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 UPJ. The use of retrograde pyelogram (RPG) at the time of pyeloplasty helps the surgeon to identify the exact location of UPJ, and thus be able to use a muscle-splitting, miniature incision for open pyeloplasty. OBJECTIVE:We hypothesize that when performing a muscle-splitting, miniature incision open approach; preoperative RPG frequently changes the traditional pyeloplasty flank incision at the tip of the 11th or 12th rib. MATERIALS & METHODS:A retrospective review of open pyeloplasties performed by a single surgeon at our institution from 7/1/2010 to 12/31/2018 was performed to determine rate of use of RPG, open pyeloplasty incision location and to determine what factors are predictive of incisional site. RESULTS:114 of 122 (93.4%) patients with 115 renal units had pyeloplasties with preoperative RPG performed. Of the 8 procedures without RPG, two had a pelvic kidney diagnosed prior to surgery, two had narrow ureteric orifices that were difficult to cannulate, and four had associated reflux. In 31/115 (27%) pyeloplasties the incision was changed from a standard incision position at the 11th or 12th rib to an alternative incision (i.e. extended muscle-transecting incision at the tip of the 11th or 12th rib, or to an alternate incision site including Gibson, McBurney's incision, or low anterior abdominal incision). 84/115 (73.0%) had a miniature (<2 cm) incision at the tip of the 11th or 12th rib. Grade IV hydronephrosis was a significant predictor for changing the traditional incision site (p = 0.02). Preoperative nephrostomy tube insertion was also associated with an increased likelihood of having an alternate incision (p = 0.04). Incision site was not significantly affected by age of the patient at surgery, patient sex, size of the affected kidney, T1/2 times of <30 min, split function of <30%, kidney length differential, or laterality. CONCLUSION:The consistent use of RPG prior to pyeloplasty helps surgeons to plan for a small muscle-splitting, miniature open incisions. In our experience, 27% of pyeloplasties required alternative incision sites based on the results of pre-operative RPG.
journal_name
J Pediatr Uroljournal_title
Journal of pediatric urologyauthors
Salama AK,Szymanski KM,Casey J,Roth J,Whittam B,Cain MPdoi
10.1016/j.jpurol.2020.04.022subject
Has Abstractpub_date
2020-08-01 00:00:00pages
479.e1-479.e5issue
4eissn
1477-5131issn
1873-4898pii
S1477-5131(20)30126-1journal_volume
16pub_type
杂志文章abstract::Metanephric adenoma is an extremely rare tumor of the kidney. The clinical and anatomic characteristics are not yet well defined, but it is currently considered to be a benign tumor with a good prognosis, although recently two metastatic cases have been reported. Around 50% of cases are incidental findings, and sympto...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2006.10.003
更新日期:2007-08-01 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:INTRODUCTION:Complications remain the top evaluation priority subsequent to hypospadias repair. Complications vary in further management, and usually require one or more reoperations. Patients and/or their parents concern not only with the success rate of reoperation, but also with the risk of numerous reoperations. O...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2020.11.010
更新日期:2020-11-12 00:00:00
abstract:OBJECTIVE:Urolithiasis in children can cause considerable morbidity. Our aim was to evaluate the impact of intervention on the recoverability of kidney functions. MATERIALS AND METHODS:This prospective study included 93 children (66 boys and 27 girls) with median age of 3 years (range 0-14). Inclusion criteria were pr...
journal_title:Journal of pediatric urology
pub_type: 杂志文章,多中心研究
doi:10.1016/j.jpurol.2011.02.011
更新日期:2011-06-01 00:00:00
abstract:INTRODUCTION:Orchiopexy for a palpable undescended testis can be approached through a traditional inguinal incision or trans-scrotally. Despite the possible advantages of the scrotal approach, including reduced postoperative pain and shorter recovery, it is not consistently advocated. OBJECTIVE:The objective of this s...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2018.08.022
更新日期:2019-02-01 00:00:00
abstract:INTRODUCTION:Patients with spina bifida and other spinal dysraphisms commonly suffer from fecal incontinence and constipation, which can be treated with antegrade continence enemas. Currently, information regarding outcomes and satisfaction in children who have Chait cecostomy tubes is lacking. The aim of our study was...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2017.04.008
更新日期:2017-08-01 00:00:00
abstract::End-stage renal disease is becoming a contemporary global concern with increasing prevalence. The available treatment strategies are limited to dialysis and renal transplantation. However, limited organ supply and autoimmune rejection are the shortcomings that limit widespread application of transplantation. Favorably...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2018.01.008
更新日期:2018-04-01 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:OBJECTIVE:Hydrocele and testicular edema caused by division of lymphatic vessels during varicocelectomy could lead to decrease in testicular function. In-vivo methylene blue mapping of testicular lymphatic vessels should prevent damage to the lymphatic system. MATERIALS AND METHODS:We retrospectively compared outcomes...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2007.09.005
更新日期:2008-04-01 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::Renal medullary carcinoma is a lethal subtype of renal cancer that afflicts patients with sickle-cell hemoglobinopathies. Here we present the case of a 13-year-old boy with renal medullary carcinoma who is the first, to our knowledge, to be managed using a planned laparoscopic radical nephrectomy. ...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2007.02.007
更新日期:2008-02-01 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: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: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 prospectivel...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2018.09.011
更新日期:2019-02-01 00:00:00
abstract:INTRODUCTION:'Transition' not only involves finding an adult healthcare provider, but also includes the process of developing the patient's ability to care for him/herself. Recent literature states that 40% of young adults with special healthcare needs are receiving the tools needed for transition. Pediatric urologists...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2016.04.015
更新日期:2016-08-01 00:00:00
abstract:PURPOSE:Intestinal bladder augmentation predisposes the patient to many complications. The aim of this study was to determine whether augmentation has an adverse effect on growth. MATERIALS AND METHODS:Longitudinal growth data were collected and analyzed for nine patients with bladder exstrophy and augmentation, and c...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2007.07.002
更新日期:2008-02-01 00:00:00
abstract:OBJECTIVE:Beckwith-Wiedemann syndrome (BWS) is a constellation of congenital anomalies that classically presents with macroglossia, abdominal wall defects and gigantism. Although renal and adrenal pathology are the most commonly associated urologic findings of BWS, we report a case of a girl with BWS and symptomatic cl...
journal_title:Journal of pediatric urology
pub_type: 杂志文章,评审
doi:10.1016/j.jpurol.2010.06.003
更新日期:2011-04-01 00:00:00
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...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2019.10.013
更新日期:2020-02-01 00:00:00
abstract::Anorectal impalement is an uncommon mode of injury in children, with only a few case reports in the pediatric literature. No report describes a clinical presentation with bladder stones in a child, as in our case. This case highlights the need to maintain a high index of suspicion in all cases of rectal impalement, an...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2011.09.001
更新日期:2012-02-01 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:OBJECTIVE:Laparoscopic or retroperitoneoscopic pyeloplasty for ureteropelvic junction obstruction in children has become a routine procedure. The aim of this study was to evaluate functional outcome for patients who had undergone a laparoscopic dismembered pyeloplasty. PATIENTS AND METHODS:Seventy children underwent a...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2009.10.015
更新日期:2010-08-01 00:00:00
abstract:BACKGROUND:Prompt diagnosis and treatment of paediatric urolithiasis are required to avoid long term sequelae of renal damage. OBJECTIVE:To systematically review the literature regarding the diagnostic imaging modalities and treatment approaches for paediatric urolithiasis. STUDY DESIGN:PubMed, Science Direct, Scopus...
journal_title:Journal of pediatric urology
pub_type: 杂志文章,评审
doi:10.1016/j.jpurol.2020.07.003
更新日期:2020-10-01 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: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:INTRODUCTION AND OBJECTIVE:Female pediatric patients with continuous drip incontinence present a diagnostic challenge. At times, these symptoms may be due to an ectopic ureter inserting below the external sphincter. The evaluation may consist an ultrasound and voiding cystourethrogram (VCUG), but these may not be diagn...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2005.06.009
更新日期:2007-02-01 00:00:00
abstract:PURPOSE:We conducted a cross-sectional study to evaluate whether the different positions during urination influence the electrical activity of the abdominal and perineal musculature, as well as the uroflowmetric parameters of children with lower urinary tract dysfunction (LUTD). MATERIALS AND METHODS:Ninety-four child...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2014.03.013
更新日期:2014-12-01 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:OBJECTIVE:Iatrogenic ureteral injury in children is a rare occurrence, with sparse literature available regarding optimal repair techniques. We reviewed our experience in the management of iatrogenic pediatric ureteral injuries, particularly with respect to initial versus delayed diagnoses. METHODS:All pediatric iatro...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2008.08.004
更新日期:2009-02-01 00:00:00
abstract:BACKGROUND:Continuous antimicrobial prophylaxis (prophylaxis) is associated with a reduction in recurrent urinary tract infections in children with vesicoureteral reflux. However, adherence to daily medications has been shown to be poor. OBJECTIVE:To determine patient/caregiver factors associated with non-adherence an...
journal_title:Journal of pediatric urology
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.jpurol.2019.04.019
更新日期:2019-08-01 00:00:00
abstract:OBJECTIVE:Postoperative hydrocele development is a frustrating complication of varicocele surgical repair. To avoid this complication, we began to offer percutaneous embolization as a treatment option. We present our initial experience with this technique. METHODS:A retrospective review of all patients who underwent p...
journal_title:Journal of pediatric urology
pub_type: 杂志文章
doi:10.1016/j.jpurol.2010.01.003
更新日期:2010-12-01 00:00:00