Abstract:
INTRODUCTION:Congenital pelviureteric junction obstruction (PUJO) is one of the most frequent causes of neonatal hydronephrosis. Obstruction at the PUJ has potential severe adverse outcomes, such as renal damage. While pyeloplasty has been established as the definitive treatment, the exact pathophysiology of congenital PUJO remains unknown. Recent research has proposed neuronal innervation defects as an etiological factor in congenital PUJO. We aim to study the expression of various neuronal markers in PUJO specimens compared with controls, and evaluate whether severity of renal disease or dysfunction pre-operatively is related to expression of neuronal markers in resected PUJO specimens. MATERIALS AND METHODS:All consecutive patients who underwent dismembered pyeloplasty at KK Women's and Children's Hospital, Singapore, for intrinsic PUJO from 2008 to 2012 were included. Patients with other co-occurring renal pathologies were excluded. Controls were obtained from nephrectomy patients with Wilm's tumor or other benign renal conditions during the same period. Specimens were stained immunohistochemically with neuronal markers protein gene product 9.5 (PGP9.5), synaptophysin, and S-100, and with CD-117, a marker for interstitial cells of Cajal (Table). Levels of expression of the markers were assessed semiquantitatively (decreased, increased or no change) in comparison with controls by two independent observers. Pre-operative data of patients' renal anatomical (ultrasonography measurements of renal pelvis size) and functional parameters (differential renal function measured using MAG-3 renal scans) were obtained. DISCUSSION:Thirty-eight PUJO specimens (38 renal units) and 20 controls were studied. Mean patient age at pyeloplasty was 25.3 months (2.9-167.6 months). Median pre-operative pelvic size was 25.0 mm (17.0-50.0 mm). Both PUJO specimens and controls showed great heterogeneity in distribution of innervation. All four immunohistochemical markers were not predictive of significant pre-operative renal pelvis dilation or pre-operative diminished renal function of the operated kidney. CONCLUSIONS:There exists marked variability in expression of neuronal markers synaptophysin, PGP9.5, and S-100, and CD-117 in PUJO specimens compared with controls. Our results show no clinical significance of the expression of neuronal markers in predicting degree of pre-operative renal pelvis dilation or differential renal function. The heterogeneity of expression of neuronal markers in PUJO specimens and controls in our population is at variance with prior studies. The etiology of PUJO is likely to be complex and multifactorial.
journal_name
J Pediatr Uroljournal_title
Journal of pediatric urologyauthors
How GY,Chang KTE,Jacobsen AS,Yap TL,Ong CCP,Low Y,Allen JC,Kuick CH,Lim MZL,Laksmi NKdoi
10.1016/j.jpurol.2017.07.014subject
Has Abstractpub_date
2018-02-01 00:00:00pages
51.e1-51.e7issue
1eissn
1477-5131issn
1873-4898pii
S1477-5131(17)30305-4journal_volume
14pub_type
杂志文章abstract::Bladder trabeculation (BT) is commonly noted on cystogram images of patients with neurogenic bladder (NB). BT is associated with a hostile bladder often requiring prompt, more aggressive management. We aimed to define and validate a reliable grading system for BT severity. The proposed grading system will improve clin...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2020.03.007
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:BACKGROUND:Preputioplasty as a part of hypospadias repair restores the normal appearance of phallus, which is especially important in distal and mid penile hypospadias. However possibility of its inherent complications such as iatrogenic phimosis or preputial breakdown are the cause of controversy and reluctance regard...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2020.04.014
更新日期:2020-06-01 00:00:00
abstract:PURPOSE:We report surgical technique and outcomes in consecutive patients with primary distal hypospadias. MATERIALS AND METHODS:A prospectively maintained database of all patients operated by WS in 2000-2008 was reviewed for pertinent data in consecutive patients. RESULTS:A total of 551 consecutive patients of mean ...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2009.09.010
更新日期:2010-08-01 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: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:INTRODUCTION:Pediatric robot-assisted laparoscopic (RAL) pyeloplasty has become a viable minimally invasive surgical option for ureteropelvic junction obstruction (UPJO) based on its efficacy and safety. However, RAL pyeloplasty in infants can be a challenging procedure because of the smaller working spaces. The use of...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2018.06.010
更新日期:2018-12-01 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: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: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:INTRODUCTION:Second-trimester anhydramnios is incompatible with survival unless amniotic fluid volume is restored. We describe the long-term outcome of a child with documented anhydramnios at 17 weeks. CASE REPORT:A 28-year-old gravida II had anhydramnios at 17 weeks. At 19 weeks, the bladder measured 12 cm, and karyo...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2011.11.007
更新日期:2012-06-01 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:Acute scrotal pain (ASP) remains one of the most common male urologic emergencies in the pediatric age group. The most concerning outcome of testicular torsion (TT) is the need for orchiectomy, which has a negative impact on the child's development in general and on sexual development and psychology in par...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2020.09.011
更新日期:2020-12-01 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::Disorders/differences of sex development (DSD) are congenital conditions in which there is atypical chromosomal, gonadal and/or phenotypic sex. While there remains controversy around the traditionally binary concept of sex, most patients with DSD are reared either male or female depending on their genetic sex, gonadal...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2020.05.166
更新日期:2020-10-01 00:00:00
abstract:OBJECTIVES:To undertake a baseline audit of our pediatric urodynamic service, identifying areas for improvement, and to determine whether clinical management was affected by urodynamic results. PATIENTS AND METHODS:All pediatric urodynamic studies during one calendar year were reviewed to determine the quality of repo...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2004.11.004
更新日期:2005-02-01 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:We have previously reported our early experience (2 patients) of single-incision nephrectomy via the retroperitoneal prone route using an advanced access platform (GelPOINT Mini). Here, we review our series to date and also present a detailed video demonstrating the technique. METHOD:In the prone position, a...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2015.04.010
更新日期:2015-10-01 00:00:00
abstract:INTRODUCTION AND BACKGROUND:Elective circumcision is a common procedure, known to be safe and associated with minimal morbidity. There are few data reporting the rates of readmission and reoperation following elective circumcision. OBJECTIVE:We sought to define the rates of readmission and reoperation in the first 7 d...
journal_title:Journal of pediatric urology
pub_type: 杂志文章,多中心研究
doi:10.1016/j.jpurol.2015.10.006
更新日期:2016-02-01 00:00:00
abstract:OBJECTIVE:To evaluate long-term outcomes between various methods of augmentation cystoplasty. METHODS:A retrospective analysis was performed of patients undergoing seromuscular colocystoplasty lined with urothelium (SCLU, n=26), and their outcomes compared to a similar population of patients in the same institution wh...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2007.04.004
更新日期:2007-12-01 00:00:00
abstract:INTRODUCTION:Bladder augmentation (BA) has been used for various congenital and acquired conditions to create a low pressure, continent catheterizable reservoir. The prevalence of calculi within the BA have been reported to be from 3 to 52.5%. The present study reports the prevalence and risk factors of bladder calculi...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2014.12.003
更新日期:2015-04-01 00:00:00
abstract:OBJECTIVE:To review our initial experience with the retroperitoneoscopic approach, which is rapidly becoming the procedure of choice for paediatric adrenalectomy. Swift access to the vascular pedicle makes this approach ideal for adrenal surgery where haemodynamic instability is a common feature. METHOD:Patients were ...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2006.05.010
更新日期:2007-04-01 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:AIM:Evaluation of cosmetic and functional outcome of single-stage exstrophy-epispadias complex repair in older children and those with previously failed repair. MATERIALS AND METHODS:This study comprised 15 children (12 boys and 3 girls) with classic bladder exstrophy and a mean age at repair of 8.6 months (range 2-24...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2007.01.193
更新日期:2007-10-01 00:00:00
abstract:INTRODUCTION:Successful surgical therapy for pediatric upper urinary tract calculi (UUTC) minimizes the need for repeat surgical interventions. However, staged procedures, whether planned or unplanned, are sometimes necessary. We assessed predictors of repeat intervention for children with UUTC using a nationwide admin...
journal_title:Journal of pediatric urology
pub_type: 杂志文章,多中心研究
doi:10.1016/j.jpurol.2018.02.017
更新日期:2018-06-01 00:00:00
abstract::PURPOSE: Despite extensive research, the molecular basis of hypospadias and anorectal malformations is poorly understood, likely due to a multifactorial basis. The incidence of hypospadias is increasing, thus making research in this area warranted and timely. This review presents recent molecular work broadening our u...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2007.01.199
更新日期:2007-10-01 00:00:00
abstract:BACKGROUND:The necessity for urinary diversion with trans-anastomotic ureteral stenting during pyeloplasty is currently under debate. Performing a stentless repair could eliminate stent-related morbidity, including: stent migration, urinary tract infection, flank pain, and bladder spasms. In addition, there would be no...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2015.06.003
更新日期:2015-08-01 00:00:00
abstract:INTRODUCTION:Patients with chronic illnesses are known to have anxiety disorders and are likely to be depressed. Anxiety and depression (A/D) has been studied in adults with spina bifida (SB), however, no study has directly screened for A/D in pediatric patients with neurogenic bladder (NB) and their caregivers. OBJEC...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2014.11.017
更新日期:2015-04-01 00:00:00
abstract:INTRODUCTION:Bladder Exstrophy and Epispadias Complex (BEEC) is associated with an increased risk of impaired mental health, quality of life, and psychosocial functioning. Therefore, screening patients to help identify and evaluate potential psychosocial difficulty is arguably an important consideration for BEEC Servic...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2014.10.013
更新日期:2015-04-01 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