Journal of Pediatric Urology最新文献

Introduction/objective: Patients and families of children with hypospadias often seek online information to understand the nature of their child's condition and the implications for the child's health and well-being. There is increasing awareness that the relevance and comprehensibility of online health information may not meet parental needs. This study aimed to understand the informational needs of patients and their families and to evaluate the readability and relevance of the content of North American accredited pediatric urology fellowship programs.

Methods: Qualitative interviews with patients (children, teen and adults) and their caregivers were conducted, and reported informational needs for hypospadias were extracted. Subsequently, online hypospadias materials from all fellowship program-accredited pediatric hospitals were compiled. Full-text online information was extracted. The content was reviewed and categorized into categories by two independent reviewers and summarized. Reviewers then independently edited text to remove extraneous information and calculated readability scores using the Flesch Reading Ease Score (FRES), Flesch-Kincaid Grade Level (FKGL), Gunning-Fog Index (GFI), Simple Measure of Gobbledygook (SMOG), Coleman-Liau Index (CLI), and Automated Readability Index (ARI).

Results: Results from the qualitative analysis demonstrated five information domains: education and knowledge translation, seeking information, quality of information, understandability and consistency, and modality. Participants described the information received by their care providers that was clear and concise; albeit seeking additional details about hypospadias and its treatment, anesthesia, circumcision, complications, counseling, family history, and fertility. 82 % of SPU-accredited pediatric hospitals provided online hypospadias material on their website. The FRES score was classified as difficult and the FKGL, GFI and SMOG scores estimated 10-12 reading grade.

Conclusions: Online hypospadias resources published by leading hospitals with pediatric urology fellowship programs and national urologic associations exceed the recommended reading level for patient and caregiver education. Content analysis reveals that topics of primary importance to patients and families are covered, including etiology, treatment options and long-term outcomes. A standard for online educational resources should be established to improve readability and patient experiences and to address primary parent and patient concerns.

Purpose: To evaluate the role of manual detorsion (MD) in gonadal salvage and determining non-emergency surgery in testicular torsion (TT).

Methods: We retrospectively analysed paediatric patients treated for TT over 10 years at a tertiary centre. MD was attempted based on surgeon preference. Successful MD was defined by complete pain resolution, and normal colour Doppler ultrasound showing no spermatic cord torsion and normal perfusion. All patients underwent surgical exploration. Data analysed included age, referral status, pain duration, MD attempt and result, time to surgery, surgical findings, and outcomes. A comparative analysis between data from previous a published series (2014-2018) and after previous published series (2019-2023) was executed.

Results: Two hundred and seventy-six patients were included. Sixty percent were referred from other centres (165/276). MD was attempted in 57 % (156/276), resulting in significantly less gonadal loss (9 % vs 46 %, p < 0.05). MD was successful in 44 % (68/156) of attempts; all underwent non-emergency bilateral orchiopexy; one patient developed new TT during the waiting period, successfully treated with MD; at surgery, three (3/68, 4 %) cases had partial non-ischemic cord torsion and none suffered testicular loss. After unsuccessful MD, residual cord torsion was 33 % (29/88). After median follow-up of 8 months, gonadal loss (14/156, 9 %) occurred after unsuccessful MD; no losses occurred following successful MD. Successful MD correlated with significantly improved gonadal salvage (p < 0.05). There was no gonadal loss after non-emergency surgery.

Conclusion: Our data shows that attempting MD results in increased testicular salvage rates, and that a successful manoeuvre may safely enable non-emergency orchiopexy.

Introduction: Isolated female epispadias is a rare congenital anomaly.

Objectives: We report on sub-symphseal repair of this anomaly.

Methods: Our study was an ambidirectional observational cohort one with minimum 6 months post operative evaluation. Surgical approach involved creation of paraurethral skin flap to lengthen the urethra and bladder neck (BN) plication under cystoscopic guidance. Second layer cover of the urethral tube using bilateral Maritus labial flap was performed.

Results: Of the 7 patients, 6 were fully continent.

Conclusions: Our approach is effective for gaining both urinary continence and cosmesis issues.