Preoperative Oxybutynin Reduces Postoperative Opioid Use Following Common Pediatric Urology Surgeries.

Purpose: Urologic surgery involving placement of an indwelling ureteral and/or urethral drain can be associated with significant catheter-related bladder discomfort causing increased postoperative morbidity and opioid medication use. We sought to assess if a single dose of oxybutynin given preoperatively reduces immediate postoperative opioid use in common pediatric urology surgeries.

Materials And Methods: This single-institution retrospective study identified pediatric patients who underwent surgery on the urinary tract with concomitant placement of a urethral and/or ureteral drain.

Self-guided Online Medical Hypnosis Program Improves Dry Nights in Children With Nocturnal Enuresis in a Prospective Single-Center Pilot Study.

Bedwetting is a common condition in children. We evaluated the effectiveness of medical hypnosis as a first-line therapy in children with primary monosymptomatic nocturnal enuresis (PMNE). The study enrolled children in a prospective single-center pilot clinical trial consisting of 1 month diary of dry nights prior to using the commercially available hypnosis intervention (www.

Robotic assisted retrovesical approach to prostatic utricle excision and other complex pelvic pathology in children is safe and feasible.

Introduction: Excision of the prostatic utricle has been a challenging surgical problem due to the location deep in the pelvis between the rectum and bladder. Robotic-assisted laparoscopic surgery allows minimally invasive access to this location.

Objective: To describe the robotic surgical outcomes and important techniques associated with robotic excision of the prostatic utricle and explain how these techniques apply to similar pediatric pelvic pathology.

Hypertonic saline-induced urolithiasis presenting as acute renal failure in a child with traumatic brain injury: A case report.

We report the case of a 4 year old female with severe traumatic brain injury who developed bilateral obstructing ureteral stones after hypertonic saline treatment. She developed calcium phosphate stones after two weeks of hypertonic saline therapy, and was successfully treated with ureteral stents and ureteroscopy. She has remained stone-free since that time.

Parental perception of bladder spasms and hematuria after surgery for vesicoureteral reflux: A prospective multicenter study.

Introduction: Anti-reflux surgery success has been well-documented in the literature. Little data exists about the characterization of the child's symptoms regarding pain, bladder spasms, and hematuria following these procedures. These symptoms may affect the choice of surgery for families and providers.

Postoperative management factors affect urinary retention following posterior spinal fusion for adolescent idiopathic scoliosis.

Study Design: Retrospective cohort study.

Objectives: This study investigates postoperative urinary retention (POUR) following posterior spinal fusion (PSF) for adolescent idiopathic scoliosis (AIS) and the effects of postoperative analgesia and mobility on retention. High opioid use and decreased postoperative mobility are proposed risk factors for retention in adults.

Ultrasound-guided Pudendal Block Is a Viable Alternative to Caudal Block for Hypospadias Surgery: A Single-Surgeon Pilot Study.

Objective: To evaluate pudendal nerve block as an alternative to caudal block for hypospadias surgery.

Methods: Data were obtained by chart review. Children who underwent hypospadias repair between 2012 and 2016 by a single surgeon at an academic institution were included.

24 Hour urine metabolic differences between solitary and multiple stone formers: Results of the Collaboration on Urolithiasis in Pediatrics (CUP) working group.

Introduction: Specific factors associated with the risk of developing pediatric urinary stone disease remain unclear, especially those that may be associated with recurrent stone disease.

Objective: We compared the results of 24-h urine collections in children with a solitary stone episode to those with multiple stone episodes to determine if there is a difference that may be associated with multiple stone formation in children.

Study Design: A multi-institutional retrospective analysis was completed to assess 24-h urinary metabolic profiles in children with urolithiasis aged 2-18 years old.

Invasive High-grade Upper Tract Urothelial Carcinoma in a 14-Year-Old Girl.

We present an unusual pediatric case of invasive upper tract urothelial carcinoma with an associated genetic predisposition. A 14-year-old female presented with intermittent right flank pain, and was found to have a poorly functioning hydronephrotic right kidney. Laparoscopic nephrectomy was performed.

Do Overweight and Obese Pediatric Stone Formers Have Differences in Metabolic Abnormalities Compared With Normal-weight Stone Formers?

Objective: To determine if 24-hour urinary parameters in children with nephrolithiasis across 4 institutions were influenced by body mass index (BMI).

Materials And Methods: The 24-hour urinary parameters obtained from children with nephrolithiasis between 2000 and 2013 were stratified by BMI percentile ≥85th and <85th (overweight and obese patients vs healthy weight, respectively). A total of 206 children were included in the study.

National multi-institutional cooperative on urolithiasis in children: Age is a significant predictor of urine abnormalities.

Introduction: Pediatric nephrolithiasis is a growing problem and prior studies have shown the greatest increase in nephrolithiasis in the adolescent population. Metabolic abnormalities have historically been cited as the primary cause of pediatric nephrolithiasis; however, dietary and other factors such as obesity have also been studied with mixed results.

Objective: We reviewed the charts of pediatric patients with a history of nephrolithiasis to determine the number and types of metabolic abnormalities present on 24-h urine analysis.

Nocturnal enuresis: an approach to assessment and treatment.

On the basis of strong evidence, although primary monosymptomatic nocturnal enuresis (PMNE) is common and most children will outgrow the condition spontaneously, the psychological effect to the child can be significant and represents the main reason for treatment of these children. On the basis of international consensus panels, treatment of PMNE should be targeted toward the specific type of bedwetting patterns the child has, using bladder diary, sleep history, and daytime elimination concerns as a guide (Table 3). On the basis of international consensus panels, it is important for the primary care physician to be able to differentiate children with PMNE from children with nonmonosymptomatic nocturnal enuresis (NMNE) and secondary nocturnal enuresis.

Supracostal tubeless percutaneous nephrolithotomy: a retrospective cohort study.

Purpose: To evaluate the safety of tubeless percutaneous nephrolithotomy in patients undergoing supracostal percutaneous renal access.

Patients And Methods: Between October 1999 and October 2010, 302 patients underwent percutaneous nephrolithotomy via a supracostal access tract. Two hundred forty-eight (82.

Single-center experience with pediatric laparoscopic extravesical reimplantation: safe and effective in simple and complex anatomy.

Purpose: Minimally invasive approaches to the surgical management of vesicoureteric reflux (VUR) have become more prominent over the last 10 years with progress in both endoscopic and laparoscopic/robotic surgery. We hypothesized that laparoscopic extravesical detrussoraphy (LED) for the management of VUR in children with complex bladders and/or bilateral VUR was safe and effective.

Subjects And Methods: Under institutional review board approval we evaluated the charts of all patients seen at our institution over the last 8 years who had undergone LED for the management of VUR.

The impact of surgical approach and urinary diversion on patient outcomes in pediatric pyeloplasty.

Purpose: Recent comparisons of the impact of the surgical approach on pediatric pyeloplasty outcomes have generally incorporated a form of internal ureteral drainage. We hypothesized that the surgical approach does not affect outcomes in children who undergo unstented pyeloplasty and stenting offers no long-term benefit in those with pediatric pyeloplasty.

Materials And Methods: After receiving institutional review board approval we examined the records of all children who underwent initial pyeloplasty from December 2001 to December 2009.

Impact of anatomical and socioeconomic factors on timing of urological consultation for boys with cryptorchidism.

Purpose: Cryptorchidism is a common finding in infants and young boys. Early repair lessens the extent of testicular injury. We hypothesized that anatomical and socioeconomic factors affect the timing of consultation and treatment for boys with cryptorchidism.

A single-center experience with prone retroperitoneoscopic versus open renal surgery in children: an age- and procedure-matched comparison.

Purpose: We determined how surgical outcomes differ among children undergoing prone retroperitoneoscopic (RP) and open total and partial nephrectomies for benign renal disease.

Patients And Methods: A retrospective analysis was performed, using medical records of children who were undergoing benign renal surgery at a single institution from 2001 to 2010. Patients were divided into open or RP cohorts, then subdivided into those who were undergoing total or partial nephrectomies.

Factors associated with delayed treatment of acute testicular torsion-do demographics or interhospital transfer matter?

Purpose: Testicular torsion is a true urological emergency. We determined whether a delay in treatment due to hospital transfer or socioeconomic factors would impact the orchiectomy rate in children with this condition.

Materials And Methods: We retrospectively evaluated the records of boys seen at a single institution emergency department who proceeded to surgery for a diagnosis of acute testicular torsion from 2003 to 2008.

Cross-sectional evaluation of parental decision making factors for vesicoureteral reflux management in children.

Purpose: Parental decision making in children with vesicoureteral reflux has potentially become more complex with the evolution of ethnic diversity in the United States, the Internet, the publication of contradictory clinical data and the emergence of minimally invasive surgery. We performed a cross-sectional study of parental management for pediatric vesicoureteral reflux.

Materials And Methods: We administered a 26-item questionnaire to parents of children with vesicoureteral reflux seen at Texas Children's Hospital urology offices or undergoing antireflux surgery at that institution.

Dextranomer/hyaluronic injection for the management of vesicoureteric reflux in complete ureteral duplication: should age and gender be factors in decision making?

Background And Purpose: The injection of dextranomer/hyaluronic acid (DHA) has become an accepted treatment for children with vesicoureteral reflux (VUR). Complete ureteral duplication has been considered by some practitioners as counterindication for its use. We reviewed the Texas Children's Hospital (TCH) records for children with complete ureteral duplication who were treated with DHA for VUR.

A report of an iatrogenic bladder rupture in a normal healthy child during voiding cystourethrography.

Iatrogenic and spontaneous bladder disruption in healthy children during a voiding cystourethrography is very uncommon. We present a case of iatrogenic extraperitoneal bladder rupture in a healthy normal child during the filling phase of a voiding cystourethrography performed by a pediatric radiologist, using routine gravity technique. This injury completely healed after 48 hours of catheter drainage with observation and was confirmed with a normal voiding cystourethrogram.

Bladder injuries during laparoscopic orchiopexy: incidence and lessons learned.

Purpose: Laparoscopic orchiopexy is a safe operation. However, the bladder can be injured during creation of the transperitoneal tunnel for the cryptorchid testis. We reviewed our experience with this complication.

Distinctive morphology of renal cell carcinomas in tuberous sclerosis.

Tuberous sclerosis complex results from mutations in 1 of 2 interacting gene products, hamartin or tuberin. The syndrome is characterized by hamartomas and neoplastic lesions, including angiomyolipomas of the kidney and other organs. Renal cell carcinoma (RCC) in tuberous sclerosis remains relatively poorly characterized because historical studies were confounded by the inclusion of epithelioid angiomyolipomas.

Pressure, fluid and anatomical characteristics of abdominoscrotal hydroceles in infants.

Purpose: Abdominoscrotal hydrocele is a poorly understood entity and multiple theories attempt to explain its occurrence. To our knowledge the factors contributing to the formation of abdominoscrotal hydrocele are unknown, as are its cellular, biochemical and hydrostatic properties. We prospectively evaluated abdominoscrotal hydrocele at surgery to define its cause and its effects on the testicle.