{"title":"What the editors are reading: Population and health services","authors":"Courtney S. Streur, Emilie K. Johnson","doi":"10.1016/j.jpurol.2024.11.012","DOIUrl":"10.1016/j.jpurol.2024.11.012","url":null,"abstract":"","PeriodicalId":16747,"journal":{"name":"Journal of Pediatric Urology","volume":"21 1","pages":"Pages 209-211"},"PeriodicalIF":2.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142750397","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}
Julia Bhuiyan , Raghuveer Kavarthapu , Mary Soliman , G Thomas Brown , Jacqueline C. Yano , Tazim Dowlut-McElroy , Veronica Gomez-Lobo
{"title":"Histologic analysis of gonadal tissue in patients with Turner syndrome and Y chromosome material","authors":"Julia Bhuiyan , Raghuveer Kavarthapu , Mary Soliman , G Thomas Brown , Jacqueline C. Yano , Tazim Dowlut-McElroy , Veronica Gomez-Lobo","doi":"10.1016/j.jpurol.2024.07.016","DOIUrl":"10.1016/j.jpurol.2024.07.016","url":null,"abstract":"<div><div>This study investigates gonadal histology in individuals with Turner syndrome assigned female at birth and Y-chromosome material (TS+Y) who underwent prophylactic gonadectomy. Despite case reports suggesting spontaneous menarche and pregnancies in TS+Y, this research reveals the absence of germ cells, indicating low fertility likelihood. Germ cell neoplasia in-situ was present in some patients, emphasizing a non-negligible risk of cancer precursor. As no malignancies were found even in older individuals, the study challenges the immediate need for prophylactic gonadectomy upon TS+Y diagnosis. Limited fertility benefits are suggested, emphasizing the need for further research on optimal timing and criteria for the procedure.</div></div>","PeriodicalId":16747,"journal":{"name":"Journal of Pediatric Urology","volume":"21 1","pages":"Pages 217-220"},"PeriodicalIF":2.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141841693","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":"Commentary to histologic analysis of gonadal tissue in patients with turner syndrome and Y chromosome material","authors":"Pr Rémi Besson","doi":"10.1016/j.jpurol.2024.08.017","DOIUrl":"10.1016/j.jpurol.2024.08.017","url":null,"abstract":"","PeriodicalId":16747,"journal":{"name":"Journal of Pediatric Urology","volume":"21 1","pages":"Pages 224-225"},"PeriodicalIF":2.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142267605","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}
Leah E. Beland , Alexandra R. Siegal , Nathan Hyacinthe, Christopher J. Long, Mark R. Zaontz, Karl F. Godlewski, Dana A. Weiss, Jason P. Van Batavia, Emily Ai, Christopher J. Moran, Aseem R. Shukla, Arun K. Srinivasan, Sameer Mittal, Stephen A. Zderic, Thomas F. Kolon, Katherine M. Fischer
{"title":"Does socioeconomic opportunity impact distal hypospadias surgical outcomes or post-operative care?","authors":"Leah E. Beland , Alexandra R. Siegal , Nathan Hyacinthe, Christopher J. Long, Mark R. Zaontz, Karl F. Godlewski, Dana A. Weiss, Jason P. Van Batavia, Emily Ai, Christopher J. Moran, Aseem R. Shukla, Arun K. Srinivasan, Sameer Mittal, Stephen A. Zderic, Thomas F. Kolon, Katherine M. Fischer","doi":"10.1016/j.jpurol.2024.09.012","DOIUrl":"10.1016/j.jpurol.2024.09.012","url":null,"abstract":"<div><h3>Introduction</h3><div>Complications following hypospadias repair are common and several risk factors have been implicated such as penile biometrics and surgeon experience. Less well understood is that impact that social determinants of health have on hypospadias outcomes.</div></div><div><h3>Objective</h3><div>Anatomic and technical factors have been identified that contribute to complications; however, the impact that social determinants of health have on outcomes remains unclear. We hypothesized that the development of complications following distal hypospadias repair in children is negatively associated with the presence of resources and conditions necessary for development.</div></div><div><h3>Methods</h3><div>A retrospective analysis of children ≤18 years who underwent distal hypospadias repair from January 2016 to December 2022 was performed. Patients with <30 days follow-up were excluded from the primary analysis. The COI (Childhood Opportunity Index), calculated from residential address, was used as a measure of the resources and conditions present in a community necessary for healthy child development. The primary outcome was the presence of post-operative complications and the association of complications with COI. The secondary outcome was the association of COI and race with loss of follow-up (defined as no follow-up after 30 days post-operatively). Univariate and multivariable logistic regression analyses were used to assess the association of complications with COI, insurance status, anatomic, and technical factors.</div></div><div><h3>Results</h3><div>938 patients were identified, of which 166 were lost to follow-up. The overall complication rate was 14.1%. There was no significant difference in COI, insurance type, race, or primary language between patients with and without complications (p > 0.05). Glans width, degree of chordee, and repair type were associated with complications on univariate regression analysis (p < 0.01) and glans width and degree of chordee were significant on multivariate analysis (p < 0.01). COI was not significant on univariate or multivariate analysis. Lower COI, non-white race, and government insurance were associated with lack of follow-up (p < 0.01) (Summary figure).</div></div><div><h3>Discussion</h3><div>Socioeconomic opportunity is not an independent risk factor for complications after distal hypospadias repair; complications are impacted by anatomic factors and repair type. However, children with a lower COI were more likely to be lost to follow-up, and thus complications in this group may be underreported.</div></div><div><h3>Conclusion</h3><div>While socioeconomic opportunity does not appear to be a risk factor in the development of complications after distal hypospadias repair, non-white children and those with lower COI were more likely to be lost to follow-up and without proper follow-up this group has an unknown true complication rate.<span><figure><span><img><ol><li><","PeriodicalId":16747,"journal":{"name":"Journal of Pediatric Urology","volume":"21 1","pages":"Pages 136-146"},"PeriodicalIF":2.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142468301","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}
Eirik Gulseth , Andreas Urdal , Marit Helen Andersen , Ragnhild Sørum Falk , Gunnar Aksnes , Ragnhild Emblem , Trond Diseth , Anne Wæhre
{"title":"Mental health and health-related quality of life in adolescents surgically treated for hypospadias in childhood","authors":"Eirik Gulseth , Andreas Urdal , Marit Helen Andersen , Ragnhild Sørum Falk , Gunnar Aksnes , Ragnhild Emblem , Trond Diseth , Anne Wæhre","doi":"10.1016/j.jpurol.2024.09.031","DOIUrl":"10.1016/j.jpurol.2024.09.031","url":null,"abstract":"<div><h3>Background</h3><div>There is limited research and conflicting results on the mental health and health-related quality of life of individuals surgically treated for hypospadias in childhood. Furthermore, the significance of patient-reported outcomes (PRO) in hypospadias is growing. More research is necessary on these topics, particularly in adolescents.</div></div><div><h3>Objective</h3><div>We aimed to compare mental health, health-related quality of life, body satisfaction, self-esteem, penile appearance, and sexual function outcomes in 16-year-old adolescents who had surgery for hypospadias in childhood with a healthy comparison group.</div></div><div><h3>Study design</h3><div>The study involved 16-year-old adolescents who had surgery for hypospadias in one Norwegian hospital. An age-matched comparison group of healthy adolescents was previously recruited. The study assessed self-reported outcomes on mental health using the Strengths and Difficulties Questionnaire, health-related quality of life using the Pediatric Quality of Life Inventory, body satisfaction and self-esteem using the Self-Perception Profile for Adolescents, and genital perception and sexual function using the Pediatric Penile Perception Score and a non-validated structured interview.</div></div><div><h3>Results</h3><div>In total, 117 adolescents operated for hypospadias and 61 healthy adolescents were included. The outcomes for mental health and health-related quality of life were not statistically different between groups. However, 18 (16%) hypospadias patients were classified as cases/borderline on mental health outcomes, compared to 2 (3%) in the comparison group (p = 0.01). Patients classified as cases/borderline on mental health reported lower health-related quality of life, self-esteem, and more stressful life events. Self-reported penile appearance and sexual function were comparable between groups, however the proximal hypospadias group displayed lower satisfaction.</div></div><div><h3>Discussion</h3><div>Although the present study had generally positive outcomes, a significant finding was that a higher number of adolescents who had previously undergone hypospadias surgery during childhood were classified as cases or borderline cases with respect to mental health issues. Hypospadias surgery in childhood may pose challenges for some patients during adolescence, particularly in the proximal group. Regular monitoring by healthcare professionals is crucial in providing necessary support. A limitation is the small size of the subgroups.</div></div><div><h3>Conclusion</h3><div>Most patients report good mental health, quality of life, and self-esteem even though patients with hypospadias report more mental health issues than the comparison group. Proximal hypospadias were less satisfied with penile appearance and sexual function. However, due to the small sample size, conclusions about this group should be treated cautiously. Assessing self-reported outcomes in follo","PeriodicalId":16747,"journal":{"name":"Journal of Pediatric Urology","volume":"21 1","pages":"Pages 59-70"},"PeriodicalIF":2.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142566357","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}
Amanda M. Macaraeg , Sara M. Alshehabi , Kathy H. Huen , Carol A. Davis-Dao , Sarah H. Williamson , Timothy C. Boswell , Christina Chalmers , Heidi A. Stephany , Kai-wen Chuang , Elias J. Wehbi , Zeev N. Kain , Sherrie H. Kaplan , Antoine E. Khoury
{"title":"Experiences and barriers with home bladder manometry in the pediatric neurogenic bladder population: A qualitative study","authors":"Amanda M. Macaraeg , Sara M. Alshehabi , Kathy H. Huen , Carol A. Davis-Dao , Sarah H. Williamson , Timothy C. Boswell , Christina Chalmers , Heidi A. Stephany , Kai-wen Chuang , Elias J. Wehbi , Zeev N. Kain , Sherrie H. Kaplan , Antoine E. Khoury","doi":"10.1016/j.jpurol.2024.10.017","DOIUrl":"10.1016/j.jpurol.2024.10.017","url":null,"abstract":"<div><h3>Background</h3><div>Patients with neurogenic bladder are at risk of developing renal deterioration secondary to increased intravesical pressures. To date, urodynamics is the gold standard test to properly assess bladder dynamics. Home bladder manometry is a low-cost and simple method to evaluate bladder pressures and volumes during clean intermittent catheterization (CIC). Previous literature has shown that home manometry measurements correlate with urodynamic pressures and hydronephrosis on ultrasound. However, no studies have evaluated the challenges and barriers faced by caregivers with the process.</div></div><div><h3>Objective</h3><div>Our objective was to investigate the experiences and perceptions of caregivers, healthcare providers, and nurses with home manometry.</div></div><div><h3>Study design</h3><div>We conducted semi-structured interviews and focus group discussions with 23 stakeholders. Stakeholders included caregivers of pediatric spina bifida neurogenic bladder patients, providers, and nursing staff. Grounded Theory Methods were used to analyze transcripts and identify preliminary concepts that described attitudes towards the current home bladder manometry process.</div></div><div><h3>Results</h3><div>Interview participants were composed of 10 (43 %) caregivers, 9 (40 %) healthcare providers, and 4 (17 %) nursing staff. The mean age was 39 years (range 26–66). The four themes identified during discussions were perspectives on home manometry, patient-specific characteristics, challenges with home manometry, and learning experience. All caregivers expressed understanding and agreement with the purpose and importance of home manometry. Emergent concepts identified as targets for improvement were the need for standardization of teaching processes with focus on hands-on practice, understanding of patient characteristics and the home environment that make the process more challenging, and the need for appropriate materials including extension tubing and catheters.</div></div><div><h3>Conclusions</h3><div>Home bladder manometry is a feasible and beneficial way for neurogenic bladder patients to monitor their bladder pressures and volumes at home. This qualitative study offers valuable insights into the experiences and viewpoints of caregivers, healthcare providers, and nurses regarding both home manometry and the general experience with CIC.<span><figure><span><img><ol><li><span><span>Download: <span>Download high-res image (364KB)</span></span></span></li><li><span><span>Download: <span>Download full-size image</span></span></span></li></ol></span><span><span><p><span>Summary figure</span>. <!-->Illustration of the home manometry process in male and female patients. With the patient in a relaxed supine position, the caregiver inserts the catheter into the bladder and holds the catheter upwards. A ruler is aligned where zero is level with the penoscrotal junction (in males) (a), or the urethral meatus (in females) (b). The heig","PeriodicalId":16747,"journal":{"name":"Journal of Pediatric Urology","volume":"21 1","pages":"Pages 173-180"},"PeriodicalIF":2.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142621459","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":"What the editors are reading: Perinatal urology","authors":"Marie-Klaire Farrugia","doi":"10.1016/j.jpurol.2024.11.014","DOIUrl":"10.1016/j.jpurol.2024.11.014","url":null,"abstract":"","PeriodicalId":16747,"journal":{"name":"Journal of Pediatric Urology","volume":"21 1","pages":"Pages 206-208"},"PeriodicalIF":2.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142750392","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}
Thomas Loubersac, Hortense Alliot, Fabrizio Vatta, Marc-David Leclair
{"title":"Extraperitoneal robotic approach to the uretero-vesical junction in children: Initial experience and a step-by-step video presentation","authors":"Thomas Loubersac, Hortense Alliot, Fabrizio Vatta, Marc-David Leclair","doi":"10.1016/j.jpurol.2024.09.020","DOIUrl":"10.1016/j.jpurol.2024.09.020","url":null,"abstract":"<div><h3>Introduction & objectives</h3><div>The use of transperitoneal robotic-assisted procedures for ureterovesical junction (UVJ) anomalies in pediatric patients is increasing. However, the extra-peritoneal approach potentially less invasive, remains underexplored with robotic approach in pediatric patients. We present our experience of robot-assisted <strong>extra-vesical laparoscopic</strong> extra-peritoneal UVJ surgery.</div></div><div><h3>Materials & methods</h3><div>Extraperitoneal access was made through a 1,5 cm horizontal incision below the umbilicus. Digital dissection was performed under the rectus fascia to the pubic symphysis. The space was further developed under direct vision with laparoscope.</div><div>The Da Vinci Xi platform was docked after the placement of 4 robotic 8 mm-trocars and an 8 mm assistant port.</div></div><div><h3>Results</h3><div>We performed extraperitoneal robot-assisted laparoscopic UVJ surgery in 3 patients:</div><div>- Case 1: 9-year-old boy: left-sided ureterectomy, UV reimplantation (UVR) with psoas hitch for a symptomatic mega-ureter.</div><div>- Case 2: 13-year-old girl: right-sided VUR on a duplex system treated with an extravesical Lich-Gregoir antireflux plasty.</div><div>- Case 3: 8-year-old boy: left-sided bladder diverticulectomy with UVR.</div><div>There is no complication above Clavien 2 and no recurrence of febrile UTI during the follow-up period (from 6 to 17 months).</div></div><div><h3>Conclusions</h3><div>Extra-peritoneal robotic approach for UVJ surgery further for UVR in pediatric urology seems feasible with good short-term result even for the complex ones.</div></div>","PeriodicalId":16747,"journal":{"name":"Journal of Pediatric Urology","volume":"21 1","pages":"Pages 212-214"},"PeriodicalIF":2.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142400555","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":"Timing of feminizing genitoplasty in patients with congenital adrenal hyperplasia","authors":"Smail Acimi","doi":"10.1016/j.jpurol.2024.08.025","DOIUrl":"10.1016/j.jpurol.2024.08.025","url":null,"abstract":"","PeriodicalId":16747,"journal":{"name":"Journal of Pediatric Urology","volume":"21 1","pages":"Pages 228-229"},"PeriodicalIF":2.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142468284","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}