Alkaline urine is associated with increased risk of calcium phosphate nephrolithiasis in medically complex children receiving enteral nutrition.

Introduction: Calcium phosphate stones are commonly found in medically complex children (MCC) receiving enteral feeds. The objective of this study is to investigate the etiology for calcium phosphate stones in this patient population.

Study Design: This is a retrospective cohort study of gastrostomy fed, MCC who presented to a high-volume Pediatric Stone Center from 2015 to 2019.

Time to therapy and safety of testicular tissue cryopreservation in children undergoing gonadotoxic treatment or hematopoietic stem cell transplant.

Background: With the use of multimodal treatments and hematopoietic stem cell transplant, the majority of children diagnosed with malignancies and hematologic diseases are now surviving into adulthood. Due to the gonadotoxic effects and potential for future infertility associated with many of these treatments, fertility counseling with sperm cryopreservation prior to starting therapy is the standard of care for post-pubertal males. Unfortunately, the options are limited for pre-pubertal patients or those unable to provide a specimen.

One and done: Feasibility and Safety of Primary Ureteroscopy in a Pediatric Population.

Background: Pediatric urolithiasis has been increasing at rate of 4-10 % annually in the United States, most notably within adolescents and females. A significant number of patients will require surgical management of their stones. Primary ureteroscopy (URS) affords the opportunity to treat stones under a single anesthetic with lower re-treatment rates or anatomical and stone characteristic limitations compared to shockwave lithotripsy.

Distinguishing characteristics of pediatric patients with primary hyperoxaluria type 1 in PEDSnet.

Background: Primary hyperoxaluria type 1 (PH1) is an autosomal recessive inborn error of metabolism that causes oxalate deposition, leading to recurrent calcium oxalate kidney stones, chronic kidney disease and systemic oxalosis, which produces a broad range of serious life-threatening complications. Patients with PH1 have delayed diagnosis due to the rarity of the disease and the overlap with early-onset kidney stone disease not due to primary hyperoxaluria.

Objective: The objective of this study was to determine the clinical features of individuals <21 years of age with PH1 that precede its diagnosis.

The real world experience of pediatric primary hyperoxaluria patients in the PEDSnet clinical research network.

The rarity of primary hyperoxaluria (PH) challenges our understanding of the disease. The purpose of our study was to describe the course of clinical care in a United States cohort of PH pediatric patients, highlighting health service utilization. We performed a retrospective cohort study of PH patients < 18 years old in the PEDSnet clinical research network from 2009 to 2021.

Reoperative Anorectal Procedures in Patients with Anorectal Malformations - Is Bladder Function Affected?

Background: Anorectal malformations (ARM) are associated with neurogenic bladder. The traditional surgical ARM repair is a posterior sagittal anorectoplasty (PSARP), which is believed to have a minimal effect on bladder dynamics. However, little is known about the effects of reoperative PSARP (rPSARP) on bladder function.

Kidney function outcomes in patients after complete primary repair of bladder exstrophy and penopubic epispadias: Results from the international bladder exstrophy consortium.

Introduction: Historically, repair of bladder exstrophy (BE) is associated with compromise to the upper tracts; the single stage repair of BE was considered to exacerbate risks of kidney impairment.

Objective: We aim to evaluate the risk of upper urinary tract deterioration or chronic kidney disease after the complete primary repair of exstrophy (CPRE).

Study Design: As part of the U.

International Pediatric Multidisciplinary Management Using Telemedicine to Promote Equitable Care.

To evaluate the use of telemedicine as a collaboration tool between a pediatrician and subspecialists looking to address challenges, such as the lack of health care specialists, which are present in the Dominican Republic. During this 6-year study, 65 patients were evaluated by a medical team consisting of a local pediatrician and 17 subspecialists from a leading academic medical center in the Unites States. Patient's age ranged from 2 months to 16 years of age (mean 8 years old).

Enteral nutrition and the risk of nephrolithiasis in complex pediatric patients.

Purpose: Medically complex, non-ambulatory children can often suffer from nephrolithiasis. The purpose of this study is to determine risk factors which are predictive for recurrent stone formation in this patient population.

Material And Methods: A retrospective cohort study was performed on non-ambulatory patients with cerebral palsy and/or severe developmental delay presenting to a high-volume Pediatric Stone Center from 2015 to 2019.

Diagnosis, management and recurrence rates of Mitrofanoff polyps.

Background: Intraluminal polyps are a known complication following creation of a urinary continent catheterizable channel (Mitrofanoff). These polyps can lead to difficult catheterizations in addition to symptomatic bleeding. However, there is limited data available regarding management and outcomes of these polyps.

Comparison of risk of anticholinergic utilization for treatment of neurogenic bladder between in utero or postnatal myelomeningocele repair.

Introduction: In utero myelomeningocele (MMC) repair has resulted in significant decrease in need for shunt-dependent hydrocephalus, however its impact on bladder function remains less clear. Neurogenic detrusor overactivity (NDO) due to MMC can be addressed with combination of clean intermittent catheterization (CIC) and anticholinergic (AC) therapy to minimize its effect on bladder function and upper urinary tract. The aim of this study was to compare the risk of postnatal AC utilization for in patients that underwent either postnatal or in utero MMC repair related to neurogenic bladder (NGB) management.

Outcomes according to channel type for continent catheterizable channels in patients undergoing simultaneous urinary and fecal reconstruction.

Introduction: When creating a continent catheterizable channel (CCC) the choice of bowel segment used as the conduit should be tempered with the morbidity associated with it. The split-appendix technique allows the creation of both a urinary and fecal CCC without the need for a bowel anastomosis. However, there is concern that by splitting the appendix there is compromise to its blood supply and may affect outcomes.

Does a Multidisciplinary Pediatric Stone Center Improve Outcomes?

Introduction: Urolithiasis is becoming more prevalent in children in the United States. A multidisciplinary pediatric stone center was initiated in 2014 to address this growing public health issue. The purpose of this manuscript is to assess the development of the stone center and its clinical outcomes.

Need for botulinum toxin injection and bladder augmentation after isolated bladder outlet procedure in pediatric patients with myelomeningocele.

Introduction: In patients with neurogenic bladder outlet incompetence, a bladder outlet procedure (BOP) may be required to achieve urinary continence. However, when performed in isolation, a BOP can be associated with bladder deterioration and upper-tract injury. In the event of bladder deterioration, additional procedures such as bladder augmentation (BA) or botulinum toxin injection (BTI) may be pursued.

Impact of body mass index on 30-day postoperative morbidity in pediatric and adolescent patients undergoing continent urinary tract reconstruction.

Introduction: Obesity has been thought to increase the risk of complications and need for additional resources with surgery, but only a limited amount of evidence is available in the pediatric population.

Objective: The objectives were to describe the weight status of pediatric and adolescent patients undergoing a continent urinary tract reconstruction and to determine the association between obesity and 30-day postoperative morbidity.

Study Design: A retrospective cohort study was performed for pediatric and adolescent patients aged up to 20 years who underwent a continent urinary tract reconstruction between January 2010 and November 2016.

Is anuria prior to pediatric renal transplantation associated with poor allograft outcomes?

Introduction: Anuria from end-stage renal disease leads to a defunctionalized bladder and may pose technical challenges at the time of renal transplantation. Anuria's effect on bladder function after renal transplantation is considered to be minimal in adults, although a paucity of evidence is available in children. The purpose of this study was to examine the effects of anuria prior to pediatric renal transplantation for ESRD due to medical renal disease on allograft outcome.

Risk of Reaugmentation after Enterocystoplasty Using a Reconfigured Bowel Segment in Patients with Spina Bifida: A Bi-Institutional Cohort Study.

Purpose: Reaugmentation cystoplasty rates vary in the literature but have been reported as high as 15%. It is likely that bladders augmented with detubularized and reconfigured bowel are less likely to require reaugmentation. We assessed the incidence of reaugmentation among patients with spina bifida at 2 high volume reconstruction centers.

Ultrasound versus computed tomography for the detection of ureteral calculi in the pediatric population: a clinical effectiveness study.

Objective: To determine the diagnostic performance of ultrasound for diagnosing ureteral calculi in children using a clinical effectiveness approach.

Methods: Billing records and imaging reports were used to identify children (≤ 18 years old) evaluated for suspected urolithiasis using ultrasound between March 2012 and March 2017. Patients without unenhanced CT within 24 h (reference standard) were excluded.

Pediatric Partial Nephrectomy for Upper Urinary Tract Duplication Anomalies: A Comparison Between Different Surgical Approaches and Techniques.

Objective: To review and compare 4 different surgical approaches for partial nephrectomy of a nonfunctioning moiety in children with upper urinary tract duplication anomalies.

Materials And Methods: A retrospective review of all pediatric patients who underwent open partial nephrectomy (OPN), laparoscopic partial nephrectomy (LPN), robotic partial nephrectomy (RPN), or laparoendoscopic single site partial nephrectomy (LESS-PN) for the treatment of a nonfunctioning moiety in a duplicated collecting system at 2 medical centers between 2007 and 2017. Patient demographics, perioperative data, surgical techniques, complications, and results were compared.

Preoperative nutritional status and use of total parenteral nutrition in pediatric and adolescent patients undergoing continent urinary tract reconstruction.

Introduction: A nutritional assessment is a critical but often neglected aspect of a preoperative evaluation. Malnutrition is clearly associated with worse surgical outcomes in adults undergoing major abdominal surgery, whereas a paucity of evidence is available in the pediatric population.

Objective: The objectives were to describe the preoperative nutritional status of pediatric and adolescent patients undergoing continent urinary tract reconstruction and to determine the association among malnutrition, use of total parenteral nutrition (TPN), and surgical outcomes.

Comparison of ultrasound versus computed tomography for the detection of kidney stones in the pediatric population: a clinical effectiveness study.

Background: The incidence of pediatric nephrolithiasis in the United States is increasing. There is a paucity of literature comparing the diagnostic performance of computed ultrasound (US) to tomography (CT) in the pediatric population.

Objective: To determine the diagnostic performance of renal US for nephrolithiasis in children using a clinical effectiveness approach.

Prospective evaluation of urinary incontinence in severely obese adolescents presenting for weight loss surgery.

Background: Obesity has been associated with daytime urinary incontinence (UI), likely due to increased intra-abdominal pressure.

Objectives: To assess incontinence symptoms in severely obese adolescents before and 3 years after bariatric surgery.

Setting: Tertiary care pediatric hospitals in the United States.

Analyte variations in consecutive 24-hour urine collections in children.

Purpose: The metabolic evaluation of children with nephrolithiasis begins with a 24-h urine collection. For adults, the diagnostic yield increases with consecutive collections; however, little is known regarding the variability of multiple 24-h studies in the pediatric population. We sought to evaluate the variability of consecutive 24-h urine collection in children through a multi-institutional study hypothesizing that compared with a single collection, consecutive 24-h urine collections would reveal a greater degree of clinically useful information in the evaluation of children at risk for nephrolithiasis.

Triamcinolone injection for treatment of Mitrofanoff stomal stenosis: Optimizing results and reducing cost of care.

Introduction: Stomal stenosis is the most common complication after the creation of a continent catheterizable channel (CCC), but is challenging to treat.

Objective: To describe early experience with triamcinolone injection for the treatment of stomal stenosis.

Materials And Methods: A retrospective review was performed of patients who had undergone a triamcinolone injection (40 mg/ml) for the treatment of stomal stenosis at the present institution.

Clinical and urodynamic outcomes in children with anorectal malformation subtype of recto-bladder neck fistula.

Introduction: Patients with anorectal malformations (ARMs) have a high incidence of genitourinary anomalies. Those with a recto-bladder neck fistula may represent a high-risk group, but their long-term urologic outcomes are poorly described.

Objective: To evaluate the clinical and urodynamic outcomes in a large cohort of patients with an ARM subtype of recto-bladder neck fistula.