Abstract:
INTRODUCTION:The proactive management of children with myelomeningocele (MMC) has contributed to decreasing their progression to end-stage renal disease, thanks to early urological evaluation and timing implementation of treatments. OBJECTIVE:To demonstrate that early urological evaluation of the urinary tract in MMC shows functional alterations in most cases, and that it requires medical intervention, even when in some cases the complementary imaging studies do not show any abnormalities. MATERIAL AND METHODS:A retrospective study including 60 patients aged <1 year with MMC who were followed by a multidisciplinary team. All of them underwent renal/bladder ultrasound, videourodynamic studies, renal scintigraphy/dimercaptosuccinic acid (DMSA), and laboratory tests for kidney function. The studied variables were: bladder capacity and pressure, presence of overactivity, vesicoureteral reflux (VUR), urinary dilations and abnormalities on renal scintigraphy/DMSA. All the patients received clean intermittent catheterization (CIC). RESULTS:See Summary Table all the patients showed alterations in at least some of the assessed urodynamic variables: reduced cystometric capacity, 21.6%; detrusor overactivity, 55%; end filling detrusor pressure >20 cm H2O, 43.3%; inefficient bladder voiding, 98.3%; indirect dyssynergic patterns, 28.8%. The high-risk videourodynamic findings were observed in 28 cases (46.6%). DMSA was abnormal in 30%. Renal impairment was detected in 6.6% of cases. A total of 66% of cases received oxybutynin. DISCUSSION:Almost all the children in this sample population showed urinary dysfunction, and approximately half of them had high-risk videourodynamic findings. Although many cases showed reflex urinary contractions, almost the entire sample had inefficient bladder voiding. An important limitation of this work was the lack of simultaneity in obtaining each of the requested studies. CONCLUSIONS:In the initial urological evaluation of patients with myelomeningocele, almost all the urodynamic studies showed abnormalities and one-third showed abnormal DMSA, which led to therapeutic actions being initiated, although imaging studies were normal in a great number of patients. CIC alone, starting immediately after birth, is not sufficient. To eliminate or decrease upper tract damage, oxybutynin should be started in addition.
journal_name
J Pediatr Uroljournal_title
Journal of pediatric urologyauthors
Sager C,Burek C,Corbetta JP,Weller S,Ruiz J,Perea R,Lago E,Gomez Y,Durán V,López JCdoi
10.1016/j.jpurol.2016.12.024subject
Has Abstractpub_date
2017-06-01 00:00:00pages
271.e1-271.e5issue
3eissn
1477-5131issn
1873-4898pii
S1477-5131(17)30044-Xjournal_volume
13pub_type
杂志文章abstract:BACKGROUND:Little has been reported to date on the instillation of antimicrobials directly into the bladder in children. Children with complex urinary tract anomalies struggle frequently with recurrent urinary tract infections (UTI), with frequent emergence of antibiotic resistance. Gentamicin bladder instillation to t...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2020.08.007
更新日期:2020-08-19 00:00:00
abstract:INTRODUCTION:Although there are significant demographic and clinical variations in treatment decisions for infants with high-grade hydronephrosis concerning for ureteropelvic junction obstruction (UPJO), there has been little research on the roles of parents and surgeons in the surgical decision-making (DM) process. O...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2019.05.027
更新日期:2019-10-01 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: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:OBJECTIVE:Iatrogenic ureteral injury in children is a rare occurrence, with sparse literature available regarding optimal repair techniques. We reviewed our experience in the management of iatrogenic pediatric ureteral injuries, particularly with respect to initial versus delayed diagnoses. METHODS:All pediatric iatro...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2008.08.004
更新日期:2009-02-01 00:00:00
abstract:OBJECTIVE:Faecal incontinence secondary to myelomeningocele, Hirschsprung disease, and anorectal anomalies remains a significant and common problem. We aimed to report our 5-year experience with the Peristeen trans-anal irrigation system (TAIS) to manage such children. PATIENTS AND METHOD:This study was a combination ...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2013.08.006
更新日期:2014-04-01 00:00:00
abstract:OBJECTIVE:To evaluate the etiology of posterior and/or bulbar strictures in children in an industrialized country and assess the outcome of its repair by perineal approach. Urethral strictures in children are rare and often challenging to treat. Trauma is the main etiology in developing countries. However, data for ind...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2012.09.007
更新日期:2013-12-01 00:00:00
abstract:BACKGROUND:Hypospadias is one of the most common congenital anomalies in childhood. The aim of this study is to apply elastosonography on normal and hypospadic penis to verify the structural differences in tissues composition and stiffness. MATERIALS AND METHODS:We analyzed medical chart of patients treated at our Ins...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2016.02.007
更新日期:2016-08-01 00:00:00
abstract:INTRODUCTION:Ureteropelvic junction obstruction (UPJO) is one of the most frequent urological diseases affecting the pediatric population. It can be due to both intrinsic stenosis of the junction and extrinsic causes such as the presence of crossing vessels (CVs), which can be detected by color Doppler ultrasound (CD-U...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2017.09.019
更新日期:2018-02-01 00:00:00
abstract:OBJECTIVE:To report trends in surgical approach and associations with outcomes in children undergoing extirpative renal surgery in the state of Maryland over a 12-year period. METHODS:The Maryland Health Services Cost Review Commission (HSCRC) database was queried to identify children undergoing total or partial nephr...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2013.12.011
更新日期:2014-08-01 00:00:00
abstract:INTRODUCTION:Orchiopexy for a palpable undescended testis can be approached through a traditional inguinal incision or trans-scrotally. Despite the possible advantages of the scrotal approach, including reduced postoperative pain and shorter recovery, it is not consistently advocated. OBJECTIVE:The objective of this s...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2018.08.022
更新日期:2019-02-01 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:INTRODUCTION/BACKGROUND:The Nurse Practitioner (NP)-Led Newborn Circumcision Clinic (NCC), developed in 2016, provides clamp-style circumcision to newborns without general anesthesia. There is a paucity of research regarding outcomes, satisfaction, and the cost benefit of such NP-led clinics. OBJECTIVE:The purpose of ...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2020.08.008
更新日期:2020-10-01 00:00:00
abstract:INTRODUCTION AND OBJECTIVES:Vesicoureteral reflux (VUR) has been one of the defining conditions unique to pediatric urology since its inception. The clinical implications of this disease process depend on intrinsic patient factors such as age, genetics, epigenetics, voiding habits, anatomic anomalies, and extrinsic fac...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2018.04.004
更新日期:2018-10-01 00:00:00
abstract:INTRODUCTION:Patients with spina bifida and other spinal dysraphisms commonly suffer from fecal incontinence and constipation, which can be treated with antegrade continence enemas. Currently, information regarding outcomes and satisfaction in children who have Chait cecostomy tubes is lacking. The aim of our study was...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2017.04.008
更新日期:2017-08-01 00:00:00
abstract:BACKGROUND:The purpose of ureterocystoneostomy to correct vesicoureteral reflux is to thereby prevent recurrent febrile urinary tract infections (UTIs). The objective of this study was to determine the frequency of UTI in adult women who underwent reimplantation as children, with the emphasis on infections during pregn...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2006.09.006
更新日期:2007-06-01 00:00:00
abstract::Post-void residual (PVR) determination is an integral part of the evaluation of children presenting with lower urinary tract symptoms. Historically the PVR volume has been obtained by urinary catheterization after the child has voided, however, with the advent of ultrasound technology, PVR was determined in a noninvas...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2010.10.007
更新日期:2011-02-01 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:INTRODUCTION AND OBJECTIVE:Vesicoureteral reflux (VUR) has been associated with the development and progression of reflux nephropathy (RN). Management of VUR has become more conservative over time as therapies have not been reliably proven to prevent renal scarring. We sought to examine the incidence of end stage renal...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2020.06.023
更新日期:2020-10-01 00:00:00
abstract:OBJECTIVE:To compare and evaluate dissection and Plastibell(®) circumcision techniques for the treatment of phimosis. METHODS:In 2006-2007, 125 children were submitted to circumcision by the same surgeon. The children were randomly divided into two groups (PD: Plastibell(®) and DC: dissection). In both groups the surg...
journal_title:Journal of pediatric urology
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.jpurol.2010.01.005
更新日期:2010-12-01 00:00:00
abstract:OBJECTIVE:Renal disorders can cause hypertension, but less is known about the influence of hydronephrosis on blood pressure. Hydronephrosis due to pelvo-ureteric junction obstruction (PUJO) is a fairly common condition (incidence in newborns of 0.5-1%). Although hypertensive effects of hydronephrosis have been suggeste...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2015.01.008
更新日期:2015-04-01 00:00:00
abstract:OBJECTIVE:Beckwith-Wiedemann syndrome (BWS) is a constellation of congenital anomalies that classically presents with macroglossia, abdominal wall defects and gigantism. Although renal and adrenal pathology are the most commonly associated urologic findings of BWS, we report a case of a girl with BWS and symptomatic cl...
journal_title:Journal of pediatric urology
pub_type: 杂志文章,评审
doi:10.1016/j.jpurol.2010.06.003
更新日期:2011-04-01 00:00:00
abstract:PURPOSE:There is a paucity of recent evidence regarding long-term urological and sexual outcomes following surgery for Hirschsprung disease (HD). We aimed to undertake a systematic review of all HD literature to define these outcomes. MATERIALS AND METHODS:A systematic literature search was conducted on studies from 1...
journal_title:Journal of pediatric urology
pub_type: 杂志文章,评审
doi:10.1016/j.jpurol.2016.07.019
更新日期:2016-12-01 00:00:00
abstract:INTRODUCTION:Primary epispadias is a rare congenital malformation involving the urogenital system. In patients with epispadias, bladder closure enhances bladder growth and continence. METHODS:Several steps were carried out to bring the bladder neck to the midline and allow tension-free bladder neck reconstruction and ...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2016.04.016
更新日期:2016-08-01 00:00:00
abstract::The Mitrofanoff procedure, first described in 1980, has been widely adopted for pediatric continent urinary diversion to increase patient independence and continence, decrease morbidity and infections, and preserve renal function. Although this principle employs the appendix primarily, numerous other tissue conduits h...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2005.02.001
更新日期:2005-10-01 00:00:00
abstract:INTRODUCTION:Many theories have been proposed for the coexistence of constipation and lower urinary tract dysfunction (LUTD), such as bladder compression from a distended rectum and stimulation of sacral reflexes from a full rectum. In these cases, successful treatment of constipation should result in resolution of bla...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2015.05.032
更新日期:2015-12-01 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:INTRODUCTION:Laparoscopic pyeloplasty has achieved good cosmetic and functional outcomes. Both transumbilical single-site and transumbilical multi-port approaches are currently being used. No comparison of transumbilical single-site laparoscopic pyeloplasty (TSLP) and transumbilical multi-port laparoscopic pyeloplasty ...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2017.05.009
更新日期:2017-12-01 00:00:00
abstract:OBJECTIVE:To report a novel cause of nocturnal enuresis (NE) and highlight the literature giving insight into this novel mechanism. PATIENT:A 12-year-old morbidly obese female with 2-year history of nightly secondary monosymptomatic NE. RESULTS:On evaluation, a history of severe sleep disturbed breathing was elicited...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2009.08.009
更新日期:2010-06-01 00:00:00
abstract:OBJECTIVE:To explore the effectiveness of the enuresis alarm with overlearning for treatment of primary nocturnal enuresis (PNE). A key objective was to explore the effect of overlearning on treatment gains, and its impact on relapse. PATIENTS AND METHODS:The RMIT University Psychology Clinic has been treating PNE in ...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2013.08.008
更新日期:2014-04-01 00:00:00