Journal of Pediatric Urology最新文献

{"title":"Empowerment and change: Women in paediatric urology.","authors":"Francisca Yankovic, Rosa Romero, Gundela Holmdahl, Rosalia Misseri, Alaa El-Ghoneimi, Marie-Klaire Farrugia, Anju Goyal","doi":"10.1016/j.jpurol.2026.106245","DOIUrl":"https://doi.org/10.1016/j.jpurol.2026.106245","url":null,"abstract":"<p><p>As increasing numbers of women pursue careers in medicine and surgery, the paediatric urology workforce is progressively approaching gender parity. However, women continue to face specific barriers to career advancement, including conscious and unconscious gender bias, stereotypes, challenges in achieving work-life balance, limited mentorship, and barriers to leadership. This article summarizes the first session specifically focused on women's experiences and challenges in paediatric urology, presented during the European Society for Paediatric Urology (ESPU) Congress in Vienna in September 2025. A pre-session survey of female paediatric urologists was conducted to assess current perceptions of barriers to professional development, identify potential solutions, and explore future directions. The article also reviews the evolution of female representation within paediatric urology organizations, including the ESPU, as well as within clinical departments and leadership positions over recent years. Based on the discussions and survey findings, strategies to promote the empowerment, career advancement, and professional development of women in paediatric urology are proposed.</p>","PeriodicalId":16747,"journal":{"name":"Journal of Pediatric Urology","volume":" ","pages":"106245"},"PeriodicalIF":2.2,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149111332","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":"Letter to the Editor re: \"Healthcare burden in spina bifida: Measuring time toxicity in the first year of life\".","authors":"Chujie Chen","doi":"10.1016/j.jpurol.2026.106248","DOIUrl":"https://doi.org/10.1016/j.jpurol.2026.106248","url":null,"abstract":"","PeriodicalId":16747,"journal":{"name":"Journal of Pediatric Urology","volume":" ","pages":"106248"},"PeriodicalIF":2.2,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148874497","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":"Traversing from childhood surgery to adult life: Long-term functional and psychosexual outcomes in males with differences/disorders of sex development.","authors":"Vivek K Singh, Shilpa Sharma, Minu Bajpai, Devendra K Gupta, Pradeep K Chaturvedi","doi":"10.1016/j.jpurol.2026.106246","DOIUrl":"https://doi.org/10.1016/j.jpurol.2026.106246","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Long-term outcomes of disorders of sex development (DSD) following masculinizing genitoplasty remain inadequately defined, particularly regarding transition through puberty into adult social, reproductive, and sexual roles. This study aimed to comprehensively evaluate the long-term domains in males with DSD following surgery in childhood.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;After ethical approval, DSD males aged ≥18 years post-genitoplasty were assessed for surgical, hormonal, urinary, sexual, fertility-related, and psychosocial outcomes. Information was obtained through structured interviews, clinical examination, semen parameters (WHO standards) and validated tools-including the International Prostate Symptom Score (IPSS) and International Index of Erectile Function (IIEF). Subgroup analysis was performed across three 46,XY DSD etiological categories: partial androgen insensitivity syndrome (PAIS), 5α-reductase deficiency (5αRD), and Other variants (OV) [46, XX Testicular, ovotesticular, dysgenetic forms].&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;All 12 participants identified as male, were comfortable in their gender role, with heterosexual orientation. Nine voided standing and three sitting, with overall satisfaction regarding voiding. Six were married and sexually active, and two had fathered five children spontaneously. Among seven who provided semen samples, five had sperm in the ejaculate, all with asthenozoospermia. Serum Leutinizing hormone (LH), Follicular Stimulating hormone (FSH) and testosterone levels were normal in most patients, whereas normal inhibin B was observed in only 2. Subgroup analysis demonstrated significant differences in testosterone across PAIS (n = 5), 5αRD (n = 2), and OV (n = 4), with highest levels in 5αRD and lowest in OV. PAIS showed best preserved gonadal function parameters; sperm count and Inhibin FSH ratio (IFR), 5αRD partial preservation, and OV consistently poorer outcomes. Concerns regarding penile size were reported by 10 (83.3%), and severe ED was present in 8/12 (66.7%) per IIEF. All participants reported satisfactory psychosocial adjustment; eight were employed and four were students. Correlation analyses revealed no significant association between testosterone and SPL (p = 0.494) and only non-significant positive trends between Sertoli-cell markers(inhibin B p = 0.324; IFR p = 0.221) and sperm count. Median SPL was 2.0:2.5:3.5 cm in PAIS:5αRD:OV; median sperm count was 28:18:0 million/ml. Penile length and erectile scores were comparable across groups, while sperm output was lowest in OV.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Discussion: &lt;/strong&gt;This single-centre longitudinal study provides rare long-term data on post-genitoplasty outcomes in DSD males. Gonadal and Sertoli-cell dysfunction were most pronounced in dysgenetic variants, whereas PAIS demonstrated a more favourable endocrine and functional profile.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Most participants maintained stable male identity and p","PeriodicalId":16747,"journal":{"name":"Journal of Pediatric Urology","volume":" ","pages":"106246"},"PeriodicalIF":2.2,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148982923","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 to the Editor re: \"Healthcare burden in spina bifida: Measuring time toxicity in the first year of life\".","authors":"Caleb Q Ashbrook, Raphael R Pasala, Corina B Do, Vijay Rings, Lauren E Corona, Brendan T Frainey, Douglass B Clayton","doi":"10.1016/j.jpurol.2026.106247","DOIUrl":"https://doi.org/10.1016/j.jpurol.2026.106247","url":null,"abstract":"","PeriodicalId":16747,"journal":{"name":"Journal of Pediatric Urology","volume":" ","pages":"106247"},"PeriodicalIF":2.2,"publicationDate":"2026-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148886953","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 revision patterns and conduit type as predictors of continent catheterizable channel durability in children: A two-center time-to-event analysis.","authors":"Wael M Moneir, Amr Hodhod, Ahmad Alshammari, Sultan Almaiman, Abdullah Alrumaih, Abdulwahab Alhams, Abdullah Alaqeel, Fayez Almodhen, Yasser Jamalalail, Tariq Burki","doi":"10.1016/j.jpurol.2026.106243","DOIUrl":"https://doi.org/10.1016/j.jpurol.2026.106243","url":null,"abstract":"<p><strong>Objective: </strong>Appendicovesicostomy (APV) and Monti enteric channels are commonly used catheterisable channels utilizing the Mitrofanoff principle. However, their long-term durability and predictors of revision remain uncertain. This study aimed to evaluate revision-free survival and identify predictors of revision following APV and Monti channel creation.</p><p><strong>Patients and methods: </strong>We conducted a retrospective study of children less than 18 years old undergoing CCC creation using APV or Monti at two tertiary care hospitals between 2015 and 2024. Categorical data were evaluated using Fisher's exact test, while continuous data were compared using the Mann-Whitney U test. Time-to-event analysis was performed using Kaplan-Meier methods and Cox proportional hazards regression to assess revision-free survival and identify predictors of surgical revision.</p><p><strong>Results: </strong>At a median age (range) of 10 (3-17) years, seventy channels were created in 69 patients, including 48 APV and 22 Monti conduits, with a median follow-up of 36.5 months. Mitrofanoff-related complications were seen with 23 APV and 16 Monti channels (P = 0.052). Overall, 45.7% of patients required revision. Revisions were required in 19 APV and 13 Monti channels (P = 0.128). More than one revision was necessary in 10 conduits, six of which were Monti channels (P = 0.209). Kaplan-Meier analysis demonstrated a marked early decline in revision-free survival, with most revisions occurring within the first 18 months postoperatively. Conduit type was the only independent predictor of revision (HR 2.60, 95% CI 1.05-6.44, P = 0.038), with Monti channels demonstrating a higher hazard than APV. Age at surgery was not an independent predictor (HR 1.19 per year, 95% CI 0.98-1.43, P = 0.075). Time-stratified analysis demonstrated no significant predictors in either the early or late postoperative periods.</p><p><strong>Comment and conclusions: </strong>CCC creation is associated with a high rate of early revisions, with most failures occurring within the first 18 months. Monti channels were associated with a higher adjusted hazard of revision than APV, while age at surgery was not independently associated with outcome. These findings underscore the importance of patient counseling, structured follow-up protocols, and early surveillance for complications.</p>","PeriodicalId":16747,"journal":{"name":"Journal of Pediatric Urology","volume":" ","pages":"106243"},"PeriodicalIF":2.2,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148887926","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":"Workflow mapping and stakeholder perspectives to enhance quality improvement in pediatric clean intermittent catheterization education.","authors":"Manraj N Kaur, Lillian C Hayes, Catherine Sheehan, Erin McNamara, Melise A Keays, Stuart B Bauer","doi":"10.1016/j.jpurol.2026.106241","DOIUrl":"https://doi.org/10.1016/j.jpurol.2026.106241","url":null,"abstract":"<p><strong>Background: </strong>Clean Intermittent Catheterization (CIC) is commonly used to manage urinary retention and lower urinary tract dysfunction in pediatric patients. Despite its widespread use, variability exists in how CIC education and support are delivered across clinical settings. This exploratory qualitative study aimed to examine current CIC education workflows, identify barriers and facilitators to care delivery, and inform future quality improvement efforts within a high-volume pediatric urology program.</p><p><strong>Methods: </strong>Using an interpretive description approach within the exploratory phase of a broader quality improvement initiative, we conducted semi-structured interviews and focus groups with 16 healthcare providers and administrative staff involved in CIC education across pediatric urology care settings. Discussions explored CIC referral processes, scheduling workflows, teaching practices, follow-up approaches, and perceived barriers and facilitators to CIC education. Interviews were audio-recorded, transcribed verbatim and analyzed inductively using thematic analysis and workflow mapping.</p><p><strong>Results: </strong>Workflow mapping identified four interrelated processes in the CIC teaching pathways, referral and decision-making, scheduling and pre-visit preparation, the CIC teaching encounter, and post-teaching follow-up, with substantial variability across each. Four themes were identified: 1) variability in referral and scheduling processes, 2) nursing staff as central coordinators of CIC education, 3) caregiver readiness and psychological factors influencing teaching, and 4) variability in follow-up and lack of standardized reinforcement. Opportunities for improvement were also identified.</p><p><strong>Conclusion: </strong>This CIC workflow assessment identified variability and key barriers influencing CIC education across pediatric care settings and highlighted opportunities for improvement. Findings informed a preliminary, practice-informed toolkit proposing standardized workflows, pre-visit educational materials, and patient- and caregiver-centered protocols. The toolkit has not been implemented or evaluated; its effect on adherence, experience, and outcomes remains to be tested.</p>","PeriodicalId":16747,"journal":{"name":"Journal of Pediatric Urology","volume":" ","pages":"106241"},"PeriodicalIF":2.2,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148930170","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 to the Editor re: \"Is robot-assisted appendicovesicostomy equivalent to the current gold standard open procedure? A comparative analysis\".","authors":"Aseem R Shukla, Arun K Srinivasan, Sameer Mittal, Suhaib Abdulfattah","doi":"10.1016/j.jpurol.2026.106180","DOIUrl":"https://doi.org/10.1016/j.jpurol.2026.106180","url":null,"abstract":"","PeriodicalId":16747,"journal":{"name":"Journal of Pediatric Urology","volume":" ","pages":"106180"},"PeriodicalIF":2.2,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148906125","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":"Letter to the Editor re: \"Associations of clinical and laboratory parameters with pediatric urolithiasis composition: A retrospective, single-center study\".","authors":"Guohua Zhou","doi":"10.1016/j.jpurol.2026.106238","DOIUrl":"https://doi.org/10.1016/j.jpurol.2026.106238","url":null,"abstract":"","PeriodicalId":16747,"journal":{"name":"Journal of Pediatric Urology","volume":" ","pages":"106238"},"PeriodicalIF":2.2,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148850924","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 utility of renal sonographic measurements as predictors of early vesicoureteral reflux outcomes.","authors":"Ryan A Albright, M Bridget Zimmerman, Christopher S Cooper","doi":"10.1016/j.jpurol.2026.106225","DOIUrl":"10.1016/j.jpurol.2026.106225","url":null,"abstract":"<p><strong>Introduction and objectives: </strong>Increasing degrees of abnormal ureteral bud embryogenesis may result in increased vesicoureteral reflux (VUR) and renal dysplasia and decreased spontaneous VUR resolution. Renal ultrasound (US) measurements may be predictive of early clinical outcomes in children with VUR. The hypothesis is that increased renal parenchymal thickness (ParT) or medullary pyramidal thickness (PT) are associated with decreased grades of VUR and increased rates of spontaneous resolution.</p><p><strong>Methods: </strong>Medical records and imaging of 202 children ≤2 years of age (median age [IQR] 0.37 [0.12-1.41] years) with primary VUR and renal US within 6 months of initial voiding cystourethrogram and at least 2 years of follow-up were reviewed. US measurements included renal length, PT, and ParT. US parameters were compared using linear mixed models adjusted for age and sex. Logistic regression models assessed predictors of spontaneous resolution, including renal length, PT, and ParT in addition to age, sex, grade, VUR laterality (unilateral or bilateral), and UTI history.</p><p><strong>Results: </strong>78 children (39%) achieved spontaneous resolution, 73 (36%) underwent operative intervention, and 51 (25%) had persistent reflux. Higher grades of VUR correlated with lower mean PT and ParT (p < 0.0001). Lower grades of VUR were strongly associated with increased rates of spontaneous resolution at 1 and 2 years (p = 0.002 and p < 0.0001, respectively). Patients with spontaneous resolution at 1 and 2 years had smaller renal lengths (p < 0.001 and 0.015, respectively), greater PT (p < 0.001), and greater ParT (p = 0.004 and 0.019). After VUR grade, PT was the strongest independent predictor of spontaneous resolution (AUC 0.70 at 1 year; 0.711 at 2 years). Combining PT with renal length improved predictive accuracy of spontaneous resolution (AUC 0.73), and combining PT with VUR grade and renal length achieved the highest predictive accuracy (AUC up to 0.79 at 2 years).</p><p><strong>Discussion: </strong>Increased PT and ParT and decreased renal length were independent predictors of spontaneous VUR resolution. PT provided the strongest predictive value and enhanced discrimination when added to predictive models with grade, age, gender, laterality, and presenting symptoms. The addition of more objective sonographic measurements of renal length, PT, and ParT to VUR grade in multivariate models should permit more accurate individualized patient management.</p><p><strong>Conclusion: </strong>The addition of quantitative measurements of renal length, PT, and ParT to VUR grade in multivariate models improved predictive accuracy of early spontaneous VUR resolution.</p>","PeriodicalId":16747,"journal":{"name":"Journal of Pediatric Urology","volume":" ","pages":"106225"},"PeriodicalIF":2.2,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13525409/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148840492","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":"Challenges in the management of proximal hypospadias for early-career pediatric urologists.","authors":"Tatjana Heisinger-Heidler, Ilina Rosoklija, Emilie K Johnson, Elizabeth B Yerkes, James T Rague","doi":"10.1016/j.jpurol.2026.106235","DOIUrl":"https://doi.org/10.1016/j.jpurol.2026.106235","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Proximal hypospadias repair is technically complex, with numerous surgical techniques and variable outcomes. Fellowship programs aim to prepare trainees for independent practice, but case exposure is often limited and inconsistent. The challenges faced by early-career pediatric urologists and how fellowship training and early career support can be improved remain unclear.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To examine the experiences and challenges of early-career pediatric urologists in the management of patients with proximal hypospadias.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Study design: &lt;/strong&gt;An anonymous, web-based survey was sent to fellowship-trained pediatric urologists within 1-5 years of completing a 2-year ACGME (Accreditation Council for Graduate Medical Education)-accredited fellowship to assess fellowship experiences, perceived preparedness for practice, and early-career challenges in managing proximal hypospadias. Respondent demographics were obtained. Survey items were analyzed descriptively with proportions (n/N (%)). Not all survey items were completed by each participant. Subgroup analyses of respondents with 1-2 years (\"less experienced\") versus 3-5 years (\"more experienced\") of practice were performed using chi-square and Fisher's exact tests.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Of 92 individuals contacted, 40 (43.5%) responded. Most were male (21/39; 53.8%), aged 30-39 years (33/39; 84.6), and practiced in academic settings (34/39; 87.2%). Although most respondents felt very well prepared for preoperative, operative, and postoperative care after fellowship, early-career challenges were identified, including difficulty with intraoperative decision-making (25/38; 65.8%), low case volume (21/38; 55.3%) and postoperative complication management (16/38; 42.1%). Since fellowship, 74.4% (29/39) performed fewer than 10 proximal hypospadias cases annually. While informal mentorship was common (31/39; 79.5%), formal mentorship was rare (1/39; 2.6%). Respondents frequently used discussions with senior colleagues (34/39; 87.2%), fellowship notes (29/39; 74.4%) and surgical videos (26/39; 66.7%) to prepare for complex cases. Respondents felt the most helpful supports were observing senior colleagues (29/38; 76.3%), hands-on courses (24/38; 63.2%) and direct mentorship after fellowship (23/38; 60.5%). Less experienced respondents reported lower case volumes (p = 0.02) and most frequently identified infrequent case exposure as primary early-career challenge (p = 0.004). Reported modifications to surgical approach since fellowship differed significantly between groups (p &lt; 0.001).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Discussion: &lt;/strong&gt;While most respondents felt well prepared to undertake proximal hypospadias repair upon fellowship completion, this preparedness did not always translate into confidence during early career independent practice. Low case volumes and the desire for additional mentorship emerged as key components to improve confidence, highli","PeriodicalId":16747,"journal":{"name":"Journal of Pediatric Urology","volume":" ","pages":"106235"},"PeriodicalIF":2.2,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148840549","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}