Sonographically Determined Fecal Width: An Objective Indicator of Management of Bladder and Bowel Dysfunction in Children.

Objective: To test whether sonographically determined fecal width (SDFW) correlates with symptom improvement in a population of children with bladder and bowel dysfunction (BBD) managed with standard urotherapy (SU), even for those patients lacking initial bowel complaints.

Methods: We retrospectively analyzed 200 pediatric BBD patients managed with SU for at least 3 months. Self-reported symptom improvement (complete, partial, no response) following International Children's Continence Society guidelines was tabulated.

Dermoid Cyst in a Multicystic Dysplastic Kidney: A Case Report and Literature Review.

Most multicystic dysplastic kidneys (MCDKs) are discovered prenatally. There is no consensus regarding initial workup and appropriate follow-up. We present a 9-year-old female who was fetally diagnosed with a MCDK and without follow-up returned with an 18-cm multicystic mass.

En Bloc Retroperitoneoscopic Removal of Horseshoe Kidney for End-stage Renal Disease.

Horseshoe kidney (HSK) is the most common renal fusion anomaly. There have been reports of an association of HSKs with medical renal disease. We report a case of a child with nephrotic-range proteinuria and a HSK.

Cross Talk Between GH-Regulated Transcription Factors HNF6 and CUX2 in Adult Mouse Liver.

Hepatocyte-enriched nuclear factor (HNF)6 and CUX2 are GH and STAT5-regulated homeobox transcription factors. CUX2 shows female-specific expression and contributes to liver sex differences by repressing many male-biased genes and inducing many female-biased genes, whereas HNF6 is expressed at similar levels in male and female liver. In cell-based transfection studies, CUX2 inhibited HNF6 transcriptional regulation of the sex-specific gene promoters CYP2C11 and CYP2C12, blocking HNF6 repression of CYP2C11 and HNF6 activation of CYP2C12.

Duration of urinary leakage after open non-stented dismembered pyeloplasty in pediatric patients.

Objective: We aimed to determine the duration and associated complications of postoperative urinary leakage in pediatric patients undergoing open, non-stented dismembered pyeloplasty for ureteropelvic junction obstruction.

Methods: A retrospective review of 100 patients who underwent an open non-stented dismembered pyeloplasty between 2003 and 2008 was performed. Duration of urinary leakage and postoperative complications were tabulated.

Is the comparison of a left varicocele testis to its contralateral normal testis sufficient in determining its well-being?

Objective: To determine whether a size difference between a left testis involved with a varicocele and the contralateral normal testis is sufficient in its size assessment.

Methods: We reviewed all pediatric scrotal ultrasounds at Helen DeVos Children's Hospital between 2001 and 2008. Sonographic testicular measurements were recorded for patients with clinically diagnosed left varicocele (n = 81 for "varicocele" group) and for patients with no specific pathologic findings (n = 184 for "normal" group).

Rate and associations of epididymal cysts on pediatric scrotal ultrasound.

Purpose: We established the baseline occurrence of epididymal cysts, and the correlation between epididymal cysts and testicular size.

Materials And Methods: We retrospectively reviewed all pediatric scrotal ultrasounds done at our institution in 8 years. We analyzed the proportion of cysts by patient age and compared testicular size in boys with vs without epididymal cysts.

Is age at toilet training associated with the presence of vesicoureteral reflux or the occurrence of urinary tract infection?

Purpose: We sought to determine whether age at toilet training is influenced by a history of vesicoureteral reflux or urinary tract infection.

Materials And Methods: We reviewed records on 1,184 patients treated at a pediatric urology practice. All patients had information available regarding age at toilet training, renal sonography and voiding cystourethrography, and presence or absence of urinary tract infection.

Correlation of hydronephrosis index to society of fetal urology hydronephrosis scale.

Purpose. We seek to correlate conventional hydronephrosis (HN) grade and hydronephrosis index (HI). Methods.

MrNomogram: a web-based multivariable pediatric renal nomogram.

Unlabelled: Multivariable Pediatric Renal Nomogram, or MrNomogram, is a web-based clinical tool for the evaluation of pediatric renal length. Unlike other available age-adjusted renal nomograms, MrNomogram takes into consideration the fact that the renal length is influenced by multiple demographic variables. It provides a more accurate prediction of pediatric renal length, given the patient's demographic characteristics, such as age, gender, height, etc.

An approach for using full thickness skin grafts for complex penile surgeries in children.

Purpose: Many problems in pediatric urology derive from a paucity of penile skin resulting from prior surgical interventions. While hypospadias surgery is most often responsible for creating this problem, excessive circumcision also can leave a patient with too little skin to cover the penis. To our knowledge we describe the first series of pediatric patients in whom FTSGs were used in a variety of difficult circumstances where penile skin was lacking.

Voiding dysfunction: outcome in infants with congenital vesicoureteral reflux.

Objectives: To assess the rate of development of voiding dysfunction as an outcome in patients with congenital vesicoureteral reflux.

Methods: A computerized database was used to review the medical records of all patients with congenital reflux diagnosed before 6 months of age from 1988 to 2002. Only those infants with reflux who were followed up for at least 6 months past the age of toilet training were included.

A multivariable assessment of renal size and growth of scarred kidneys in children.

Purpose: We applied a recently developed multivariable renal size nomogram to sonographic measurements of kidneys with known scarring to assess systematically their sizes and growth patterns compared to normal kidneys.

Materials And Methods: We retrospectively reviewed renal sonograms of 138 kidneys (55 right and 83 left) with known scarring. The sizes of these scarred kidneys were compared to the 95% prediction limits calculated according to the multivariable renal size nomogram, adjusting for patient age, gender, race, weight and height.

Endocrine disruption and hypospadias.

The complexity of human biology makes it impossible to know for certain if endocrine disruption accounts for human penile deformities. Toxicologists point out that an overall assessment of risk must include other factors in addition to exposure including absorption, metabolism, excretion, bioaccumulation and other chemical interactions (Harrison et al., 1997).

A multivariate analysis of dysfunctional elimination syndrome, and its relationships with gender, urinary tract infection and vesicoureteral reflux in children.

Purpose: We explored and quantified the relationships between dysfunctional elimination syndrome (DES), and gender, urinary tract infection (UTI) and vesicoureteral reflux (VUR) in children.

Materials And Methods: Data on 2,759 pediatric patients treated at a referral practice who underwent renal sonography and voiding cystourethrography were summarized. The patients were children with VUR or normal genitourinary anatomy who presented with UTI or dysfunctional voiding and children screened for genitourinary problems such as hematuria, sibling reflux or bedwetting.

Epididymal cysts in children: natural history.

Purpose: We reviewed the outcome of conservative management of epididymal cyst in children at our institution.

Materials And Methods: We retrospectively reviewed the records of all patients with epididymal cyst from 1991 to 2002. Age and mode of presentation as well as time to complete involution of the cysts were studied.

Infant vesicoureteral reflux: a comparison between patients presenting with a prenatal diagnosis and those presenting with a urinary tract infection.

Objectives: To evaluate the severity, laterality, and gender distribution of infant vesicoureteral reflux (VUR) and its potential impact on renal outcome, we compared patients presenting fetally (FDR group) and those presenting with a urinary tract infection (INF group).

Methods: A retrospective review of 202 patients with the diagnosis of VUR before 6 months of age was performed. The grade of VUR, gender, laterality, initial renal scarring, breakthrough urinary tract infections, new renal scarring, and surgical intervention were compared between the INF group (n = 146) and FDR group (n = 56).

The renal length nomogram: multivariable approach.

Purpose: We built a multivariate renal length nomogram based on ultrasound measurements in pediatric patients with normal renal anatomy.

Materials And Methods: Included in the study were 707 children 1 week to 18 years old without vesicoureteral reflux, urinary obstruction or other known anatomical anomalies. Renal length was compared among subgroups of children.

Reduced renin expression and altered gene transcript profiles in multicystic dysplastic kidneys.

Purpose: Some patients with multicystic dysplasia experience hypertension in infancy which can be clinically improved with simple nephrectomy. Little is known of the role of renin in multicystic dysplasia and therefore, we studied renin expression in nonhypertensive multicystic dysplasia and compared it with hypertensive multicystic dysplasia. Additionally, global gene transcript profiles were studied in nonhypertensive multicystic dysplasia.

Evaluation and management of ectopic penile testis.

Ectopic testes are found in the superficial inguinal scrotum, base of penis, perineum, or medial thigh. In cases in which the testis crosses the midline, the cord structures may cross intra-abdominally or after exiting the inguinal canal. We describe a patient with an ectopic testis located on the penile shaft ipsilateral to a scrotal testis.