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. OBJECTIVE:This study was designed to validate a simple preoperative radiographic score to predict the type of surgical repair for traumatic posterior urethral strictures in children. MATERIALS AND METHODS:This retrospective study was conducted in a tertiary care center in northern India between 2000 and 2015. All patients under 15 years with traumatic bulboprostatic stricture disease were included. Preoperative voiding cystourethrogam (VCUG) and retrograde urethrogram (RGU) films were used to calculate the gapometry index (G/U index), defined as the length of urethral gap divided by the bulbar urethral length. This index was then analyzed for two patient groups based on the anatomical approach employed for achieving an end-to-end urethroplasty: group 1, who underwent a simple perineal approach, and group 2, who needed a more elaborate procedure. Statistical analysis was performed with the two-tailed t-test with SPSS version 18. RESULTS:A total of 38 patients met the inclusion criteria. The age distribution and G/U index for both groups are detailed in the table. The difference in mean length of the urethral gap for both groups was statistically significant (2.1 cm in group 1 vs. 3.6 cm in group 2). There was a direct correlation between the complexity of surgical procedure required to bridge the urethral gap and the G/U index. The overall success for urethroplasty in either group was between 92.3% and 94.6%. DISCUSSION:Urethral extensibility is more suitable for younger children. This challenges the traditional viewpoint that the transpubic approach for urethroplasty is more favorable in children. No previous study has been cited in literature correlating the gapometry index with the surgical approach for posterior urethral defects. Our results reflect that a preoperative G/U index of 0.44 correlate with a simple perineal repair, whereas an index of above 0.87 indicates the likelihood of needing a more elaborate transpubic approach. CONCLUSIONS:Preoperative assessment of G/U index in children with traumatic posterior urethral injuries can successfully predict the operative approach and may therefore aid in better management of these patients.
journal_name
J Pediatr Uroljournal_title
Journal of pediatric urologyauthors
Sekhon V,Kudchadkar SJ,Raj A,Ansari MSdoi
10.1016/j.jpurol.2017.05.016subject
Has Abstractpub_date
2017-12-01 00:00:00pages
624.e1-624.e5issue
6eissn
1477-5131issn
1873-4898pii
S1477-5131(17)30254-1journal_volume
13pub_type
杂志文章abstract:BACKGROUND:There are many variables affecting the success of treatment in children with primary monosymptomatic nocturnal enuresis (PMNE). This study investigates the possible effect of cigarette smoke exposure on desmopressin treatment response in children with PMNE. METHOD:The medical records of pediatric patients w...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2019.10.012
更新日期:2020-02-01 00:00:00
abstract:INTRODUCTION AND OBJECTIVE:In the case of non-palpable testes, we often find a small nodule which is called "testicular nubbin (TN)" in scrotum or inguinal canal. There is no agreement about the treatment for TN. This time we investigated whether or not ultrasound examination (US) can be a useful modality for detecting...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2020.08.022
更新日期:2020-12-01 00:00:00
abstract:INTRODUCTION:Stomal stenosis is the most common complication after the creation of a continent catheterizable channel (CCC), but is challenging to treat. OBJECTIVE:To describe early experience with triamcinolone injection for the treatment of stomal stenosis. MATERIALS AND METHODS:A retrospective review was performed...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2017.06.007
更新日期:2017-08-01 00:00:00
abstract:BACKGROUND:Anterior urethral valves (AUV) and associated anterior urethral diverticula (AUD) are a rare cause of congenital lower urinary tract obstruction. They occur 25-30 times less frequently than posterior urethral valves (PUV) and historically tend to have a less aggressive presentation and outcome. However, due ...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2020.03.024
更新日期:2020-10-01 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:BACKGROUND/AIM:Endoscopic stenting is an accepted treatment option for children with symptomatic or progressive primary obstructive megaureter (PROM). Here, long-term outcomes with endoscopic stenting are reviewed. METHODS:Patients with PROM treated surgically over a 12-year period were identified using a prospectivel...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2018.09.011
更新日期:2019-02-01 00:00:00
abstract:INTRODUCTION:Upper tract damage (UTD) is a life-threatening complication of neurogenic bladder (NB). Early identification of risk factors for UTD and institution of remedial measures may probably prevent UTD. The aim was to study the predictors of UTD in children 2 years or older with NB. METHOD:This cross-sectional, ...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2017.02.026
更新日期:2017-10-01 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:Neutrophil gelatinase-associated lipocalin (NGAL) is a marker of acute kidney injury, and has been shown to be a sensitive marker of renal damage in urinary tract obstruction. Children with neurogenic bladders are at risk of renal damage as a result of increased pressure within the urinary system. A marker o...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2018.12.008
更新日期:2019-04-01 00:00:00
abstract:OBJECTIVE:The differential diagnosis of an acute scrotum is of great importance in clinical practice and may be difficult in some cases. The aim of this study was to differentiate inflammatory from non-inflammatory causes of acute scrotum using relatively simple laboratory tests which can be performed quickly and easil...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2012.03.009
更新日期:2013-06-01 00:00:00
abstract::Ureteropelvic junction (UPJ) stenosis is the most common cause of pathological neonatal hydronephrosis. UPJ obstruction may be treated conservatively in some cases, but surgery is indicated if symptoms occur or renal function deteriorates. Pyeloplasty is the procedure of choice for UPJ stenosis. Pyeloplasty can be per...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2019.03.022
更新日期:2019-08-01 00:00:00
abstract::Duplications of the rectum constitute one of the rare congenital anomalies. Presentation as a sequestrated interlabial mass without any associated anomaly has not been reported before. We cannot readily offer any embryological explanation for this congenital distortion. Total extirpation of the lesion was easily achie...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2009.05.001
更新日期:2010-02-01 00:00:00
abstract:INTRODUCTION:Inflammatory myofibroblastic tumours of the bladder (IMTB) are rare, and feature a benign and reactive proliferation of myofibroblasts. 25% of the reported IMTB cases in the literature occur in children. The present study presents a review of IMTB in children. DISCUSSION:The data from 42 reported cases of...
journal_title:Journal of pediatric urology
pub_type: 杂志文章,评审
doi:10.1016/j.jpurol.2015.03.009
更新日期:2015-10-01 00:00:00
abstract:INTRODUCTION:Fetal alcohol spectrum disorders (FASD) is an important preventable public health concern, associated to a number of common pediatric problems such as incontinence. Little is known about the prevalence and presentation of incontinence in FASD, which hinders effective management. OBJECTIVE:The aim of the p...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2020.02.012
更新日期:2020-06-01 00:00:00
abstract:OBJECTIVE:To determine the outcome of urethroplasty for failed hypospadias repair and to compare this with a matched cohort of patients treated with urethroplasty for other reasons. PATIENTS AND METHODS:Between January 2000 and August 2007, 25 patients with a failed hypospadias repair were treated with urethroplasty (...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2010.04.013
更新日期:2011-04-01 00:00:00
abstract::Priapism is a medical emergency. An idiopathic case can be a difficult clinical problem in the pediatric emergency room. This case highlights the successful use of penile irrigation and injection of phenylephrine in a 13-year-old boy with idiopathic ischemic priapism 12 h after sexual intercourse. ...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2008.09.004
更新日期:2009-04-01 00:00:00
abstract:PURPOSE:To evaluate incidence of urinary tract infection (UTI) and natural history of downgraded vesicoureteral reflux (VUR) in children with high-grade VUR following endoscopic correction. MATERIALS AND METHODS:We retrospectively studied 54 children (13 males and 41 females) with a mean age of 1.8 years who underwent...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2012.02.006
更新日期:2013-04-01 00:00:00
abstract:BACKGROUND:The epidemiology and risk factors for paediatric urolithiasis (UL) in developed countries are evolving, with increasing rates of metabolic stone-formers. In the United Kingdom (UK), only a single London cohort has been studied in the past three decades. Regional disease patterns across the UK remain unknown....
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2020.03.009
更新日期:2020-06-01 00:00:00
abstract:INTRODUCTION:Preoperative hormonal stimulation (PHS) is commonly administered to improve hypospadias outcomes. However, current literature provides no clear evidence to support its use, and controversies exist regarding its effect on postoperative complications. Herein we systematically evaluate the effect of PHS on po...
journal_title:Journal of pediatric urology
pub_type: 杂志文章,meta分析,评审
doi:10.1016/j.jpurol.2017.06.019
更新日期:2017-10-01 00:00:00
abstract:OBJECTIVE:Urolithiasis in children can cause considerable morbidity. Our aim was to evaluate the impact of intervention on the recoverability of kidney functions. MATERIALS AND METHODS:This prospective study included 93 children (66 boys and 27 girls) with median age of 3 years (range 0-14). Inclusion criteria were pr...
journal_title:Journal of pediatric urology
pub_type: 杂志文章,多中心研究
doi:10.1016/j.jpurol.2011.02.011
更新日期:2011-06-01 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:BACKGROUND AND OBJECTIVE:Most patients with intermittent hydronephrosis have preserved differential renal function (DRF), while others already have impaired DRF at diagnosis. We summarized the clinical manifestations of intermittent hydronephrosis to elucidate what may be related to DRF loss. STUDY DESIGN:We retrospec...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2020.04.026
更新日期:2020-08-01 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:We review outcomes after management of meatal balanitis xerotica obliterans (BXO). The primary outcome was recurrent meatal BXO. METHODS:A database comprising mostly hypospadias patients was queried for meatal BXO. The disease was confirmed histologically in all cases. Management included topical steroids...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2016.10.014
更新日期:2017-04-01 00:00:00
abstract:OBJECTIVE:To determine the effect of Mathieu and tubularized incised plate (TIP) urethroplasty techniques on the outcome of repair in recurrent hypospadias. MATERIAL AND METHODS:A total of 78 patients who had undergone surgical correction by either Mathieu or TIP urethroplasty after unsuccessful hypospadias surgery we...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2008.02.007
更新日期:2008-10-01 00:00:00
abstract:BACKGROUND:Overuse of computed tomography (CT) in the initial evaluation of children with upper urinary tract calculi (UUTC) has been well documented. Follow-up imaging patterns, however, remain undefined. Sequential imaging following an acute episode of UUTC represents additional opportunity for enacting good imaging ...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2018.04.019
更新日期:2018-12-01 00:00:00
abstract::We examined the use of shared medical appointments (SMA) for educating and counseling children with penile problems. Forty-eight families were seen over 4 months with 21 participating in the SMA group and 27 in the traditional group. Using a questionnaire to assess adequacy of education, there was no difference in the...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2017.09.030
更新日期:2018-02-01 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:INTRODUCTION:As robotic-assisted surgery becomes increasingly utilized for pediatric ureteropelvic junction (UPJ) obstruction, open surgeons have countered by using muscle-splitting, miniature (≤2 cm) incisions. To prepare for this type of incision during pyeloplasty, it is necessary to define the exact location of the...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2020.04.022
更新日期:2020-08-01 00:00:00
abstract::Uro-enteric fistulae are difficult clinical conditions that have a significant bearing on the patient's quality of life. Surgical correction, though challenging, is the usual mode of treatment offered to these patients. We describe a case of urethro-ileal pouch fistula which could be managed successfully without surge...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2011.06.007
更新日期:2012-02-01 00:00:00