Journal of Pediatric Urology最新文献

{"title":"Stretched penile length for Syrian children aged 0–5 years: Cross-sectional study","authors":"Roua Arian,&nbsp;Anas Alsheikh Hamdoun,&nbsp;Dania Shahrour,&nbsp;Ibrahim Kejji,&nbsp;Mohammed Al-mahdi Al-kurdi,&nbsp;Mohamad Morjan","doi":"10.1016/j.jpurol.2024.10.019","DOIUrl":"10.1016/j.jpurol.2024.10.019","url":null,"abstract":"<div><h3>Background</h3><div>The early detection of the anatomical anomalies (e.g. micropenis) of the male external genital organs is crucial for both medical and psychological reasons. During routine pediatric visits, careful inspection using standards of penis size is beneficial for the diagnosis of micropenis and macropenis. Stretched penile length (SPL) has been shown to be more dependable than the flaccid penis length. Consequently, the SPL must be measured and compared to age-appropriate normal values.</div></div><div><h3>Objective</h3><div>This cross-sectional study aimed to determine the normal range of stretched penile length in newborns and children aged 1 month to 5 years in Syria and explore the correlation between SPL, height, and weight.</div></div><div><h3>Study design</h3><div>Data was collected from 300 Syrian males aged 0–5 years. SPL measurements were taken using a standardized procedure. Participants were divided into eight age groups. Statistical analysis determined the mean SPL, standard deviation, range, and rate of increase in SPL for each group. The distribution of SPL data was assessed using the Shapiro–Wilk test. Pearson correlation analysis examined the relationship between SPL and height, weight, and BMI.</div></div><div><h3>Results</h3><div>Mean SPL increased with age, ranging from 2.36 cm in newborns to 4.29 cm in children aged 48–60 months. The 48–60 months group exhibited the largest range of SPL. The rate of SPL increase was highest in children aged 1–2.9 months. SPL values followed a normal distribution. Significant positive correlations were found between SPL and weight in the 36–47.99 months group and between SPL and height in the 6–11.9 months and 36–47.99 months groups.</div></div><div><h3>Conclusion</h3><div>This study establishes the normal reference range of SPL in Syrian newborns and children aged 1 month to 5 years. The findings indicate that SPL is influenced significantly by height and weight in certain age groups. These results contribute to understanding penile development and can assist in the diagnosis and treatment of conditions affecting penile size.</div></div>","PeriodicalId":16747,"journal":{"name":"Journal of Pediatric Urology","volume":"21 1","pages":"Pages 191-196"},"PeriodicalIF":2.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142590689","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":"Assessment of the CDC hypospadias atlas for epidemiological research - A survey of experts","authors":"Catherine Nguyen ,&nbsp;Cassandra Gormley ,&nbsp;Beverly Spray ,&nbsp;Xiaoyi Shan ,&nbsp;Stephen Canon","doi":"10.1016/j.jpurol.2024.10.015","DOIUrl":"10.1016/j.jpurol.2024.10.015","url":null,"abstract":"<div><h3>Background</h3><div>Hypospadias is a common congenital malformation. There are several classification systems for hypospadias. However, the phenotypic subtypes of hypospadias are inconsistently reported across databases due to the inherently subtle variability of the penile anatomy. Consistent classification of hypospadias would enable more accurate data regarding etiological correlates of specific subtypes as well as perioperative care and surgical outcomes. Existing classifications are designed for use by hypospadias surgeons, although there is a need for a system for epidemiologic data abstractors, who are generally not clinicians. The online Center for Disease Control (CDC) manual for birth defect surveillance includes a hypospadias atlas with photograph representation for different hypospadias phenotypic subtypes. However, this atlas is not widely known or used as a reference by pediatric urologists. We sought to evaluate the consistency amongst surgeons who specialize in managing this condition on the classification of hypospadias using the CDC atlas to determine whether this can be a tool in epidemiologic data collection.</div></div><div><h3>Method</h3><div>We developed a questionnaire using photographs taken directly from the CDC atlas for hypospadias. Demographic data regarding geographical location and years in practice also were obtained. The survey was distributed via email to members of the Society for Pediatric Urology and American Association of Pediatric Urologists. Responses were anonymously collected.</div></div><div><h3>Result</h3><div>166 responses were received from 407 surveys request yielding a response rate of 40.8 %. Agreement with the CDC atlas on the classification of hypospadias by responders was 93.4 % for glanular hypospadias, 56.6 % for subcoronal hypospadias, 3.6 % for penile hypospadias, 54.2 for scrotal hypospadias, and 59 % for perineal hypospadias.</div></div><div><h3>Conclusion</h3><div>Our survey indicated that there is general disagreement in classification of hypospadias in the CDC atlas amongst members of pediatric urology societies. There exists a need for better standardization of a hypospadias classification system for epidemiologic research in hypospadias. Limitations of our study include a less than 50 % of survey responses received and large proportion of responders were from the United States.<span><figure><span><img><ol><li><span><span>Download: <span>Download high-res image (287KB)</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>. <!-->Images of hypospadias subtypes obtained directly from the CDC website. The arrows indicating the location of the meatus are part of the images published.</p></span></span></figure></span></div></div>","PeriodicalId":16747,"journal":{"name":"Journal of Pediatric Urology","volume":"21 1","pages":"Pages 169-172"},"PeriodicalIF":2.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142621261","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":"A potpourri of pediatric urology","authors":"Kathleen Kieran","doi":"10.1016/j.jpurol.2024.11.017","DOIUrl":"10.1016/j.jpurol.2024.11.017","url":null,"abstract":"","PeriodicalId":16747,"journal":{"name":"Journal of Pediatric Urology","volume":"21 1","pages":"Pages 204-205"},"PeriodicalIF":2.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142791855","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 ‘Histologic analysis of gonadal tissue in patients with Turner syndrome and Y chromosome material’","authors":"Tuba Ozdemir-Sanci","doi":"10.1016/j.jpurol.2024.07.033","DOIUrl":"10.1016/j.jpurol.2024.07.033","url":null,"abstract":"","PeriodicalId":16747,"journal":{"name":"Journal of Pediatric Urology","volume":"21 1","pages":"Page 221"},"PeriodicalIF":2.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142140326","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":"Prevalence of disorders of sex development in patients with hypospadias and cryptorchidism","authors":"Callum Lavoie ,&nbsp;Brian Chun ,&nbsp;Melanie Au ,&nbsp;Christine Do ,&nbsp;S. Scott Sparks ,&nbsp;Andy Y. Chang","doi":"10.1016/j.jpurol.2024.09.017","DOIUrl":"10.1016/j.jpurol.2024.09.017","url":null,"abstract":"<div><h3>Background</h3><div>Hypospadias and undescended testicles (UDT) are common congenital conditions, affecting approximately 1 in 125 and 1 in 33 boys, respectively. There has been limited contemporary data regarding the prevalence of Disorders of Sex Development (DSD) in patients with a history of both hypospadias and UDT.</div></div><div><h3>Objective</h3><div>Our objective is to determine the prevalence of DSD among patients presenting with hypospadias and UDT.</div></div><div><h3>Design, setting, and participants</h3><div>Electronic medical records were reviewed, and a retrospective chart review was conducted on 177 patients that were evaluated at our institution from 2000 to 2021 with a diagnosis of hypospadias and UDT. The degree of hypospadias, presence of and palpability of UDT, and prevalence and type of DSD were recorded.</div></div><div><h3>Outcome measurements and statistical analysis</h3><div>The degree of hypospadias, presence of and palpability of UDT, and prevalence and type of DSD were recorded. Chi-squared and Fisher's exact tests were conducted for descriptive statistical analyses as appropriate. Logistic regression analyses were conducted, with adjusted models including demographic and relevant clinical data.</div></div><div><h3>Results</h3><div>177 patients were identified with both hypospadias and UDT, with 17/111 (15.3 %) diagnosed with DSD. The most common etiology of DSD was mixed gonadal dysgenesis (35.3 %; n = 6). Proximal hypospadias made up only 59.6 % of those without DSD vs. 100 % of those with confirmed DSD (p = 0.0044). A significantly smaller proportion of DSD patients had bilaterally palpable gonads compared to those without DSD (29.4 % vs. 79.8 %, p &lt; 0.0001). Compared to those with palpable testes, patients with one non-palpable testicle had up to 26.67 times greater odds of DSD.</div></div><div><h3>Conclusions</h3><div>To date, we present the largest cohort of patients that have undergone DSD work up for the combined presentation of hypospadias and UDT. Our findings highlight an increase in DSD diagnosis in proximal hypospadias patients with non-palpable UDTs, which offers further evidence and support for pursuing DSD diagnostic work-up in all proximal hypospadias patients with UDTs.<span><figure><span><img><ol><li><span><span>Download: <span>Download high-res image (283KB)</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>. <!-->Flowchart of hypospadias location and testes palpability with DSD prevalence.</p></span></span></figure></span></div></div>","PeriodicalId":16747,"journal":{"name":"Journal of Pediatric Urology","volume":"21 1","pages":"Pages 71-77"},"PeriodicalIF":2.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142381148","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":"Ureteroscopy for stone disease in pediatric patients with neurogenic bladder: A single institution case-control study","authors":"Yashaswi Parikh ,&nbsp;Sami Shaikh ,&nbsp;Aznive Aghababian ,&nbsp;Sonam Saxena ,&nbsp;Suhaib Abdulfattah ,&nbsp;Emily Ai ,&nbsp;Iqra Nadeem ,&nbsp;Curran Uppaluri ,&nbsp;Sahar Eftekharzadeh ,&nbsp;John Weaver ,&nbsp;Karl Godlewski ,&nbsp;Katherine Fischer ,&nbsp;Christopher Long ,&nbsp;Sameer Mittal ,&nbsp;Aseem Shukla ,&nbsp;Arun Srinivasan","doi":"10.1016/j.jpurol.2024.09.009","DOIUrl":"10.1016/j.jpurol.2024.09.009","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Introduction&lt;/h3&gt;&lt;div&gt;Ureteroscopy (URS) for urolithiasis in pediatric patients may be particularly challenging for patients with co-morbidities that increase the risk for stone formation and recurrence. Patients with neurogenic bladders (NGB) and/or patients that are non-ambulatory are reported to have higher rates of additional comorbidities and a particularly increased risk of developing urolithiasis, and higher rates of infections and post-operative complications.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Objective&lt;/h3&gt;&lt;div&gt;To report outcomes of URS for stone disease in pediatric patients with NGB and/or non-ambulatory status and compare these outcomes to patients without these co-morbidities.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;An IRB-approved prospective single institutional registry was used to retrospectively identify all patients under 18 years of age who underwent URS for stone disease between July 2012 and July 2021, excluding bladder stones. Patients were categorized in two groups: patient with NGB with or without non-ambulatory status versus all other patients (control). Baseline demographics, pre-operative radiologic imaging, intra-operative details, and post-operative outcomes including 30-day complications were aggregated and compared between the two groups.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;275 URS in 198 patients were performed during the study period, and 49 (18 %) of these were performed on patients with NGB. Pre-operative imaging showed significantly higher number of stones (3 vs 2, p = 0.003) and larger total stone burden in patients with NGB than those without NGB (15 mm vs 9 mm, p = 0.009). Patients with NGB had a significantly longer length of procedure (86 vs 60 min, p = 0.002), increased need for staged procedures, increased length of stay (1 vs 0 days, p &lt; 0.001), and increased use of an extended duration of antibiotics prior to the procedure (&lt;0.001). There was no difference in need for passive dilation, stent placement, or other intra-operative parameters. There was no statistical difference in the incidence of 30-day complications between the two groups post-operatively. However, there was a higher incidence of febrile UTIs (8.2 % vs 1.3 %, p = 0.021) in patients with NGB and a lower incidence of pain related complications (0 % vs 9.3 %, p = 0.032). Patients with NGB had a higher incidence of requiring ipsilateral URS for recurrent stone disease within a year of surgery (34.6 % vs 18.9 %, p = 0.01).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;The results show that URS for urolithiasis can be done safely and effectively in pediatric patients with neurogenic bladders. The increased risk of infectious complications within 30 days of surgery warrants careful pre- and post-operative antibiotic care plan for this patient population.&lt;span&gt;&lt;div&gt;&lt;span&gt;&lt;span&gt;&lt;p&gt;&lt;span&gt;Summary table 1&lt;/span&gt;. &lt;!--&gt;Post-operative outcomes for patients with and without neurogenic bladder undergoing URS.&lt;/p&gt;&lt;/span&gt;&lt;/span&gt;&lt;div&gt;&lt;table&gt;&lt;thead&gt;&lt;tr&gt;&lt;td&gt;&lt;span&gt;","PeriodicalId":16747,"journal":{"name":"Journal of Pediatric Urology","volume":"21 1","pages":"Pages 29-34"},"PeriodicalIF":2.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142391359","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":"Predictors of follow-up of pediatric stone patients after surgical intervention","authors":"Megan Stout ,&nbsp;Alyssa Lombardo ,&nbsp;Nora Thompson ,&nbsp;Jason Benedict ,&nbsp;Seth Alpert ,&nbsp;Daniel DaJusta ,&nbsp;Molly Fuchs ,&nbsp;Rama Jayanthi ,&nbsp;Daryl Mcleod ,&nbsp;Christina B. Ching","doi":"10.1016/j.jpurol.2024.09.003","DOIUrl":"10.1016/j.jpurol.2024.09.003","url":null,"abstract":"<div><h3>Objective</h3><div>We investigated if socioeconomic and demographic factors predict post-surgical follow-up in pediatric stone patients.</div></div><div><h3>Materials and methods</h3><div>All patients having kidney stone surgery at a single academic pediatric hospital over a 5 year period (2016–2020) were identified through the use of CPT® codes specific to ureteroscopy, shock wave lithotripsy, and percutaneous nephrolithotomy. Electronic charts were reviewed for patient demographics, stone characteristics, and characteristics of intervention. Unique patients with a scheduled post-operative follow-up office visit following a first time stone surgery were included in the patient cohort (Figure 1). Primary outcome was attendance of a scheduled provider visit within 6 months after surgery. Secondary outcomes included completion of scheduled post-operative imaging and 24-h urine study. Univariable analysis was performed.</div></div><div><h3>Results</h3><div>195 pediatric patients, a median age of 15.4 years (IQR: 11.34, 17.14) at surgery, were identified. The majority were non-Hispanic white (86.2%) and female (62.1%). Most had undergone ureteroscopy alone (85.6%). Of the 195 patients, 146 (74.9%) attended a post-operative office visit. Indicators of lower socioeconomic status, such as having public insurance and being from a single-parent home, were associated with not attending a scheduled follow-up visit (p &lt; 0.01 and p = 0.02, respectively). Patients with a pre-operative urology clinic visit were more likely to follow-up with a clinic visit (p = 0.02), while those with a larger total stone burden treated were more likely to undergo ordered imaging (p &lt; 0.01).</div></div><div><h3>Discussion</h3><div>We found that indicators of lower socioeconomic status, such as having public insurance status and being in a single-parent household, were associated with lower pediatric follow-up compliance after kidney stone surgery, while patients seen in the urology clinic preoperatively were more likely to attend follow-up.</div></div><div><h3>Conclusion</h3><div>Identifying factors that may predict non-compliance could be used to help at-risk patient populations.</div></div>","PeriodicalId":16747,"journal":{"name":"Journal of Pediatric Urology","volume":"21 1","pages":"Pages 23-28"},"PeriodicalIF":2.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142468277","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 commentary: “Experimental study of the effectiveness of warm ischemia and cold ischemia during testis-sparing surgery in rats”","authors":"Emine Doğan,&nbsp;Ayşe Karaman","doi":"10.1016/j.jpurol.2024.09.028","DOIUrl":"10.1016/j.jpurol.2024.09.028","url":null,"abstract":"","PeriodicalId":16747,"journal":{"name":"Journal of Pediatric Urology","volume":"21 1","pages":"Pages 21-22"},"PeriodicalIF":2.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142468278","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":"End-stage and chronic kidney disease in classic bladder exstrophy: A retrospective muti-institutional cohort study","authors":"Joshua D. Roth ,&nbsp;Diana Bowen ,&nbsp;Molly E. Fuchs ,&nbsp;Patricio C. Gargollo ,&nbsp;Harrison Gottlich ,&nbsp;David S. Hains ,&nbsp;Andrew C. Strine ,&nbsp;Konrad M. Szymanski","doi":"10.1016/j.jpurol.2024.10.016","DOIUrl":"10.1016/j.jpurol.2024.10.016","url":null,"abstract":"<div><h3>Introduction</h3><div>While most children with classic bladder exstrophy (CBE) are born with normal kidneys, some experience renal deterioration in adulthood. Little is known about the incidence of end-stage and chronic kidney disease (ESKD and CKD, respectively) in this population. Our group has recently published on surgical outcomes in a multi-institutional cohort of 216 people with CBE. Our aim was to describe the incidence of ESKD and prevalence of CKD in this cohort of people with CBE.</div></div><div><h3>Methods</h3><div>We retrospectively reviewed records of patients with CBE followed at five tertiary care centers described previously. The primary outcome was incidence of ESKD, defined as permanent peritoneal/hemodialysis or renal transplantation. The secondary outcome was prevalence of CKD stage 3 or higher (CKD3+, estimated glomerular filtration rate [eGFR]&lt;60 ml/min/1.73 m²) at the last appointment. Creatinine-based eGFRs were calculated using the CKD-EPI Creatinine Equation (adults) and the Schwartz formula (children). Survival analysis and Fisher's exact test were used.</div></div><div><h3>Results</h3><div>A total of 201 patients (93 % of the original cohort) had renal function data available (63 % male). Four patients who had a primary urinary diversion remained diverted at a median follow-up of 20.1 years. None developed ESKD and one developed CKD3+. The remaining 197 patients had a primary bladder closure. At a median follow-up of 18.8 years old, 12 were diverted, 108 were augmented and 77 were neither. Three patients developed ESKD (1.5 %) at a median age of 23.4 years (1 hemodialysis, 2 transplantation). On survival analysis, the risk of ESKD was 0 % at 10 years, 1 % at 20 years and 5 % at 30 years (<strong>Figure 1</strong>). This was higher than the risk of 0.003 % at 21 years of age in the general population (p &lt; 0.001). The median age of 141 individuals with eGFR data was 21.6 years old (65 % male). No children, 4 % of adolescents and 8 % of adults had CKD3+ (p = 0.45). On exploratory analyses, prevalence of CKD3+ did not differ by center or birth year (p ≥ 0.99).</div></div><div><h3>Conclusions</h3><div>The risk of ESKD and CKD among patients with CBE is not insignificant and appears to be more common than the general population. The potential role of modifiable contributing factors, such as increased bladder outlet resistance, warrants further investigation. Reliable long-term follow up is needed in this population to monitor for ESKD and CKD.</div></div>","PeriodicalId":16747,"journal":{"name":"Journal of Pediatric Urology","volume":"21 1","pages":"Pages 41-46"},"PeriodicalIF":2.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142590686","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":"Potential impact of severe hydronephrosis secondary to ureteropelvic junction obstruction on pediatric blood pressure","authors":"Qingqing Tian,&nbsp;Chu Zhang,&nbsp;Xiang Zhao,&nbsp;Kechi Yu,&nbsp;Erhu Fang,&nbsp;Xuefeng Zhou,&nbsp;Yonghua Niu,&nbsp;Ning Li","doi":"10.1016/j.jpurol.2024.10.014","DOIUrl":"10.1016/j.jpurol.2024.10.014","url":null,"abstract":"<div><h3>Background</h3><div>Hydronephrosis could affect blood pressure (BP) according to published case reports and animal experiments. The impact on pediatric BP is often overlooked due to children's inherently lower BP, superior vascular elasticity and greater resistance to hypertension than adults.</div></div><div><h3>Objective</h3><div>This study aimed to prospectively observe the effects of hydronephrosis, secondary to ureteropelvic junction obstruction (UPJO), on pediatric BP.</div></div><div><h3>Methods</h3><div>Children with hydronephrosis secondary to UPJO who required pyeloplasty were categorized into five age groups: neonates, infants, toddlers, preschoolers, and school-aged children. Preoperative and postoperative systolic blood pressure (SBP), diastolic blood pressure (DBP), active renin concentration (ARC), and aldosterone concentration (AC) were compared among these age groups, followed by comparison with a control group of children without nephritis or cardiovascular conditions. The impact of severe hydronephrosis secondary to UPJO on pediatric BP and its association with the renin-angiotensin-aldosterone system (RAAS) were examined.</div></div><div><h3>Results</h3><div>This study enrolled 114 children with severe hydronephrosis secondary to UPJO and 153 without nephritic or cardiovascular conditions between September 2021 and June 2023. As the control group aged, SBP and DBP increased, whereas ARC and AC decreased. Overall, hydronephrosis group had higher SBP, DBP, ARC, and AC than the control<del>s</del> group. These differences differed between the age groups. After pyeloplasty, the postoperative BP of hydronephrosis group approximated that of the control group. Postoperative ARC levels were higher than those in the control group but were much lower than the preoperative levels. AC did not decrease significantly after surgery. The change in DBP in children with hydronephrosis before and after pyeloplasty showed a positive correlation with the change in AC.</div></div><div><h3>Conclusions</h3><div>Pediatric patients with severe hydronephrosis, a condition secondary to UPJO, displayed elevated BP, ARC, and AC. Following pyeloplasty, these patients noted a reduction in BP. The correlation between elevated blood pressure and the RAAS necessitates further comprehensive investigation.<span><figure><span><img><ol><li><span><span>Download: <span>Download high-res image (205KB)</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>. </p></span></span></figure></span></div></div>","PeriodicalId":16747,"journal":{"name":"Journal of Pediatric Urology","volume":"21 1","pages":"Pages 108-114"},"PeriodicalIF":2.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142621686","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}