Purpose: This study compares anteroposterior diameter of the renal pelvis (APDRP) and urinary tract dilation (UTD) prenatal grading systems for their accuracy in predicting postnatal outcomes.
Materials and methods: A retrospective multicenter study (June 2013-December 2024) included 211 patients classified prenatally using APDRP and UTD systems. Postnatal outcomes included spontaneous resolution, urinary tract infections (UTI), vesicoureteral reflux (VUR), urinary obstruction, and surgical need. ROC curve analysis was performed to assess predictive performance.
Results: 46 % of cases encountered spontaneous resolution; both classifications showed strong correlation with dilation severity (p < 0.001). For VUR endpoint, severe APDRP grade was associated with an OR of 4.24 (95%Cl 1.26-14.29, p = 0.02); UTD A2-3 had an OR of 3.12 (95%Cl = 1.02-9.58, p-value = 0.04). Regarding UTI, severe APDRP grade had an OR of 7.66 (95%Cl = 1.59-36.96, p-value = 0.01), while OR for UTD A2-3 was 5.59 (95%Cl = 1.25-25.01, p-value = 0.02). For obstructive uropathy, severe APDRP grade had an OR of 22.5 (95%Cl = 7.24-69.91, p-value <0.001); OR of UTD A2-3 was 8.65 (95%Cl = 2.96-25.28, p-value <0.001). Regarding need for surgery, severe APDRP grade had an OR of 22.10 (95%Cl = 7.73-63.11, p-value < 0.001), while UTD A2-3 had an OR of 11.41 (95%Cl = 3.93-33.14, p-value <0.001). ROC analysis showed that APDRP outperformed UTD in predicting spontaneous resolution (AUC 0.811 vs. 0.736), VUR (0.649 vs. 0.614), UTI (0.690 vs. 0.650), obstruction (0.799 vs. 0.686), andsurgery (0.792 vs. 0.705).
Conclusions: The APDRP system appears to be more accurate than UTD for the prediction of spontaneous resolution of dilation, urinary tract obstruction and need for surgical intervention.
{"title":"Prenatal diagnosis of urinary tract dilation: Comparative prognostic value of APDRP and UTD grading systems.","authors":"Valeria Silecchia, Davide Meneghesso, Federica Fati, Alessandro Morlacco, Enrico Vidal","doi":"10.1016/j.jpurol.2026.105748","DOIUrl":"https://doi.org/10.1016/j.jpurol.2026.105748","url":null,"abstract":"<p><strong>Purpose: </strong>This study compares anteroposterior diameter of the renal pelvis (APDRP) and urinary tract dilation (UTD) prenatal grading systems for their accuracy in predicting postnatal outcomes.</p><p><strong>Materials and methods: </strong>A retrospective multicenter study (June 2013-December 2024) included 211 patients classified prenatally using APDRP and UTD systems. Postnatal outcomes included spontaneous resolution, urinary tract infections (UTI), vesicoureteral reflux (VUR), urinary obstruction, and surgical need. ROC curve analysis was performed to assess predictive performance.</p><p><strong>Results: </strong>46 % of cases encountered spontaneous resolution; both classifications showed strong correlation with dilation severity (p < 0.001). For VUR endpoint, severe APDRP grade was associated with an OR of 4.24 (95%Cl 1.26-14.29, p = 0.02); UTD A2-3 had an OR of 3.12 (95%Cl = 1.02-9.58, p-value = 0.04). Regarding UTI, severe APDRP grade had an OR of 7.66 (95%Cl = 1.59-36.96, p-value = 0.01), while OR for UTD A2-3 was 5.59 (95%Cl = 1.25-25.01, p-value = 0.02). For obstructive uropathy, severe APDRP grade had an OR of 22.5 (95%Cl = 7.24-69.91, p-value <0.001); OR of UTD A2-3 was 8.65 (95%Cl = 2.96-25.28, p-value <0.001). Regarding need for surgery, severe APDRP grade had an OR of 22.10 (95%Cl = 7.73-63.11, p-value < 0.001), while UTD A2-3 had an OR of 11.41 (95%Cl = 3.93-33.14, p-value <0.001). ROC analysis showed that APDRP outperformed UTD in predicting spontaneous resolution (AUC 0.811 vs. 0.736), VUR (0.649 vs. 0.614), UTI (0.690 vs. 0.650), obstruction (0.799 vs. 0.686), andsurgery (0.792 vs. 0.705).</p><p><strong>Conclusions: </strong>The APDRP system appears to be more accurate than UTD for the prediction of spontaneous resolution of dilation, urinary tract obstruction and need for surgical intervention.</p>","PeriodicalId":16747,"journal":{"name":"Journal of Pediatric Urology","volume":"22 2","pages":"105748"},"PeriodicalIF":1.9,"publicationDate":"2026-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146099871","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}
Pub Date : 2026-01-15DOI: 10.1016/j.jpurol.2026.105738
M İrfan Dönmez, Salvatore Cascio, Bernhard Haid, Massimo Garriboli, Anka Nieuwhof-Leppink, Luis H Braga, Christina Ching, Caleb P Nelson, Ilina Rosoklija, Luke Harper
{"title":"Foundations of innovation: Basic research tools transforming pediatric urology.","authors":"M İrfan Dönmez, Salvatore Cascio, Bernhard Haid, Massimo Garriboli, Anka Nieuwhof-Leppink, Luis H Braga, Christina Ching, Caleb P Nelson, Ilina Rosoklija, Luke Harper","doi":"10.1016/j.jpurol.2026.105738","DOIUrl":"https://doi.org/10.1016/j.jpurol.2026.105738","url":null,"abstract":"","PeriodicalId":16747,"journal":{"name":"Journal of Pediatric Urology","volume":" ","pages":"105738"},"PeriodicalIF":1.9,"publicationDate":"2026-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146105962","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}
Pub Date : 2026-01-14DOI: 10.1016/j.jpurol.2026.105736
George Steinhardt
{"title":"Commentary to \"Additional diagnostic information and interobserver reliability of late imaging 120 minutes after tracer application in MAG3 scintigraphies in children with unilateral hydronephroses\".","authors":"George Steinhardt","doi":"10.1016/j.jpurol.2026.105736","DOIUrl":"https://doi.org/10.1016/j.jpurol.2026.105736","url":null,"abstract":"","PeriodicalId":16747,"journal":{"name":"Journal of Pediatric Urology","volume":" ","pages":"105736"},"PeriodicalIF":1.9,"publicationDate":"2026-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146113576","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}
Pub Date : 2026-01-13DOI: 10.1016/j.jpurol.2026.105722
Warren Snodgrass, Nicol Bush
Purpose: 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.
Methods: 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.
Results: There were 237 primary and 163 reoperative STAC repairs done between 2019 and 2024. VC averaged 74° (median 75°) in primary cases, with 85 % having more than 30-45° and 1 in 4 more than 90°. VC in reoperations was less (p < 0.00001), averaging 54° (median 50°). 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 >90° initially (p < 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.
Conclusions: 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.
{"title":"Efficacy of three corporotomies to correct ventral penile curvature. Experience in 400 patients with severe hypospadias.","authors":"Warren Snodgrass, Nicol Bush","doi":"10.1016/j.jpurol.2026.105722","DOIUrl":"https://doi.org/10.1016/j.jpurol.2026.105722","url":null,"abstract":"<p><strong>Purpose: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>There were 237 primary and 163 reoperative STAC repairs done between 2019 and 2024. VC averaged 74° (median 75°) in primary cases, with 85 % having more than 30-45° and 1 in 4 more than 90°. VC in reoperations was less (p < 0.00001), averaging 54° (median 50°). 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 >90° initially (p < 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.</p><p><strong>Conclusions: </strong>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.</p>","PeriodicalId":16747,"journal":{"name":"Journal of Pediatric Urology","volume":"22 2","pages":"105722"},"PeriodicalIF":1.9,"publicationDate":"2026-01-13","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}
Pub Date : 2026-01-13DOI: 10.1016/j.jpurol.2026.105737
Ashorne K. Mahenthiran, Christopher Ferari, Shelly King, Jin Kyu Kim, Rosalia Misseri, Martin Kaefer, Richard C. Rink, Benjamin M. Whittam, Joshua Roth, Kirstan K. Meldrum, Mark P. Cain, Konrad M. Szymanski, Pankaj P. Dangle
Introduction
Pediatric urologists are often tasked with recognizing upper urinary tract obstruction and managing these cases appropriately. The Whitaker test (WhT) is a diagnostic modality created to identify obstruction by measuring pressure differentials along the renal pelvis and bladder via antegrade contrast administration. Over time, the diuretic renogram has become preferred in the workup of pediatric obstruction due to concerns regarding need for percutaneous nephrostomy tube placement and variability in findings based on technique during WhT.
Objective
This study evaluates the clinical utility of the WhT in a contemporary pediatric cohort — especially in patients with equivocal diuretic renograms or prior interventions for urinary tract obstruction.
Study design
A retrospective chart review was conducted to identify patients less than 18 years old who underwent WhT between 2019 and 2025 at our tertiary referral center. Data collected included patient demographics such as prior upper tract reconstruction, renogram interpretations by radiologists, indications for and results of WhT, and concordance versus discordance between renogram and WhT. In cases of discordance, we examined whether ultimate decision-making reflected the findings of WhT or renogram.
Results
38 patients underwent WhT between 2019 and 2025. Approximately 60 % of the cohort was male and 60 % of the cohort had prior upper tract urinary reconstruction. The most common indication for WhT was concern for recurrent unilateral ureteropelvic junction obstruction (UPJO) after pyeloplasty (30.8 %). Overall, almost 80 % of treatment decisions, regarding whether to intervene or observe, were aligned with WhT findings of whether obstruction was present.
Discussion
This study confirms that there remains clinical value to WhT in the workup of pediatric urinary tract obstruction. Our findings align with prior literature that WhT is a useful supplemental tool to renogram, particularly in equivocal cases or for patients with prior reconstruction. The retrospective, single-center design of this study inherently limits its evidentiary strength and generalizability.
Conclusion
Our study found that select patients with inconclusive renal scans and complex urologic history may benefit from WhT for conclusive decisions regarding whether surgical intervention is needed to manage upper urinary tract obstruction.
{"title":"The utility of the Whitaker test in the modern era of pediatric urology: A retrospective cohort study","authors":"Ashorne K. Mahenthiran, Christopher Ferari, Shelly King, Jin Kyu Kim, Rosalia Misseri, Martin Kaefer, Richard C. Rink, Benjamin M. Whittam, Joshua Roth, Kirstan K. Meldrum, Mark P. Cain, Konrad M. Szymanski, Pankaj P. Dangle","doi":"10.1016/j.jpurol.2026.105737","DOIUrl":"10.1016/j.jpurol.2026.105737","url":null,"abstract":"<div><h3>Introduction</h3><div>Pediatric urologists are often tasked with recognizing upper urinary tract obstruction and managing these cases appropriately. The Whitaker test (WhT) is a diagnostic modality created to identify obstruction by measuring pressure differentials along the renal pelvis and bladder via antegrade contrast administration. Over time, the diuretic renogram has become preferred in the workup of pediatric obstruction due to concerns regarding need for percutaneous nephrostomy tube placement and variability in findings based on technique during WhT.</div></div><div><h3>Objective</h3><div>This study evaluates the clinical utility of the WhT in a contemporary pediatric cohort — especially in patients with equivocal diuretic renograms or prior interventions for urinary tract obstruction.</div></div><div><h3>Study design</h3><div>A retrospective chart review was conducted to identify patients less than 18 years old who underwent WhT between 2019 and 2025 at our tertiary referral center. Data collected included patient demographics such as prior upper tract reconstruction, renogram interpretations by radiologists, indications for and results of WhT, and concordance versus discordance between renogram and WhT. In cases of discordance, we examined whether ultimate decision-making reflected the findings of WhT or renogram.</div></div><div><h3>Results</h3><div>38 patients underwent WhT between 2019 and 2025. Approximately 60 % of the cohort was male and 60 % of the cohort had prior upper tract urinary reconstruction. The most common indication for WhT was concern for recurrent unilateral ureteropelvic junction obstruction (UPJO) after pyeloplasty (30.8 %). Overall, almost 80 % of treatment decisions, regarding whether to intervene or observe, were aligned with WhT findings of whether obstruction was present.</div></div><div><h3>Discussion</h3><div>This study confirms that there remains clinical value to WhT in the workup of pediatric urinary tract obstruction. Our findings align with prior literature that WhT is a useful supplemental tool to renogram, particularly in equivocal cases or for patients with prior reconstruction. The retrospective, single-center design of this study inherently limits its evidentiary strength and generalizability.</div></div><div><h3>Conclusion</h3><div>Our study found that select patients with inconclusive renal scans and complex urologic history may benefit from WhT for conclusive decisions regarding whether surgical intervention is needed to manage upper urinary tract obstruction.</div></div>","PeriodicalId":16747,"journal":{"name":"Journal of Pediatric Urology","volume":"22 2","pages":"Article 105737"},"PeriodicalIF":1.9,"publicationDate":"2026-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146081023","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}
Pub Date : 2026-01-13DOI: 10.1016/j.jpurol.2026.105731
Kazim Okan Dolu
{"title":"Letter to the Editor re: \"Comparative analysis of three chatbot responses on pediatric primary nocturnal enuresis\".","authors":"Kazim Okan Dolu","doi":"10.1016/j.jpurol.2026.105731","DOIUrl":"https://doi.org/10.1016/j.jpurol.2026.105731","url":null,"abstract":"","PeriodicalId":16747,"journal":{"name":"Journal of Pediatric Urology","volume":" ","pages":"105731"},"PeriodicalIF":1.9,"publicationDate":"2026-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146093349","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}
Pub Date : 2026-01-13DOI: 10.1016/j.jpurol.2026.105734
Esra Nagehan Akyol Onder , Çağla Serpil Doğan , Sibel Tiryaki , Muhammet İrfan Dönmez , Arife Uslu Gökçeoğlu , Aslı Çelebi Tayfur , Demet Alaygut , Ebru Bekiroğlu Yılmaz , İsmail Selvi , Çağrı Akın Şekerci , Nurcan Cengiz , Kaan Savaş Gülleroğlu
Objective
Myelomeningocele (MMC) is the most common cause of neurogenic bladder dysfunction in children. Adequate assessment and management can prevent complications of MMC. The objective of this study is to provide a comprehensive update on the diagnostic approaches, treatment strategies, and follow-up protocols for MMC in Turkish pediatric patients.
Methods
In October 2024, a consensus committee, established with the participation of the Turkish Society for Pediatric Nephrology, the Society for Pediatric Urology, and the Turkish Pediatric Urology Association, met to review the literature and update a national consensus report addressing the nephro-urological management of myelomeningocele in children and adolescents.
Results
The consensus group discussed and formulated recommendations on the diagnosis, treatment, and follow-up of children with MMC, based on available evidence and expert consensus where evidence was limited.
Conclusions
Newborns with MMC should undergo an early ultrasound as soon as possible after birth, and clean intermittent catheterization should be initiated promptly. A lifelong multidisciplinary follow-up, including attention to transition to adult care, is required for optimal management.
{"title":"The Turkish consensus recommendations on the nephro-urological management of myelomeningocele in children and adolescents","authors":"Esra Nagehan Akyol Onder , Çağla Serpil Doğan , Sibel Tiryaki , Muhammet İrfan Dönmez , Arife Uslu Gökçeoğlu , Aslı Çelebi Tayfur , Demet Alaygut , Ebru Bekiroğlu Yılmaz , İsmail Selvi , Çağrı Akın Şekerci , Nurcan Cengiz , Kaan Savaş Gülleroğlu","doi":"10.1016/j.jpurol.2026.105734","DOIUrl":"10.1016/j.jpurol.2026.105734","url":null,"abstract":"<div><h3>Objective</h3><div>Myelomeningocele (MMC) is the most common cause of neurogenic bladder dysfunction in children. Adequate assessment and management can prevent complications of MMC. The objective of this study is to provide a comprehensive update on the diagnostic approaches, treatment strategies, and follow-up protocols for MMC in Turkish pediatric patients.</div></div><div><h3>Methods</h3><div>In October 2024, a consensus committee, established with the participation of the Turkish Society for Pediatric Nephrology, the Society for Pediatric Urology, and the Turkish Pediatric Urology Association, met to review the literature and update a national consensus report addressing the nephro-urological management of myelomeningocele in children and adolescents.</div></div><div><h3>Results</h3><div>The consensus group discussed and formulated recommendations on the diagnosis, treatment, and follow-up of children with MMC, based on available evidence and expert consensus where evidence was limited.</div></div><div><h3>Conclusions</h3><div>Newborns with MMC should undergo an early ultrasound as soon as possible after birth, and clean intermittent catheterization should be initiated promptly. A lifelong multidisciplinary follow-up, including attention to transition to adult care, is required for optimal management.</div></div>","PeriodicalId":16747,"journal":{"name":"Journal of Pediatric Urology","volume":"22 2","pages":"Article 105734"},"PeriodicalIF":1.9,"publicationDate":"2026-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146080985","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}
Pub Date : 2026-01-12DOI: 10.1016/j.jpurol.2026.105733
Ibrahim Ulman , Tariq Abbas , Ursula Tonnhofer , Luis H. Braga , Ahmed T. Hadidi
Introduction
Hypospadias is one of the most common congenital anomalies, yet surgical training remains variable worldwide. Despite advances in surgical techniques, outcomes continue to be challenged by high complication rates, uneven case distribution, and lack of standardized curricula.
Objective
To evaluate current hypospadias training, competency assessment, and the role of modern educational tools, using data from the Hypospadias International Society (HIS) 2024 Cairo meeting and a review of the literature.
Study design
This narrative review integrates published evidence with findings from a cross-sectional survey of 103 international HIS members and congress attendees. The survey explored surgical exposure, perceived training needs, and preferred educational modalities.
Results
Survey respondents reported a gap between the ideal number of hypospadias procedures required for competency and the actual exposure achieved during residency and fellowship. While most endorsed microsurgical training and stepwise progression, limited case volumes and inconsistent curricula were identified. Competency-based assessment tools such as the Objective Structured Assessment of Technical Skills (OSATS) and structured feedback provide more objective evaluation compared to traditional models. Advances in simulation—including animal models, 3D-printed and synthetic replicas, and emerging VR/AR platforms—offer reproducible environments for skill development. E-learning and tele-mentoring further expand access to training across regions.
Discussion
Hypospadias education benefits from combining traditional high-volume center experience with reproducible modern training tools. Structured curricula and competency-based assessments may reduce variability in surgical outcomes.
Conclusion
Training in hypospadias surgery should emphasize structured frameworks, objective assessment, and innovative modalities. Concentrating training in specialized centers, while integrating simulation and digital platforms, may better prepare future surgeons and improve patient outcomes.
{"title":"Education and training in hypospadias surgery: Current status, competency assessment, and the role of modern educational tools","authors":"Ibrahim Ulman , Tariq Abbas , Ursula Tonnhofer , Luis H. Braga , Ahmed T. Hadidi","doi":"10.1016/j.jpurol.2026.105733","DOIUrl":"10.1016/j.jpurol.2026.105733","url":null,"abstract":"<div><h3>Introduction</h3><div>Hypospadias is one of the most common congenital anomalies, yet surgical training remains variable worldwide. Despite advances in surgical techniques, outcomes continue to be challenged by high complication rates, uneven case distribution, and lack of standardized curricula.</div></div><div><h3>Objective</h3><div>To evaluate current hypospadias training, competency assessment, and the role of modern educational tools, using data from the Hypospadias International Society (HIS) 2024 Cairo meeting and a review of the literature.</div></div><div><h3>Study design</h3><div>This narrative review integrates published evidence with findings from a cross-sectional survey of 103 international HIS members and congress attendees. The survey explored surgical exposure, perceived training needs, and preferred educational modalities.</div></div><div><h3>Results</h3><div>Survey respondents reported a gap between the ideal number of hypospadias procedures required for competency and the actual exposure achieved during residency and fellowship. While most endorsed microsurgical training and stepwise progression, limited case volumes and inconsistent curricula were identified. Competency-based assessment tools such as the Objective Structured Assessment of Technical Skills (OSATS) and structured feedback provide more objective evaluation compared to traditional models. Advances in simulation—including animal models, 3D-printed and synthetic replicas, and emerging VR/AR platforms—offer reproducible environments for skill development. E-learning and tele-mentoring further expand access to training across regions.</div></div><div><h3>Discussion</h3><div>Hypospadias education benefits from combining traditional high-volume center experience with reproducible modern training tools. Structured curricula and competency-based assessments may reduce variability in surgical outcomes.</div></div><div><h3>Conclusion</h3><div>Training in hypospadias surgery should emphasize structured frameworks, objective assessment, and innovative modalities. Concentrating training in specialized centers, while integrating simulation and digital platforms, may better prepare future surgeons and improve patient outcomes.</div></div>","PeriodicalId":16747,"journal":{"name":"Journal of Pediatric Urology","volume":"22 2","pages":"Article 105733"},"PeriodicalIF":1.9,"publicationDate":"2026-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146081021","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}
Pub Date : 2026-01-11DOI: 10.1016/j.jpurol.2026.105729
Nav La, Schawanya K Rattanapitoon, Chutharat Thanchonnang, Nathkapach K Rattanapitoon
{"title":"Letter to the Editor re: \"ROS scavengers and genital skin healing in boys with hypospadias\".","authors":"Nav La, Schawanya K Rattanapitoon, Chutharat Thanchonnang, Nathkapach K Rattanapitoon","doi":"10.1016/j.jpurol.2026.105729","DOIUrl":"https://doi.org/10.1016/j.jpurol.2026.105729","url":null,"abstract":"","PeriodicalId":16747,"journal":{"name":"Journal of Pediatric Urology","volume":" ","pages":"105729"},"PeriodicalIF":1.9,"publicationDate":"2026-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146097307","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}
Pub Date : 2026-01-10DOI: 10.1016/j.jpurol.2026.105723
Putu Angga Risky Raharja, Tariq O Abbas
{"title":"Response to Letter to the Editor re: \"Evaluating the utility of ChatGPT in enhancing parental education and clinical support in hypospadias care\".","authors":"Putu Angga Risky Raharja, Tariq O Abbas","doi":"10.1016/j.jpurol.2026.105723","DOIUrl":"https://doi.org/10.1016/j.jpurol.2026.105723","url":null,"abstract":"","PeriodicalId":16747,"journal":{"name":"Journal of Pediatric Urology","volume":" ","pages":"105723"},"PeriodicalIF":1.9,"publicationDate":"2026-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146149772","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}
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