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 prospectively maintained departmental database. Data were analysed using Microsoft Excel 2013 and unpaired t-tests through GraphPad Software QuickCalcs. RESULTS:Fifty-seven patients with PROM were surgically managed in the study centre from 2005 to 2017. Twenty-nine of fifty-seven patients had the stent as the primary procedure, whereas the remainder had ureterostomy, re-implantation or nephrectomy. Six patients had bilateral PROM, giving a total of 35 renal units that were fully analysed. There was 7:1 male predominance, and 20 of 29 patients (69%) were diagnosed antenatally. The median age at stent insertion was 8 months (40 days-10 years); the median prestent ureteric diameter was 19 mm and the median pre-operative function on MAG3 was 44%. Cystoscopic stent insertion was feasible in all patients. The stent was left for a median of 183 days. In 9 of 35 (26%) renal units, the JJ stent was a successful sole long-term treatment, with median follow-up of 5 years and 8 months. The success rate was not different in children aged <1 year (8/22; 36%) in comparison to children aged >1 year (1/13; 8%), P = 0.1. The remaining 26 renal units required further surgical intervention: ureteric re-implantation in 25 and nephrectomy in one. Indications for further surgery were stent complications in 11 renal units and stent failure in 15 (Table 1). Complications related to the stent were noted in 14 renal units (41%), half being stent migration. Other complications included UTIs, stent encrustation and recurrent haematuria. There was no identifiable prestent parameter, whether clinical or radiological, that could predict which patients were likely to be successfully managed solely by stent insertion. Stent insertion was never successful as a definitive procedure when the distal ureteric diameter was >12 mm on the ultrasound after stent removal. DISCUSSION:Success rates with primary stenting as a sole treatment for PROM was 26%, which is less than that seen in other reports (50-66%). This may be attributed to the long-term follow-up in this study, together with the strict criteria for success. CONCLUSION:In the authors' experience, cystoscopically inserted JJ stents are of limited success as the sole treatment for PROM. In infants aged <1 year, stent insertion remains a reasonable temporising measure until the infant is old enough for a definitive procedure.
journal_name
J Pediatr Uroljournal_title
Journal of pediatric urologyauthors
Awad K,Woodward MN,Shalaby MSdoi
10.1016/j.jpurol.2018.09.011subject
Has Abstractpub_date
2019-02-01 00:00:00pages
66.e1-66.e5issue
1eissn
1477-5131issn
1873-4898pii
S1477-5131(18)30568-0journal_volume
15pub_type
杂志文章abstract:BACKGROUND:Posterior urethral valves (PUVs) are one of the leading causes of pediatric chronic kidney disease (CKD). Growth impairment is prevalent in pediatric CKD, and children with PUVs are at high risk for growth retardation. OBJECTIVE:The objective of this study was to describe growth profiles in PUVs and to iden...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2019.03.001
更新日期:2019-05-01 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:OBJECTIVE:To investigate preoperative urinary flow patterns in hypospadic infants and compare them to those from normal infant boys. PATIENTS AND METHODS:Twenty-one boys (median age 14.0, range 12.8-21.6 months) referred for distal hypospadias surgery were compared to 19 healthy boys (median age 12.0, 9.2-19.8 months)...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2010.05.013
更新日期:2011-08-01 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::This study demonstrates significantly improved bowel symptoms and satisfaction with Peristeen® use in pediatric patients with neurogenic bowel. The longer patients used Peristeen®, the greater the reduction in severity of their Neurogenic bowel and the greater the satisfaction with their bowel management. ...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2019.09.023
更新日期:2019-12-01 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:OBJECTIVE:To evaluate the impact of imaging modalities on the evaluation and prognosis of children with multicystic dysplastic kidney (MCDK) disease. PATIENTS AND METHODS:A retrospective analysis of all children with MCDK diagnosed from 2004 until 2012 was performed. The study included 63 patients for whom all postnat...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2014.03.004
更新日期:2014-08-01 00:00:00
abstract:OBJECTIVE:Bladder spasms are a common cause of pain after surgical procedures that call for postoperative catheter drainage. Several therapeutic methods have been used to lessen these spasms but none have received widespread success. PATIENTS AND METHODS:Twenty-six children were included in a prospective randomized tr...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2006.11.003
更新日期:2007-08-01 00:00:00
abstract:OBJECTIVE:To examine the association with renal damage in patients with posterior urethral valves (PUV) of two renin-angiotensin system gene polymorphisms: angiotensin converting enzyme insertion/deletion (ACE I/D) and angiotensin type 2 receptor (AT2R A1332G), PATIENTS AND METHODS: In 120 patients with PUV, after stab...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2010.01.002
更新日期:2010-12-01 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: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 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/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: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...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2016.04.008
更新日期:2016-08-01 00:00:00
abstract:BACKGROUND:Elevated body mass index (BMI) is a well-known risk factor for perioperative complications in adults, but has not been investigated in children undergoing urologic procedures. Given the low rate of complications associated with urologic surgery, a large sample is required for their characterization, but BMI ...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2015.04.014
更新日期:2015-08-01 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::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:BACKGROUND:An association has been found between lower urinary tract dysfunction (LUTD) and emotional and behavioral problems, particularly in cases of urinary incontinence. Other associated symptoms and the coexistence of functional constipation require further investigation. OBJECTIVE:To assess whether emotional and...
journal_title:Journal of pediatric urology
pub_type: 杂志文章,多中心研究
doi:10.1016/j.jpurol.2018.12.003
更新日期:2019-08-01 00:00:00
abstract:INTRODUCTION:Redo orchiopexy involves a hazardous dissection inside the inguinal canal (IC) where scar tissue encircles the testicular vessels (TesV), vas deferens (VD), and the testis. OBJECTIVE:The aim was to describe and evaluate a combined preperitoneal and inguinal approach (CPI) through a single cutaneous incisi...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2015.05.035
更新日期:2016-02-01 00:00:00
abstract:OBJECTIVE:Seven percent of patent processus vaginalis (PPVs) are obliterated at exploration. This potentially increases the risk of cord injury with a subsequent increased risk of testicular atrophy or reduced fertility. We report a modification of a technique to improve identification of the PPV and thus potentially m...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2007.08.008
更新日期:2008-06-01 00:00:00
abstract::Although some centres have successfully integrated remote clinics into their paediatric urological practice, for many, remote clinics have developed due to the COVID-19 pandemic. One UK-based institution has integrated remote clinics in their practice for over two years and has developed guidelines considering which c...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2021.01.001
更新日期:2021-01-06 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:BACKGROUND:Anogenital distance (AGD), the distance from the anus to the genitals, is a marker of normal genital development. AGD and other biometric parameters of external female genitalia are important as ultrasonographic markers that can determine fetal gender in the first trimester. Neural tube defects are one of th...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2020.07.015
更新日期:2020-10-01 00:00:00
abstract::Hyponatremic hypertensive syndrome is a combination of renovascular hypertension and hyponatremia. Although reported in adults, it is rare in children. We report a 7-year-old boy having renal artery stenosis associated with hyponatremic hypertensive syndrome. ...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2008.01.204
更新日期:2008-10-01 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:OBJECTIVE:In principle, the prepuce can be reconstructed during hypospadias repair, but the procedure has not gained wide acceptance and preputial reconstruction (PR) is surrounded by several controversies. MATERIAL AND METHODS:A review is provided of the technique for PR, how PR combines with the other steps of hypos...
journal_title:Journal of pediatric urology
pub_type: 杂志文章,评审
doi:10.1016/j.jpurol.2016.07.018
更新日期:2017-02-01 00:00:00
abstract:BACKGROUND:Predicting the fate of a unilateral non-palpable testis based on its scrotal counterpart has been recommended by some, yet disputed by others, and the question remains open. OBJECTIVE:To investigate the accuracy of contralateral testis hypertrophy in predicting the absence of a unilateral non-palpable testi...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2016.12.013
更新日期:2017-06-01 00:00:00
abstract:BACKGROUND:Estimation of the quality of the urethral plate (UP) seems to be important when assessing postoperative outcomes of hypospadias repair, but its evaluation remains subjective. We developed an objective model aiming to standardize this assessment, proposing a methodology that could be adopted in future studies...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2020.07.043
更新日期:2020-10-01 00:00:00
abstract::A renal ossifying tumor of infancy is a rare event with few cases having been published, and the etiology has not yet been established. We report on two new cases of this unusual neoplasm. A 2-year-old boy presented with intermittent painless gross hematuria. After several diagnostic procedures, an open pyelolithotomy...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2006.05.009
更新日期:2007-06-01 00:00:00
abstract:OBJECTIVE:Children with valve bladder syndrome represent the worst end of the posterior urethral valve spectrum. When conservative measures fail to control recurrent infections, prevent deterioration of the upper tract (in the form of increasing hydronephrosis and or worsening of kidney function) and improve incontinen...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2007.06.005
更新日期:2007-12-01 00:00:00