Neuroblastoma in a Newborn Female.

Neuroblastoma is the most common solid tumor in neonates. Although often aggressive in older children, carrying high mortality rates despite multimodal therapies, neuroblastoma appears to behave differently in the neonatal population. When diagnosis is clear, the disease can often be managed with close observation alone.

Efficacy and safety of alvimopan use in benign urinary tract reconstruction.

Purpose: To analyze the use of alvimopan, a peripheral mu-opioid receptor antagonist, in expediting gastrointestinal recovery after benign abdominal urinary tract reconstruction. Alvimopan use has been well defined in the management of radical cystectomy and urinary diversion for oncologic indications. It has not been studied in benign abdominal genitourinary reconstruction.

Surgical management of pediatric renal masses: surgeon subspecialty practice patterns.

Introduction: Management of pediatric renal masses has lagged behind adult paradigms adopting minimally invasive surgery (MIS) and nephron-sparing surgery (NSS). This study investigated national practice patterns between pediatric urologists (PU) and pediatric surgeons (PS) in pediatric renal malignancy.

Materials And Methods: The Pediatric National Surgical Quality Improvement Program database was queried for CPT codes for radical/partial nephrectomy from 2012-2017 performed for renal malignancy.

Recurrent Bladder Cancer in a Teenage Male.

Urothelial cell carcinoma of the bladder is exceedingly rare in pediatric patients. Based on current literature, bladder cancer in this population is thought to be low-grade, noninvasive, and unlikely to recur, suggesting significant biologic differences when compared to the adult population. This is a 15-year-old male diagnosed with low-grade urothelial cell carcinoma with subsequent multifocal recurrence on surveillance cystoscopy managed by induction and maintenance intravesical Bacillus Calmette-Guerin.

International Publication Patterns on Operative Management of Wilms Tumor: A Review by Surgeon Specialty and Surgical Modality.

Objective: To review the temporal trends in the published literature of the surgical management of Wilms tumor (WT) relative to surgical modality and authorship by surgeon specialty (pediatric urology [PU] vs pediatric surgery [PS]).

Methods: The MEDLINE/PubMed database was queried for manuscripts published by PU or PS including operative management of WT from 1993-2017. After manuscript review, 187 of 2420 studies were included.

Influence of BMI in nephrolithiasis in an Appalachian pediatric population: A single-center experience.

Introduction: The prevalence of pediatric nephrolithiasis has increased significantly in the past 20 years. Metabolic abnormalities predisposing adults to nephrolithiasis in obese patients include increased urinary sodium and uric acid excretion as well as low urine pH; however, limited data are available in the pediatric population.

Objective: The aim was to investigate whether obese pediatric patients presenting with nephrolithiasis have a unique metabolic profile similar to reported findings in obese adults with nephrolithiasis.

Technical refinements to improve outcomes following distal hypospadias repair.

Introduction: Hypospadias complications, most notably meatal stenosis, are commonly reported to occur after tubularized incised plate (TIP) hypospadias repair. We focus on a point of technique in TIP repair and its effect on outcome of this possible complication, as well as other commonly reported complications. Meatal stenosis after TIP can be avoided if the urethra and overlying glans are dissected and sutured separately with no attempt at cross suturing whether the urethra ends below, behind, or above the glans sutures.

Pattern of clinical presentation of congenital anomalies of the kidney and urinary tract among infants and children.

Aim: Congenital anomalies of the kidneys and urinary tract (CAKUT) comprise various entities of structural malformations that result from defects in morphogenesis of the kidney and/or urinary tract. These anomalies are the most commonly diagnosed malformations in the prenatal period and constitute the leading cause of end-+stage renal disease (ESRD) in children, worldwide. This prospective study was performed to report the patterns of clinical presentation and diagnosis of infants and children with such malformations.

Distal hypospadias repair using only glans wing mobilization and approximation.

Introduction: Since its first description in 1994, tubularized incised plate (TIP) technique has become the most commonly performed hypospadias procedure and involves incision of the urethral plate with subsequent tubularization. Glans wings are then developed to cover the neourethra, thereby creating a cosmetically appealing repair. In some distal hypospadias cases, mobilization and approximation of glans wings is sufficient to create a normal appearing urethral meatus.

Crossed testicular ectopia with preoperative ultrasound.

Crossed testicular ectopia/transverse testicular ectopia is a rare congenital anomaly. It is most commonly identified intraoperatively in the setting of inguinal hernia repair with contralateral cryptorchidism. We report a case of crossed testicular ectopia identified in a 3-month-old male who presented with right cryptorchidism.

Outcomes of hypospadias repair in older children: a prospective study.

Purpose: The American Academy of Pediatrics recommendation is to perform hypospadias repair at age 6 to 12 months. However, our patient population included a significant proportion of patients in adolescence and beyond undergoing primary repair. We report a comparison of outcomes in patients in different age groups.

Assessment of recoverability of kidney function in children with obstructive calcular anuria: multicenter study.

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).

Extracorporeal shock wave lithotripsy monotherapy for renal stones >25 mm in children.

Objectives: To determine the safety and efficacy of extracorporeal shock wave lithotripsy (ESWL) as monotherapy for renal stones >25 mm in children.

Methods: Our prospective study included 24 children <14 years old with radiopaque renal stones >25 mm treated by ESWL as first-line treatment using the electromagnetic Dornier DoLi S device. Pretreatment kidney, ureter, and bladder plain films and intravenous urography and post-treatment ultrasonography and kidney, ureter, and bladder plain films were used to monitor the clearance of fragments.

Ureteroureterostomy via inguinal incision for ectopic ureters and ureteroceles without ipsilateral lower pole reflux.

Purpose: We report outcomes from ureteroureterostomy performed through an inguinal herniorrhaphy type incision for definitive management of ectopic ureters or ureteroceles in the absence of ipsilateral lower pole reflux.

Materials And Methods: Records were reviewed for 23 consecutive patients who underwent lower ureteroureterostomy for 26 duplicated systems with ectopic ureter or ureterocele and no ipsilateral lower pole reflux. In 21 patients surgery was performed through an inguinal incision similar to that for herniorrhaphy, while a Pfannenstiel incision was used initially in the series in 2 others with bilateral duplex systems.

Metabolic stone composition in Egyptian children.

Objective: The composition of urinary stones in children depends on socioeconomic conditions, geography and dietary habits. Pediatric urolithiasis remains endemic in developing countries. The aim of this study was to analyze stone composition in an Egyptian patient population.

Safety of ungated shockwave lithotripsy in pediatric patients.

Objective: Ungated extracorporeal shockwave lithotripsy (ESWL) in adults is associated with cardiac arrhythmias. We report on the safety and efficacy of this method for treatment of renal calculi in children.

Patients And Methods: Children under 14 years with radio-opaque renal stones were treated by ungated ESWL.

Tubularized incised plate (TIP) in previously operated (redo) hypospadias.

Objective: We report our experience of using the tubularized incised plate (TIP) technique for repair of hypospadias in patients who had undergone one or more failed attempts at repair.

Methods: A total of 30 children (age range 2-10 years; mean 4.3 years) with hypospadias presented to our unit for redo hypospadias.

Comparison of outcomes of tubularized incised plate hypospadias repair and circumcision: a questionnaire-based survey of parents and surgeon.

Aim: We administered a standardized questionnaire to parents and operating surgeon to determine their opinions regarding outcomes from tubularized incised plate (TIP) hypospadias repair.

Methods: Likert scale questionnaires were used to assess six outcomes: overall penile appearance, cosmesis of meatus and skin, penile size, straightness during erection, and voided stream. These were answered by consecutive parents of boys 6 weeks following TIP hypospadias repair, as well as by the surgeon.

Scrotal exploration for unilateral nonpalpable testis.

Purpose: We previously reported initial scrotal exploration for unilateral nonpalpable testis, followed by laparoscopy when a viable testis was not found. Although we concluded that scrotal exploration could often make laparoscopy unnecessary, the knowledge that patients with presumed nubbins would undergo laparoscopy meant that the surgeon did not have to decide whether findings were definitive. In a second series of consecutive patients laparoscopy was used only when it appeared indicated.

Decision making during laparoscopic orchiopexy for intra-abdominal testes near the internal ring.

Purpose: We studied whether testicular proximity to the ipsilateral internal ring or ability to reach the contralateral ring predicted the likelihood that laparoscopic orchiopexy would deliver an intra-abdominal testis to the dependent scrotum.

Materials And Methods: Records of patients undergoing laparoscopic orchiopexy for testes within 2 cm of the internal ring were reviewed. Factors considered included patient age, mobility of the testis to the contralateral ring, intraoperative positioning in the upper vs lower scrotum, and postoperative findings of testicular viability and location.

Predictive factors of lower calyceal stone clearance after Extracorporeal Shockwave Lithotripsy (ESWL): a focus on the infundibulopelvic anatomy.

Introduction: Controversy exists as to whether ESWL is suitable for lower pole renal stones, given the dependent position of the lower calyces. This study aims to test the effect of lower pole anatomy, namely lower polar infundibulo-pelvic angle, infundibular length and width, on clearance of fragments after ESWL.

Patients And Methods: We conducted a retrospective study of 205 renal units with single lower pole stones of not more than 25 mm in their greatest diameter that were treated by ESWL alone.

The use of trastuzumab in the treatment of hormone refractory prostate cancer; phase II trial.

Purpose: To investigate the efficacy and toxicity of the antibody to the HER-2/neu receptor (trastuzumab, Herceptin) in the treatment of advanced hormone-refractory prostate cancer (HRPC).

Materials And Methods: Eighteen patients with HRPC were recruited for this phase II trial in which they received trastuzumab for 12 weeks or until disease progression or unacceptable toxicity was documented. HER-2 receptor overexpression was evaluated using immunohistochemistry (IHC) and dual-color fluorescence in-situ hybridization (FISH) assays.

Combination of low-dose flutamide and finasteride for PSA-only recurrent prostate cancer after primary therapy.

Objectives: To evaluate the efficacy and tolerability of combined finasteride and low-dose flutamide for prostate-specific antigen (PSA)-only recurrence after definitive therapy and to determine the predictors of recurrence-free survival.

Methods: Seventy-one men with biochemical recurrence after primary therapy for prostate cancer were prospectively enrolled from 1996 to 1998. Forty-two patients had undergone radical retropubic prostatectomy and 29 had undergone external beam radiotherapy.