Pub Date : 2024-10-01DOI: 10.1016/j.jpurol.2024.06.023
{"title":"Response to commentary on: Parents’ experiences of treatment and outcomes in high-grade vesicoureteral reflux in infants – One piece in the puzzle of VUR management?","authors":"","doi":"10.1016/j.jpurol.2024.06.023","DOIUrl":"10.1016/j.jpurol.2024.06.023","url":null,"abstract":"","PeriodicalId":16747,"journal":{"name":"Journal of Pediatric Urology","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141550713","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 : 2024-10-01DOI: 10.1016/j.jpurol.2024.06.019
{"title":"Commentary to “Size matters: Total testicular volume predicts sperm count in Tanner V varicocele patients”","authors":"","doi":"10.1016/j.jpurol.2024.06.019","DOIUrl":"10.1016/j.jpurol.2024.06.019","url":null,"abstract":"","PeriodicalId":16747,"journal":{"name":"Journal of Pediatric Urology","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141524660","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 : 2024-10-01DOI: 10.1016/j.jpurol.2024.07.013
{"title":"Comment on “The effect of preoperative hormonal stimulation on the urethral plate; A histologic and histochemical study”: Which hormone, which plate, which reduction?","authors":"","doi":"10.1016/j.jpurol.2024.07.013","DOIUrl":"10.1016/j.jpurol.2024.07.013","url":null,"abstract":"","PeriodicalId":16747,"journal":{"name":"Journal of Pediatric Urology","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141838307","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 : 2024-10-01DOI: 10.1016/j.jpurol.2024.09.023
{"title":"What the editors are reading: Innovation and technology","authors":"","doi":"10.1016/j.jpurol.2024.09.023","DOIUrl":"10.1016/j.jpurol.2024.09.023","url":null,"abstract":"","PeriodicalId":16747,"journal":{"name":"Journal of Pediatric Urology","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142381151","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 : 2024-10-01DOI: 10.1016/j.jpurol.2024.07.024
{"title":"Commentary to “The impact of audiovisual information on parental anxiety levels prior to hypospadias surgery: A prospective single center cohort study”","authors":"","doi":"10.1016/j.jpurol.2024.07.024","DOIUrl":"10.1016/j.jpurol.2024.07.024","url":null,"abstract":"","PeriodicalId":16747,"journal":{"name":"Journal of Pediatric Urology","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141933582","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 : 2024-10-01DOI: 10.1016/j.jpurol.2024.07.008
Undescended testis (UDT, cryptorchidism) is the most frequent genital anomaly in boys. However, its treatment varies widely throughout the world. This second part of our roundtable discussion aims to continue to ask global experts to express their attitudes towards several case scenarios of UDT in order to explore the rationale for their clinical decisions. As the European Association of Urology – Young Academic Urologists Pediatric Urology Working Group, we believe that this roundtable series will facilitate colleagues all over the world to reflect and improve their practices regarding the treatment of UDT.
{"title":"Undescended testis: A roundtable discussion based on clinical scenarios – Part 2","authors":"","doi":"10.1016/j.jpurol.2024.07.008","DOIUrl":"10.1016/j.jpurol.2024.07.008","url":null,"abstract":"<div><div><span>Undescended testis (UDT, cryptorchidism) is the most frequent </span>genital anomaly<span> in boys. However, its treatment varies widely throughout the world. This second part of our roundtable discussion aims to continue to ask global experts to express their attitudes towards several case scenarios of UDT in order to explore the rationale for their clinical decisions. As the European Association of Urology<span> – Young Academic Urologists Pediatric Urology Working Group, we believe that this roundtable series will facilitate colleagues all over the world to reflect and improve their practices regarding the treatment of UDT.</span></span></div></div>","PeriodicalId":16747,"journal":{"name":"Journal of Pediatric Urology","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141703943","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 : 2024-10-01DOI: 10.1016/j.jpurol.2024.02.008
<div><h3>Introduction</h3><div>When evaluating the timeliness of orchiopexy for cryptorchidism, health disparities are apparent among Hispanic and African American males and those with public insurance. Since the publication of these data, the COVID-19 pandemic has stressed our healthcare system and significantly affected the provision of pediatric urology care.</div></div><div><h3>Objective</h3><div>We sought to assess if certain groups were disproportionately affected in progression to orchiopexy after the diagnosis of cryptorchidism during and after the pandemic in US freestanding children's hospitals.</div></div><div><h3>Study design</h3><div>Using the PHIS database, pediatric patients ≤5 years who underwent orchiopexy between January 2018 and December 2022 were retrospectively analyzed. Exclusion criteria included prematurity, retractile testes, and testicular torsion. Primary outcomes were age at orchiopexy and the proportion of individuals undergoing timely orchiopexy for cryptorchidism.</div></div><div><h3>Results</h3><div>Over the study period 3140 patients ≤5 years old underwent orchiopexy for cryptorchidism. Non-Hispanic Blacks and Hispanics were significantly less likely to have timely orchiopexy and underwent orchiopexy 2.13 and 3.60 months later compared to whites (p < 0.01). As compared to pre-COVID-19, during the pandemic the proportion of patients who had timely surgery was higher and the median age was significantly lower (p = 0.01 and p < 0.01, respectively) in white patients only. Over the study period, patients with public insurance were less likely to have timely orchiopexy and underwent orchiopexy 2.94 months later (p < 0.01) than patients with private insurance. Compared to during the pandemic, post-pandemic a significantly lower proportion of publicly insured patients have since undergone timely orchiopexy (p = 0.04). Patients in the West were less likely to have timely orchiopexy and had a higher age at time of orchiopexy (p < 0.01) than other regions. However, in the West during the pandemic, the proportion of children who had timely surgery was higher compared to pre-and post-COVID-19 (p < 0.01).</div></div><div><h3>Discussion</h3><div>Overall, regardless of insurance status, race, or location, a significant proportion of patients did not undergo timely orchiopexy. During the pandemic white patients had a lower median age and an increased proportion underwent timely orchiopexy, despite the number of orchiopexies remaining constant. Disparities in the post-COVID-19 era have been further exacerbated for publicly insured patients, who a significantly lower proportion of have since undergone timely orchiopexy. Specific efforts are required across the United States to increase timely orchiopexy for all boys.</div></div><div><h3>Conclusions</h3><div>Progression to timely orchiopexy remains low for all boys in the era surrounding COVID-19; certain groups appear to be more adversely affected.<span><figure><span>
{"title":"Contemporary disparities in progression to orchiopexy for cryptorchidism as reported in the Pediatric Health Information System (PHIS) database","authors":"","doi":"10.1016/j.jpurol.2024.02.008","DOIUrl":"10.1016/j.jpurol.2024.02.008","url":null,"abstract":"<div><h3>Introduction</h3><div>When evaluating the timeliness of orchiopexy for cryptorchidism, health disparities are apparent among Hispanic and African American males and those with public insurance. Since the publication of these data, the COVID-19 pandemic has stressed our healthcare system and significantly affected the provision of pediatric urology care.</div></div><div><h3>Objective</h3><div>We sought to assess if certain groups were disproportionately affected in progression to orchiopexy after the diagnosis of cryptorchidism during and after the pandemic in US freestanding children's hospitals.</div></div><div><h3>Study design</h3><div>Using the PHIS database, pediatric patients ≤5 years who underwent orchiopexy between January 2018 and December 2022 were retrospectively analyzed. Exclusion criteria included prematurity, retractile testes, and testicular torsion. Primary outcomes were age at orchiopexy and the proportion of individuals undergoing timely orchiopexy for cryptorchidism.</div></div><div><h3>Results</h3><div>Over the study period 3140 patients ≤5 years old underwent orchiopexy for cryptorchidism. Non-Hispanic Blacks and Hispanics were significantly less likely to have timely orchiopexy and underwent orchiopexy 2.13 and 3.60 months later compared to whites (p < 0.01). As compared to pre-COVID-19, during the pandemic the proportion of patients who had timely surgery was higher and the median age was significantly lower (p = 0.01 and p < 0.01, respectively) in white patients only. Over the study period, patients with public insurance were less likely to have timely orchiopexy and underwent orchiopexy 2.94 months later (p < 0.01) than patients with private insurance. Compared to during the pandemic, post-pandemic a significantly lower proportion of publicly insured patients have since undergone timely orchiopexy (p = 0.04). Patients in the West were less likely to have timely orchiopexy and had a higher age at time of orchiopexy (p < 0.01) than other regions. However, in the West during the pandemic, the proportion of children who had timely surgery was higher compared to pre-and post-COVID-19 (p < 0.01).</div></div><div><h3>Discussion</h3><div>Overall, regardless of insurance status, race, or location, a significant proportion of patients did not undergo timely orchiopexy. During the pandemic white patients had a lower median age and an increased proportion underwent timely orchiopexy, despite the number of orchiopexies remaining constant. Disparities in the post-COVID-19 era have been further exacerbated for publicly insured patients, who a significantly lower proportion of have since undergone timely orchiopexy. Specific efforts are required across the United States to increase timely orchiopexy for all boys.</div></div><div><h3>Conclusions</h3><div>Progression to timely orchiopexy remains low for all boys in the era surrounding COVID-19; certain groups appear to be more adversely affected.<span><figure><span>","PeriodicalId":16747,"journal":{"name":"Journal of Pediatric Urology","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139920422","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 : 2024-10-01DOI: 10.1016/j.jpurol.2024.08.001
{"title":"Response regarding “Assessing the effects of bladder decellularization protocols on extracellular matrix (ECM) structure, mechanics, and biology”","authors":"","doi":"10.1016/j.jpurol.2024.08.001","DOIUrl":"10.1016/j.jpurol.2024.08.001","url":null,"abstract":"","PeriodicalId":16747,"journal":{"name":"Journal of Pediatric Urology","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142055911","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 : 2024-10-01DOI: 10.1016/j.jpurol.2024.07.010
Laparoscopic ureteral reimplantation has gained increasing popularity in treating pediatric primary vesicoureteral reflux (VUR) and obstructive megaureter (OM). However, it is technically challenging with a relatively low success rate compared to open surgery. Here we designed a hybrid technique which incorporates laparoscopic surgery and pneumovesical ureteral reimplantation. From 2023 February to 2024 February, five boys and four girls underwent the hybrid reimplantation smoothly. There were seven children with VUR and two with OM. Patient age ranged from eight months to ten years. The mean time was 201.5 min (range 155–240 min) for unilateral operation and 260 min for bilateral operation. Follow-up ranged from 6.4 to 18.7 months. All patients remained asymptomatic, with voiding cystourethrogram showing cure or urinary ultrasonography showing significant improvement. In conclusion, the hybrid laparoscopic ureteral reimplantation appeared to be a simple and effective minimally invasive surgery for treating primary VUR and OM in children.
{"title":"Hybrid laparoscopic ureteral reimplantation for the treatment of primary vesicoureteral reflux and obstructive megaureter","authors":"","doi":"10.1016/j.jpurol.2024.07.010","DOIUrl":"10.1016/j.jpurol.2024.07.010","url":null,"abstract":"<div><div>Laparoscopic ureteral reimplantation has gained increasing popularity in treating pediatric primary vesicoureteral reflux (VUR) and obstructive megaureter (OM). However, it is technically challenging with a relatively low success rate compared to open surgery. Here we designed a hybrid technique which incorporates laparoscopic surgery and pneumovesical ureteral reimplantation. From 2023 February to 2024 February, five boys and four girls underwent the hybrid reimplantation smoothly. There were seven children with VUR and two with OM. Patient age ranged from eight months to ten years. The mean time was 201.5 min (range 155–240 min) for unilateral operation and 260 min for bilateral operation. Follow-up ranged from 6.4 to 18.7 months. All patients remained asymptomatic, with voiding cystourethrogram showing cure or urinary ultrasonography showing significant improvement. In conclusion, the hybrid laparoscopic ureteral reimplantation appeared to be a simple and effective minimally invasive surgery for treating primary VUR and OM in children.</div></div>","PeriodicalId":16747,"journal":{"name":"Journal of Pediatric Urology","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141700995","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 : 2024-10-01DOI: 10.1016/j.jpurol.2024.09.020
Thomas Loubersac, Hortense Alliot, Fabrizio Vatta, Marc-David Leclair
Introduction & objectives: The use of transperitoneal robotic-assisted procedures for ureterovesical junction (UVJ) anomalies in pediatric patients is increasing. However, the extra-peritoneal approach potentially less invasive, remains underexplored with robotic approach in pediatric patients. We present our experience of robot-assisted extra-vesical laparoscopic extra-peritoneal UVJ surgery.
Materials & methods: Extraperitoneal access was made through a 1,5 cm horizontal incision below the umbilicus. Digital dissection was performed under the rectus fascia to the pubic symphysis. The space was further developed under direct vision with laparoscope. The Da Vinci Xi platform was docked after the placement of 4 robotic 8 mm-trocars and an 8 mm assistant port.
Results: We performed extraperitoneal robot-assisted laparoscopic UVJ surgery in 3 patients: - Case 1: 9-year-old boy: left-sided ureterectomy, UV reimplantation (UVR) with psoas hitch for a symptomatic mega-ureter. - Case 2: 13-year-old girl: right-sided VUR on a duplex system treated with an extravesical Lich-Gregoir antireflux plasty. - Case 3: 8-year-old boy: left-sided bladder diverticulectomy with UVR. There is no complication above Clavien 2 and no recurrence of febrile UTI during the follow-up period (from 6 to 17 months).
Conclusions: Extra-peritoneal robotic approach for UVJ surgery further for UVR in pediatric urology seems feasible with good short-term result even for the complex ones.
{"title":"Extraperitoneal robotic approach to the uretero-vesical junction in children: Initial experience and a step-by-step video presentation.","authors":"Thomas Loubersac, Hortense Alliot, Fabrizio Vatta, Marc-David Leclair","doi":"10.1016/j.jpurol.2024.09.020","DOIUrl":"https://doi.org/10.1016/j.jpurol.2024.09.020","url":null,"abstract":"<p><strong>Introduction & objectives: </strong>The use of transperitoneal robotic-assisted procedures for ureterovesical junction (UVJ) anomalies in pediatric patients is increasing. However, the extra-peritoneal approach potentially less invasive, remains underexplored with robotic approach in pediatric patients. We present our experience of robot-assisted extra-vesical laparoscopic extra-peritoneal UVJ surgery.</p><p><strong>Materials & methods: </strong>Extraperitoneal access was made through a 1,5 cm horizontal incision below the umbilicus. Digital dissection was performed under the rectus fascia to the pubic symphysis. The space was further developed under direct vision with laparoscope. The Da Vinci Xi platform was docked after the placement of 4 robotic 8 mm-trocars and an 8 mm assistant port.</p><p><strong>Results: </strong>We performed extraperitoneal robot-assisted laparoscopic UVJ surgery in 3 patients: - Case 1: 9-year-old boy: left-sided ureterectomy, UV reimplantation (UVR) with psoas hitch for a symptomatic mega-ureter. - Case 2: 13-year-old girl: right-sided VUR on a duplex system treated with an extravesical Lich-Gregoir antireflux plasty. - Case 3: 8-year-old boy: left-sided bladder diverticulectomy with UVR. There is no complication above Clavien 2 and no recurrence of febrile UTI during the follow-up period (from 6 to 17 months).</p><p><strong>Conclusions: </strong>Extra-peritoneal robotic approach for UVJ surgery further for UVR in pediatric urology seems feasible with good short-term result even for the complex ones.</p>","PeriodicalId":16747,"journal":{"name":"Journal of Pediatric Urology","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142400555","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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