Abstract:
BACKGROUND:Parents of uncircumcised boys often report confusion regarding the proper care and hygiene practices for the uncircumcised penis. The lack of guidance from healthcare providers may be due to a lack of consensus on the proper care of the prepuce. OBJECTIVE:The aim of this study was to determine whether or not there exists consensus among pediatric urologists on the care of the uncircumcised penis and on the advice they provide to parents. METHODS:An electronic survey was delivered to 514 members of the Society for Pediatric Urology (SPU). The survey contained demographical and clinical questions which were analyzed using descriptive statistics. RESULTS:Of 261 SPU members who opened the e-mail invitation, a total of 204 responses were received for a response rate of 78% (overall response rate 40%). Nine responses were excluded for members practicing outside of the United States or whose locations were not disclosed for a final number of responses of 195. Overall, pediatric urologists reported a high level of confidence in providing advice to parents with a median confidence score of 10 (scale 1-10, IQR 9-10). Only 66% reported providing advice to parents on when to begin retracting the foreskin, with 48% basing their advice on the patient's age and 19% on the patient's toilet training status (Figure). Respondents who based their advice on age, advised beginning retraction at 2-5 years (61%), 6-11 years (17%), less than 2 years (12%), and greater than 12 years (10%). For frequency of retraction before toilet training, 50% recommended no retraction, 25% with cleaning or baths, 10% with each diaper change, and 13% provided no advice. After toilet training, 48% of respondents recommended retracting the foreskin with cleaning or baths, 41% with each void, and 19% recommended no retraction. The majority of respondents agreed that problems with voiding (77%), infection (74%), and hygiene (64%) were indications for treatment of phimosis. In asymptomatic cases, 47% believed that phimosis required treatment if persisting beyond a specific age, the most common being greater than 12 years of age (40%). CONCLUSIONS:Although pediatric urologists reported being highly confident in advising parents on the care of the uncircumcised penis, there is not a clear consensus among these subspecialists on when to begin and how often to retract the foreskin, or when phimosis requires treatment. These findings offer insight into current practice patterns to better inform primary care providers and parents.
journal_name
J Pediatr Uroljournal_title
Journal of pediatric urologyauthors
Li B,Shannon R,Malhotra NR,Rosoklija I,Liu DBdoi
10.1016/j.jpurol.2018.05.024subject
Has Abstractpub_date
2018-12-01 00:00:00pages
548.e1-548.e5issue
6eissn
1477-5131issn
1873-4898pii
S1477-5131(18)30320-6journal_volume
14pub_type
杂志文章abstract:OBJECTIVE:To evaluate outcomes of desmopressin treatment in monosymptomatic enuresis (ME) and nonmonosymptomatic enuresis (NME). MATERIALS AND METHODS:PubMed was searched for all studies investigating enuresis, up to July 2009, in which desmopressin was administered alone or combined with other treatments. Each study ...
journal_title:Journal of pediatric urology
pub_type: 杂志文章,评审
doi:10.1016/j.jpurol.2010.04.014
更新日期:2011-02-01 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: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:It is extremely important to not only address the short-term success following endoscopic correction of vesicoureteral reflux (VUR) but also the long-term efficacy and safety of the tissue augmenting substance utilized for endoscopic correction. OBJECTIVE:This study retrospectively evaluated all cases of ur...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2018.04.021
更新日期:2018-12-01 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::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:BACKGROUND:Urethrocutaneous fistula UCF is the most common complication following surgical repair of hypospadias. Currently, the surgical technique mostly used to prevent recurrence employs preputial dartos or testicular tunica vaginalis flaps as a urethral covering. However, autologous tissues are limited in patients ...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2019.10.002
更新日期:2019-12-01 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
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::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
abstract:BACKGROUND:Congenital adrenal hyperplasia (CAH) consists of a group of diseases characterized by an enzyme deficiency, particularly 21-hydroxylase deficiency. The condition may present in the simple virilizing form or in the salt-wasting form, with varying degrees of genital ambiguity. The non-heterosexual orientation ...
journal_title:Journal of pediatric urology
pub_type: 杂志文章,评审
doi:10.1016/j.jpurol.2018.08.004
更新日期:2018-12-01 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:Long-term outcomes are of special concern in children after urinary diversion. In a single institution study we evaluated retrospectively the long-term outcomes of urinary diversion in children, in whom the ileocecal segment had been used, in respect to complications of the efferent segment. METHODS:The M...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2016.05.008
更新日期:2016-08-01 00:00:00
abstract:INTRODUCTION AND OBJECTIVE:Staged pelvic osteotomy (SPO) prior to bladder closure has been shown to be a safe and effective method for achieving pubic approximation in cloacal exstrophy (CE) patients with extreme diastasis. However, SPO outcomes have never been compared to those for combined pelvic osteotomy (CPO) at t...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2014.06.018
更新日期:2014-12-01 00:00:00
abstract:OBJECTIVE:To address the issue of sexual function and fertility in PUV patients. PATIENTS AND METHODS:Of 47 patients (age > 18 years) treated for PUV in infancy 28 were contactable. They were sent a standard questionnaire requesting details on voiding dysfunction symptoms, and experience of erection, orgasm and ejacul...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2011.11.006
更新日期:2013-02-01 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:INTRODUCTION:Primary nocturnal enuresis is one of the sleep related phenomena characterized by disruption in the relationship between arousal and urination. Corticotropin-releasing factor (CRF) is a neurohormone released from the paraventricular nucleus of the hypothalamus into the median eminence to elicit release of ...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2016.08.030
更新日期:2017-02-01 00:00:00
abstract:BACKGROUND:Robot-assisted laparoscopic extravesical ureteral reimplantation (RALUR-EV) is a minimally invasive alternative to open surgery. We have previously reported retrospective outcomes from our study group, and herein provide an updated prospective analysis with a focus on success rate, surgical technique, and co...
journal_title:Journal of pediatric urology
pub_type: 杂志文章,多中心研究
doi:10.1016/j.jpurol.2018.01.020
更新日期:2018-06-01 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:The use of administrative health data for research has prompted questions about its validity for this purpose. OBJECTIVE/STUDY DESIGN:The purpose of this study was to determine the concordance of Pediatric Health Information System (PHIS) perioperative antibiotic charges with the institution's medication ...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2017.01.009
更新日期:2017-04-01 00:00:00
abstract:OBJECTIVE:Our study aims to evaluate variations in management of asymptomatic adolescent grade 2 and 3 varicoceles by pediatric urologists. SUBJECTS AND METHODS:Electronic survey of all 267 current members of AAP Urology with 74 (28%) responding. RESULTS:When managing patients with positive examination findings, 49% ...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2013.11.001
更新日期:2014-06-01 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:OBJECTIVE:Voiding disorders are commonly encountered in paediatric urology practice. Urinary incontinence often leads to the impairment of self-esteem but can also cause renal damage, when recurrent urinary tract infection (UTI) or vesico-ureteral reflux (VUR) exists. The aim of this study was to assess the efficacy of...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2005.09.004
更新日期:2006-10-01 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::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: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: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:BACKGROUND:Most children with symptoms of urolithiasis and urinary solute excretion abnormalities leading to stone formation have no calculi revealed by ultrasound or X-ray plain film ("occult urolithiasis"). This covers a large group of children presenting with common symptoms such as abdominal pain, hematuria, and dy...
journal_title:Journal of pediatric urology
pub_type: 杂志文章,评审
doi:10.1016/j.jpurol.2016.12.021
更新日期:2017-04-01 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:OBJECTIVE:To prospectively evaluate the efficacy and safety of a perimeatal-based penile skin flap for neourethral coverage after repair of distal hypospadias with tubularized incised plate urethroplasty (TIPU). METHODS:In 12 New Zealand white rabbits a ventral urethral defect was created and reconstruction was accomp...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2013.12.010
更新日期:2014-06-01 00:00:00