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Letter to the editor re: “Rotation of the corpora cavernosa for ventral penile curvature: A length-preserving approach” 致编辑的信“旋转海绵体阴茎腹侧弯曲:一种保持长度的方法”。
IF 1.9 3区 医学 Q2 PEDIATRICS Pub Date : 2025-12-01 DOI: 10.1016/j.jpurol.2025.08.026
Eralp Kubilay
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引用次数: 0
Response to Commentary on “Does incontinence in a child with bladder exstrophy negatively affect caregivers? A mental health inventory survey” 对“膀胱外翻儿童尿失禁是否会对护理人员产生负面影响?”心理健康清单调查"。
IF 1.9 3区 医学 Q2 PEDIATRICS Pub Date : 2025-12-01 DOI: 10.1016/j.jpurol.2025.08.015
Suhaib Abdulfattah, Kimberly Dawes, Rakesh S. Joshi, Jaishri Ramji, Aseem R. Shukla
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引用次数: 0
Quality of information on hypospadias from artificial intelligence chatbots: How safe is AI for patient and family information? 人工智能聊天机器人关于尿道下裂的信息质量:人工智能对患者和家庭信息的安全性如何?
IF 1.9 3区 医学 Q2 PEDIATRICS Pub Date : 2025-12-01 DOI: 10.1016/j.jpurol.2025.08.029
Peter Stapleton , Jordan Santucci , Monica Thet , Nathan Lawrentschuk , Lachlan Dodds , Thomas Cundy , Niranjan Sathianathen

Introduction

Hypospadias is the most prevalent congenital anomaly of the penis, with an estimated incidence of 0.4–8.2 cases per 1000 live births (1). However, most of the parents and families of those with hypospadias experience anxiety and uncertainty regarding the information about hypospadias (2, 3). Leading to many families conduct their own independent internet search for information to better understand a diagnosis. The reliability and quality of this information for patients and families has not previously been formally assessed. The objective of this study is to assess the ability of AI chatbots to provide accurate and readable information to patients and families on hypospadias.

Methods

AI chatbot inputs were sourced from google trends and healthcare organisations. Google trends was used to identify the top 10 google search terms relating to ‘Hypospadias’ based on search volume. Royal Children Hospital in Melbourne (RCH) and the Urology Care Foundation American Urology Association – Hypospadias (AUA) headers were used as healthcare related hypospadias inputs4 different AI chatbot programs ChatGPT version 4.0, Perplexity, Chat Sonic, and Bing AI. Three urology consultants blinded to the AI chatbots assessed responses for accuracy and safety and a further two trained investigators, blinded to AI chatbot type and each other's evaluation scores, assessed AI chatbot responses using various evaluation instruments including PEMAT, DISCERN, misinfomration and Flesch-Kincaid readability formula as well as word count and citation.

Results

As demonstrated in the 4 AI chatbots assessed contained high quality health consumer information median DISCERN 4 (IQR 3–5). The degree of misinformation was low overall and across all AI chatbot responses, with a median of 1 (IQR 1-1).
The PEMAT Understandability scores was high overall with a median of 91.7 % (IQR 80–92.3). However, all AIs performed poorly in the actionability of their responses with an overall median of 40 % (20–80). The median word count per AI chatbot response was 213 (IQR 141–273).

Conclusion

AI chatbots provided understandable, high level and accurate health information relating to hypospadias. However, the information was delivered at a reading level which may limit its use in a paediatric or general public setting, and only one chatbot gave clearly actionable interventions or direction. Overall, AI chatbots are a clinically safe and appropriate adjunct to face to face consultation for healthcare information delivery and will likely take a more prominent domain as technology advances.
简介:尿道下裂是最常见的阴茎先天性异常,估计每1000例活产婴儿中有0.4-8.2例(1)。然而,大多数尿道下裂患者的父母和家庭对尿道下裂的信息感到焦虑和不确定(2,3)。导致许多家庭自己进行独立的互联网搜索信息,以更好地了解诊断。这一信息对患者和家属的可靠性和质量以前没有进行过正式评估。本研究的目的是评估人工智能聊天机器人为尿道下裂患者和家属提供准确可读信息的能力。方法:人工智能聊天机器人输入来自谷歌趋势和医疗机构。谷歌trends用于根据搜索量确定与“尿道下裂”相关的谷歌搜索词排名前10位。墨尔本皇家儿童医院(RCH)和泌尿外科护理基金会美国泌尿外科协会-尿道下裂(AUA)标题被用作医疗保健相关的尿道下裂输入4种不同的人工智能聊天机器人程序ChatGPT version 4.0, Perplexity, Chat Sonic和Bing AI。三名对人工智能聊天机器人不知情的泌尿科顾问评估了回答的准确性和安全性,另外两名训练有素的调查人员对人工智能聊天机器人的类型和彼此的评估分数不知情,他们使用各种评估工具评估人工智能聊天机器人的回答,包括PEMAT、DISCERN、错误信息和Flesch-Kincaid可读性公式以及字数和引用。结果表明,被评估的4个AI聊天机器人包含高质量的健康消费者信息,中位数为DISCERN 4 (IQR 3-5)。在所有人工智能聊天机器人的回答中,错误信息的总体程度很低,中位数为1 (IQR 1-1)。PEMAT可理解性评分总体上较高,中位数为91.7% (IQR 80-92.3)。然而,所有人工智能在其反应的可操作性方面表现不佳,总体中位数为40%(20-80)。每个AI聊天机器人回复的中位数字数为213 (IQR 141-273)。结论:人工智能聊天机器人提供了可理解、高水平、准确的尿道下裂相关健康信息。然而,这些信息的阅读水平可能会限制其在儿科或一般公共环境中的使用,而且只有一个聊天机器人给出了明确的可操作干预或指导。总的来说,人工智能聊天机器人在临床上是安全的,也是面对面咨询医疗信息传递的适当辅助手段,随着技术的进步,它可能会占据更重要的领域。
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引用次数: 0
Response to Letter to the editor re: “Nephron-sparing surgery in bilateral Wilms tumors: Limitations of current criteria and impact of tumor size on renal morbidity” 回复关于“双侧肾母细胞瘤保留肾单位手术:现行标准的局限性和肿瘤大小对肾脏发病率的影响”的编辑信。
IF 1.9 3区 医学 Q2 PEDIATRICS Pub Date : 2025-12-01 DOI: 10.1016/j.jpurol.2025.10.007
Burak Ardicli, Idil Rana User, Seden Hayal Akar, Berna Oguz, Mustafa Tezer Kutluk, Saniye Ekinci
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引用次数: 0
Letter to the editor re: "Agreement between two uroflowmetry tests in children with lower urinary tract symptoms". 致编辑的信:两种尿流测定法在有下尿路症状的儿童中的一致性。
IF 1.9 3区 医学 Q2 PEDIATRICS Pub Date : 2025-12-01 Epub Date: 2025-08-26 DOI: 10.1016/j.jpurol.2025.07.040
Damla Nur Tatlı, Nihat Karabacak, İlker Şen, Mustafa Özgür Tan
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引用次数: 0
Response to Letter to the editor re: "Laparoscopic varicocelectomy: Does intraoperative lymphography with vital dye influence the outcome?" 腹腔镜精索静脉曲张切除术:术中重要染色淋巴造影术是否影响预后?
IF 1.9 3区 医学 Q2 PEDIATRICS Pub Date : 2025-12-01 Epub Date: 2025-08-23 DOI: 10.1016/j.jpurol.2025.08.019
Ana Ludy Lopes Mendes, Marco Castagnetti
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引用次数: 0
The Vortex shunt: Short-term feasibility studies in the fetal lamb model of lower urinary tract obstruction and pleural effusion 涡旋分流术:下尿路梗阻和胸腔积液胎羊模型的短期可行性研究。
IF 1.9 3区 医学 Q2 PEDIATRICS Pub Date : 2025-12-01 DOI: 10.1016/j.jpurol.2025.04.027
Enrico Danzer , Yair J. Blumenfeld , Tomohiro Arai , Marianna Scuglia , Eric Johnson , James K. Wall , Wasinee Tianthong , David Basurto , Roland Devlieger , Jan Deprest , Francesca M. Russo , Kunj R. Sheth

Background

The suboptimal shunt design of the currently available vesico-amniotic and thoraco-amniotic shunts is likely at tributed to the risk of shunt failure, either by displacement, kinking, or obstruction, resulting in treatment failure and the need for additional fetal intervention.

Objective

To evaluate the feasibility of ultrasound-guided insertion, drainage, and short-term dislodgement risks of the novel Vortex shunt in fetal lambs with surgically induced lower urinary tract obstruction (LUTO) and pleural effusion.

Study design

LUTO was surgically created in eight fetal lambs at a median of 71 days (range 69–72; term = 145) gestation. LUTO phenotype developed in 5, of which four survived to shunt insertion at a median of 98 days (range 97–99). The three lambs that did not develop the LUTO phenotype and the one intrauterine fetal demise underwent pleural effusion creation. In the shunted LUTO fetuses 24 h post-deployment, the location and patency of the shunt were evaluated on fetal ultrasound and autopsy. In pleural effusion fetuses, shunt deployment was followed by immediate euthanasia and obduction.

Results

The deployment of the Vortex shunt was successful in all animals. In the LUTO group, bladder drainage was observed immediately after shunt placement, and functionality was confirmed 24 h later. Immediate drainage of the pleural effusion after shunt insertion led to the resolution of the pleural effusion. Accurate shunt positioning was verified in all fetuses through post-procedural and pre-necropsy ultrasound and during autopsy. There were no complications related to the shunt deployment. The short duration between shunt placement and autopsy limits our ability to draw definitive conclusions about the long-term effects of our shunt.

Discussion

These preclinical experiments provide proof-of-concept data on the novel fetal Vortex shunt. We demonstrated short-term safety and functionality without dislodgement after 24 h of deployment. The findings are the basis for long-term preclinical efficacy and safety studies in the LUTO fetal lamb model.

Conclusion

The novel Vortex shunt was tested for short-term safety and functionality in a preclinical fetal lamb model of lower urinary tract obstruction and pleural effusion.
背景:目前可用的膀胱-羊膜和胸-羊膜分流器的次优分流设计可能导致分流失败的风险,无论是移位,扭结或阻塞,导致治疗失败和需要额外的胎儿干预。目的:评价超声引导下旋涡分流器在手术致下尿路梗阻(LUTO)合并胸腔积液的胎羊羔中置入、引流的可行性及短期移位风险。研究设计:在8只平均71天(范围69-72天;足月=妊娠期。5例出现LUTO表型,其中4例存活至分流插入,平均时间为98天(范围97-99天)。未发生LUTO表型的3只羔羊和1只宫内胎儿死亡的羔羊经历了胸腔积液的产生。在部署后24 h的LUTO分流胎儿中,通过胎儿超声和尸检评估分流的位置和通畅程度。在胸腔积液胎儿,分流部署后立即安乐死和内收。结果:旋涡分流器在所有动物中均成功部署。LUTO组在分流器放置后立即观察膀胱引流,24 h后确认膀胱功能。在插入分流器后立即引流胸腔积液,导致胸腔积液的溶解。通过手术后和尸检前超声以及尸检,证实了所有胎儿的分流定位准确。没有与分流部署相关的并发症。分流器放置和尸检之间的短暂时间限制了我们对分流器的长期影响得出明确结论的能力。讨论:这些临床前实验为新型胎儿漩涡分流术提供了概念验证数据。在24小时的部署后,我们证明了短期的安全性和功能性,没有移位。这些发现为LUTO胎羊模型的长期临床前疗效和安全性研究奠定了基础。结论:在临床前的下尿路阻塞和胸腔积液胎羊模型中,对新型涡旋分流器的短期安全性和功能性进行了测试。
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引用次数: 0
The significance of ureterocele diameter for management and outcome 输尿管囊肿直径对治疗及预后的意义。
IF 1.9 3区 医学 Q2 PEDIATRICS Pub Date : 2025-12-01 DOI: 10.1016/j.jpurol.2025.05.002
Lukas Steinkellner , Jonas Thüminger , Mona Kerling , Nadine Gisnapp , Christa Gernhold , Josef Oswald , Bernhard Haid
<div><h3>Introduction</h3><div>Ureteroceles<span><span> are rare congenital malformations of the </span>urinary tract<span> and challenging in management. Other than localisation (ectopic or orthotopic) and features of the upper tract, there are no well-tested predictive variables. We aimed at evaluating the initial sonographically measured ureterocele diameter (UD) as a predictor for underlying anatomy, success of primary management and long-term complications.</span></span></div></div><div><h3>Patients and methods</h3><div><span>All patients (n = 131, 41m/90f) referred to a single tertiary department with the diagnosis of an ureterocele between 07/1995 and 07/2019 were included. The UD was measured sonographically at the time of initial diagnosis. Most patients (n = 108, 82.4 %) underwent scintigraphy (either MAG3 or DMSA-scan) and </span>voiding cystourethrography<span>. After initial wait-and-see or primary endoscopic intervention, complications and symptomatic or high-grade VUR<span> were indications for further surgical treatment, following an individualised protocol. Beneath data from sonographic exams, occurrence of urinary tract infections and voiding problems, all surgical and endoscopic data was recorded. Variables were examined using univariate and stepwise multivariate statistical methods.</span></span></div></div><div><h3>Results</h3><div>With a median age at first presentation of 2 months (IQR 8) the mean follow-up accounted to 6.5 years ± 4.8 years (range 0–20 years, median 5.4 years, IQR 7.3). Information on the initial diameter was available in 123 patients (94 %) with a median of 14 mm (IQR 14, range: 4–40).</div><div>In a stepwise multivariate analysis, the UD significantly correlated with the localisation (ectopic/orthotopic, p = 0.001, AUC 0.7), successful primary endoscopic intervention (p = 0.02, AUC 0.71) and successful wait-and-see (p = 0.003, AUC 0.82). Female sex showed a significant impact on the probability of successful primary endoscopic intervention (p = 0.002, AUC 0.71) and was besides age the only variable correlating with UTIs prior to treatment (p = 0.01, AUC 0.8) whereas UD was not. Figure. The anatomic localisation (ectopic or orthotopic) showed less significance than UD in all the analyses performed. In a prediction model based on the multivariate analysis a diameter of <10 mm and >26 mm showed a ≥90 % probability of either orthotopic or ectopic localisation.</div></div><div><h3>Conclusion</h3><div>In this retrospective cohort sonographically measured ureterocele diameter was an easy and non-invasively detectable feature predicting localisation and proved a stronger predictive variable for the success of primary management strategies, superior to endoscopically verified ureterocele localisation, in a stepwise multivariant analysis. Furthermore, UD was predictive of long-term complications with an AUC of 0.7. Conversely, neither UD nor localisation predicted the frequency of UTIs prior to treatment, un
导读:输尿管囊肿是一种罕见的先天性泌尿道畸形,其治疗具有挑战性。除了定位(异位或正位)和上尿路特征外,没有经过良好测试的预测变量。我们的目的是评估超声测量输尿管精索直径(UD)作为基础解剖、初步治疗成功和长期并发症的预测指标。患者和方法:纳入1995年7月至2019年7月期间在单一三级科室就诊的所有诊断为输尿管囊肿的患者(n = 131, 41m/90f)。在最初诊断时,超声测量UD。大多数患者(n = 108, 82.4%)接受了显像(MAG3或dmsa扫描)和排尿膀胱尿道造影。在最初的等待观察或初级内窥镜干预后,并发症和症状性或高度VUR是进一步手术治疗的指征,并遵循个体化方案。在超声检查、尿路感染和排尿问题的数据下,所有手术和内窥镜数据都被记录下来。采用单变量和逐步多元统计方法对变量进行检验。结果:首发年龄中位数为2个月(IQR 8),平均随访时间为6.5年±4.8年(范围0-20年,中位数5.4年,IQR 7.3)。123例(94%)患者获得了初始直径的信息,中位直径为14毫米(IQR 14,范围:4-40)。在逐步多变量分析中,UD与定位(异位/正位,p = 0.001, AUC 0.7)、成功的初级内镜干预(p = 0.02, AUC 0.71)和成功的等待观察(p = 0.003, AUC 0.82)显著相关。女性性别对初级内镜干预成功的概率有显著影响(p = 0.002, AUC 0.71),并且是除年龄外唯一与治疗前uti相关的变量(p = 0.01, AUC 0.8),而UD则没有。数字。解剖定位(异位或正位)在所有分析中都不如UD重要。在基于多变量分析的预测模型中,26mm的直径显示了≥90%的正位或异位定位的概率。结论:在这一回顾性队列中,超声测量输尿管囊肿直径是一种简单且无创的预测定位的特征,并且在逐步多变量分析中被证明是初级治疗策略成功的更强的预测变量,优于内窥镜验证输尿管囊肿定位。此外,UD预测长期并发症的AUC为0.7。相反,UD和定位都不能预测治疗前尿路感染的频率,这强调了CAP的重要性,尤其是在女性患者中。
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引用次数: 0
Abdominoscrotal hydrocele: A simple strategy for reliable surgical correction 腹阴囊鞘膜积液:一种简单可靠的手术矫正策略。
IF 1.9 3区 医学 Q2 PEDIATRICS Pub Date : 2025-12-01 DOI: 10.1016/j.jpurol.2025.05.028
Marco Pistone , Giorgio Persano , Antonio Franco , Giorgio Franco , Fabio Ferro
{"title":"Abdominoscrotal hydrocele: A simple strategy for reliable surgical correction","authors":"Marco Pistone ,&nbsp;Giorgio Persano ,&nbsp;Antonio Franco ,&nbsp;Giorgio Franco ,&nbsp;Fabio Ferro","doi":"10.1016/j.jpurol.2025.05.028","DOIUrl":"10.1016/j.jpurol.2025.05.028","url":null,"abstract":"","PeriodicalId":16747,"journal":{"name":"Journal of Pediatric Urology","volume":"21 6","pages":"Pages 1950-1952"},"PeriodicalIF":1.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144564911","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}
引用次数: 0
Response to Letter to the editor re: “The impact of foot reflexology on postoperative pain and fear in children following circumcision: A randomized controlled trial” 关于“足部反射疗法对包皮环切术后儿童疼痛和恐惧的影响”致编辑的信的回复。
IF 1.9 3区 医学 Q2 PEDIATRICS Pub Date : 2025-12-01 DOI: 10.1016/j.jpurol.2025.06.008
Abdullah Sarman , Suat Tuncay , Ali Ay
{"title":"Response to Letter to the editor re: “The impact of foot reflexology on postoperative pain and fear in children following circumcision: A randomized controlled trial”","authors":"Abdullah Sarman ,&nbsp;Suat Tuncay ,&nbsp;Ali Ay","doi":"10.1016/j.jpurol.2025.06.008","DOIUrl":"10.1016/j.jpurol.2025.06.008","url":null,"abstract":"","PeriodicalId":16747,"journal":{"name":"Journal of Pediatric Urology","volume":"21 6","pages":"Pages 1687-1688"},"PeriodicalIF":1.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144340230","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}
引用次数: 0
期刊
Journal of Pediatric Urology
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