Journal of Pediatric Urology最新文献

{"title":"Upper tract dilation is an independent risk factor for febrile UTI in children with primary vesicoureteral reflux","authors":"Sikai Song,&nbsp;Kai Wen Cheng,&nbsp;Ala'a Farkouh,&nbsp;Jason Carlson,&nbsp;Cayde Ritchie,&nbsp;Ruby Kuang,&nbsp;Daniel Wilkinson,&nbsp;Matthew Buell,&nbsp;Joshua Pearce,&nbsp;Levi Miles,&nbsp;Jocelyn Huang,&nbsp;David A. Chamberlin,&nbsp;Joshua D. Chamberlin","doi":"10.1016/j.jpurol.2024.10.007","DOIUrl":"10.1016/j.jpurol.2024.10.007","url":null,"abstract":"<div><h3>Background</h3><div>Children with vesicoureteral reflux (VUR), particularly high-grade VUR, are known to be at increased risk for urinary tract infection (UTI). Current guidelines highlight certain clinical factors in the management of children with VUR; however, the clinical utility of upper tract dilation in the setting of VUR remains unclear.</div></div><div><h3>Objective</h3><div>The purpose of this study is to evaluate risk factors for febrile UTI (fUTI) in children with primary VUR in a modern cohort with emphasis on upper tract dilation parameters, including hydronephrosis and hydroureter.</div></div><div><h3>Methods</h3><div>A prospectively maintained database of children with VUR at a single academic institution from July 2013 to February 2023 was reviewed. Demographic and clinical data were included. Ultrasounds closest to initial VCUG were reviewed for upper tract dilation, including the presence of hydronephrosis, Society of Fetal Urology (SFU) hydronephrosis grade, presence of hydroureter, and anterior-posterior renal pelvic diameter (APRPD). The primary outcome of interest was the development of a fUTI after VUR diagnosis. Patients were censored after their first fUTI or after VUR surgery.</div></div><div><h3>Results</h3><div>A total of 235 children with primary VUR were evaluated, including 125 (53.2 %) females and 110 (46.8 %) males. The median age of VUR diagnosis was 10.8 months (IQR: 2.3–63.6 months). A total of 41 (17.4 %) children developed a fUTI after VUR diagnosis with a median follow up of 2.3 years (IQR: 0.9–4.6 years). On univariate analysis, variables found to be associated with fUTI included age &lt;1 year at VUR diagnosis (p = 0.021), female sex (p = 0.013), high-grade VUR (p = 0.024), APRPD ≥7 mm (p = 0.007), high-grade hydronephrosis (p = 0.004), presence of hydronephrosis (p = 0.029), and hydroureter (p = 0.008). In children with VUR and high-grade hydronephrosis, a larger APRPD was associated with higher fUTI rates (p = 0.008). On multivariate analysis controlling for age, sex, and VUR grade, APRPD ≥7 mm (OR 2.8, p = 0.009), high-grade hydronephrosis (OR 2.5, p = 0.025), and presence of hydronephrosis (OR 2.3, p = 0.049) were independent risk factors for fUTI. On multivariate models controlling for other upper tract dilation parameters, APRPD ≥7 mm was the most significant parameter associated with increased fUTI risk in primary VUR.</div></div><div><h3>Conclusion</h3><div>Upper tract dilation is a novel, independent risk factor for fUTI in children with primary VUR, with APRPD being the strongest predictor. Clinicians may consider upper tract dilation parameters in addition to age, sex, and VUR grade when individualizing care in children with primary VUR.</div></div>","PeriodicalId":16747,"journal":{"name":"Journal of Pediatric Urology","volume":"21 1","pages":"Pages 197-203"},"PeriodicalIF":2.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142590704","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":"Histologic analysis of gonadal tissue in patients with Turner syndrome and Y chromosome material (Response to commentary)","authors":"Julia Bhuiyan,&nbsp;Raghuveer Kavarthapu,&nbsp;Mary Soliman,&nbsp;G Thomas Brown,&nbsp;Jacqueline C. Yano,&nbsp;Tazim Dowlut-McElroy,&nbsp;Veronica Gomez-Lobo","doi":"10.1016/j.jpurol.2024.08.016","DOIUrl":"10.1016/j.jpurol.2024.08.016","url":null,"abstract":"","PeriodicalId":16747,"journal":{"name":"Journal of Pediatric Urology","volume":"21 1","pages":"Pages 226-227"},"PeriodicalIF":2.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142267639","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: “Urologist burnout: Prevalence, impact, and strategies for resilience”","authors":"Emily Reeson,&nbsp;Daniel Salevitz,&nbsp;Gwen M. Grimsby","doi":"10.1016/j.jpurol.2024.10.004","DOIUrl":"10.1016/j.jpurol.2024.10.004","url":null,"abstract":"","PeriodicalId":16747,"journal":{"name":"Journal of Pediatric Urology","volume":"21 1","pages":"Pages 237-238"},"PeriodicalIF":2.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142468279","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":"Innovative use of physical therapy for pediatric bowel and bladder dysfunction: Not just biofeedback!","authors":"Mary Noreen Cheng,&nbsp;Bridget Ugaste,&nbsp;Earl Y. Cheng","doi":"10.1016/j.jpurol.2024.10.008","DOIUrl":"10.1016/j.jpurol.2024.10.008","url":null,"abstract":"<div><div>Biofeedback has been shown to be an effective tool in the treatment of pelvic floor dysfunction in patients with bowel and bladder dysfunction, and commonly, biofeedback is provided within a physical therapy plan of care. In building a pelvic floor physical therapy program at our institution, we have found that physical therapy extends beyond biofeedback. Our preliminary experience demonstrates that patients experience more rapid symptomatic improvement when biofeedback is combined with additional therapy to address abnormal core and respiratory function.</div></div>","PeriodicalId":16747,"journal":{"name":"Journal of Pediatric Urology","volume":"21 1","pages":"Pages 215-216"},"PeriodicalIF":2.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142502577","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":"Suprapubic vesicostomy buttons: Indications, complications and bladder outcomes","authors":"Roma Subhash Varik ,&nbsp;Niamh Geoghegan ,&nbsp;Diane De Caluwe ,&nbsp;Nishat Rahman ,&nbsp;Marie-Klaire Farrugia","doi":"10.1016/j.jpurol.2024.10.025","DOIUrl":"10.1016/j.jpurol.2024.10.025","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Introduction&lt;/h3&gt;&lt;div&gt;Vesicostomy button drainage is a recognised alternative to clean intermittent catheterization (CIC) in children with urethral obstruction, sensate urethra or neurological/behavioural issues.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Aim&lt;/h3&gt;&lt;div&gt;To report the indications, complications and long-term bladder functional outcomes in a 15-year cohort of patients with button vesicostomy.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Materials and methods&lt;/h3&gt;&lt;div&gt;AMT Mini one gastrostomy button&lt;sup&gt;R&lt;/sup&gt; was inserted via a surgical vesicostomy, or percutaneously under cystoscopic guidance. Retrospective data included demographics, indications, complications, and long-term bladder capacity/emptying pre-post-button removal.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;29 children (23 males) underwent vesicostomy button insertion at 3.5 (0.5–14.5) years. Diagnosis was neurogenic (11), bladder outlet obstruction (9), cloaca/urogenital sinus (3), anorectal malformation (ARM) (2), other bladder dysfunction (3) and diversion (1). There were no short-term complications. UTI occurred in 31 %, leakage in 28 % and blockage in 7 %. At a median of 10 (2–18) years, 14 (48 %) are still on button drainage; 6 (21 %) progressed to Mitrofanoff catheterisation. In 9 (31 %) who no longer require the button, all children were able to void urethrally, with good emptying, at 4.5 (1–7) years follow-up.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Discussion&lt;/h3&gt;&lt;div&gt;Continent vesicostomy allows toilet-training and improved quality of life. We estimated that the cost of a button vesicostomy and tubing approximates £1502 per year. 5–6 Speedicaths per day (costing £38 per pack) cost £2772 per year. Asymptomatic bacterial colonisation does not require antibiotic treatment; it is best avoided by changing the button every 12 weeks. Symptomatic febrile UTI's are commonly secondary to the underlying pathology; we recommend changing the button half-way through the antibiotic treatment course. Leakage was managed by increasing the water in the balloon. Button blockage, commonly due to balloon encrustation, is preventable by regular button changes.&lt;/div&gt;&lt;div&gt;Button drainage may be temporary (until bladder dysfunction resolves, or changed to a Mitrofanoff), or a long-term (in life-long neuro-developmental/behavioural issues). The button was no longer required in 9: bladder function improved post spinal cord un-tethering in 3; 2 PUV; 2 ARM; 1 myopathy and 1 diversion. Of note, the button did not appear to affect bladder dynamics with sustained resolution of bladder dysfunction in 31 %.&lt;/div&gt;&lt;div&gt;Our main limitation was diversity of pathologies, making comparison of urodynamics more challenging: a larger study with more numbers in each patient group would be the next step.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;Suprapubic buttons are a safe second-line bladder drainage option in patients who are unable to CIC. The technique may be a temporary solution where bladder dysfunction may resolve, or until the child is ready for catheterisatio","PeriodicalId":16747,"journal":{"name":"Journal of Pediatric Urology","volume":"21 1","pages":"Pages 101-107"},"PeriodicalIF":2.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142621900","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":"Comment on “Foreskin neurovascular structure: A histological analysis comparing 0–3 years and 6–11 years children”","authors":"Ahmet Emin Dogan","doi":"10.1016/j.jpurol.2024.10.029","DOIUrl":"10.1016/j.jpurol.2024.10.029","url":null,"abstract":"","PeriodicalId":16747,"journal":{"name":"Journal of Pediatric Urology","volume":"21 1","pages":"Page 233"},"PeriodicalIF":2.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142676136","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":"Effect of enhanced recovery after surgery on postoperative outcomes in children undergoing robot-assisted laparoscopic pyeloplasty","authors":"Jun Pei ,&nbsp;Shili Wang ,&nbsp;Xingyu Pan ,&nbsp;Moudong Wu ,&nbsp;Xiong Zhan ,&nbsp;Kaiyun Fang ,&nbsp;Dan Wang ,&nbsp;Wei Wang ,&nbsp;Guohua Zhu ,&nbsp;Hongyu Tang ,&nbsp;Nini An ,&nbsp;Jinpu Peng","doi":"10.1016/j.jpurol.2024.09.019","DOIUrl":"10.1016/j.jpurol.2024.09.019","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Objective&lt;/h3&gt;&lt;div&gt;To assess the effects of the enhanced recovery after surgery (ERAS) perioperative protocol on the outcomes of robot-assisted laparoscopic pyeloplasty (RALP) in pediatric patients.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;A total of 57 children who underwent RALP at our center between November 2021 and December 2023 were included in the study. They were randomly assigned to either the ERAS (intervention) group or the non-ERAS (control) group. The analysis focused on comparing the length of hospital stay, recovery of gastrointestinal function, incidence of complications within 90 days post-surgery, postoperative extubation time (urinary tube and double-J tube), postoperative auxiliary examinations, and readmission rates within 30 days. Additionally, the patients were divided into two age groups: &lt;4 years old and ≥4 years old, to assess pain severity.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;There were no significant differences in preoperative general information, preoperative auxiliary examination findings, or intraoperative conditions between the ERAS and non-ERAS groups. The ERAS group had a significantly shorter postoperative hospital stay compared to the non-ERAS group. Furthermore, the time to the first postoperative bowel movement was shorter, and the incidence of postoperative complications was significantly lower in the ERAS group. Among children &lt;4 years old, there was no significant difference in pain severity between the two groups. However, in children ≥4 years old, the ERAS group experienced significantly lower pain levels at 6 and 24 h post-surgery compared to the non-ERAS group.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Discussion&lt;/h3&gt;&lt;div&gt;The findings of this prospective randomized controlled trial should determine if ERAS is superior to traditional perioperative management in children undergoing RALP, particularly regarding postoperative hospital stay, intestinal function recovery, pain response, and complication rates. We anticipate that our data will offer valuable clinical insights and guidance for the implementation of ERAS in pediatric robotic surgery for urinary diseases.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;The ERAS protocol can reduce the length of hospital stay, aid in the recovery of gastrointestinal function, and lower postoperative complication rates. It also has the potential to lessen postoperative pain to varying degrees in certain pediatric patients. ERAS is a safe and effective protocol for pediatric patients undergoing RALP.&lt;span&gt;&lt;div&gt;&lt;span&gt;&lt;span&gt;&lt;p&gt;&lt;span&gt;Summary Table&lt;/span&gt;. &lt;!--&gt;Postoperative hospital stay and gastrointestinal function recovery of the two groups.&lt;/p&gt;&lt;/span&gt;&lt;/span&gt;&lt;div&gt;&lt;table&gt;&lt;thead&gt;&lt;tr&gt;&lt;th&gt;Postoperative condition&lt;/th&gt;&lt;th&gt;ERAS (n = 30)&lt;/th&gt;&lt;th&gt;non-ERAS (n = 27)&lt;/th&gt;&lt;th&gt;&lt;em&gt;P&lt;/em&gt; Value&lt;/th&gt;&lt;/tr&gt;&lt;/thead&gt;&lt;tbody&gt;&lt;tr&gt;&lt;td&gt;Length of hospital stay (d)&lt;/td&gt;&lt;td&gt;2.0 (2.0–3.0)&lt;/td&gt;&lt;td&gt;3.0 (3.0–6.0)&lt;/td&gt;&lt;td&gt;＜&lt;strong&gt;0.001&lt;/strong&gt;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td&gt;Time of first flatus (h)&lt;/td&gt;&lt;td&gt;18.0 (10.5–24.0)&lt;/t","PeriodicalId":16747,"journal":{"name":"Journal of Pediatric Urology","volume":"21 1","pages":"Pages 181-190"},"PeriodicalIF":2.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142400554","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 mediating effects of parental hope and psychological resilience on social support and decision conflict in children with hypospadias","authors":"BoXin Liu ,&nbsp;SuFang Li ,&nbsp;YaNan Xu ,&nbsp;Shanshan Ding ,&nbsp;Pei Ning","doi":"10.1016/j.jpurol.2024.09.026","DOIUrl":"10.1016/j.jpurol.2024.09.026","url":null,"abstract":"<div><h3>Introduction</h3><div>The most common congenital genital abnormality of the urinary system in infants is hypospadias; its frequency is rising to 0.33 percent globally. Surgical reconstruction is the most effective treatment for hypospadias.Parents, as surrogate decision-makers for children, frequently experience decision-making conflicts when making decisions. Stress is neither a straightforward stimulus nor a simple response. However, a stressor (stimulus) caused by life events and influenced by numerous intermediate factors including personality, social support, and psychosomatic symptoms or diseases is a multi-factor process of stress response (response). The surgical decision conflict of parents of children with hypospadias is a type of stress response, and social support may have an effect on parents' hope, psychological resilience, and decision conflict, with hope and psychological resilience serving as mediators between social support and decision conflict.</div></div><div><h3>Aim</h3><div>To investigate the structural relationship between parental social support, hope, psychological resilience, and parents decision conflict in children with hypospadias.</div></div><div><h3>Study design</h3><div>A cross-sectional design was used to collect the data of 210 parents of children with hypospadias from Department of Urology, Shenzhen Children's Hospital from April 2022 to March 2023.</div></div><div><h3>Results</h3><div>Social support indirectly affects decision conflict through hope and psychological resilience, with a total indrect effect of -0.511 (P &lt; 0.05).</div></div><div><h3>Discussion</h3><div>Decision conflicts and regret can be reduced if medical professionals provide adequate and clear information, decision assistance, and meet support requirements during the decision-making process. Improving the level of psychological resilience, hope, and social support among parents of children with hypospadias is a crucial strategy for reducing the level of decision conflict they experience. In the process of making surgical decisions for children with hypospadias, the more sufficient social support from relatives, friends, and medical staff can stimulate their hope, boost their belief in the success of surgery, and the greater their psychological resilience, the more effectively decision conflict can be reduced. Some potential limitations of this study should be considered. Firstly, this study was a cross-sectional survey design. It may have some limitations in providing causal relationships between selected variables. Second, the survey investigated only one hospital, which reduces the generalizability of the findings.</div></div><div><h3>Conclusion</h3><div>The data support the proposed model and confirm the structural relationship among the four study variables. This study provides new information on the mediating role of hope and psychological resilience between social support and decision-making conflict.</div></div>","PeriodicalId":16747,"journal":{"name":"Journal of Pediatric Urology","volume":"21 1","pages":"Pages 154-159"},"PeriodicalIF":2.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142468282","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":"OnabotulinumA toxin injections: A novel option for management of refractory nocturnal enuresis","authors":"Tyler L. Overholt ,&nbsp;Davis M. Temple ,&nbsp;Adam B. Cohen ,&nbsp;Anthony Atala ,&nbsp;Marc A. Colaco ,&nbsp;Steve J. Hodges","doi":"10.1016/j.jpurol.2024.10.010","DOIUrl":"10.1016/j.jpurol.2024.10.010","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Introduction&lt;/h3&gt;&lt;div&gt;While not entirely understood, nocturnal enuresis (NE) has been considered pathophysiologically distinct from other non-neurogenic voiding disorders. We believe that a significant component of the pathology is due to bladder overactivity. Intravesical Onabotulinumtoxin A (OBTA) injections are utilized in overactive bladder management. We hypothesized that OBTA injections would be efficacious for NE management in pediatric patients with symptoms refractory to conventional therapies.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Materials and methods&lt;/h3&gt;&lt;div&gt;A retrospective cohort analysis of patients &lt;18-years-old with primary NE who underwent OBTA injections was performed. Injections were performed by a single surgeon at a single tertiary referral center per standardized protocol. Treatment response was defined as no improvement, greater than 50 % improvement in nightly accidents, or complete resolution of accidents. The primary outcome was treatment success, defined as greater than 50 % improvement in nightly accidents or complete resolution. Secondary outcomes included treatment response duration and complication data. Descriptive and bivariate statistics were performed as indicated. A Kaplan Meier analysis was performed to assess failure free survival following OBTA injection.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Fifty patients met inclusion criteria for this analysis. All patients had trialed at least one lifestyle modification, a bowel regimen, and at least two medications with symptom persistence. The median post-procedure follow-up time was 9.5 months (range 2–82). Improvement in incontinence symptoms compared to pre-operative baseline was seen in 94.0 % of patients, with 58.0 % demonstrating complete resolution of incontinence through most recent follow up. There was no difference in improvement rates or resolution rates in male vs female gender. The median failure free survival identified on Kaplan Meier analysis was 12.5 months (Figure 1) Minor post-operative complications (4 urinary tract infections; 1 retentive episode necessitating catheterization) were identified in five patients. There were no major post-operative complications.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Discussion&lt;/h3&gt;&lt;div&gt;Efficacy of OBTA injections was high, with treatment success demonstrated in 94 % of patients and failure free survival of 12.5 months. This procedure also demonstrated a favorable safety profile, with few minor post-operative complications identified. These results indicate that this procedure may be a beneficial therapeutic option for patients with NE refractory to multiple lines of conventional therapy. This study is limited by its retrospective design with short median follow up and potential for recall bias. It is strengthened by its large sample size and novelty.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;To our knowledge, this is the first analysis of the efficacy of OBTA injections for management of primary NE. A follow up clinical trial is essential to","PeriodicalId":16747,"journal":{"name":"Journal of Pediatric Urology","volume":"21 1","pages":"Pages 47-52"},"PeriodicalIF":2.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142558090","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":"Parental regret following decision for sons to undergo elective post-neonatal circumcision","authors":"Tomer Bashi ,&nbsp;Hadas Rorman ,&nbsp;Ziv Savin ,&nbsp;Noam Bar-Yaakov ,&nbsp;Snir Dekalo ,&nbsp;Jacob Ben-Chaim ,&nbsp;Yuval Bar-Yosef","doi":"10.1016/j.jpurol.2024.10.005","DOIUrl":"10.1016/j.jpurol.2024.10.005","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Introduction&lt;/h3&gt;&lt;div&gt;The reasons for performing a circumcision among males after the neonatal period are usually cultural or medical. We aimed to evaluate parental regret for providing consent and to identify factors associated with such regret.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;Included were the parents of males aged 6 months to 18 years who underwent circumcision under general anesthesia at a single center between 2/2017 and 01/2023. Those who underwent additional surgical procedures during the same session were excluded. Parents responded telephonically to the Decision Regret Scale (DRS) questionnaire. Regret was classified as none (0 points), mild (1–25) or moderate-to-strong (26–100). &lt;strong&gt;Surgical and demographic data were retrieved for comparison to DRS scores and identification of predictors of parental regret.&lt;/strong&gt;&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;In total, 201 of the 265 suitable patients met the inclusion criteria. Parents of 130 patients (65% response rate) whose average age was 5.06 (IQR 1.58,7.53) years completed the DRS questionnaire (study group). The average time since surgery was 41.8 (IQR 25.4,59.3) months. Forty surgeries were undertaken for cultural reasons and 90 for medical considerations. Eighteen parents reported regret (15 mild and 3 moderate-to-strong) for their decision to consent to their son's circumcision. The time from responding since surgery was the only significant variable in the DRS scores, with a 33-month gap predicting no regret (p = 0.02 compared to shorter gaps). The reasons for circumcision did not significantly differ between the \"regret\" and \"no-regret\" groups (p = 0.23).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Discussion&lt;/h3&gt;&lt;div&gt;Our current investigation revealed a lower incidence of parental regret when compared to previous reports following distal hypospadias repair, likely attributable to the lower complication rate associated with circumcision. &lt;strong&gt;Our data reflect the experience of a single center in a country where neonatal male circumcision is routinely performed for cultural and religious reasons, thus precluding the generalization of our findings to places where post-natal circumcision is less commonplace.&lt;/strong&gt;&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;Consent to their son's post-neonatal circumcision was regretted by 13.8% of parents. Time since surgery significantly influenced the reduction of their negative attitudes.&lt;span&gt;&lt;div&gt;&lt;span&gt;&lt;span&gt;&lt;p&gt;&lt;span&gt;Summary Table&lt;/span&gt;. &lt;!--&gt;Clinical characteristics of the study cohort stratified by parental decisional regret (n = 130)&lt;/p&gt;&lt;/span&gt;&lt;/span&gt;&lt;div&gt;&lt;table&gt;&lt;thead&gt;&lt;tr&gt;&lt;th&gt;Variable&lt;/th&gt;&lt;th&gt;No decisional regret (n = 112)&lt;/th&gt;&lt;th&gt;Decisional regret (n = 18)&lt;/th&gt;&lt;th&gt;p-value&lt;span&gt;&lt;span&gt;&lt;sup&gt;a&lt;/sup&gt;&lt;/span&gt;&lt;/span&gt;&lt;/th&gt;&lt;/tr&gt;&lt;/thead&gt;&lt;tbody&gt;&lt;tr&gt;&lt;td&gt;Age, years (median [IQR])&lt;/td&gt;&lt;td&gt;4.85 (1.59,7.41)&lt;/td&gt;&lt;td&gt;6.37 (1.61,9.9)&lt;/td&gt;&lt;td&gt;0.15&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td&gt;Cultural reason&lt;/td&gt;&lt;td&gt;35/40 (87.5%)&lt;/td&gt;&lt;td&gt;5/40 (12.5%)&lt;/td&gt;&lt;td&gt;0.23&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td&gt;Medical rea","PeriodicalId":16747,"journal":{"name":"Journal of Pediatric Urology","volume":"21 1","pages":"Pages 162-166"},"PeriodicalIF":2.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142566535","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}