Journal of Pediatric Urology最新文献

{"title":"Pathological re-evaluation of testicular torsion specimens: Implications for surgical intervention strategies","authors":"Pengyu Chen ,&nbsp;Yue Wang ,&nbsp;Jiahong Su ,&nbsp;Qiuling Miao ,&nbsp;Zhilin Yang ,&nbsp;Weimo Li ,&nbsp;Xuerui Sun ,&nbsp;Weipeng Huang ,&nbsp;Shoulin Li","doi":"10.1016/j.jpurol.2026.105789","DOIUrl":"10.1016/j.jpurol.2026.105789","url":null,"abstract":"<div><h3>Objective</h3><div>This study aims to conduct a retrospective pathological analysis of testicular tissue specimens excised due to testicular torsion, to reassess the validity of previous surgical decisions and provide a comprehensive summary of the appropriate surgical indications for orchiectomy.</div></div><div><h3>Methods</h3><div>Medical records of patients who underwent orchiectomy due to testicular torsion at XXX Hospital between 2015 and 2023 were reviewed, and the excised testicular specimens were re-evaluated using the Mikuz grading system.</div></div><div><h3>Results</h3><div>113 patients who underwent orchiectomy were included in this study. Following the Mikuz classification, 14 patients were classified as Grade 1, 31 as Grade 2, and 68 as Grade 3. A longer duration of symptoms was associated with a lower proportion of patients with Grade 1 testicular injury while increasing age was correlated with a higher likelihood of developing Grade 1. In the Grade 1 group, 78.6 % of patients had a monocyte count of less than 0.5 × 10⁹/L, whereas the monocyte counts in the Grade 2 and Grade 3 groups were significantly higher than those in the Grade 1 group.</div></div><div><h3>Conclusion</h3><div>The findings of this study indicate that 12.4 % (14/113) of patients who underwent orchiectomy had low-grade testicular injury. Currently, objective measures are deficient for assessing the extent of testicular injury post-torsion, necessitating cautious decision-making regarding orchiectomy during surgical intervention. Patients presenting with brief symptom duration and low monocyte count may be more suitable candidates for orchiopexy as opposed to orchiectomy.</div></div>","PeriodicalId":16747,"journal":{"name":"Journal of Pediatric Urology","volume":"22 2","pages":"Article 105789"},"PeriodicalIF":1.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146170926","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: \"Laparoscopic Mitrofanoff procedure in children: Feasibility and outcome analysis over 18 years in a single centre\".","authors":"Ismael Elhalaby, Ahmed Elhalaby, Mustafa Azizoglu","doi":"10.1016/j.jpurol.2025.10.022","DOIUrl":"10.1016/j.jpurol.2025.10.022","url":null,"abstract":"","PeriodicalId":16747,"journal":{"name":"Journal of Pediatric Urology","volume":" ","pages":"105657"},"PeriodicalIF":1.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145677970","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: \"An objective analysis of > 600 paired hypospadias graft measurements: Prepuce vs oral graft take and HBOT effect\".","authors":"Jiayi Chen","doi":"10.1016/j.jpurol.2026.105741","DOIUrl":"10.1016/j.jpurol.2026.105741","url":null,"abstract":"","PeriodicalId":16747,"journal":{"name":"Journal of Pediatric Urology","volume":" ","pages":"105741"},"PeriodicalIF":1.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146099775","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 tele-nursing on parental anxiety and care satisfaction after circumcision: A quasi-experimental study","authors":"Asiye Balki ,&nbsp;Atiye Erbaş ,&nbsp;Selin Keskin Kiziltepe","doi":"10.1016/j.jpurol.2025.105708","DOIUrl":"10.1016/j.jpurol.2025.105708","url":null,"abstract":"<div><h3>Introduction</h3><div>Circumcision has been practised in almost every region of the world throughout human history for cultural, social, religious, and medical reasons. Although it is generally considered a simple procedure, studies have shown that parents of circumcised children often experience high levels of fear, anxiety, and worry during the process.</div></div><div><h3>Objective</h3><div>This study aimed to determine the effect of tele-nursing services provided to parents of circumcised children after discharge on their anxiety levels and satisfaction with care.</div></div><div><h3>Materials and methods</h3><div>This parallel-design, quasi-experimental study was conducted between November 2022 and July 2023 with 108 parents (54 in the intervention group and 54 in the control group) whose children had undergone circumcision. Participants were assigned to groups using the block randomisation method. The intervention group received tele-nursing follow-up after discharge, while the control group received routine discharge information only. Data collection tools included the participant information form, Beck Anxiety Scale, PedsQL Health Care Parental Satisfaction Scale, tele-nursing education content, and telephone counselling follow-up form. Data were analysed using non-parametric tests such as the chi-square, Mann–Whitney U, and Wilcoxon tests, with statistical significance set at p &lt; 0.05.</div></div><div><h3>Results</h3><div>The final measurement of anxiety scores indicated that parents in the intervention group had significantly lower anxiety than those in the control group (Z = −5.206, p = 0.000). Similarly, the final parental care satisfaction scores were significantly higher in the intervention group than in the control group (Z = −4.957, p = 0.000).</div></div><div><h3>Conclusion</h3><div>These findings demonstrate that tele-nursing services provided to parents of circumcised children after discharge effectively reduced parental anxiety and increased satisfaction with care. It is recommended that clinical nurses be supported and encouraged to provide tele-nursing services to maintain continuity of postoperative care, particularly for follow-up and education after surgical procedures.</div></div>","PeriodicalId":16747,"journal":{"name":"Journal of Pediatric Urology","volume":"22 2","pages":"Article 105708"},"PeriodicalIF":1.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146080987","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":"Parafistulous penile skin flap: A modified technique for repair of urethrocutaneous fistulas post hypospadias repair in children","authors":"Mahmoud Aboelnasr ,&nbsp;Mohammed Abdallah Hindawy ,&nbsp;Elsayed Mohamed Salih ,&nbsp;Farouk Ismail El-Guoshy ,&nbsp;Mohamed Emadeldin ,&nbsp;Adel Elatreisy","doi":"10.1016/j.jpurol.2026.105754","DOIUrl":"10.1016/j.jpurol.2026.105754","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate the efficacy of our novel technique utilizing a para-fistulous penile skin flap to repair urethrocutaneous fistulas in children.</div></div><div><h3>Methods</h3><div>A Prospective case series study included repairing 69 urethrocutaneous fistulas with our technique. It consists of a para-fistulous penile skin flap, with a second dartos layer obtained with a specific approach and a third full-thickness skin layer.</div><div>Concomitant Meatoplasty was performed for associated meatal stenosis. Surgical success is defined as normal voiding without fistula recurrence. Both univariate and multivariate analyses were utilized to assess predictors of fistula recurrence.</div></div><div><h3>Results</h3><div>The mean age ±SD was 6.5 ± 4.8 years, and the mean fistula size was 6.5 ± 3.9 mm. A total of 40 fistulas (58 %) measured ≥5 mm, while 29 (42 %) were &lt;5 mm. Sixty cases (93.8 %) were diagnosed with a single fistula, while four patients (6.3 %) had multiple fistulas. Additionally, 11 cases (17.2 %) were associated with meatal stenosis. The mean operative time was 56.8 ± 6.8 min, and the mean follow-up period was 11.75 ± 5 months. Four patients (6.2 %) experienced low-grade complications. Sixty-three cases (91.3 %) achieved successful fistula repair, and the success rate for large (&gt;5 mm) and multiple fistulas was 95 % and 88.9 %, respectively.</div><div>On univariate analysis, Multiple Previous hypospadias repairs, preoperative meatal stenosis, postoperative wound infection, and superficial skin necrosis were significantly associated with fistula recurrence (P &lt; 0.05); however, multivariate regression analysis showed a significant correlation with preoperative meatal stenosis (p = 0.003) and superficial skin necrosis (p = 0.045).</div></div><div><h3>Conclusion</h3><div>This study demonstrates the efficacy of our novel Para-fistulous Penile Skin Flap technique in repairing urethrocutaneous fistulas in pediatrics, achieving good outcomes for both large and multiple fistulas. Preoperative meatal stenosis and postoperative superficial skin necrosis were the independent predictors of fistula recurrence.</div></div>","PeriodicalId":16747,"journal":{"name":"Journal of Pediatric Urology","volume":"22 2","pages":"Article 105754"},"PeriodicalIF":1.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146142792","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":"Efficacy of three corporotomies to correct ventral penile curvature. Experience in 400 patients with severe hypospadias","authors":"Warren Snodgrass,&nbsp;Nicol Bush","doi":"10.1016/j.jpurol.2026.105722","DOIUrl":"10.1016/j.jpurol.2026.105722","url":null,"abstract":"<div><h3>Purpose</h3><div>We determined the efficacy of 3 corporotomies to straighten ventral curvature (VC) measuring 30–135° during the first stage of a 3-stage STAC repair in patients with proximal hypospadias, as confirmed by artificial erection (AE) at STAC 2 and STAC 3.</div></div><div><h3>Methods</h3><div>Consecutive males with proximal hypospadias and VC 30° or more underwent primary or reoperative STAC repair. Straightening was done by 3 ventral corporotomies during STAC 1, with AE repeated during STAC 2 and 3, and any reoperations after STAC repair for complications. Residual VC at STAC 2 was straightened by 1 Heineke-Mikulicz dorsal plication. The primary outcome was any ventral curvature. Secondary outcomes included bleeding complications requiring intraoperative or postoperative intervention, and reported change in erection quality in Tanner 4,5 patients.</div></div><div><h3>Results</h3><div>There were 237 primary and 163 reoperative STAC repairs done between 2019 and 2024. VC averaged 74° (<strong>median 75°)</strong> in primary cases, with 85 % having more than 30–45° and 1 in 4 more than 90°. VC in reoperations was less (<em>p</em> &lt; 0.00001), averaging 54° (<strong>median 50°).</strong> All patients had at least 2 AE after corporotomies, with the final an average of 17 (11.5–58) months later. 81 % had no VC at STAC 2. Residual VC in the remainder was always 30° or less, was more common in those with &gt;90° initially (<em>p</em> &lt; 0.00001), and was successfully corrected with a single Heineke-Mikulicz dorsal plication in most. Therefore, 99 % of patients were proven by AE to have successful straightening. There were no bleeding complications requiring intervention. One adult reported 15 % decrease in erection fullness.</div></div><div><h3>Conclusions</h3><div>3 corporotomies alone were successful in 81 %, which increased to 99 % with a subsequent dorsal plication in those with residual VC. The fact that residual curvature occurs after all straightening methods, including 3 corporotomies, emphasizes need for AE to be repeated at the next operation in staged repairs and during reoperations.</div></div>","PeriodicalId":16747,"journal":{"name":"Journal of Pediatric Urology","volume":"22 2","pages":"Article 105722"},"PeriodicalIF":1.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146099698","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":"Caregiver burnout in parents of children with neurogenic bladder: Prevalence and determinants","authors":"Bing Xie ,&nbsp;Peng-yu Chen ,&nbsp;Xue-rui Sun ,&nbsp;Ting-ting Yan ,&nbsp;Li-dan Zhong ,&nbsp;Rui Qian ,&nbsp;Wang Xin ,&nbsp;Yanan Xu","doi":"10.1016/j.jpurol.2026.105774","DOIUrl":"10.1016/j.jpurol.2026.105774","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate the prevalence and determinants of caregiving burnout among parents of children with neurogenic bladder in China.</div></div><div><h3>Methods</h3><div>A multi-center, cross-sectional study was conducted from January 2022 to March 2024. A total of 238 parents of children with NB from tertiary hospitals in Shenzhen, Wuhan, Zhengzhou, and Chongqing were enrolled. Validated scales were used to assess parenting burnout, work-family conflict, co-parenting quality, and psychological capital. Multiple linear regression and interaction analyses were performed to identify key predictors.</div></div><div><h3>Results</h3><div>The mean parental burnout score was (96.11 ± 26.96), with 28.6 % of parents experiencing high burnout. Significant predictors included lower educational level (β = −0.254, p &lt; 0.001), gender of parents (β = 0.153, p = 0.001), lower monthly income (β = −0.166, p = 0.001), higher work-family conflict (β = 0.194, p &lt; 0.001), poorer co-parenting (β = −0.232, p &lt; 0.001), and lower psychological capital (β = −0.167, p = &lt; 0.001). Disease severity and time since diagnosis interacted with income to exacerbate burnout in low-income families.</div></div><div><h3>Conclusion</h3><div>Parents of children with NB experience high levels of caregiving burnout, influenced by socioeconomic, psychological, and family-system factors. Targeted interventions—such as financial aid, psychological support, and co-parenting programs—are urgently needed to mitigate burnout and improve family outcomes.</div></div>","PeriodicalId":16747,"journal":{"name":"Journal of Pediatric Urology","volume":"22 2","pages":"Article 105774"},"PeriodicalIF":1.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146227225","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 modified urodynamic quality control quick checklist for pediatrics: Reducing technical artifacts to enhance assessment reliability","authors":"Ting Kang,&nbsp;Wenjiao Huang,&nbsp;Qian Yang,&nbsp;Xinyu Hu,&nbsp;Chi Yuan","doi":"10.1016/j.jpurol.2026.105755","DOIUrl":"10.1016/j.jpurol.2026.105755","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the effectiveness of a modified quick checklist for quality control in reducing the incidence of technical artifacts during pediatric urodynamic studies (UDS).</div></div><div><h3>Methods</h3><div>A single-center quasi-experimental study with a pre-post intervention design was conducted, comprising three phases: technical artifact analysis (baseline period), modified quick checklist development, and intervention effect evaluation (intervention period). During the baseline period, urodynamic data from 174 pediatric patients were retrospectively collected. Technical artifact classification criteria were established based on guidelines from the International Continence Society (ICS) and the International Children's Continence Society (ICCS), adapted to pediatric characteristics. A modified quick checklist was subsequently developed, validated via expert consultation (content validity index, CVI) and optimized through pre-testing. The intervention phase enrolled 127 pediatric patients, applying the modified quick checklist and comparing technical artifact rates between groups.</div></div><div><h3>Results</h3><div>No significant differences were observed between the baseline and intervention groups regarding age, gender, or underlying conditions (<em>P</em> &gt; 0.05). Following the implementation of the modified quick checklist, there was a significant improvement in the completion rate of the standard cough test before perfusion (χ² = 6.108, <em>P</em> = 0.013), complete measurement records (χ² = 7.730, <em>P</em> = 0.005), and the completion rate of the standard cough test before pressure measurement termination (χ² = 32.008, <em>P</em> &lt; 0.001). However, no statistically significant differences were noted in indicators such as abdominal pressure variability or catheter displacement.</div></div><div><h3>Conclusion</h3><div>The modified pediatric urodynamic quality control checklist effectively reduces technical artifacts in pediatric UDS examinations, enhances procedural standardization and data quality, and serves as a practical quality control tool for the precise assessment of pediatric lower urinary tract dysfunction.</div></div>","PeriodicalId":16747,"journal":{"name":"Journal of Pediatric Urology","volume":"22 2","pages":"Article 105755"},"PeriodicalIF":1.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146137550","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":"Additional diagnostic information and interobserver reliability of late imaging 120 minutes after tracer application in MAG3 scintigraphies in children with unilateral hydronephroses.","authors":"L Steinkellner, C Gernhold, J Thüminger, G Schweighofer Zwink, J Dierneder, L Lusuardi, J Oswald, B Haid","doi":"10.1016/j.jpurol.2025.12.012","DOIUrl":"10.1016/j.jpurol.2025.12.012","url":null,"abstract":"<p><strong>Purpose: </strong>There is no universally accepted definition of obstruction in the use of dynamic renography for the evaluation of high-grade hydronephrosis. Prolonged, but insignificant pelvicalyceal tracer retention is often difficult to differentiate from significant obstruction in cases with neither clear obstruction nor unimpaired outflow. We hypothesized that an additional measurement of the residual activity 120 mins after tracer application might reduce the probability of equivocal findings.</p><p><strong>Methods: </strong>In 37 consecutive MAG3 scans performed for the evaluation of isolated unilateral highgrade hydronephroses ≥SFU III in 28 patients a late static image after 120 mins was additionally acquired in the case of a high residual activity of >30% after 45 mins. Nine board-certified specialists (6 in nuclear medicine, 3 in pediatric urology) independently reviewed all examinations with and without the information on the additional late imaging 120 mins post injection (p.i.) using a predefined ordinal scale from 1 (=normal) to 5 (= obstructive). We measured the extent of change in reporting associated with the addition of late imaging and controlled for the level of interobserver agreement. After follow-up the impact on surgical indications was reviewed. Ranks were compared using Wilcoxon-Mann tests, interobserver agreement was calculated via evaluation of individual findings with ANOVA. P-values <0.05 were considered significant.</p><p><strong>Results: </strong>The addition of a late image resulted in a \"less obstructive\" interpretation (decreased rank, -0.31, p = 0.000048) compared to standard protocol and led to a reduction of equivocal findings (39 % vs. 28%, p=0.003). There was a low variation in the assessments with no significant differences in rank distribution (p = 0.137) and no difference between nuclear medicine specialists and pediatric urologists. After a median 66 months of follow-up, 25/28 (89 %) patients were eligible for reevaluation, of whom 18/25 (72 %) proceeded to pyeloplasty. Of those with a significantly less obstructive assessment due to late imaging, 6/9 underwent pyeloplasty.</p><p><strong>Conclusion: </strong>In preselected patients with high residual activity after 45 mins, measurement of the residual activity 120 min after tracer application influenced interpretation of the diuretic renography towards a less frequent diagnosis of obstruction and reduced the number of equivocal assessments. In this study, the clinical impact of the additional late imaging proved small and relevant only for few patients. Until further studies have found different results, the acquisition of additional late imaging should remain a very individual decision.</p>","PeriodicalId":16747,"journal":{"name":"Journal of Pediatric Urology","volume":" ","pages":"105696"},"PeriodicalIF":1.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145889407","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 on \"Socioeconomic and demographic factors predict post-surgical follow-up\".","authors":"Megan A Stout, Jason Benedict, Christina B Ching","doi":"10.1016/j.jpurol.2025.105721","DOIUrl":"10.1016/j.jpurol.2025.105721","url":null,"abstract":"","PeriodicalId":16747,"journal":{"name":"Journal of Pediatric Urology","volume":" ","pages":"105721"},"PeriodicalIF":1.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146113583","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}