. Using a skin flap reduced the recurrence rate. We recommend a minimum follow-up of 12 months, as nearly 50 % of recurrences occur in the medium-to long-term.</p>","PeriodicalId":16747,"journal":{"name":"Journal of Pediatric Urology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145064838","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":"Evaluation of pelvic floor muscle activity, pulmonary function, respiratory muscle strength, core muscle endurance, and functional capacity in children with lower urinary tract dysfunction.","authors":"Deniz Tuncer, Ayca Arslanturk-Yildirim, Esma Nur Yuvakgil, Hayrettin Ozturk","doi":"10.1016/j.jpurol.2025.08.027","DOIUrl":"https://doi.org/10.1016/j.jpurol.2025.08.027","url":null,"abstract":"<p><strong>Introduction: </strong>Lower urinary tract dysfunction (LUTD) is a multifactorial condition affecting children, often presenting with voiding difficulties, urgency, and incontinence. While the condition has primarily been evaluated from a urological perspective, growing evidence suggests that pelvic floor dysfunction may also impact posture, respiration, and trunk muscle performance.</p><p><strong>Objective: </strong>To evaluate pelvic floor muscles (PFMs) activity, pulmonary function, respiratory muscle strength, core muscle endurance and functional capacity in children with LUTD, and to compare these parameters with healthy peers.</p><p><strong>Material and methods: </strong>This cross-sectional study evaluated 14 children with LUTD and 14 matched controls (ages 6-15). The symptom severity was evaluated via questionnaires. PFMs activity was measured using surface electromyography. Pulmonary function was evaluated with spirometry [(Forced Vital Capacity (FVC), Forced Expiratory Volume in the First Second (FEV₁), FEV₁/FVC, Peak Expiratory Flow (PEF), Forced Expiratory Flow at 25-75 % of FVC (FEF_25-75)], and respiratory muscle strength was measured using maximal inspiratory and expiratory pressures (MIP and MEP). Core muscle endurance was assessed via curl-up, static back endurance, prone plank, and side plank tests. Functional capacity was assessed using the 6-min walk test (6MWT).</p><p><strong>Results: </strong>Symptom severity was significantly higher in the LUTD group (p < 0.001). They showed reduced PFMs activity during contraction (work average: p = 0.007; mode: p = 0.001; maximal voluntary contraction: p = 0.006) and weaker respiratory muscle strength (MIP: p = 0.001; MEP: p < 0.001). Although FVC and FEV₁ were similar between groups, the LUTD group had lower PEF (p = 0.017) and FEF_25-75 (p = 0.013). Core endurance was significantly reduced in all tests (p < 0.001), with no difference in 6MWT.</p><p><strong>Conclusion: </strong>Children with LUTD show impaired pelvic floor function, weaker respiratory muscles, and poor core endurance, even without clear functional limitations. This highlights the need for a multidisciplinary approach including core and respiratory training alongside standard urological care.</p><p><strong>Clinical trial registration: </strong>The study was prospectively registered on October 17, 2024, in the ClinicalTrials.gov database (Identifier: NCT06652178).</p>","PeriodicalId":16747,"journal":{"name":"Journal of Pediatric Urology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145040608","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 on \"Rotation of the corpora cavernosa for ventral penile curvature: A length-preserving approach\".","authors":"Eralp Kubilay","doi":"10.1016/j.jpurol.2025.08.026","DOIUrl":"https://doi.org/10.1016/j.jpurol.2025.08.026","url":null,"abstract":"","PeriodicalId":16747,"journal":{"name":"Journal of Pediatric Urology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145054361","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: Rotation of the corpora cavernosa for ventral penile curvature: A length-preserving approach.","authors":"Sonia Pérez-Bertólez","doi":"10.1016/j.jpurol.2025.08.025","DOIUrl":"https://doi.org/10.1016/j.jpurol.2025.08.025","url":null,"abstract":"","PeriodicalId":16747,"journal":{"name":"Journal of Pediatric Urology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145054312","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 agreement between two uroflowmetry tests in children with lower urinary tract symptoms.","authors":"Damla Nur Tatlı, Nihat Karabacak, İlker Şen, Mustafa Özgür Tan","doi":"10.1016/j.jpurol.2025.07.040","DOIUrl":"https://doi.org/10.1016/j.jpurol.2025.07.040","url":null,"abstract":"","PeriodicalId":16747,"journal":{"name":"Journal of Pediatric Urology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145075517","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 Conventional vs device-assisted paediatric circumcision: A systematic review and meta-analysis.","authors":"Mingjia Shi, Guangchun Wang, Keqiang Li, Xuefen Yu","doi":"10.1016/j.jpurol.2025.08.022","DOIUrl":"https://doi.org/10.1016/j.jpurol.2025.08.022","url":null,"abstract":"","PeriodicalId":16747,"journal":{"name":"Journal of Pediatric Urology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145023529","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":"Laparoscopic varicocelectomy: Does intraoperative lymphography with vital dye influence the outcome?","authors":"Ana Ludy Lopes Mendes, Marco Castagnetti","doi":"10.1016/j.jpurol.2025.08.019","DOIUrl":"https://doi.org/10.1016/j.jpurol.2025.08.019","url":null,"abstract":"","PeriodicalId":16747,"journal":{"name":"Journal of Pediatric Urology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145054300","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":"Nephron-sparing surgery in bilateral Wilms tumors: Limitations of current criteria and impact of tumor size on renal morbidity.","authors":"Burak Ardicli, Idil Rana User, Seden Hayal Akar, Berna Oguz, Mustafa Tezer Kutluk, Saniye Ekinci","doi":"10.1016/j.jpurol.2025.08.021","DOIUrl":"https://doi.org/10.1016/j.jpurol.2025.08.021","url":null,"abstract":"<p><strong>Background: </strong>Patients with synchronous bilateral Wilms tumor (BWT) face challenges in balancing oncological control and nephron-sparing surgery (NSS). This study aimed to identify objective criteria for NSS in BWT by applying SIOP RTSG 2016 Umbrella Study criteria, the RENAL nephrometry scoring system, three-dimensional (3D) tumor volume measurements, and residual healthy kidney volume assessment.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 14 patients with synchronous BWT. 3D volume reconstructions were performed using 3D Slicer software. NSS eligibility was assessed based on the SIOP RTSG 2016 Umbrella study criteria and the RENAL nephrometry scoring system.</p><p><strong>Results: </strong>The total median tumor volume at diagnosis was 347,800.35 mm³, which decreased to 75,195.59 mm³ after neoadjuvant chemotherapy, as measured by 3D imaging (p = 0.028). In the early postoperative period, 43 % of patients (n = 6) developed acute renal failure requiring hemodialysis; however, none progressed to chronic kidney disease. Tumor volume at diagnosis showed a strong correlation with postoperative serum creatinine levels (p = 0.005, r = 0.70). According to SIOP RTSG 2016 NSS criteria, only five (18 %) kidneys were deemed suitable for NSS. Additionally, when we evaluated our patients using the RENAL nephrometry scoring system, we found that tumor complexity did not significantly change after neoadjuvant chemotherapy. Nevertheless, NSS was performed in 17 kidneys. The 5-year overall survival rate was 92.9 %, while the disease-free survival rate was 78.6 %.</p><p><strong>Conclusions: </strong>This study demonstrated that it is not possible to predict the feasibility of NSS for BWT using the currently available criteria in the literature. Tumor volume or the volume of residual healthy renal parenchyma were also not helpful in predicting feasibility. An increased tumor volume at the time of diagnosis appears to be associated with a higher risk of postoperative renal replacement therapy requirement. Multicenter studies with larger patient cohorts are needed to establish objective criteria to determine which kidney can undergo NSS in BWT cases.</p>","PeriodicalId":16747,"journal":{"name":"Journal of Pediatric Urology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145033526","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":"\"Can spot urine CA19-9 be a potential biomarker in lower urinary tract dysfunction in children?\"","authors":"Turker Altuntas, Mehmet Umut Kutukoglu, Onur Can Ozkan, Cagri Akin Sekerci, Kamil Cam, Tufan Tarcan, Selcuk Yucel","doi":"10.1016/j.jpurol.2025.08.023","DOIUrl":"https://doi.org/10.1016/j.jpurol.2025.08.023","url":null,"abstract":"<p><strong>Aim: </strong>The study aimed to evaluate urinary CA 19-9 as a potential biomarker in children with lower urinary tract dysfunction (LUTD) symptoms with a focus on underlying pathology and urodynamic parameters.</p><p><strong>Materials and methods: </strong>This prospective study included a total of 200 children aged between 5 and 16 years: 25 with neurogenic LUTD, 27 with non-neurogenic LUTD, and 148 controls without lower urinary tract symptoms. Urinary CA19-9 was analyzed using ELISA. Urinary CA 19-9 values were compared between groups. Urinary CA19-9 levels in the neurogenic group were compared with urodynamic parameters and subgroup analysis according to the presence of upper urinary tract (UUT) damage. In addition, correlation analyses were performed for both the neurogenic and non-neurogenic groups with non-invasive parameters and for the neurogenic group with invasive parameters. ROC analysis was performed to determine the threshold value for the 2 patient groups.</p><p><strong>Results: </strong>The mean age of the patients was 9.18 years. Urinary CA19-9 levels were found to be 77.34 U/ml in the neurogenic group, 58.63 U/ml in the non-neurogenic group, and 49.87 U/ml in the control group (p < 0.001). No statistically significant results were found in the subgroup analysis of the neurogenic group based on UUT damage, a detrusor leak point pressure (DLPP) > 20 cm H₂O, or compliance <10 ml/cm H₂O. Correlation analysis revealed a significant correlation between urinary CA 19-9 values and PVR only. In ROC analysis for LUTD children - control comparison, the threshold value of urinary CA 19-9 was 57.46 U/ml. It was 60.53 U/ml for neurogenic and 54.84 U/ml for non-neurogenic group.</p><p><strong>Conclusion: </strong>This prospective study suggests urinary CA 19-9 as a potential biomarker for diagnosing neurogenic and non-neurogenic LUTD in children. However, its correlation with UUT and urodynamic parameters was not established, highlighting the need for larger studies.</p>","PeriodicalId":16747,"journal":{"name":"Journal of Pediatric Urology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145040567","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}