Significant improvement in hydronephrosis with pyeloplasty prior to 3 months of age in patients with antenatal severe hydronephrosis.

Introduction: Pyeloplasty is the definitive management of ureteropelvic junction obstruction (UPJO). One of the challenging questions is when to perform pyeloplasty. We studied if improvement post-pyeloplasty in the first 3 months of life could show greater improvement in hydronephrosis than surgery at an older age.

Can we improve the usefulness of the diuretic renogram in the diagnosis of ureteropelvic junction obstruction (UPJO) in children? Introduction of mercaptoacetyltriglycine-suspected obstruction scoring system (MAG-SOS).

Introduction: Mercaptoacetyltriglycine (MAG-3) renogram is one of the gold standard diagnostic tools of ureteropelvic junction obstruction (UPJO); however, there is no widely agreed indications of pyeloplasty based on MAG-3 findings. In this study, we introduce a renogram scoring system that can help improve the prognostic value of MAG-3 renogram and in the decision making of pyeloplasty.

Patients And Methods: We retrospectively reviewed consecutive pyeloplasties for antenatal hydronephrosis from 2010 to 2020.

Quality improvement assessment of a bianchi-technique pediatric orchiopexy perioperative pain management pathway.

Background: Surgical correction of undescended testes is a common surgical procedure which can be performed via a two-incision technique or a single high scrotal incision (Bianchi technique). The Bianchi technique requires less surgical time and may be associated with less pain in the initial postoperative period, however it has been adopted slowly due to a lack of familiarity and perceived technical challenges of the technique. Traditionally postoperative orchiopexy pain is managed with a caudal or ilioinguinal/iliohypogastric nerve block.

Use of a magnetic double J stent in pediatric patients: A case-control study at two Canadian pediatric centers.

Background: Ureteral stents with magnetic tips (Blackstar©) were recently approved for use in Canada. To our knowledge this is the first published evidence of their use in pediatric patients. Traditionally, pediatric stent insertion and removal are performed under general anesthetic.

Variability of renal colic management and outcomes in two Canadian cities.

Background: Some centres favour early intervention for ureteral colic while others prefer trial of spontaneous passage, and relative outcomes are poorly described. Calgary and Vancouver have similar populations and physician expertise, but differing approaches to ureteral colic. We studied 60-day hospitalization and intervention rates for patients having a first emergency department (ED) visit for ureteral colic in these diverse systems.

Incidence of bleeding in children undergoing circumcision with ketorolac administration.

Introduction: Circumcision is the most common surgical procedure performed by pediatric urologists. Ketorolac has been shown to have an efficacy similar to morphine in multimodal analgesic regimens without the commonly associated adverse effects. Concerns with perioperative bleeding limit the use of ketorolac as an adjunct for pain control in surgical patients.

Incidence of children at risk for obstructive sleep apnea undergoing common day surgery procedures.

Objective: The purpose of this study was to evaluate the prevalence of sleep-related breathing disorders (SRBD) in children undergoing elective day surgery procedures.

Methods: A validated Pediatric Sleep Questionnaire (PSQ) was distributed to the parents of children aged 2months to 18 years who met inclusion criteria and were undergoing urologic, otolaryngologic, and general surgical day surgery procedures a 3-month period of time. The prevalence of children at risk for pediatric SRBD was determined from PSQ results.

Outcomes of an accelerated care pathway for pediatric blunt solid organ injuries in a public healthcare system.

Purpose: An accelerated clinical care pathway for solid organ abdominal injuries was implemented at a level one pediatric trauma center. The impact on resource utilization and demonstration of protocol safety was assessed.

Methods: Data were collected retrospectively on patients admitted with blunt abdominal solid organ injuries from 2012 to 2015.

Sex-related Differences in Emergency Department Renal Colic Management: Females Have Fewer Computed Tomography Scans but Similar Outcomes.

Background: Sex-related differences occur in many areas of medicine. Emergency department (ED) studies have suggested differences in access to care, diagnostic imaging use, pain management, and intervention. We investigated sex-based differences in the care and outcomes for ED patients with acute renal colic.

Impact of penile degloving and proximal ventral dissection on curvature correction in children with proximal hypospadias.

Introduction: Penile degloving is an important step in orthoplasty. Although its role in correcting mild curvature in distal and midshaft hypospadias has been previously reported, its impact on ventral curvature (VC) correction in proximal defects warrants further investigation. Therefore, we sought to document the effect of degloving and proximal urethral dissection on VC correction in children with proximal hypospadias.

Urinary tract abnormalities in boys with recurrent urinary tract infections after hypospadias repair.

Objective: To examine the development of recurrent urinary tract infections (UTIs) in boys who have undergone hypospadias repair.

Materials And Methods: We retrospectively reviewed the records of all boys who had recurrent UTIs after primary or redo tubularized incised plate (TIP) or transverse island flap (TVIF) repairs, between 1998 and 2009. Data on age, operating details, postoperative complications and imaging studies were collected.

Does routine ultrasound change management in the follow-up of patients with vesicoureteral reflux?

Introduction: Children with vesicoureteral reflux (VUR) usually need a renal ultrasound (RUS). There is little data on the role of follow-up RUS in VUR. We evaluated the impact of follow-up RUS on the change in clinical management in patients with VUR.

Perceptions of the roles of social networking in simulation augmented medical education and training.

Simulation-augmented education and training (SAET) is an expensive educational tool that may be facilitated through social networking technologies or Computer Supported Collaborative Learning (CSCL). This study examined the perceptions of medical undergraduates participating in SAET for knot tying skills to identify perceptions and barriers to implementation of social networking technologies within a broader medical education curriculum. The majority of participants (89%) found CSCL aided their learning of the technical skill and identified privacy and accessibility as major barriers to the tools implementation.

Nephron sparing surgery for unilateral Wilms tumor in children with predisposing syndromes: single center experience over 10 years.

Purpose: Unilateral Wilms tumors associated with predisposing syndromes are treated with preoperative chemotherapy followed by surgical resection. We describe our experience with nephron sparing surgery for Wilms tumor in this population at risk for metachronous lesions.

Materials And Methods: We conducted a retrospective review of all children with a predisposing syndrome who underwent nephrectomy for malignancy during a 10-year period (2000 to 2010).

An online practice and educational networking system for technical skills: learning experience in expert facilitated vs. independent learning communities.

This study explored the activities of trainees learning technical skills using an educational networking tool with and without expert facilitation. Medical students (participants) were video-recorded practicing suturing and knot tying techniques and the resulting videos were uploaded to an educational networking site. Participants were then divided into two groups (one group containing an expert facilitator while the other group did not) and encouraged to comment on the videos within their group.

Evaluation of tensiometric assessment as a measure of skill degradation.

This pilot study explored the use of tensiometry as a measure of retention of knot tying skills. Medical students learned a one-handed square knot tying technique. Their final performances were video recorded and these videos were uploaded on to a website.

Hydronephrosis in children with abdominal and pelvic neoplasms: outcome and survival analysis of a single center pediatric oncology series.

Purpose: We ascertained the incidence and outcome of hydronephrosis related to abdominal or pelvic neoplasms and survival in pediatric patients.

Materials And Methods: We retrospectively reviewed our institutional oncology database between January 1995 and November 2009. We reviewed the charts of all children with intra-abdominal (nonrenal) and pelvic neoplasms.

Postmortem sperm retrieval: the Canadian perspective.

Postmortem sperm retrieval has been used worldwide. Following retrieval, sperm can then be used (usually by the surviving partner) to produce a child related to the now-deceased male. This paper describes a request for postmortem sperm retrieval made by the family of a man who had suffered trauma leading to his death.

A near-fatal case of sepsis with an antibiotic-resistant organism complicating a routine transrectal prostate biopsy in a health care worker.

A 58-year-old physician with an elevated prostate specific antigen developed severe septic shock following a repeat transrectal prostate biopsy despite standard preoperative prophylactic protocol. This case highlights the significance of harbouring antibiotic-resistant bacteria and the risk of previous quinolone exposure. We believe this case may herald a rare but potentially serious consequence of increasingly common antibiotic resistance and that high-risk patients should be studied to determine their likelihood of carrying antibiotic-resistant flora in their genitourinary/gastrointestinal tract.

Laser photoablation of renal pelvic tumours.

We evaluated the clinical effects of the Zeiss OPMILAS (Oberkochen, Germany) multi-yttrium-aluminum-garnet (YAG) laser in the treatment of renal pelvic tumours as an alternative to nephroureterectomy. Four patients with evidence of transitional cell carcinoma (TCC) in the renal pelvis and a previous history of TCC of the bladder or opposite renal pelvis were treated with the Zeiss OPMILAS multi-YAG laser. Three patients underwent a retrograde ureteroscopic approach and 1 patient required percutaneous resection.

Rhabdomyolysis following renal autotransplantation.

A 26-year-old male body builder diagnosed with renal artery stenosis and middle aortic syndrome underwent an autotransplantation with bench reconstruction and end-to-end anastomosis using the hypogastric artery. Shortly after the procedure, the patient developed rhabdomyolysis and renal insufficiency, possibly related to his increased muscle mass, potentially greater susceptibility to hypertrophic skeletal muscle cells or his unique vascular condition. We review the risk factors, diagnosis, management and outcome of a case of rhabdomyolysis in a male patient who underwent autotransplantation for renal vascular hypertension.

Quality of life and sexuality of men with prostate cancer 3 years after cryosurgery.

The current study was designed to describe the long-term life quality and sexuality of men enrolled in a phase 2 clinical trial of cryosurgery for the treatment of localized prostate cancer. A total of 75 men were administered the Functional Assessment of Cancer Treatment-Prostate (FACT-P) before treatment and after treatment at 6 weeks, and at 3, 6, 12, 24, and 36 months. Additionally, these men completed a Sexuality Follow-Up Questionnaire (SFQ) 3 years after cryosurgery.