Abstract:
BACKGROUND:Children with daytime urinary incontinence secondary to idiopathic overactive bladder (IOAB) commonly present to paediatric urologists following failure of standard urotherapy and/or 1st-line anticholinergics. Off-label oral medications and intravesical botulinum toxin A (BtA) are being increasingly used for treatment-refractory IOAB, despite the paucity of high-quality evidence and guidelines. Knowledge of contemporary paediatric urologists' practice allows specialists to keep up-to-date with current trends in the management of IOAB in children. OBJECTIVES:1. To present an analysis of contemporary tertiary management of IOAB in children and 2. to highlight current trends in practice and identify areas of high variability in care for targeted research. METHODS:Paediatric urologists (55 individuals) who attended the 2018 national British Association of Paediatric Urologists (BAPU) congress responded to a 20-question survey presented at the congress. Respondents could submit one answer per question, and one survey was taken per respondent, using secure software to disable any manipulation. Answers were analysed prospectively by a single reviewer. RESULTS:Of UK paediatric urologists, 98% regularly manage children with IOAB, 48% use 48-h frequency/volume charts and others use three or seven-day bladder diaries to aid diagnosis. Oxybutynin is the 1st-line therapy for 85%, 2nd-line is tolterodine (53%), and 3rd-line is solifenacin (41%). Mirabegron is used either alone or in combination with solifenacin as 4th-line management by 55%. Those who use intravesical Botulinum toxin A (BtA) accounted for 81% and 84% of these perform invasive urodynamic assessment prior to BtA administration. Post-BtA, assessment was clinical in 18%, 24% use invasive urodynamics, whereas uroflowmetry is preferred by 58%. Of the paediatric urologists, 72% believe the most clinically significant outcome of treatment is patient-reported improvement. Treatment success is defined variably: 49% define success as completely dry, whereas 35% accept a 90% improvement as success. CONCLUSIONS:Off-label medications are being used widely either alone or in combination by paediatric urologists. In oral therapy-resistant IOAB, BtA is being used by the majority of specialists, usually after formal urodynamic assessment. However, post-BtA assessment and evaluation of treatment success for IOAB are variable.
journal_name
J Pediatr Uroljournal_title
Journal of pediatric urologyauthors
Melling CV,Goyal Adoi
10.1016/j.jpurol.2019.10.013subject
Has Abstractpub_date
2020-02-01 00:00:00pages
37.e1-37.e8issue
1eissn
1477-5131issn
1873-4898pii
S1477-5131(19)30326-2journal_volume
16pub_type
杂志文章abstract:INTRODUCTION:When patients with neurogenic bladder become refractory, there are different alternatives, such as the use of β3-adreceptor agonists. The aim of the present study is to evaluate efficacy and safety of Mirabegron as adjuvant treatment. MATERIAL AND METHODS:37 patients under 18 years of age who underwent Mi...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2020.07.020
更新日期:2020-10-01 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:Idiopathic Overactive Bladder is the most common cause of urinary incontinence in children. Anticholinergic medications are successful in only 20% of those with daily wetting so there is a real need to find a more effective treatment for this condition. Onabotulinum toxin A injections are often used as a tre...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2020.10.012
更新日期:2020-10-19 00:00:00
abstract:OBJECTIVE:Extravesical robot-assisted laparoscopic ureteral reimplantation (RALUR) is a popular alternative to open surgery. We report our experience with RALUR and evaluate clinical variables as predictors for failure. METHODS:We retrospectively evaluated the records of patients who underwent RALUR by a single surgeo...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2014.01.028
更新日期:2014-10-01 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:INTRODUCTION:Parents making complex decisions about hypospadias surgery may experience anxiety and uncertainty related to multiple sources of information with questionable reliability and limited relevance to their concerns. OBJECTIVE:The purpose of this study was to identify knowledge gaps, information-seeking behavi...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2020.01.008
更新日期:2020-04-01 00:00:00
abstract::This is the first report of a single trocar nephrectomy for poorly functioning dysplastic kidney and ectopic ureter, performed in 5 patients from 2010 to 2011. The mean operative time was 63 min and mean postoperative hospital stay was 31 h. There were no perioperative complications. The single trocar nephrectomy is a...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2012.10.007
更新日期:2013-08-01 00:00:00
abstract:OBJECTIVE:To gain insight into the efficacy and safety of urethral de-obstruction in boys with overactive bladder (OAB) complaints refractory to conservative treatment. MATERIALS AND METHODS:All boys, older than 5 years, referred in 2009 for OAB complaints were included, n = 180. Nine had abdominal or penile pain as p...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2013.03.011
更新日期:2013-12-01 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 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: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::Suppose that the recurrence in pediatric urolithiasis has a close relationship with metabolic abnormalities and is affected by residual burden and prophylaxis. If so, the recurrence rates could be reduced with effective surgery and appropriate prophylaxis. Here we retrospectively evaluate the metabolic risk factors da...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2020.12.003
更新日期:2020-12-06 00:00:00
abstract:OBJECTIVE:Congenital penile torsion is a three-dimensional deformity with helical rotation of the distal corporal bodies with the penile crurae remaining fixed to the pubic rami. The first case of congenital penile torsion (hypospadias) was described in 1857. Isolated penile torsion is an under-reported anomaly. The re...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2016.12.031
更新日期:2017-10-01 00:00:00
abstract::Isolated congenital megacystis represents a rare variant of fetal megacystis without other associated anomalies. The etiology is unclear, and various management strategies have been proposed. We report a case of isolated congenital megacystis that resolved over the first year of life with observation alone. Considerat...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2012.07.012
更新日期:2013-02-01 00:00:00
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::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:OBJECTIVE:Congenital megaprepuce is a specific form of buried penis. Children affected by this malformation usually suffer from a subjective difficulty in voiding which is the main indication for early surgical correction. The aim of this study was to report a single center's 12-year experience in the treatment of mega...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2012.10.010
更新日期:2013-12-01 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:PURPOSE:Ureteropelvic junction obstruction (UPJO) is the major cause of hydronephrosis in children and may lead to renal injury and early renal dysfunction. However, diagnosis of the degree of obstruction and severity of renal injury relies on invasive and often inconclusive renal scans. Biomarkers from voided urine th...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2015.10.008
更新日期:2016-04-01 00:00:00
abstract:BACKGROUND:There is an ongoing quest on how to minimize complications in hypospadias surgery. There is however a lack of high-quality data on the following parameters that might influence the outcome of primary hypospadias repair: age at initial surgery, the type of suture material, the initial technique, and the type ...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2014.11.014
更新日期:2015-04-01 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:OBJECTIVE:To study the factors that may influence the effectiveness of 0.2% betamethasone/hyaluronidase cream in the treatment of phimosis. METHODS:We treated 427 patients (3-10 years old, mean 6.33) in a prospective, randomized, blind study, with 214 patients on a 4-week and 213 patients on an 8-week course. All pati...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2006.05.006
更新日期:2006-08-01 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::We report an extremely rare case of a female neonate with antenatally diagnosed bilateral moderate hydronephrosis and appropriate postnatal follow up who presented at 6 weeks of life with sudden onset of anuria secondary to bilateral pelvi-ureteric junction obstructions. While most antenatally diagnosed hydronephrosis...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2005.10.010
更新日期:2006-10-01 00:00:00
abstract:INTRODUCTION:The Urinary Tract Dilation (UTD) system was created to address variability in hydronephrosis grading. It is unknown if or how pediatric urologists are integrating this newer system into practice. OBJECTIVE:We sought to evaluate the current use of hydronephrosis grading systems, inter-rater reliability (IR...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2020.04.025
更新日期:2020-08-01 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:OBJECTIVE:To assess whether repairing hypospadias before or after 18 months affects psychological adjustment, health-related quality of life (HRQoL) and surgical outcome. PATIENTS AND METHODS:Seventy-seven boys aged 6-17 years were assigned to one of two groups, according to whether they had a hypospadias repair befor...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2008.12.008
更新日期:2009-10-01 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:INTRODUCTION:Advice (BBA) into the standards of patients' care in both monosymptomatic and non-monosymptomatic nocturnal enuresis. Although the idea of this recommendation was clear and reflects clinical experience, duration and efficacy have not been definitely established. Recent data have demonstrated the lack of ef...
journal_title:Journal of pediatric urology
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1016/j.jpurol.2017.03.039
更新日期:2017-12-01 00:00:00
abstract:INTRODUCTION:Testicular microlithiasis (TM) is a condition characterized by calcium deposits within the testis, usually detected incidentally during ultrasonography of the scrotum. TM has been associated with the presence of, and possibly the development of, testicular malignancy. Our aim was to document international ...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2017.12.007
更新日期:2018-04-01 00:00:00