Insulin-like 3 exposure of the fetal rat gubernaculum modulates expression of genes involved in neural pathways.

Insulin-like 3 (INSL3) signaling directs fetal gubernacular development and testis descent, but the actions of INSL3 in the gubernaculum are poorly understood. Using microarray gene expression profiling of fetal male rat gubernaculum explants exposed to 10 or 100 nM INSL3, significant changes in expression were identified for approximately 900 genes. Several of the genes showing the largest inductions regulate neuronal development or activity, including Pnoc (34-fold), Nptx2 (9-fold), Nfasc (4-fold), Gfra3 (3-fold), Unc5d (3-fold), and Crlf1 (3-fold).

Pediatric laparoscopic pyeloplasty: lessons learned from the first 52 cases.

Background And Purpose: The use of laparoscopy for pediatric pyeloplasty is increasing. We review our experience with our first 50 cases and describe the main technical points learned during this experience.

Patients And Methods: We retrospectively reviewed the charts of all patients who underwent laparoscopic pyeloplasties (LP) over a 4-year period (January 2004 to January 2008) at our institution.

Genetic and environmental contributors to cryptorchidism.

Cryptorchidism is a common congenital anomaly that shows familial clustering and increased prevalence in first-degree relatives, suggesting that genetic factors contribute to the etiology. Animal models and some human data suggest that environmental exposures may also contribute to risk. Potential variables during development that may contribute to the occurrence of cryptorchidism in the genetically susceptible individual include maternal hormonal influences as well as other environmental factors that affect hormonal signaling.

The minimally invasive open pyeloplasty.

Background: The dismembered pyeloplasty is the operation of choice for ureteropelvic junction obstruction (UPJO). Recently, with the advent of improved minimally invasive techniques and equipment, laparoscopic dismembered pyeloplasty has gained popularity. We present our experience with a minimally invasive open pyeloplasty.

Congenital anomalies of the kidney and urinary tract (CAKUT): a current review of cell signaling processes in ureteral development.

Objective: The objective of this review is to present a concise summary of the genetic signaling processes involved in abnormal mouse Wolffian development and their correlation to those abnormalities affecting ureteral development in children.

Materials And Methods: We performed an extensive review of the current literature pertaining to mouse Wolffian duct development and combined these findings with our own data.

Conclusion: This article reviews embryological findings in mice with ureteral abnormalities and draws connections between the mouse anomaly and what is seen in children.

Iatrogenic ureteral injury after laparoscopic cholecystectomy in a 13-year-old boy.

We present a report of a delayed ureteral injury after a laparoscopic cholecystectomy. The patient presented with one episode of gross hematuria after surgery. He was treated with ureteral stent drainage and did well with no long-term sequelae.

Minimally invasive open renal surgery.

Purpose: Improved pediatric laparoscopic techniques and instruments have led to the increased popularity of laparoscopic pyeloplasty and nephrectomy at some centers. The recent trend has compared laparoscopic to open techniques to draw parallel conclusions from the adult literature that laparoscopic surgery in children offers the same advantages. Historically open renal surgery in the pediatric population has been done successfully but usually through more traumatic incisions.

Ipsilateral ureteroureterostomy in the surgical management of the severely dilated ureter in ureteral duplication.

Purpose: Ipsilateral ureteroureterostomy for the surgical management of severely dilated ureter in ureteral duplication is well supported in the surgical literature but often not done. We evaluated our institutional experience with ureteroureterostomy in duplication anomalies to assess the feasibility and success of this procedure.

Materials And Methods: An 8-year retrospective review of the records of all patients with complete renal duplex anomalies was evaluated.

Global gene expression patterns in mouse wolffian duct development.

Purpose: We identified genes responsible for terminal differentiation of the mouse ureter.

Materials And Methods: We isolated the wolffian ducts of Black Swiss mice from embryonic days 12.5 to 14.

Presentation of fused vas deferens.

Transverse testicular ectopia is a rare condition that usually presents as a unilateral nonpalpable testis and a contralateral descended testis with an associated hernia. Currently, with the use of diagnostic laparoscopy, transverse testicular ectopia is found before groin exploration. We reviewed 2 cases that were referred to our institution.

Does a slower treatment rate impact the efficacy of extracorporeal shock wave lithotripsy for solitary kidney or ureteral stones?

Purpose: We compared the efficacy of an SR (70 to 80 shocks per minute) and an FR (120 shocks per minute) for ESWL for solitary stones less than 2 cm located in the kidney or proximal ureter.

Materials And Methods: A total of 349 patients with a solitary, radiopaque kidney or ureteral stone underwent ESWL on a DoLi(R) 50 lithotriptor. Patients were grouped based on stone size, stone location and whether SR or FR treatment was performed.