Abstract:
INTRODUCTION:Cloacal exstrophy (CE) is the most severe manifestation of the epispadias-exstrophy spectrum. Previous studies have indicated an increased rate of renal anomalies in children with classic bladder exstrophy (CBE). Given the increased severity of the CE defect, it was hypothesized that there would be an even greater incidence among these children. OBJECTIVE:The primary objective was to characterize renal anatomy in CE patients. Two secondary objectives were to compare these renal anatomic findings in male and female patients, and female patients with and without Müllerian anomalies. STUDY DESIGN:An Institutional Review Board-approved retrospective review of 75 patients from an institutional exstrophy database. Data points included: age at analysis, sex, and renal and Müllerian anatomy. Abnormal renal anatomy was defined as a solitary kidney, malrotation, renal ectopia, congenital cysts, duplication, and/or proven obstruction. Abnormal Müllerian anatomy was defined as uterine or vaginal duplication, obstruction, and/or absence. RESULTS:The Summary Table presents demographic data and renal anomalies. Males were more likely to have renal anomalies. Müllerian anomalies were present in 65.7% of female patients. Girls with abnormal Müllerian anatomy were 10 times more likely to have renal anomalies than those with normal Müllerian anatomy (95% CI 1.1-91.4, P = 0.027). DISCUSSION:Patients with CE had a much higher rate of renal anomalies than that reported for CBE. Males and females with Müllerian anomalies were at greater risk than females with normal uterine structures. Mesonephric and Müllerian duct interaction is required for uterine structures to develop normally. It has been proposed that women with both Müllerian and renal anomalies be classified separately from other uterine malformations on an embryonic basis. In these patients, an absent or dysfunctional mesonephric duct has been implicated as potentially causal. This provided an embryonic explanation for uterine anomalies in female CE patients. There were also clinical implications. Women with renal agenesis and uterine anomalies were more likely to have endometriosis than those with isolated uterine anomalies, but were also more likely to have successful pregnancies. Males may have had an analogous condition with renal agenesis and seminal vesicle cysts. Future research into long-term kidney function in this population, uterine function, and possible male sexual duct malformation is warranted. CONCLUSION:Congenital renal anomalies occurred frequently in children with CE. They were more common in boys than in girls. Girls with abnormal Müllerian anatomy were more likely to have anomalous renal development. Mesonephric duct dysfunction may be embyologically responsible for both renal and Müllerian maldevelopment.
journal_name
J Pediatr Uroljournal_title
Journal of pediatric urologyauthors
Suson KD,Inouye B,Carl A,Gearhart JPdoi
10.1016/j.jpurol.2016.04.008subject
Has Abstractpub_date
2016-08-01 00:00:00pages
207.e1-5issue
4eissn
1477-5131issn
1873-4898pii
S1477-5131(16)30032-8journal_volume
12pub_type
杂志文章abstract::The ability to consistently review abstracts in an unbiased and objective fashion is a skill that most academics hope to master. However, robust standardized rating systems are sparse, with most scientific boards leaving the task of rating abstracts poorly defined and at the whim of the reviewer. In an effort to bring...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2018.07.009
更新日期:2018-10-01 00:00:00
abstract:OBJECTIVE:To determine the efficacy and long-term outcome of pyeloplasty in poorly functioning kidneys in the pediatric age group. METHOD:Retrospective data analysis was performed on patients who underwent pyeloplasty in 2000-2008. The parameter analyzed was postoperative outcome. Success was defined on the basis of e...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2010.12.012
更新日期:2012-02-01 00:00:00
abstract:INTRODUCTION:Advice (BBA) into the standards of patients' care in both monosymptomatic and non-monosymptomatic nocturnal enuresis. Although the idea of this recommendation was clear and reflects clinical experience, duration and efficacy have not been definitely established. Recent data have demonstrated the lack of ef...
journal_title:Journal of pediatric urology
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1016/j.jpurol.2017.03.039
更新日期:2017-12-01 00:00:00
abstract:OBJECTIVE:Voiding disorders are commonly encountered in paediatric urology practice. Urinary incontinence often leads to the impairment of self-esteem but can also cause renal damage, when recurrent urinary tract infection (UTI) or vesico-ureteral reflux (VUR) exists. The aim of this study was to assess the efficacy of...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2005.09.004
更新日期:2006-10-01 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:OBJECTIVE:To present our experience with infant pyeloplasty, comparing outcomes between robotic-assisted laparoscopic pyeloplasty (RALP) and open pyeloplasty (OP). MATERIALS AND METHODS:A retrospective review was performed of all children <1 year of age who underwent unilateral dismembered pyeloplasty at a single pedi...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2013.10.016
更新日期:2014-04-01 00:00:00
abstract:OBJECTIVE:Our study aims to evaluate variations in management of asymptomatic adolescent grade 2 and 3 varicoceles by pediatric urologists. SUBJECTS AND METHODS:Electronic survey of all 267 current members of AAP Urology with 74 (28%) responding. RESULTS:When managing patients with positive examination findings, 49% ...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2013.11.001
更新日期:2014-06-01 00:00:00
abstract:BACKGROUND:Pediatric ureteropelvic junction obstruction (UPJO) is caused by congenital intrinsic narrowing and/or a lower pole-crossing renal artery. When a crossing renal vessel (CRV) is missed at the time of pyeloplasty, a redo-pyeloplasty is often required. OBJECTIVES:The aims were to analyze clinical predictors fo...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2015.04.017
更新日期:2015-08-01 00:00:00
abstract:OBJECTIVE:Acquired recto-urethral fistula is an uncommon entity in children and occurs as a consequence of pelvic disorder, including trauma, iatrogenic injury, inflammatory bowel disease, pelvic neoplasm and infection. We have reviewed our experience with treatment of recto-urethral fistula and focussed on the outcome...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2009.03.001
更新日期:2009-12-01 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 AND OBJECTIVE:Staged pelvic osteotomy (SPO) prior to bladder closure has been shown to be a safe and effective method for achieving pubic approximation in cloacal exstrophy (CE) patients with extreme diastasis. However, SPO outcomes have never been compared to those for combined pelvic osteotomy (CPO) at t...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2014.06.018
更新日期:2014-12-01 00:00:00
abstract::Renal medullary carcinoma is a lethal subtype of renal cancer that afflicts patients with sickle-cell hemoglobinopathies. Here we present the case of a 13-year-old boy with renal medullary carcinoma who is the first, to our knowledge, to be managed using a planned laparoscopic radical nephrectomy. ...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2007.02.007
更新日期:2008-02-01 00:00:00
abstract:PURPOSE:Intestinal bladder augmentation predisposes the patient to many complications. The aim of this study was to determine whether augmentation has an adverse effect on growth. MATERIALS AND METHODS:Longitudinal growth data were collected and analyzed for nine patients with bladder exstrophy and augmentation, and c...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2007.07.002
更新日期:2008-02-01 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:Congenital megaprepuce is a specific form of buried penis. Children affected by this malformation usually suffer from a subjective difficulty in voiding which is the main indication for early surgical correction. The aim of this study was to report a single center's 12-year experience in the treatment of mega...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2012.10.010
更新日期:2013-12-01 00:00:00
abstract:OBJECTIVE:Idiopathic hypercalciuria (IHC) has been recognized as a common disorder in childhood, and is a major factor in the formation of renal stones and urinary tract infections (UTIs). Since hydrochlorothiazide ameliorates hypercalciuria, we assessed its efficacy in preventing recurrent UTIs in hypercalciuric girls...
journal_title:Journal of pediatric urology
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.jpurol.2012.09.008
更新日期:2013-12-01 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:To evaluate the outcome of secondary surgical procedures for the management of failed pyeloplasty in children. MATERIALS AND METHODS:Between 1996 and 2007, 590 cases of primary ureteropelvic junction (UPJ) obstruction underwent open dismembered pyeloplasty at our center. Of these patients, 18 (3%) with recurre...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2008.09.001
更新日期:2009-04-01 00:00:00
abstract:INTRODUCTION AND OBJECTIVE:Endourological and percutaneous approaches are the standard of care for treatment of pediatric urolithiasis. However, in certain situations, an endoscopic-assisted robotic pyelolithotomy (EARP) can be an acceptable alternative. Limited data exist on pediatric EARP; thus, the authors describe ...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2019.12.007
更新日期:2020-04-01 00:00:00
abstract:BACKGROUND:Post-traumatic posterior urethral injuries in children are rare events. Their management algorithms are extrapolations from adult literature and they continue to pose a difficult challenge for pediatric urologists. Not much data for age-related feasibility of an end-to-end urethroplasty are available. OBJEC...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2017.05.016
更新日期:2017-12-01 00:00:00
abstract:AIM:To compare complication rates after distal hypospadias surgery using the tubularized incised plate (TIP) and Mathieu techniques. METHODS:For this meta-analysis, the Medline (1990-2009), Embase (1990-2009) and Cochrane databases were searched using the keyword 'hypospadias'. Inclusion criteria were: i) primary repa...
journal_title:Journal of pediatric urology
pub_type: 杂志文章,meta分析,评审
doi:10.1016/j.jpurol.2010.11.008
更新日期:2012-06-01 00:00:00
abstract:OBJECTIVE:The objective of this study was to determine if later toilet training is associated with urge incontinence in children. METHODS:We used a case-control study design to yield level 2 evidence. RESULTS:Initiation of toilet training after 32 months of age was associated with urge incontinence (P=0.02). CONCLUS...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2009.05.012
更新日期:2009-12-01 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:BACKGROUND:Perioperative antibiotics prevent infections after surgery. Guidelines for antibiotic use allow the surgeon to balance the risks of adverse events and drug resistance with the benefit of reduced infection rates. However, due to a lack of evidence-based guidelines within pediatric urology, antibiotic practice...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2020.05.148
更新日期:2020-10-01 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::End-stage renal disease is becoming a contemporary global concern with increasing prevalence. The available treatment strategies are limited to dialysis and renal transplantation. However, limited organ supply and autoimmune rejection are the shortcomings that limit widespread application of transplantation. Favorably...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2018.01.008
更新日期:2018-04-01 00:00:00
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 outcome...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2014.12.013
更新日期:2015-06-01 00:00:00
abstract::We report on a child with hypertension secondary to MCDK who underwent an elective retroperitoneoscopic nephrectomy and is normotensive on follow up. We looked at the pathological correlation with respect to the hypertension caused by a non-functioning kidney. ...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2011.03.019
更新日期:2011-10-01 00:00:00
abstract:UNLABELLED:Classical bladder exstrophy affects 1 in 30 000 live births. Results of surgical treatment from different institutions employing various surgical techniques are not uniform, thus there is a need for a consensus on the best technique for bladder exstrophy repair. Surgical correction in bladder exstrophy would...
journal_title:Journal of pediatric urology
pub_type: 杂志文章,评审
doi:10.1016/j.jpurol.2015.05.030
更新日期:2015-12-01 00:00:00
abstract:OBJECTIVE:To assess whether repairing hypospadias before or after 18 months affects psychological adjustment, health-related quality of life (HRQoL) and surgical outcome. PATIENTS AND METHODS:Seventy-seven boys aged 6-17 years were assigned to one of two groups, according to whether they had a hypospadias repair befor...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2008.12.008
更新日期:2009-10-01 00:00:00