Abstract:
INTRODUCTION/BACKGROUND:The Monti ileovesicostomy provides an excellent substitution for an appendicovesicostomy when the appendix is unavailable or suitable for use. The spiral Monti is a useful modification to the traditional Monti as it allows creation of a longer channel when needed. In 2007, the short-term outcomes were reported; they compared traditional and spiral Monti in 188 patients with an average follow-up of 43 months. In the present population, a total of 25 subfasical revisions were performed in 21 patients: nine (8.3%) subfascial revisions in the traditional Monti (TM) patients and 12 (15.2%) subfascial revisions in the spiral Monti (SM) patients. The study found an increased risk of subfascial revisions of either TM or SM when the stoma was located at the umbilicus versus right lower quadrant (16.8% vs 6.3%, P < 0.05). On subgroup analysis, this increased subfascial revision rate appeared to be driven by SM channels to the umbilicus rather than other stomal locations, but this trend was not statistically significant. OBJECTIVE:It was hypothesized that with longer follow-up, the spiral Monti would require more subfascial revisions due to progressive lengthening of the channel. STUDY DESIGN:A retrospective chart review was performed for all patients undergoing a traditional Monti (TM) or spiral Monti (SM) procedure at the present institution (1997-2013). Patient demographics, bowel segment used, stomal location, channel or stomal revisions, number of anesthetic endoscopic procedures performed, and indications for revision were reviewed. Kaplan-Meier analysis and Cox proportional hazards modeling was used for analysis. RESULTS:Of the 296 patients identified, 146 had Monti procedures and 150 had spiral Monti procedures (median follow-up 7.7 years). Median age at surgery was 10.6 years. Myelomeningocele was the most common underlying cause of neuropathic bladder, totaling 169 (57.1%) patients. Stomas were located at the umbilicus (106, 35.8%), right lower quadrant (183, 61.8%) and left lower quadrant (seven, 2.4%). Median follow-up for the entire cohort was 7.7 years (range: 1 month-15.7 years). Stomal stenosis rate was 7.4%, and 96.6% of the channels were continent. A total of 87 revisions were performed in 74 patients (25.0%). Of these, 55 were subfascial revisions in 49 patients (16.6%). The umbilical spiral Monti on univariate and multivariate analysis was found to be over twice as likely to undergo subfascial revision. DISCUSSION:The majority of patients with a Monti channel had durable results and did not require further channel surgery with long-term follow-up. Spiral Monti channels to the umbilicus were more than twice as likely to undergo subfascial revision compared to all other Monti channels. Overall, one in three umbilical SM channels required a subfascial revision at 10 years after the initial surgery, compared to one in six of all other Monti channels. The study was limited by being a retrospective, single-center series; however, it does represent the largest series of pure SM and TM patients. It focused only on surgical interventions, thus was likely to underestimate the overall risk of complications, as some complications were managed conservatively. As in all studies, some patients were lost to follow-up and inevitably some of these may have had complications. Correction for this was attempted through survival analysis. CONCLUSION:The present study reported durable and reliable long-term results with Monti and spiral Monti procedures based on a large patient cohort. Spiral Monti to the umbilicus was more than twice as likely to require a subfascial revision.
journal_name
J Pediatr Uroljournal_title
Journal of pediatric urologyauthors
Whittam BM,Szymanski KM,Flack C,Misseri R,Kaefer M,Rink RC,Cain MPdoi
10.1016/j.jpurol.2014.12.013subject
Has Abstractpub_date
2015-06-01 00:00:00pages
134.e1-6issue
3eissn
1477-5131issn
1873-4898pii
S1477-5131(15)00076-5journal_volume
11pub_type
杂志文章abstract:AIM:To evaluate health-related quality of life (HRQoL) in adults with myelomeningocele (MMC) measured by SF-36. MATERIALS AND METHODS:All individuals (134) with MMC from western Sweden born before 1981, 69 with a median age of 34 years (range 27-50), participated in a telephone interview. Of these, 61 took part in SF-...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2013.05.005
更新日期:2013-10-01 00:00:00
abstract:INTRODUCTION:Debris within the bladder is commonly seen on ultrasound. The etiology of bladder debris is varied and the likelihood that urinary debris represents positive urine culture is under investigation. We hypothesize that bladder debris will increase the likelihood that a urine culture is positive compared to th...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2017.11.025
更新日期:2018-06-01 00:00:00
abstract:INTRODUCTION:Dorsal inlay graft urethroplasty using inner-face preputial graft was described as an adjunct method to the classic tubularized incised plate (TIP) urethroplasty, aiming at reducing the risk of neourethral stenosis. OBJECTIVES:To evaluate the impact of dorsal inlay grafting of preservable narrow plates, i...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2019.05.002
更新日期:2019-08-01 00:00:00
abstract:BACKGROUND:Urethrocutaneous fistula UCF is the most common complication following surgical repair of hypospadias. Currently, the surgical technique mostly used to prevent recurrence employs preputial dartos or testicular tunica vaginalis flaps as a urethral covering. However, autologous tissues are limited in patients ...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2019.10.002
更新日期:2019-12-01 00:00:00
abstract:PURPOSE:The literature on small intestinal submucosa for chordee correction in children is scarce. We reviewed our experience with 1 ply SIS for ventral corporal body grafting in cases of severe ventral penile curvature associated with proximal hypospadias in children. MATERIALS AND METHODS:From 04-2001 to 12-2007, 58...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2011.03.008
更新日期:2011-06-01 00:00:00
abstract:INTRODUCTION:Minimally invasive surgery has become an important aspect of Pediatric Urology fellowship training. In 2014, the Accreditation Council for Graduate Medical Education published the Pediatric Urology Milestone Project as a metric of fellow proficiency in multiple facets of training, including laparoscopic/ro...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2016.08.012
更新日期:2017-02-01 00:00:00
abstract:OBJECTIVE:To examine the association with renal damage in patients with posterior urethral valves (PUV) of two renin-angiotensin system gene polymorphisms: angiotensin converting enzyme insertion/deletion (ACE I/D) and angiotensin type 2 receptor (AT2R A1332G), PATIENTS AND METHODS: In 120 patients with PUV, after stab...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2010.01.002
更新日期:2010-12-01 00:00:00
abstract::Laparoendoscopic single-site surgery (LESS), a minimally invasive procedure, is gaining widespread acknowledgment in pediatric urology. We report the case of a 7-year-old girl with Turner's syndrome with 45,XO/46,XY mosaicism, for whom bilateral prophylactic gonadectomy using LESS was performed. Histopathological find...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2012.02.010
更新日期:2012-08-01 00:00:00
abstract:PURPOSE:Gil-Vernet trigonoplasty is a simple, fast and effective technique for treating primary VUR, and is the only technique used to manage unilateral reflux that does not result in contralateral new reflux, due to its inherent bilateral nature. We have tried to further simplify postoperative management of the proced...
journal_title:Journal of pediatric urology
pub_type: 临床试验,杂志文章
doi:10.1016/j.jpurol.2008.06.004
更新日期:2008-12-01 00:00:00
abstract:OBJECTIVE:We present our experience of management of high-grade renal trauma in a pediatric population, including assessment of the long-term function and morphology of the ipsilateral kidney. PATIENTS AND METHODS:From 1997 to 2005, 40 children with high-grade renal injury (III, IV, V) after blunt abdominal trauma wer...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2006.07.006
更新日期:2007-06-01 00:00:00
abstract:PURPOSE:There is limited evidence that prophylactic antibiotics prevent surgical site infection in stented, distal hypospadias repair. Our hypothesis is that the use of prophylactic antibiotics does not affect the rate of surgical site infection in this setting. METHODS:We conducted a retrospective study of consecutiv...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2020.11.033
更新日期:2020-11-30 00:00:00
abstract:OBJECTIVE:Hydrocele and testicular edema caused by division of lymphatic vessels during varicocelectomy could lead to decrease in testicular function. In-vivo methylene blue mapping of testicular lymphatic vessels should prevent damage to the lymphatic system. MATERIALS AND METHODS:We retrospectively compared outcomes...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2007.09.005
更新日期:2008-04-01 00:00:00
abstract:INTRODUCTION:Patients with gonadal dysgenesis (GD) with a Y chromosome have an increased risk of gonadal neoplasm. Few data exist on the ability of imaging to detect malignancy in intra-abdominal gonads in these patients. OBJECTIVE:We aimed to determine the correlation between preoperative imaging findings and gonadal...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2017.11.009
更新日期:2018-04-01 00:00:00
abstract:INTRODUCTION:Robot-assisted laparoscopic pyeloplasty (RALP) has been gaining acceptance among pediatric urologists. Over 300 have been described in the literature, but few studies have evaluated the role of RALP in infants alone. OBJECTIVE:We sought to examine the operative experience and outcomes of RALP in a cohort ...
journal_title:Journal of pediatric urology
pub_type: 杂志文章,多中心研究
doi:10.1016/j.jpurol.2014.11.025
更新日期:2015-06-01 00:00:00
abstract:BACKGROUND:Double J (DJ) stents placed at the end of paediatric urological procedures require another cystoscopy under general anaesthesia for removal. The second author developed a reproducible technique for snaring the DJ stent using an infant feeding tube (6-Fr or 8-Fr) and a 3-0 polypropylene suture per urethra. Ha...
journal_title:Journal of pediatric urology
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.jpurol.2019.08.009
更新日期:2019-12-01 00:00:00
abstract:INTRODUCTION:Bladder calculi are a known complication of bladder augmentation. Open cystolithotomy remains the preferred option for treating large or multiple stones. Increasingly, however, minimal access techniques have been used. Reports of Mitrofanoff cystolitholapaxy are rare and have been limited to adults. This s...
journal_title:Journal of pediatric urology
pub_type: 杂志文章,多中心研究
doi:10.1016/j.jpurol.2018.02.024
更新日期:2018-10-01 00:00:00
abstract::We describe a novel 'pubic osteotomy minimal' (POM) done on body of pubis just lateral to the insertions of rectus abdominis and adductor longus muscles to bring rectus abdominis in midline without tension for abdominal wall closure without tension. In one patient, during pubic ramotomy, we missed middle of ramus and ...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2020.05.003
更新日期:2020-06-01 00:00:00
abstract:PURPOSE:We report outcomes after dextranomer/hyaluronic acid (Dx/HA) bladder neck injection for persistent outlet incompetency despite prior sling or Leadbetter/Mitchell bladder neck revision plus sling (LMS) in children with neurogenic urinary incontinence. METHODS:Consecutive patients with outlet incompetency after ...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2012.03.013
更新日期:2013-06-01 00:00:00
abstract:PURPOSE:We hypothesized that there are practice variations in the use of surgical antibiotics by pediatric urologists in the United States. MATERIALS AND METHODS:A 31-question online survey was distributed to members of the Society of Pediatric Urology. The questionnaire examined physician preferences for surgical ant...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2010.05.001
更新日期:2011-04-01 00:00:00
abstract:OBJECTIVE:Outcome of urethral mobilization and advancement (Koff procedure) in hypospadias with a distal division of the corpus spongiosum and redo cases with distal urethral failure. MATERIALS AND METHODS:From January 1999 to November 2012, 158 children with a distal hypospadias (115 primary cases and 43 redo cases) ...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2013.10.019
更新日期:2014-06-01 00:00:00
abstract:OBJECTIVE:To provide insight in causative factors of pediatric urolithiasis in The Netherlands, a non-endemic country. PATIENTS AND METHODS:Data from 71 children with urolithiasis and stone analyses between 1996 and 2010 in the Radboud University Nijmegen Medical Centre were studied retrospectively. Patients (48 boys,...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2013.07.019
更新日期:2014-02-01 00:00:00
abstract:OBJECTIVE:Postoperative hydrocele development is a frustrating complication of varicocele surgical repair. To avoid this complication, we began to offer percutaneous embolization as a treatment option. We present our initial experience with this technique. METHODS:A retrospective review of all patients who underwent p...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2010.01.003
更新日期:2010-12-01 00:00:00
abstract:INTRODUCTION:It has become clear that obesity is associated with a variety of infectious diseases, including urinary tract infection (UTI) and renal scarring. OBJECTIVE:The aim of this study was to evaluate the association between obesity and the degree of febrile UTI (fUTI) and renal scarring in children with vesicou...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2016.08.018
更新日期:2017-02-01 00:00:00
abstract:INTRODUCTION AND OBJECTIVE:Inguinal hernias and communicating hydroceles from a patent processus vaginalis (PPV) are common problems in children. This study provides a detailed description of the laparoscopic intra-abdominal patent processus vaginalis ligation (LIPPL) procedure along with its results in pediatric urolo...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2017.03.026
更新日期:2017-10-01 00:00:00
abstract:INTRODUCTION AND OBJECTIVE:Female pediatric patients with continuous drip incontinence present a diagnostic challenge. At times, these symptoms may be due to an ectopic ureter inserting below the external sphincter. The evaluation may consist an ultrasound and voiding cystourethrogram (VCUG), but these may not be diagn...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2005.06.009
更新日期:2007-02-01 00:00:00
abstract:PURPOSE:We aimed to develop a conversion formula between different calculations for testicular volume asymmetry. MATERIALS AND METHODS:Male adolescents with varicoceles who underwent scrotal ultrasound were studied. Two formulas were analyzed: (1) testicular volume differential, TVDiff = (RTV - LTV)/(TTV), and (2) atr...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2013.12.007
更新日期:2014-04-01 00:00:00
abstract:OBJECTIVE:To assess the efficacy and safety of various minimally invasive procedures for 10-20 mm pediatric renal stones by Bayesian network meta-analysis (NWA). METHODS:We searched clinical comparative trials published in Pubmed, Embase, Cochrane Library from inception to 12 April 2020. Two researchers evaluated the ...
journal_title:Journal of pediatric urology
pub_type: 杂志文章,评审
doi:10.1016/j.jpurol.2020.08.019
更新日期:2020-12-01 00:00:00
abstract:BACKGROUND:Prompt diagnosis and treatment of paediatric urolithiasis are required to avoid long term sequelae of renal damage. OBJECTIVE:To systematically review the literature regarding the diagnostic imaging modalities and treatment approaches for paediatric urolithiasis. STUDY DESIGN:PubMed, Science Direct, Scopus...
journal_title:Journal of pediatric urology
pub_type: 杂志文章,评审
doi:10.1016/j.jpurol.2020.07.003
更新日期:2020-10-01 00:00:00
abstract:INTRODUCTION:Surgical treatment of pediatric kidney stones has changed dramatically in recent years because of the miniaturization of surgical instruments and the availability of intracorporeal lithotripters. The retrograde intrarenal surgery (RIRS) technique is nowadays considered an effective and safe procedure but s...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2017.09.011
更新日期:2018-02-01 00:00:00
abstract:INTRODUCTION:Parents making complex decisions about hypospadias surgery may experience anxiety and uncertainty related to multiple sources of information with questionable reliability and limited relevance to their concerns. OBJECTIVE:The purpose of this study was to identify knowledge gaps, information-seeking behavi...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2020.01.008
更新日期:2020-04-01 00:00:00