Antibiotic Prophylaxis with Trimethoprim-Sulfamethoxazole versus No Treatment after Mid-to-Distal Hypospadias Repair: A Prospective, Randomized Study.

Purpose: To evaluate the impact of prophylactic antibiotics after distal hypospadias repair on postoperative bacteriuria, symptomatic urinary tract infection, and postoperative complications in a prospective, randomized trial.

Materials And Methods: Consecutive patients aged 6 months to 2 years were enrolled at our institution between June 2013 and May 2017. Consenting patients were randomized to antibiotic prophylaxis with trimethoprim-sulfamethoxazole versus no antibiotic.

Clinical pathway for early discharge after complete primary repair of exstrophy and epispadias by using a spica cast.

Introduction/objective: Secure closure of the pubic diastasis during bladder exstrophy and epispadias repair decreases the abdominal wall tension at the time of reconstruction. Pelvic osteotomies are routinely performed at the time of abdominal wall and bladder reconstruction in order to more easily facilitate pubic symphyseal diastasis approximation. Postoperative pelvic immobilization is performed by methods that include modified Buck's traction, modified Bryant's traction, and spica casting.

Metabolic evaluation of urolithiasis and obesity in a midwestern pediatric population.

Purpose: The incidence of urolithiasis has been proved to be increasing in the adult population, and evidence to date suggests that the same holds true for the pediatric population. While adult urolithiasis is clearly linked to obesity, studies of pediatric patients have been less conclusive. We hypothesized that a population of otherwise healthy children with stones would have an increased body mass index compared to a control population, and that obese pediatric stone formers would have results on metabolic assessment that are distinct from nonobese stone formers.

Urolithiasis in patients on high dose felbamate.

Purpose: We report 4 cases of felbamate urolithiasis. We identified only 1 prior case report of a felbamate stone. Felbamate is an antiepileptic drug used to treat refractory seizures and has minor side effects when given in recommended doses.

Advanced transitional cell carcinoma of the bladder in a 16-year-old girl with Hinman syndrome.

The present report describes a 16-year-old girl with a history of Hinman syndrome who was found to have invasive transitional cell carcinoma of the bladder. Bladder cancer is rare in children. Typically, the tumors are of low grade and stage.

Creation and implementation of a prospective pediatric clinical outcomes registry.

Objective: To build a pediatric clinical outcomes registry (COR) using a contemporary information system designed to support research and outcome studies and to improve patient care and quality of life.

Patients And Methods: In response to physician needs, this process was implemented: 1) database needs assessment survey, 2) evaluate existing systems and vendors, 3) pilot test a COR tool, and 4) build a COR. The COR was designed to include patients with the following conditions: scoliosis, neonatal surgery, urologic surgery, cleft palate, pain management, otitis media, and voice and airway problems.

Surgical management of urolithiasis.

Pediatric patients with urolithiasis present unique challenges. Interventional techniques developed for adult patients have been adopted and adapted to facilitate effective and safe treatment in this population. Management must be stratified and individualized, taking into account the many factors described in this article.

Results of a 2-year multicenter trial of endoscopic treatment of vesicoureteral reflux with synthetic calcium hydroxyapatite.

Purpose: With no FDA approved material available for endoscopic treatment of vesicoureteral reflux, in 2001 we began a prospective multicenter trial of synthetic calcium hydroxyapatite as a subureteral bulking agent in children with traditional indications for surgical repair.

Materials And Methods: A total of 98 patients (155 ureters) with grades II to IV reflux were enrolled at 10 sites in the United States to obtain 86 patients with completed protocol end points at 3 months. Of the 86 patients 74 underwent renal and bladder ultrasonography, blood count and serum chemistry analysis, and VCUG at 1 year.

Urologic problems of the neonate.

Maternal sonography is integrated into routine prenatal care, and numerous fetal anomalies are detected, with genitourinary anomalies the most common. This has profoundly influenced the presentation and natural history of neonatal urologic problems. This article is divided into two sections.