A survey of parental leave for female physicians reveals dissatisfaction and inadequacies.

Background: The study aim was to assess parental leave experiences of female physicians across different specialties and institutions over time given that the U.S. does not have a federal paid parental leave policy.

Prevalence of and factors associated with burnout in pediatric urology fellows.

Introduction: The 2016 AUA census found 39% of practicing urologists experienced burnout. Burnout is a syndrome of emotional exhaustion, depersonalization, and decreased feelings of personal accomplishment due to workplace stress. Despite the demands of training, little is known about the prevalence of burnout in pediatric urology fellows.

Risk factors for mortality in children with hemorrhagic cystitis after hematopoietic transplant.

Introduction: Hemorrhagic cystitis (HC) is a devastating complication of bone marrow (BMT) and stem cell transplant (SCT). Much of the literature has focused on exclusively adult patient populations, with limited evidence regarding risk factors for mortality and morbidity among pediatric HC patients.

Objective: To examine factors associated with all-cause mortality in children with HC after BMT/SCT.

Greater Obstetric Barriers for Female Urologists Compared to Peer-Physicians.

Objective: To determine the prevalence of pregnancy complications, infertility, and maternal support for female urologists in comparison to the general population and other female physicians.

Methods: An anonymous, voluntary survey was distributed to female physicians via private physician social media groups from June to August 2021. The survey queried pregnancy demographics and complications, infertility diagnosis and treatment, workplace environment, and prior education on these topics.

Lack of Medicaid Coverage of Routine Newborn Circumcision Leads to Increased Operative Circumcisions, Chordee Procedures, and Balanitis.

Objective: To compare proportions of newborn circumcisions, operative circumcisions, chordee procedures, and cases of balanitis in states where Medicaid covers newborn circumcision (covered states) versus states that do not (noncovered states) using the pediatric health information system database.

Methods: A retrospective review of pediatric health information system data was conducted from 2011 to 2020. The proportions and median ages of newborn circumcision current procedural terminology (CPT 54,150, 54,160), operative circumcision (CPT 54,161), chordee (CPT 54,360), and balanitis (ICD-9 607.

Management of pediatric ureterolithiasis in the emergency room: A single institution review and new management pathway.

Introduction/background: Urolithiasis is an increasingly common condition seen in children with an annual incidence of 2-3% in children under 18, and up to 10% in adolescents. Treatment of stones varies including observation, IV hydration, pain management, medical expulsive therapy (MET), or surgery. Though well-studied and often used in adults, MET (alpha-adrenergic antagonists to facilitate passage of ureteral stones), is not routinely prescribed in pediatric patients.

High Infertility Rates and Pregnancy Complications in Female Physicians Indicate a Need for Culture Change.

Objective: This survey study aims to determine the prevalence of pregnancy complications and infertility in female physicians in comparison to the general population. Risk factors, workplace environment, and education are also examined.

Background: Physicians undertake long training and have stressful work environments during optimal childbearing years.

Pediatric Urologic Surgery: Reducing Opioid Use.

Adequate pain management is important for successful postoperative recovery after any surgical procedure. Unfortunately, the USA and many other parts of the world are in the midst of an opioid epidemic, and healthcare providers are thus tasked with balancing the comfort and recovery of their patients after an operation against the individual and societal harms of the over-prescription of opioids. The goal of this article is to discuss the range of opioid formulations currently in use, examine why this may be problematic, and explore alternatives that provide similar efficacy and may improve overall safety in the pediatric population after urologic surgery.

Opioid Use after Pediatric Urologic Surgery: Is It Really Needed?

Objectives: To identify factors associated with opioid use after pediatric urologic surgery, use this data to educate our patients and colleagues on decreasing post-operative opioid use, and assess the effectiveness of this approach.

Methods: From 1/2018 - 12/2019, a written questionnaire asking which pain medications were used after surgery was given to patients' families before routine post-operative appointments. A retrospective review of the surveys and patient charts was performed.

Healthcare transition for patients with differences of sexual development and complex urogenital conditions.

Children with major congenital anomalies are able to obtain a high level of care in pediatric care settings. In contrast, adult care models emphasize patient responsibility in ensuring their health care needs are met. As patients make this transition, they may fall through the medical "safety net" and struggle to find quality care because of their lack of preparation.

Insulin-Like Peptide 3 (INSL3) Serum Concentration During Human Male Fetal Life.

Insulin-like peptide 3 (INSL3), a protein hormone produced by Leydig cells, may play a crucial role in testicular descent as male INSL3 knockout mice have bilateral cryptorchidism. Previous studies have measured human fetal INSL3 levels in amniotic fluid only. To measure INSL3 serum levels and mRNA in fetal umbilical cord blood and fetal testes, respectively.

Prospective Evaluation of Predictors of Testis Atrophy After Surgery for Testis Torsion in Children.

Objective: To prospectively correlate pain duration, red scrotal skin, ultrasound appearance of testis, and intraoperative testis color to future testis atrophy after acute testicular torsion.

Methods: Patients 2 months-18 years old with unilateral acute scrotum were consecutively enrolled in a National Institutes of Health transcutaneous near-infrared spectroscopy study, with a subgroup analysis of the true torsion group. Presence or absence of red scrotal skin, pain duration, testicular heterogeneity on preoperative ultrasound, and intraoperative testis color based on a novel visual chart 5 minutes after detorsion were recorded.

Bowel preparation prior to reconstructive urologic surgery in pediatric myelomeningocele patients.

Introduction: Mechanical bowel preparation (MBP) has historically been the standard of care for patients undergoing reconstructive urologic surgery, including urinary diversion. To date, several studies have examined the role of mechanical bowel preparation in postoperative outcomes in pediatric patients undergoing augmentation cystoplasty. However, these patient populations have been heterogeneous in nature, with no studies dedicated to examining the role of MBP prior to reconstructive urologic surgery in pediatric patients with myelomenginoceles.

Transscrotal Near Infrared Spectroscopy as a Diagnostic Test for Testis Torsion in Pediatric Acute Scrotum: A Prospective Comparison to Gold Standard Diagnostic Test Study.

Purpose: A rapid test for testicular torsion in children may obviate the delay for testicular ultrasound. In this study we assessed testicular tissue percent oxygen saturation (%StO2) measured by transscrotal near infrared spectroscopy as a diagnostic test for pediatric testicular torsion.

Materials And Methods: This was a prospective comparison to a gold standard diagnostic test study that evaluated near infrared spectroscopy %StO2 readings to diagnose testicular torsion.

A multi-institutional study of perioperative and functional outcomes for pediatric robotic-assisted laparoscopic Mitrofanoff appendicovesicostomy.

Background: Robotic techniques are increasingly being used for reconstructive procedures in the pediatric population.

Objective: The present study reported the functional and perioperative outcomes of a multi-institutional cohort of pediatric patients who underwent robotic-assisted laparoscopic Mitrofanoff appendicovesicostomy (RALMA).

Study Design: Pediatric patients who underwent RALMA at five different centers were included.

Diagnosing Testicular Torsion before Urological Consultation and Imaging: Validation of the TWIST Score.

Purpose: The TWIST (Testicular Workup for Ischemia and Suspected Torsion) score uses urological history and physical examination to assess risk of testis torsion. Parameters include testis swelling (2 points), hard testis (2), absent cremasteric reflex (1), nausea/vomiting (1) and high riding testis (1). While TWIST has been validated when scored by urologists, its diagnostic accuracy among nonurological providers is unknown.

Perioperative and Short-Term Outcomes of Robotic vs Open Bladder Neck Procedures for Neurogenic Incontinence.

Purpose: Complex urological reconstruction may be facilitated by the improved magnification and dexterity provided by a robotic approach. Minimally invasive surgery also has the potential advantages of decreased length of stay and improved convalescence. We reviewed perioperative and short-term outcomes between robot-assisted and open bladder neck sling/repair with catheterizable channel in patients with neurogenic bladder.

Pediatric Priapism Secondary to Psychotherapeutic Medications.

With the increased application of many different drug classes for the treatment of psychiatric conditions in children, the incidence of priapism has also increased. Priapism of pharmacotherapeutic etiology in the pediatric population is a complex and poorly understood entity that continues to present new management challenges for clinicians. We present 2 cases of pediatric priapism thought to be secondary to the use of pharmacotherapeutic agents.