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 of patients who had undergone a triamcinolone injection (40 mg/ml) for the treatment of stomal stenosis at the present institution. The primary outcome of success was defined as a patient-reported or caregiver-reported return to ease with catheterization, and avoidance of stomal revision or indwelling catheter. The cost of care with various techniques for the treatment of stomal stenosis was also assessed by representing the cost as a percentage of charges for a re-operative Monti ileovesicostomy. RESULTS:A total of 22 injections were performed in 18 CCCs of 17 patients. Demographic and clinical data are provided in the Summary Table. Thirteen CCCs (72%) were successfully treated with a single injection. Three patients (10%) required a total of five repeat injections at a median of 5.1 months between injections (IQR, 4.6-12.4). One patient required a stomal revision at 34.9 months after the initial injection, while one patient also required a Chait cecostomy catheter. The median length of time for ease with catheterization was 11.6 months (IQR, 3.5-18.0) after the initial injection, and 10.4 months (IQR, 4.5-16.0) after any injection. No adverse effects or complications occurred from the injection. There were no variables associated with failure after the initial or any injection on univariate analysis. Represented as a percentage of charges for a reoperative Monti ileovesicostomy, the cost of care was 11.3% for a stomal revision, 5.8% for triamcinolone injection in the operating room, and 0.3% as an office-based procedure. DISCUSSION:The success rate for triamcinolone injection favorably compared with other options for the treatment of stomal stenosis. It surpassed the reported success rate of stomal dilation and approached that of stomal revision. Other studies have similarly observed a minimal risk of adverse effects and complications from both topical and intralesional corticosteroids. The limitations of the present study included its retrospective design at a single institution. A larger cohort of patients with a longer follow-up is necessary to determine its long-term durability. CONCLUSIONS:Triamcinolone injection was an effective and well-tolerated option for the treatment of stomal stenosis in any cutaneous stoma, thereby avoiding the need for a more invasive and costly stomal revision.
journal_name
J Pediatr Uroljournal_title
Journal of pediatric urologyauthors
Reddy PP,Strine AC,Reddy T,Noh PH,DeFoor WR Jr,Minevich E,Sheldon CA,VanderBrink BAdoi
10.1016/j.jpurol.2017.06.007subject
Has Abstractpub_date
2017-08-01 00:00:00pages
375.e1-375.e5issue
4eissn
1477-5131issn
1873-4898pii
S1477-5131(17)30275-9journal_volume
13pub_type
杂志文章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:To standardize the history and physical examination of boys who present with acute scrotum and identify parameters that best predict testicular torsion. MATERIALS AND METHODS:Over a 5-month period, a standardized history and physical examination form with 22 items was used for all boys presenting with scrota...
journal_title:Journal of pediatric urology
pub_type: 临床试验,杂志文章
doi:10.1016/j.jpurol.2010.12.010
更新日期:2011-08-01 00:00:00
abstract:OBJECTIVES:Clinical care parameters are frequently assessed by national ranking systems. However, these rankings do little to comment on institutions' academic contributions. The Publication Ranking Score (PRS) was developed to allow for objective comparisons of scientific thought-leadership at various pediatric urolog...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2013.03.012
更新日期:2013-12-01 00:00:00
abstract::Nephrogenic adenoma (NA) is a rare benign tumour of the urinary tract and is found most commonly in the bladder. Here are presented four cases of paediatric NA, two bladder and two urethral. Their diagnostic and management features in the context of differential diagnosis and natural history are discussed. A 3-year-ol...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2006.02.004
更新日期:2006-08-01 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:Recent studies have suggested contradictory trends in the incidence of undescended testis (UDT) and hypospadias (HYP), partly because of methodological issues and ascertainment bias. The recently described association of "testicular dysgenesis syndrome" links concomitant UDT and HYP, with decreasing sperm ...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2018.07.003
更新日期:2018-12-01 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:INTRODUCTION:Nephrolithiasis is a major source of morbidity in the United States. In recent decades, there has been a notable increase in stone incidence in the pediatric population. We investigate whether recurrent stone formers who had their initial stone episode earlier in life are at risk for more frequent stone re...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2020.03.014
更新日期:2020-06-01 00:00:00
abstract:OBJECTIVE:There are no clinical reports on the risk of carcinoids in the gastric segment following gastrocystoplasty. The aim of the present study was to examine whether gastric carcinoids could develop in a rat model of gastrocystoplasty. MATERIALS AND METHODS:Rats were subjected to gastrocystoplasty in which 10% of ...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2011.01.008
更新日期:2012-04-01 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:INTRODUCTION:Bladder exstrophy is a rare, congenital, complex malformation where the underlying cause is largely unknown. Both environmental and genetic mechanisms are thought to be involved. There are divergent results concerning the prevalence, birth descriptive data, and potential maternal risk factors for bladder e...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2016.05.035
更新日期:2016-10-01 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::Single incision, single port, or single site surgery for retro-peritoneoscopic nephrectomy and nephro-ureterectomy in paediatric practice using an advanced access platform (GelPOINT Mini) is described in two patients. One patient had bilateral synchronous nephrectomy. The technique, advantages, and challenges are repo...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2013.12.018
更新日期:2014-06-01 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: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:Testicular torsion is one of the most common diagnoses involved in lawsuits in the pediatric patient. Missed diagnosis and diagnostic delays put patients at risk for testicular loss and have resulted in malpractice litigation. Using a national database, we sought to describe testicular torsion malpractice cas...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2016.03.008
更新日期:2016-10-01 00:00:00
abstract:OBJECTIVE:To determine the changes in number and morphology of interstitial cells of Cajal (ICC)-like cells (ICC-LC) at the ureteropelvic junction (UPJ) of rats after experimental distal ureteral obstruction. MATERIALS AND METHODS:Of a total of 109 rats, 20 served as controls (C), 20 underwent sham-operations (SH) and...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2008.12.006
更新日期:2009-08-01 00:00:00
abstract::Laparoscopic orchidopexy has become the routine tool in managing abdominal testes. Many techniques have been used to deliver the dissected testis to the scrotal position; a trans-scrotal port is one of them. We present a technique in which the trans-scrotal port is inserted early on, and used not only for testis deliv...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2010.07.016
更新日期:2011-10-01 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::Eosinophilic cystitis is an inflammatory condition characterized by eosinophilic infiltration of whole layers of the bladder wall. The condition occurs more commonly in adults. We report a case of eosinophilic cystitis mimicking a bladder tumor in a 5-year-old boy with symptoms of dysuria and urinary incontinence. The...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2012.04.005
更新日期:2013-02-01 00:00:00
abstract:INTRODUCTION:The nocturnal polyuria is considered a significant predictive value for response to desmopressin. The cutoff value useful to define nocturnal polyuria is still a matter of debate. Moreover, it is current notion that maximal voided volume (MVV) could be used as a predictor for desmopressin response. OBJECT...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2018.11.004
更新日期:2019-04-01 00:00:00
abstract:INTRODUCTION:Both, fluoroscopic voiding cystourethrography (fVCUG) and direct isotope cystography (DIC) are diagnostic tools commonly used in pediatric urology. Both methods can detect vesicoureteral reflux (VUR) with a high sensitivity. Whilst the possibility to depict anatomical details and important structures as fo...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2014.08.015
更新日期:2015-02-01 00:00:00
abstract:INTRODUCTION:Non-Wilms renal tumors represent a compelling subset of childhood renal tumors. However, their relative rarity renders accurate diagnosis, and therapy challenging which in some instance is inferred from their adult counterparts. OBJECTIVE:To describe the incidence and analyze the diagnostic challenges, th...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2020.05.168
更新日期:2020-08-01 00:00:00
abstract:PURPOSE:Bladder outlet obstruction with intravesical pressures exceeding 40 cmH(2)O results in a progressive increase in wall thickness, eventually causing low compliance. We investigated whether intravesical pressure induces hypertrophy and/or hyperplasia of human bladder smooth muscle cells (HBSMC) mediated by a musc...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2005.11.015
更新日期:2006-08-01 00:00:00
abstract:BACKGROUND:Lower urinary tract dysfunction (LUTD) is a broad term describing the full spectrum of disorders in any of the stages of bladder function-storage or voiding LUTD is a clinical condition associated with emotional and behavioral disorders in children. This cross-sectional study aimed to investigate the associa...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2018.07.017
更新日期:2018-12-01 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:INTRODUCTION:Ultrasound (US) imaging is preferred in the initial evaluation for children with suspected nephrolithiasis; however, computed tomography (CT) continues to be used in this setting with resultant unnecessary ionizing radiation exposure. The study institution implemented a standardized clinical pathway to red...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2019.06.014
更新日期:2019-10-01 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: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: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