Journal of Pediatric Urology最新文献

{"title":"Pediatric urinary health and school health conditions in France: A political urgency?","authors":"Florine Cros, Clara Hirschaueur, Claire Morton-Fauche, Aude Thomet, Marion Albouy, Aurélien Binet","doi":"10.1016/j.jpurol.2025.07.024","DOIUrl":"https://doi.org/10.1016/j.jpurol.2025.07.024","url":null,"abstract":"<p><strong>Purpose: </strong>The high frequency of urinary disorders and their complications among school-aged children is common but few studies have investigated their predictors such as poor urinary hygiene habits, inappropriate use of school toilets, and deteriorated school toilets conditions. The question is whether individual factors (behaviors) conditioned by environmental factors (toilet conditions) play a role in functional urinary disorders.</p><p><strong>Materials and methods: </strong>We performed an electronic cross-sectional observational study from October 1, 2023, to March 31, 2024, in the department of Vienne (France), among children's parents. The survey tool consisted in 43 questions and collected data on in the field of urinary habits at school and children's urinary health: 19 predictors for occurrence of urinary disorders were identified by univariate logistic regression.</p><p><strong>Results: </strong>Of the 405 parents who completed the survey, 10 % indicated that their children had a urinary disorder. Inappropriate uses of toilets were found in 48 % of elementary school children and 18 % of preschoolers. Barriers to use toilets was predictor of urinary disorders (p < 0.005). Factors included the absence of door locking systems (p < 0.005), toilets not adapted to children's height (p < 0.05), insufficient toilet paper (p < 0.01), or lack of heating in the toilet block (p < 0.005).</p><p><strong>Conclusion: </strong>This study confirms the significant and major impact of school sanitary conditions on urinary disorders in preschool and elementary school-aged children, mediated by inappropriate use of toilets, highlighting the necessity for health promotion interventions.</p>","PeriodicalId":16747,"journal":{"name":"Journal of Pediatric Urology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145033549","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":"Bladder wall elasticity in neurogenic bladder: Insights from shear wave ultrasound elastography and its correlation with functional and structural parameters of upper and lower urinary tract.","authors":"Delona Treesa Joseph, Sugandha Agarwal, Manisha Jana, Jitendra Kumar Meena, Ajay Verma, Anjan Kumar Dhua, Devendra Kumar Yadav, Himalaya Kumar, Sachit Anand","doi":"10.1016/j.jpurol.2025.08.006","DOIUrl":"https://doi.org/10.1016/j.jpurol.2025.08.006","url":null,"abstract":"<p><strong>Introduction: </strong>Children with neurogenic bladder (NB) exhibit increased bladder-wall stiffness, yet non-invasive tools to quantify this remain limited. In this study, we assessed whether shear-wave elastography (SWE) distinguishes NB from healthy bladder and explored its relationship with routine upper- and lower-tract investigations.</p><p><strong>Methods: </strong>In this prospective single-centre study, children with NB and age-matched controls underwent bladder SWE. Young's modulus of elasticity (YME, kPa) was measured in the anterior bladder wall at two filling states: full bladder (100 % estimated capacity) and post-void. Median YME measurements were compared between patients and controls. Inter- and intra-group within-child change, i.e., ΔYME = (full - post-void), was calculated. Also, the YME values (at both states) were compared between binary patient sub-groups divided based on parameters of routine upper and lower urinary tract investigations including ultrasound, scintigraphy studies, micturating cystourethrogram and urodynamic study. Mixed-effects models with a random intercept for patient ID verified all comparisons while accounting for paired measurements.</p><p><strong>Results: </strong>A total of 44 patients and 42 healthy controls were enrolled in the study. Median YME was higher in NB than controls at both bladder states: full bladder: 9.95 kPa vs 7.50 kPa (p = 0.0006); and, post-void: 9.30 kPa vs 6.80 kPa (p = 0.023). The within-child change, ΔYME, was small and highly variable (median + 0.68 kPa in NB vs + 0.15 kPa in controls; p = 0.27), indicating no systematic stiffening or relaxation after voiding. Both classical statistics and mixed effects modelling showed no significant differences in YME (full-bladder or post-void state) values across NB patient sub-groups stratified by variables including hydroureteronephrosis, vesicoureteral reflux, renal scarring, reduced GFR, bladder capacity, pressure, compliance, hostility, or detrusor overactivity.</p><p><strong>Conclusion: </strong>Median YME values are higher in NB than in controls at both bladder states, yet the paired change (ΔYME) showed no meaningful inter-group or intra-group variation. Both classical statistics and mixed-effects models likewise detected no association between YME and the various clinical sub-groups. Therefore, until multicentric data confirm diagnostic thresholds, longitudinal reproducibility, and predictive value for upper-tract risk, SWE should be viewed only as a complementary research tool rather than a substitute for current gold standard investigations.</p>","PeriodicalId":16747,"journal":{"name":"Journal of Pediatric Urology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144958260","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":"Comparative analysis of semen parameters in adolescent males with and without varicocele.","authors":"Fahri Yavuz İlki, Cihat Ozcan, Alper Murat Albayrak, Yusuf Kadir Topçu, Selçuk Sarikaya, Selahattin Bedir","doi":"10.1016/j.jpurol.2025.08.007","DOIUrl":"https://doi.org/10.1016/j.jpurol.2025.08.007","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to compare semen parameters between adolescents with clinically diagnosed varicocele and healthy controls, in order to evaluate the potential impact of varicocele on spermatogenesis during adolescence.</p><p><strong>Materials and methods: </strong>Fifty-nine adolescent males were included in this cross-sectional study. Thirty participants had clinically confirmed varicocele, while 29 served as healthy controls. Semen samples were collected following a 4-day abstinence period and were analyzed for volume, concentration, total sperm count, motility, and morphology according to WHO criteria. Morphological evaluation was performed using Kruger strict criteria. Statistical comparisons between groups were conducted using the t-test or Mann-Whitney U test, depending on data distribution.</p><p><strong>Results: </strong>Semen volume, total sperm count, and Kruger morphology scores were significantly lower in the varicocele group compared to controls (p < 0.05). Although sperm concentration was lower in the varicocele group, this difference did not reach statistical significance (p = 0.0598). No significant differences were observed between groups in terms of total motility, progressive motility, or immotile sperm rate.</p><p><strong>Conclusion: </strong>Adolescent varicocele may negatively affect key semen quality parameters, particularly sperm morphology and total sperm output. These findings support the importance of regular semen analysis and close monitoring in adolescents with varicocele, especially in those presenting with abnormal parameters.</p>","PeriodicalId":16747,"journal":{"name":"Journal of Pediatric Urology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144958277","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":"Comparative study of open and robot-assisted approaches to ureteropelvic junction obstruction in children ≤ 12 months: A multi-institutional retrospective analysis.","authors":"Suhaib Abdulfattah, Aznive Aghababian, Sahar Eftekharzadeh, Meghan Davis, Iqra Nadeem, Sonam Saxena, Nicole J Kye, John Weaver, Hannah Bachtel, Catherine T Nguyen, Elizabeth Khusid, Christina Sze, Tenny Zhang, Kiersten Craig, Monica Xing, Katherine Fischer, Karl Godlewski, Shuvro De, Ricardo Arceo-Olaiz, Christopher Long, Dana Weiss, Chester J Koh, Ardavan Akhavan, Mohan Gundeti, Andrew J Kirsch, Arun K Srinivasan, Aseem R Shukla, Sameer Mittal","doi":"10.1016/j.jpurol.2025.08.002","DOIUrl":"https://doi.org/10.1016/j.jpurol.2025.08.002","url":null,"abstract":"<p><strong>Background: </strong>The utilization of robot-assisted laparoscopic pyeloplasty (RALP) for the surgical correction of ureteropelvic junction obstruction (UPJO) continues to increase. The aim of this study was to determine whether robot-assisted laparoscopic pyeloplasty (RALP) is a safe and equally efficacious procedure compared to open pyeloplasty (OP) in infants ≤12 months old.</p><p><strong>Methods: </strong>All patients ≤12 months old who underwent RALP or OP between January 2012 and January 2021 at five participating centers were included in this study. Patients who had pure laparoscopic approach, redo-pyeloplasty, ureterocalicostomy, abnormal nephro-ureteral anomalies, or lacked reviewable surgical records were excluded. Success was defined as lack of advanced endoscopic or re-do reconstructive intervention.</p><p><strong>Results: </strong>448 out of 497 patients met inclusion criteria: 151 RALP (34 %) and 297 OP (66 %). The median age at surgery was similar for both cohorts (p = 0.29). RALP compared to OP was associated with a higher usage of ureteral stent placement (100 % vs 88.9 %; p < 0.001) and longer procedure time (175 vs 160 min; p = 0.01), less administration of hospital morphine-equivalents post-operatively (p < 0.001) and similar length of stay (p = 0.96). There was no difference in the incidence of 30-day complications between the two groups, however higher-grade complications were seen in the OP group. Over a median follow of 26 months, the success rate after RALP and OP was 98.7 % and 89.6 % respectively (p < 0.001).</p><p><strong>Conclusion: </strong>In this large, multi-institutional comparative series of infant pyeloplasty, our results demonstrate that RALP is not only safe and feasible, but also confers the advantages of reduced opioid usage, decreased risk of high-grade complications and decreased need for additional interventions during follow-up.</p>","PeriodicalId":16747,"journal":{"name":"Journal of Pediatric Urology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144958239","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":"Comparing bladder bowel dysfunction (BBD) in children with attention deficit hyperactivity disorder (ADHD) with or without ADHD medical therapy and their initial response to BBD treatment.","authors":"Amy A Huang, Christopher S Cooper, Laura L Fuller, Jude Shelton, Hanh T D Pham, Gina M Lockwood, Douglas W Storm, Angelena B Edwards","doi":"10.1016/j.jpurol.2025.08.005","DOIUrl":"10.1016/j.jpurol.2025.08.005","url":null,"abstract":"<p><strong>Introduction: </strong>Children with attention deficit hyperactivity disorder (ADHD) are 4.5x more likely to have incontinence than their peers. Previous studies on comorbid ADHD and bladder bowel dysfunction (BBD) only included children with ADHD taking stimulant medications.</p><p><strong>Objective: </strong>Comparing response to BBD treatment between patients with ADHD taking and not taking ADHD medications.</p><p><strong>Study design: </strong>We reviewed urology patients 5-18 years of age seen between 1/1/2015 and 12/30/2022. Inclusion criteria included: BBD diagnosis, formal psychological diagnosis of ADHD and completion of our clinic's pediatric BBD questionnaire. BBD treatments included urotherapy behavioral modifications, bowel medications, and anticholinergic medications. An age-matched control cohort with BBD without ADHD served as a baseline reference of BBD. A linear mixed model compared BBD score trends between children with BBD with and without ADHD and between children taking and not taking ADHD medications.</p><p><strong>Results: </strong>Patients with ADHD and BBD (n = 122) had higher baseline BBD scores on average than controls with BBD (n = 300), 8.86 and 11.68 points for those taking and not taking ADHD medication, respectively (p < 0.001). At the final visit, the ADHD cohort had significantly higher final BBD scores, 23.46, when compared to controls, 18.16 (p < 0.001). In the \"urotherapy-only\" group, patients not taking ADHD medication had 13.40-point higher baseline BBD score than those taking ADHD medications (p = 0.005). In the \"urotherapy & bowel medication\" and \"urotherapy, bowel, & anticholinergic medication\" groups, patients not taking ADHD medication had similar rates of improvement and BBD scores at baseline and the first follow-up visit to patients taking ADHD medication. The rate of improvement between patients taking and not taking ADHD medication was significantly different in the urotherapy-only group.</p><p><strong>Discussion: </strong>Children with comorbid ADHD, regardless of ADHD medical therapy, have more severe BBD than their peers with BBD alone. Patients not taking ADHD medications improved with BBD treatment. However, ADHD medical therapy status may affect BBD management in children only performing behavioral modifications such as timed voiding or potty watch utilization.</p><p><strong>Conclusion: </strong>Children with BBD and ADHD had more severe BBD scores than peers with BBD only. In the ADHD population, the children not taking ADHD medication had more severe baseline BBD than those taking ADHD medication within the group receiving urotherapy alone but demonstrated improvement in their BBD symptoms. Children with ADHD, regardless of ADHD medication status, were similar in their baseline and first follow-up visit BBD scores and rates of improvement when bowel and/or anticholinergic medications were added to urotherapy.</p>","PeriodicalId":16747,"journal":{"name":"Journal of Pediatric Urology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12416904/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144958349","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Flank position laparoscopic orchiopexy with colon medialization versus conventional laparoscopic orchiopexy for intra-abdominal testis: A randomized controlled trial.","authors":"Seyyed Mohammad Ghahestani, Amirali Ahrabi, Ali Hosseini, Sepideh Poshtdar, Hossein Amirzargar, Seyed Reza Hosseini","doi":"10.1016/j.jpurol.2025.08.001","DOIUrl":"https://doi.org/10.1016/j.jpurol.2025.08.001","url":null,"abstract":"<p><strong>Introduction and objective: </strong>The surgical management of intra-abdominal testis (IAT) remains a topic of debate. The primary challenges in different orchiopexy methods are short testicular vessels and peritoneal adhesions of IATs. This study aims to evaluate flank position laparoscopic orchiopexy (FPLO) with colon medialization as a novel surgical method for managing IATs, in comparison with the conventional supine position laparoscopic orchiopexy (SPLO).</p><p><strong>Patients and methods: </strong>This study was a single-blind randomized parallel clinical trial. The inclusion criteria were non-palpable testes assigned to the laparoscopic approach and peeping testes requiring orchiopexy. Exclusion criteria were patients above the age of 15 years, bilateral IAT, palpable testes in the inguinal canal and scrotum, blind end vessel or vanished testis. FPLO was performed with the patient in the flank position, involving either segmental or complete release of the mesocolon attachment from the testis. The conventional method (SPLO) involved positioning the patient in the supine position and preserving testicular vasculature without additional release of the mesocolon attachment. The primary outcomes, the final position of the testis and atrophy rates, were compared between the two groups. The secondary outcomes, including surgery time, length of hospital stay, and complication rates, were also evaluated.</p><p><strong>Result: </strong>Fifty-two pediatric patients with unilateral IAT were allocated into two groups: FPLO (n = 26) and SPLO (n = 26). There were no significant differences between the FPLO and SPLO groups regarding age, prematurity, and distance of the testis from the ipsilateral internal ring. The overall success rate, defined as the final position of the testis in the scrotum at 12 months, was 96.2 % for FPLO and 73.1 % for SPLO (relative risk: 1.32, 95 % CI: 1.03-1.68, p = 0.05). No atrophy or complications were seen in either group. In logistic regression, FPLO resulted in significantly better bottom positioning of the testis in the scrotum compared to SPLO (OR: 5.91, 95 % CI: 1.51-23.06, p = 0.011), independent of the initial distance of the testis to the internal ring and the patient's age. In subgroup analysis, patients in the FPLO method requiring segmental colon medialization had significantly lower age, shorter initial testis-ipsilateral internal ring distance, shorter surgery duration, and higher bottom positioning rates than those who underwent complete colon medialization.</p><p><strong>Conclusion: </strong>FPLO demonstrates promising results in positioning the testis within the scrotum, particularly achieving optimal bottom positioning compared to the conventional SPLO method. Further studies with larger sample sizes are required to compare FPLO with other orchiopexy techniques for managing IATs.</p><p><strong>Trial registration: </strong>This study was registered in the Iranian Registry of Clinical Trials (I","PeriodicalId":16747,"journal":{"name":"Journal of Pediatric Urology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144958291","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 challenge of third and subsequents kidney transplantion in children.","authors":"Romy Gander, José Andrés Molino, Gloria Fatou Royo, Gema Ariceta, Marino Asensio","doi":"10.1016/j.jpurol.2025.08.004","DOIUrl":"https://doi.org/10.1016/j.jpurol.2025.08.004","url":null,"abstract":"<p><strong>Introduction: </strong>Third and subsequent kidney transplants (TASKT) remain a surgical and immunological challenge, allegedly associated to a higher incidence of surgical complications and graft loss. Although the improved survival of pediatric transplant recipients has led to an increasing number of potential candidates for TASKT, reports regarding TASKT in children are practically non-existent.</p><p><strong>Objective: </strong>The aim of this study was to describe the outcomes of pediatric TASKT in our program.</p><p><strong>Patients and methods: </strong>Retrospective study of TASKT in pediatric patients undertaken between January 2000-December 2024. Primary etiology of renal disease, cause of initial graft failure, history of acute rejection, surgical technique, surgical complications, and outcomes are reported.</p><p><strong>Results: </strong>Among 296 kTs, 21 corresponded to TASKT. In one patient a simultaneous liver transplant was performed. Mean recipients age at TASKT was 17.50 years (SD:5.80) and mean weight 46.5 kg (SD:11.8). The most frequent primary renal disease was congenital nephrotic syndrome in 7 (33.3 %). Sixteen patients (76.1 %) received a third KT, 4 (19.04 %) a fourth, and 1(4.7 %) a fifth graft. The approach was extraperitoneal in 14 (66.6 %) and intraperitoneal in the remaining 7 (33.3 %). Three of those intraperitoneal grafts were hockey stick incisions in the flank secondarily converted to an intraperitoneal approach. We registered postoperative complications in 8 (38.09 %): hemorrhage (3), urinary leak (2), Page's kidney (1) and eventration of the surgical wound (2). There were no graft vascular complications in any case. With a mean follow-up of 11 years (SD: 14.14), graft survival was 90 %, 85 % and 79 % at 1,3 and 5 years, respectively. Patient survival was 100 % at 1, 3, and 5 years, respectively.</p><p><strong>Discussion: </strong>Our pediatric KT program results support retransplantation in this high-risk pediatric population based on careful individual pretransplantation evaluation and planning, personalized surgical procedure and team expertise.</p><p><strong>Conclusions: </strong>In our experience TASKT constitutes a medical and surgical challenge but can be associated with good outcomes and an acceptable rate of complications in expert centers. Preoperative multidisciplinary patient risk evaluation, meticulous surgical planning and careful vessel manipulation can prevent vascular complications. The extraperitoneal approach, even in previously occupied iliac fossae, is achievable and reduces the risk of intraperitoneal complications.</p>","PeriodicalId":16747,"journal":{"name":"Journal of Pediatric Urology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144958329","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 outcomes and risk factors for complications following pediatric neurogenic bladder reconstruction: A secondary analysis of the pediatric NSQIP database (2015-2020).","authors":"Mohamed Aly, Claire A Wilson, Jacob Davidson, Danny Matti, Peter Wang, Sumit Dave","doi":"10.1016/j.jpurol.2025.07.030","DOIUrl":"10.1016/j.jpurol.2025.07.030","url":null,"abstract":"<p><strong>Introduction: </strong>Surgical management of pediatric neurogenic bladder (NB) and bowel aims to achieve safe filling pressures and achieve dryness, simultaneously allowing independence to manage voiding functions. The surgical armamentarium includes; augmentation cystoplasty (AC), bladder neck reconstruction (BNR), Mitrofanoff procedure (MP) and cecostomy (MACE). Often, patients undergo these procedures concomitantly, based on urodynamic and clinical findings.</p><p><strong>Objective: </strong>This study aims to determine the 30-day outcomes of pediatric NB reconstructive surgery, and identify independent risk factors for an early adverse outcome.</p><p><strong>Study design: </strong>This study is a secondary analysis of prospectively collected data from the National Surgical Quality Improvement Program (NSQIP) Pediatric database between 2015 and 2020. Patients <18 years of age with an International Classification of Disease, Ninth and Tenth Revision (ICD-9/10) diagnosis of Spina Bifida (SB) undergoing a urological reconstruction defined with specific Current Procedural Terminology (CPT) codes were included. Patient demographics, perioperative variables, operative timing, length of stay, 30-day readmission/reoperation data and surgical complications were assessed. Patients were categorized into four surgical groups: 1: MP only; 2: isolated BNR; 3: AC ± MP; 4: AC + BNR + MP ± MACE. A multivariable logistic regression analysis was conducted to identify risk factors for 30-day readmission and re-operation using age, body mass index (BMI), operative time and surgical groups as independent variables.</p><p><strong>Results: </strong>We identified a cohort of 700 patient encounters involving at least one of these procedures, with a median age at surgery of 10.3 years (Interquartile Range [IQR] 6.6-13.6). The majority were females (58.3 %) and 53.6 % had a normal BMI, 18.3 % were overweight and 28.1 % were obese. The overall early complication rate ranged from 14.8 % to 27.2 %, with a 15.1 % readmission rate and reoperation rate was 7.9 % following pediatric NB reconstruction. Multivariable logistic regression analysis indicated that those in surgical group 4 were 2.78 times (95 % CI-1.03 - 7.49) more likely for 30-day readmission, compared to Group 1 (p = .04). Multivariable analysis revealed no significant predictors of 30-day reoperation.</p><p><strong>Discussion: </strong>Age at surgery, BMI and operative time do not predict the risk of surgical complications following NB reconstruction. We validated that increasing procedure count was associated with increased risk of 30-day readmission.</p><p><strong>Conclusion: </strong>Increasing the number of surgical interventions for NB reconstruction is associated with higher 30-day readmission rates, while increasing age at surgery and BMI did not predict readmission or reoperation. The results of this study are generalizable, given the cohort, and can help pediatric urologists prognosticate ear","PeriodicalId":16747,"journal":{"name":"Journal of Pediatric Urology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144883070","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":"Minimally invasive approach to retroperitoneal lymph node dissection in pediatric paratesticular rhabdomyosarcoma: A multi-institutional case series.","authors":"Suhaib Abdulfattah, Julia M Morales, Kayla Meyer, Kathryn Doherty, Yashaswi Parikh, Nicole J Kye, Nora H Broadwell, Raymond Yong, Sameer Mittal, Chester J Koh, Arun K Srinivasan","doi":"10.1016/j.jpurol.2025.08.003","DOIUrl":"10.1016/j.jpurol.2025.08.003","url":null,"abstract":"<p><strong>Introduction: </strong>Retroperitoneal lymph node dissection (RPLND) is a critical surgical procedure for staging and managing paratesticular rhabdomyosarcoma (RMS) in pediatric patients. While minimally invasive surgical (MIS) approaches, including laparoscopic (LP) and robot-assisted (RA) techniques, are well-documented in adult populations, their utilization in pediatric patients remains limited. This multi-institutional study evaluates perioperative and long-term outcomes of MIS RPLND compared to open RPLND in children with PT-RMS.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on pediatric patients who underwent RPLND for paratesticular RMS between 2012 and 2024. Data collected included demographics, tumor characteristics, neoadjuvant chemotherapy, operative details, and postoperative outcomes. Descriptive statistics were used to analyze the data.</p><p><strong>Results: </strong>A total of 16 patients were included in our study (8 MIS and 8 open). The median age of MIS patients was significantly younger (12.6 vs. 15 years, p = 0.03). MIS cases demonstrated shorter operative times (median 436 vs. 590 min, p = 0.03), lower estimated blood loss (35 vs. 200 mL, p = 0.03), and shorter hospital stays (2.5 vs. 6 days, p = 0.01). Lymph node yield was lower in the MIS group (median 13 vs. 26, p = 0.46), but within the COG-recommended range. Both groups had three patients with positive lymph nodes and comparable complication rates. No recurrences were observed in the MIS group over a significantly longer median follow-up period (71.5 vs. 19 months, p = 0.05). Two patients in the open group experienced relapse, including one mortality.</p><p><strong>Conclusion: </strong>MIS RPLND is a safe and effective surgical option for managing paratesticular RMS in pediatric patients. Wider adoption and further research with larger cohorts are necessary to validate these findings and optimize surgical techniques.</p>","PeriodicalId":16747,"journal":{"name":"Journal of Pediatric Urology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144883071","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":"Staged tubularized preputial graft in proximal hypospadias, are we in the right direction?","authors":"Amr K Salama, Waleed Dawood, Ahmed Gaawan, Ahmed Fahmy, Mohamed Youssif, Samir Orabi, Haytham Badawy","doi":"10.1016/j.jpurol.2025.07.028","DOIUrl":"https://doi.org/10.1016/j.jpurol.2025.07.028","url":null,"abstract":"<p><strong>Background: </strong>Hypospadias is one of the most common congenital defects of male external genitalia. Correction of severe ventral curvature remains a main challenge to surgeons. The aim of this work was to assess short term outcomes of the staged tubularized preputial graft in primary proximal hypospadias with severe ventral curvature in our center with the hypothesis that it's comparable to published results in the two stage repair technique.</p><p><strong>Methods: </strong>A retrospective analysis of prospectively collected data that included 40 children was done, who had primary proximal hypospadias with moderate to severe ventral curvature (Study period started in December 2019 till January 2023). All patients had undergone staged tubularized preputial graft repair. Complication rates were evaluated. Cosmetic and functional outcomes were assessed using HOSE score.</p><p><strong>Results: </strong>Forty patients aged from 6 months to 8 years had proximal hypospadias with ventral curvature with a mean ventral curvature 56.13 ± 18.96° after complete penile degloving. At the second stage all grafts were taken except in two patients. Following the first stage, 4 patients only had mild residual curvature that were corrected in the second stage. Over a median (IQR) follow up of 2.9 (1.2-4.0) years after second stage, 5 patients (13.1 %) had glans dehiscence, 6 patients (15.8 %) had urethro-cutaneous fistula, 4 patients had meatal stenosis (8 %), and two patients had neourethral stricture (5.3 %). Twenty-one patients had HOSE score 15 out 16 and others had score ranged from 12 to 14.</p><p><strong>Conclusion: </strong>Repair of proximal hypospadias with severe curvature remains a challenge to paediatric urologists. A two-stage hypospadias repair with preputial grafting has achieved comparable success to other techniques. Complications (specifically glanular dehiscence and fistulas) should be explained thoroughly to the parents/caregivers which might need additional surgeries to correct it in the future.</p>","PeriodicalId":16747,"journal":{"name":"Journal of Pediatric Urology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145000865","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}