The diversity of hypospadias management in North America: a survey of pediatric urologists.

Purpose: To determine trends in hypospadias management, including surgical techniques and perioperative care, by pediatric urologists in North America.

Methods: An anonymous online survey was devised to assess approaches to hypospadias repair and management, including anesthetic considerations, catheter placement, choice of dressing, and postoperative antibiotic treatment. The survey was sent to all practicing members of the Societies for Pediatric Urology.

The adolescent glans penis: Functional and aesthetic issues following childhood hypospadias repair.

Introduction: As children with childhood hypospadias repairs transition into adolescence, the function and appearance of the genitalia acquire greater importance. For some, the direction and shape of the urinary stream can be embarrassing if abnormal, and the appearance of the glans penis and meatus are a concern as they develop the capacity for self-awareness.

Objective: Herein, we address the surgical correction and outcomes of urine spraying with or without fistulae, and cosmesis over 12 years.

Primary renal Ewing Sarcoma masquerading as Wilms in an adolescent female.

Primary renal Ewing's sarcoma (ES) of the kidney represents a rare oncologic entity belonging to the collection of small round cell tumors, which typically feature osseous presentations. Renal ES is an aggressive disease entity with high metastatic potential, either at time of presentation or following initial extirpative therapy. Herein, we report the case of a 14-year-old female who initially presented with intermittent gross painless hematuria and a large left renal mass identified on ultrasound and confirmed on follow up MRI.

Advances in bladder substitution and creation of neobladders in children.

Cystectomy and urinary bladder substitution are rare in children but may be necessary in some cases of bladder exstrophy, in the setting of malignancy, or in other settings in which the bladder is severely dysfunctional. This article details advances in surgical techniques in creating continent urinary diversions in this specialized pediatric population.

Nerve Sparing Clitoroplasty is an Option for Adolescent and Adult Female Patients with Congenital Adrenal Hyperplasia and Clitoral Pain following Prior Clitoral Recession or Incomplete Reduction.

Purpose: In the past many female patients with congenital adrenal hyperplasia and atypical genitalia were surgically treated with clitoral recession or incomplete reduction of erectile bodies. We report the results of repeat clitoral surgery performed for clitoral pain or enlargement using a nerve sparing reduction clitoroplasty technique.

Materials And Methods: We identified 6 female patients with congenital adrenal hyperplasia who had undergone prior clitoral recession or incomplete reduction elsewhere.

Age does not adversely affect sperm retrieval in men undergoing microdissection testicular sperm extraction.

Objective: To evaluate the effect of male age on the outcome of microdissection testicular sperm extraction (micro-TESE) and assisted reproductive technology.

Design: Clinical retrospective study.

Setting: Center for reproductive medicine at a tertiary university hospital.

A comparison of models for predicting sperm retrieval before microdissection testicular sperm extraction in men with nonobstructive azoospermia.

Purpose: We developed an artificial neural network and nomogram using readily available clinical features to model the chance of identifying sperm with microdissection testicular sperm extraction by readily available preoperative clinical parameters for men with nonobstructive azoospermia.

Materials And Methods: We reviewed the records of 1,026 men who underwent microdissection testicular sperm extraction. Patient age, follicle-stimulating hormone level, testicular volume, history of cryptorchidism, Klinefelter syndrome and presence of varicocele were included in the models.

Localization of sperm during microdissection testicular sperm extraction in men with nonobstructive azoospermia.

Purpose: We determined the location where sperm were identified during microdissection testicular sperm extraction and characterized the subset of patients for whom complete bilateral exploration was most beneficial.

Materials And Methods: A total of 900 men underwent a first attempt at microdissection testicular sperm extraction. Sperm extraction began with an initial wide incision in the larger testis.

Overweight men with nonobstructive azoospermia have worse pregnancy outcomes after microdissection testicular sperm extraction.

Objective: To evaluate the effect of obesity on the outcome of testicular sperm extraction (TESE) and assisted reproductive technology.

Design: Clinical retrospective study.

Setting: Center for reproductive medicine at a tertiary-care university hospital.

Laparoscopic and open partial nephrectomy: complication comparison using the Clavien system.

Background And Objectives: To compare postoperative complications in patients undergoing laparoscopic and open partial nephrectomy using a standardized complication-reporting system and a standardized tumor-scoring system.

Methods: We conducted a retrospective analysis of 189 consecutive patients with nephrometry scores available who underwent elective partial nephrectomy for renal masses. Demographic, perioperative, and complication data were recorded.

Role of optimizing testosterone before microdissection testicular sperm extraction in men with nonobstructive azoospermia.

Purpose: Although optimizing endogenous testosterone production before testicular sperm extraction is commonly practiced, whether improved preoperative testosterone levels enhance sperm retrieval remains unclear. We evaluated the influence of preoperative medical therapy in men with nonobstructive azoospermia before microdissection testicular sperm extraction.

Materials And Methods: A total of 1,054 men underwent microdissection testicular sperm extraction from 1999 to 2010.

Role of tissue digestion and extensive sperm search after microdissection testicular sperm extraction.

Objective: To report the chance of sperm discovery in the laboratory when sperm were not identified in the operating room (OR).

Design: Clinical retrospective study.

Setting: Department of urology at a tertiary university hospital.

Preoperative radiographic parameters predict long-term renal impairment following partial nephrectomy.

Purpose: We analyzed radiographic parameters describing anatomic features of renal tumors to identify preoperative characteristics that could help predict long-term decline in renal function following partial nephrectomy.

Methods: We retrospectively reviewed the records of 194 consecutive patients who underwent partial nephrectomy from January 2006 to March 2009 and analyzed a cohort of 53 patients for whom complete clinical, radiographic, and operative information was available. Computed tomography images were reviewed by a single radiologist.

H2B- and H3-specific histone deacetylases are required for DNA methylation in Neurospora crassa.

Neurospora crassa utilizes DNA methylation to inhibit transcription of heterochromatin. DNA methylation is controlled by the histone methyltransferase DIM-5, which trimethylates histone H3 lysine 9, leading to recruitment of the DNA methyltransferase DIM-2. Previous work demonstrated that the histone deacetylase (HDAC) inhibitor trichostatin A caused a reduction in DNA methylation, suggesting involvement of histone deacetylation in DNA methylation.