Journal of Pediatric Urology最新文献

{"title":"Surgery with compassion: A potential shift in surgical paradigms.","authors":"Juan M Moldes, Lorena Llobenes, María Mercedes Stremmler, Lauren Chew, Pedro-José Lopez E","doi":"10.1016/j.jpurol.2025.01.033","DOIUrl":"https://doi.org/10.1016/j.jpurol.2025.01.033","url":null,"abstract":"<p><p>Modern surgical advances have improved outcomes, yet compassion remains underemphasized in surgical practice. There is ample evidence demonstrating the benefits of compassionate care for both providers and patients. The \"Surgery with Compassion\" initiative aims to incorporate this essential quality into surgical practice. As part of this concept, we developed the \"Surgical Compassion Pause,\" a brief, intentional moment of reflection introduced just after the Time Out procedure. It is centered on both the patient and the surgical team and is based on the \"4 C's\"-Conscious Awareness, Courage, Commitment to Purpose, and Caring Connections-which together create a safe and meaningful operating room environment. This pause strengthens team bonds and provides reassurance to patients and families. We propose that, when combined with broader compassion training, it creates lasting, positive impacts for everyone involved.</p>","PeriodicalId":16747,"journal":{"name":"Journal of Pediatric Urology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143523699","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":"ROS scavengers and genital skin healing in boys with hypospadias.","authors":"Angela K Lucas-Herald, Samra Hussain, Kirsty McGinley, Rheure Alves-Lopes, S Basith Amjad, Martyn Flett, Boma Lee, Mairi Steven, Stuart O'Toole, S Faisal Ahmed","doi":"10.1016/j.jpurol.2025.02.023","DOIUrl":"https://doi.org/10.1016/j.jpurol.2025.02.023","url":null,"abstract":"<p><strong>Introduction: </strong>Hypospadias repair is associated with high complication rates. Vascular cells from boys with hypospadias have increased reactive oxygen species (ROS) compared to controls. It is not clear if ROS affects wound healing in hypospadias.</p><p><strong>Objectives: </strong>The aim of this study is to identify if cell migration and proliferation in genital skin is altered in hypospadias, and whether this is altered by antioxidants.</p><p><strong>Study design: </strong>Genital skin fibroblasts (GSFs) were grown from boys undergoing hypospadias repair or routine circumcision. Cells were imaged immediately after creating a wound scratch and 48 h later, in the presence/absence of ROS scavengers, N-acetylcysteine (NAC) or Tempol. Cell migration was determined using ImageJ software. Cell proliferation was measured using a Cell Count Kit-8 (Abcam, UK).</p><p><strong>Results: </strong>Twenty-four cases (median age (range) 1.8 (1.2, 6.3) years) and 28 controls (1.6 (1.2, 6.1) years) were recruited. Boys with hypospadias had impaired cell migration with reduced wound closure at 48 h (2.0 fold, p < 0.0001) and reduced cell proliferation (1.3 fold, p = 0.01). External Masculinisation Score was positively correlated with wound closure (r = 0.5, p < 0.0001) and cell proliferation (r = 0.3, p = 0.002). Exposure to NAC and Tempol improved wound closure (1.9 fold, p = 0.01, and 1.5 fold, p = 0.02 respectively) and cell proliferation (1.5 fold, p = 0.02 and 1.4 fold, p = 0.05 respectively).</p><p><strong>Discussion: </strong>There is an association between wound healing and virilisation of the external genitalia in boys. ROS scavengers increase cell migration and proliferation in GSFs from boys with hypospadias.</p><p><strong>Conclusion: </strong>Translational studies are required to confirm whether ROS scavengers may represent a therapeutic option for improving surgical outcome in boys with hypospadias.</p>","PeriodicalId":16747,"journal":{"name":"Journal of Pediatric Urology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143710385","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, Ramesh Babu","doi":"10.1016/j.jpurol.2025.02.035","DOIUrl":"https://doi.org/10.1016/j.jpurol.2025.02.035","url":null,"abstract":"<p><strong>Introduction: </strong>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.</p><p><strong>Methods: </strong>This retrospective study analyzed case records of patients with distal hypospadias and minimal ventral curvature. Preoperative evaluations included assessments of meatal location, glans and urethral plate width, perimeatal skin quality, and presence of chordee. Patients with small glans (<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, fistula formation, glans dehiscence at regular intervals, and patient satisfaction, which was measured using a 5-point Likert scale covering meatal appearance, glans aesthetics, urinary stream, and overall cosmetic satisfaction at 6 month follow-ups.</p><p><strong>Results: </strong>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 (p = 0.0343). Re-operation rates were lower in TFM (p = 0.0148). Patient satisfaction was significantly higher in TFM for glans aesthetics and overall appearance.</p><p><strong>Discussion: </strong>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.</p>","PeriodicalId":16747,"journal":{"name":"Journal of Pediatric Urology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-02-25","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":"Prognostic surgical factors related to short term urethroplasty complications after Tubularized Incised urethral Plate Urethroplasty in distal- and mid-type hypospadias in the Dutch Hypospadias Study.","authors":"Fred van der Toorn, Rogier Schroeder, Robert de Gier, Josine Quaedackers, Piet Callewaert, Martijn Steffens, Eric van der Horst, Martje Schotman, Monique Roobol, Goedele Beckers, Sebastiaan Remmers","doi":"10.1016/j.jpurol.2025.02.034","DOIUrl":"https://doi.org/10.1016/j.jpurol.2025.02.034","url":null,"abstract":"<p><strong>Introduction: </strong>Complications after hypospadias surgery are not rare and vary considerably between series in literature. In 2008 a national prospective observational cohort study was initiated, called the \"Dutch Hypospadias Study\" (DHS), to evaluate and possibly improve the outcomes of hypospadias surgery. The objective of the current study is to identify possible prognostic surgical factors for urethroplasty complications (UC) in the subgroup who underwent a Tubularized Incised urethral Plate Urethroplasty (TIPU) for distal and mid-type hypospadias. UC is defined as the sum of fistula, dehiscence, meatal/urethral stenosis and urethral diverticulum.</p><p><strong>Patients and methods: </strong>This TIPU subgroup patients were included in the DHS between September 2008 and June 2016. Patient and disorder characteristics, details of surgical technique, pictures of anatomic appearance and complications are documented in a \"web based\" database. The outcomes concerning UC-rates at six months after TIPU were analysed and possible prognostic surgical factors were explored.</p><p><strong>Results: </strong>A total of 723 cases (age range 6.1-54 months; median age 12 months; Inter Quartile Range (IQR) 9-14 months) were evaluated 6 months after surgical correction. A preputium reconstruction was done in 163 patients (23 %). Of these, 31 did not have a retractable foreskin which makes the total number of evaluable patients for UC 692 cases. After photo review, initially underreported dehiscence rate was doubled from 6 to 12 %. The UC-rate is 23 % with a variation of 3-44 % between the surgeons. Multivariable analysis identified the following surgical variables associated with a lower relative risk for UC: subepithelial urethroplasty suture technique (versus transepithelial technique), the running urethroplasty suture technique (versus interrupted technique) and the use of a Ch 6 or 8 catheter during urethroplasty (versus Ch 10, 12 or 14 catheter).</p><p><strong>Discussion: </strong>Technical factors including suture technique and catheter size impact UC. Limitations include observational (non-randomized) study design, lack of glans size and urethral plate characteristics in the dataset, and single-layer (vs 2-layer) urethroplasty in 93 % patients precluding analysis of a another technical factor.</p><p><strong>Conclusion: </strong>This study identifies the following 3 different details in urethroplasty technique as relative risk factors for short term UC: the subepithelial suture technique, the running suture technique and the use of a smaller catheter are associated with a lower risk for UC compared to respective the transepithelial technique, the interrupted sutures and the use of a larger catheter. For hypospadias surgeons these associations can serve as important tools to improve their outcomes if necessary.</p>","PeriodicalId":16747,"journal":{"name":"Journal of Pediatric Urology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143663698","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":"Wanting Moore: The promise of an online repository for artificial intelligence in pediatric urology.","authors":"Jonathan S Ellison","doi":"10.1016/j.jpurol.2025.02.030","DOIUrl":"https://doi.org/10.1016/j.jpurol.2025.02.030","url":null,"abstract":"","PeriodicalId":16747,"journal":{"name":"Journal of Pediatric Urology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143663702","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":"Effects of reading augmented reality storybook versus normal storybook reading on preoperative fear and anxiety levels of children in the age group of 7-12 years: A randomized controlled trial.","authors":"Alperen Sekeler, Duygu Karaarslan, Fatima Betül Gülmez","doi":"10.1016/j.jpurol.2025.02.025","DOIUrl":"https://doi.org/10.1016/j.jpurol.2025.02.025","url":null,"abstract":"<p><strong>Aim and objectives: </strong>In the preoperative period, non-pharmacological methods such as multimedia applications and visual and audio technological tools are used to reduce children's fear and anxiety levels and to distract their attention to create a more enjoyable experience. One of these innovative technologies having attracted attention recently is augmented reality technology. The study was aimed investigating the effects of reading an augmented reality storybook on fear and anxiety levels of children in the age group of 7-12 years in the preoperative period.</p><p><strong>Methods: </strong>The sample of the study consisted of 60 children who met the inclusion criteria. Of them, 30 were in the augmented reality story group, and 30 were in the normal story group. Data were collected through the following data collection tools: 'Sociodemographic Information Form', 'Children's Anxiety Meter' and 'Child Fear Scale'. The book \"One Child, One Miracle\" was used as an intervention tool in the study. The clinical trial registration number of this randomized controlled experimental study is NCT06399016.</p><p><strong>Results: </strong>In the study, a statistically significant difference and a decrease in the pre-test and post-test fear and anxiety average scores of the children in both groups was observed. The mean fear score of the children in the Augmented reality storybook reading group decreased more than did the score of the children in the normal story reading group.</p><p><strong>Conclusions: </strong>In order to prevent preoperative fear and anxiety in children staying in pediatric surgery clinics, it is recommended to expand the use of augmented reality storybooks before surgery. Reading stories is an effective, inexpensive and non-pharmacological intervention.</p>","PeriodicalId":16747,"journal":{"name":"Journal of Pediatric Urology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143615777","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 'Wanting Moore: The promise of an online repository for artificial intelligence in pediatric urology'.","authors":"Adree Khondker, Armando J Lorenzo","doi":"10.1016/j.jpurol.2025.02.029","DOIUrl":"https://doi.org/10.1016/j.jpurol.2025.02.029","url":null,"abstract":"","PeriodicalId":16747,"journal":{"name":"Journal of Pediatric Urology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143630580","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":"Ureteric fibroepithelial polyps in children: Retrospective study and systematic review of a rare urological presentation.","authors":"Helen Buschel, Nicole Hawkins, Bhanu Mariyappa-Rathnamma, Harry Stalewski, David Winkle, Peter Borzi","doi":"10.1016/j.jpurol.2025.02.021","DOIUrl":"https://doi.org/10.1016/j.jpurol.2025.02.021","url":null,"abstract":"<p><strong>Background: </strong>Fibroepithelial polyps are rare, benign lesions of mesodermal origin that have been reported in the genitourinary, oral, auditory and respiratory systems. Ureteric fibroepithelial polyps are extremely rare, with less than 200 cases reported in children over the past 20 years. The purpose of this study is to present a retrospective study and systematic literature review of children with fibroepithelial polyps. Furthermore, to present an algorithm for the investigation and management of children with suspected ureteric, fibroepithelial polyps.</p><p><strong>Methods: </strong>A retrospective review of seven children with upper tract fibroepithelial polyps managed at two centres was conducted. A systematic review of all seven original articles reporting upper tract, fibroepithelial polyps in children was performed from January 2003 to November 2023.</p><p><strong>Results: </strong>Seven children with a median age of 12 years (range 5.5-14 years) were managed with ureteric fibroepithelial polyps. The majority were male (n = 6/7) and left sided (n = 5/6). The most common presenting features were pain and haematuria. Three out of seven children had a long history of symptoms (range two to ten years). Diagnosis was challenging with numerous imaging studies required including: ultrasound, cross sectional imaging, functional studies and operative retrograde pyelogram/ureteroscopy. The majority were managed with laparoscopic pyeloplasty (n = 6/7) with one case converted to open. The systematic literature review revealed a total of 134 children. There was a male predominance (93 %) and 84 % of polyps were left sided. Numerous operative approaches were reported. There was one case of urothelial papilloma on histology with the remainder being benign fibroepithelial polyps.</p><p><strong>Conclusions: </strong>Ureteric fibroepithelial polyps are a rare pathology typically seen in males and on the left side. Diagnosis can be challenging. Various management options have been reported depending on surgeon experience, size and location of the polyp.</p>","PeriodicalId":16747,"journal":{"name":"Journal of Pediatric Urology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143573363","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: JPUROL-D-24-00137 \"Posterior urethral valves: Examining the relationship of socioeconomic factors in disease presentation and progression\".","authors":"Christopher J Staniorski, Rajeev Chaudhry, Omar Ayyash","doi":"10.1016/j.jpurol.2025.02.027","DOIUrl":"https://doi.org/10.1016/j.jpurol.2025.02.027","url":null,"abstract":"","PeriodicalId":16747,"journal":{"name":"Journal of Pediatric Urology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143567487","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":"Posterior urethral valves: Examining the relationship of socioeconomic factors in disease presentation and progression.","authors":"Irene M McAleer","doi":"10.1016/j.jpurol.2025.02.026","DOIUrl":"https://doi.org/10.1016/j.jpurol.2025.02.026","url":null,"abstract":"","PeriodicalId":16747,"journal":{"name":"Journal of Pediatric Urology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143605265","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}