Prospective evaluation of a pediatric urodynamics protocol before and after limiting urine cultures.

Purpose: While our institution has historically obtained a urine culture (UCx) from every child at the time of urodynamics (UDS), no consensus exists on UDS UCx utility, and practice varies widely. This study aims to prospectively study our symptomatic post-UDS UTI rate before and after implementing a targeted UCx protocol.

Materials And Methods: A 2-part prospective study of patients undergoing UDS at one pediatric hospital was undertaken, divided into Phase 1 (7/2016-6/2017) with routine UCx at the time of UDS and Phase 2 (7/2019-6/2020) after implementation of a protocol limiting UCx at the time of UDS to only a targeted subset of patients.

Integrated Ultrasound With Urodynamics Illustrates Effect of Bladder Volume on Upper Tract Dilation: Should we Trust Surveillance Ultrasounds?

Objective: To evaluate if ultrasound during urodynamics (uUS) will show that traditional ultrasound (tUS) routinely underestimates the potential magnitude of upper tract dilation (UTD).

Methods: Prospective pilot study of 10 consecutive patients ≥ 5 years of age undergoing same day uUS and tUS. Using randomized images, the study pediatric radiologist determined anterior-posterior renal pelvic diameter (APD), bladder volume, vesicoureteral reflux (VUR) and UTD grades.

Reassessing the utility of routine urine culture with urodynamics: UTI incidence and risk factors.

Introduction: There is no consensus regarding use of periprocedural antibiotics or routine urine cultures during urodynamics study (UDS) in children. At our hospital, we historically have obtained urine cultures during UDS. However, even with positive cultures, few patients require treatment.

Ultrasound Shear Wave Elastography: A Novel Method to Evaluate Bladder Pressure.

Purpose: Children with bladder dysfunction resulting in increased storage pressure are at risk for renal deterioration. The current gold standard for evaluation of bladder pressure is urodynamics, an invasive test requiring catheterization. We evaluated ultrasound shear wave elastography as a novel means of assessing bladder biomechanical properties associated with increased bladder pressure.

Definition of reliable, objective criteria by abdominal radiography to identify occult constipation in children with lower urinary tract symptoms.

Purpose: Treating constipation in children with voiding dysfunction may improve or resolve urinary symptoms. A clinical diagnosis of constipation may not identify all patients. Abdominal radiographs (plain x-ray of the kidneys, ureters and bladder) are often used to assess constipation but no objective definition of constipation based on abdominal radiographs exists.

Are abdominal x-rays a reliable way to assess for constipation?

Purpose: Currently to our knowledge no validated reliable tools are available to evaluate constipation in children. Abdominal x-rays are often done in clinical practice to evaluate patients with lower urinary tract symptoms. Although 3 previously published rating tools exist to score constipation based on x-ray, there is little information on their merits.

Urinary tract infection: finding an answer when conventional testing is not helpful.

Children who present with urinary tract infections (UTIs) and a fever, and who had negative radioloogical tests for vesicoureteral reflux (VUR), are often tested further with a voiding cystourethrogram (VCUG). If the VCUG is negative, health care providers and parents become frustrated, as the search for a definitive diagnosis becomes more elusive. If conventional tests do not provide the expected diagnosis of VUR, it is essential for nurses and other health care providers to be aware of alternative methods for further evaluation.

Sustainability of remission of pediatric primary nocturnal enuresis--comparison of remission using Try for Dry vs. non-Try for Dry treatment plans.

This study examined the sustainability of remission of primary nocturnal enuresis (PNE) using an algorithm-based multimodal treatment plan, Try for Dry. Remission of PNE using the Try for Dry treatment method was retained longer and more often than using a non-Try for Dry plan.

Office management of pediatric primary nocturnal enuresis: a comparison of physician advised and parent chosen alternative treatment outcomes.

Purpose: We compared the remission of pediatric primary nocturnal enuresis in groups of children who used a physician advised practice plan vs a parent chosen alternative.

Materials And Methods: Between January 2004 and January 2006 there were 119 patients with primary nocturnal enuresis enrolled in this prospective, nonrandomized study. For this study primary nocturnal enuresis was defined as wetting at night during sleep during any 6-month interval without any known causative problem.