Chemotherapy Refractory Spindle-Cell Rhabdomyosarcoma of the Bladder Treated With Consolidative Ovarian-Sparing Radical Surgery.

We present a case of chemotherapy refractory spindle cell rhabdomyosarcoma of the lower urinary tract in a 15-month-old female that ultimately required consolidative surgery with cystectomy, urethrectomy, ovarian-sparing hysterectomy, bilateral salpingectomy, anterior vaginal wall resection, and bilateral pelvic lymph node dissection. Genitourinary reconstruction was performed by ileal conduit creation and vaginoplasty. After completion of her maintenance postoperative chemotherapy regimen, the patient has remained disease-free for approximately 27 months.

Survival of nonseminomatous germ cell tumors in pediatric patients and young adults - A stage group stratified analysis.

Introduction: Testicular germ cell tumors, particularly nonseminomatous germ cell tumors (NSGCT), comprise the most common solid malignancy in male children and younger adults. While these patients experience excellent survival outcomes, few studies have characterized their survival by age. Thus, we aimed to characterize the relative survival of NSGCT by age, stratifying patients by stage group.

Untethering an unusual cause of kidney injury in a teenager with Down syndrome.

Acute kidney injury (AKI) is characterized by the acute nature and the inability of kidneys to maintain fluid homeostasis as well as adequate electrolyte and acid-base balance, resulting in an accumulation of nitrogenous waste and elevation of serum blood urea nitrogen and creatinine values. Acute kidney injury may be a single isolated event, yet oftentimes, it results from an acute chronic kidney disease. It is critical to seek out the etiology of AKI and to promptly manage the underlying chronic kidney disease to prevent comorbidities and mortality that may ensue.

Bullying has a potential role in pediatric lower urinary tract symptoms.

Purpose: National statistics estimate that a quarter of American school children are regularly bullied, making this issue the main parental concern and the leading form of school violence. To our knowledge no study in the literature has examined the association of bullying with lower urinary tract symptoms. We evaluated the relationship between being bullied and lower urinary tract symptoms in the pediatric population.

Urinary dysfunction in children is associated with exposure to environmental tobacco smoke.

Objective: Environmental tobacco smoke (ETS) is known to cause significant morbidity across a wide variety of organ systems. The purpose of this study was to examine the relationship of ETS exposure with pediatric urinary dysfunction.

Patients And Methods: Participants were drawn from a university-based pediatric urology practice throughout the first half of 2011.

Benign testicular enlargement due to diffuse interstitial fibrosis associated with cryptorchid testis in 11-month-old boy.

Benign testicular enlargement secondary to diffuse interstitial fibrosis is a rare clinical entity, especially in pediatric patients. To our knowledge, this is the first pediatric case reported of benign testicular enlargement due to interstitial fibrosis in a cryptorchid testis. We report a rare case of an 11-month-old boy with a cryptorchid testis found intraoperatively to have an asymmetrically enlarged testis secondary to diffuse, benign interstitial fibrosis of the testis.

Laparoendoscopic single-site varicocele repair in adolescents-initial experience at a single institution.

Background And Purpose: Laparoendoscopic single-site (LESS) varicocele repair is a modification of standard laparoscopic varicocele repair that uses a single port. We describe our initial experience with LESS varicocele repair.

Patients And Methods: During a 1-year period, all patients who presented for varicocele repair underwent LESS repair.

Evaluation of consistency between physician clinical impression and 3 validated survey instruments for measuring lower urinary tract symptoms in children.

Purpose: Since many children with lower urinary tract symptoms are treated based on history and physical, it is important to know which symptom survey correlates best with the physician clinical impression. We evaluated 3 tools that have been demonstrated to predict severity of lower urinary tract symptoms, the Dysfunctional Voiding Symptom Score, the Akbal survey and the Nelson survey. Total scores from each survey were compared to clinical impression.

Laparoendoscopic single site orchiopexy.

We report a laparoendoscopic single site orchiopexy in a 2-year-old boy with a right nonpalpable testis. Diagnostic laparoscopy using a 5-mm port revealed a right intraabdominal testis. The 5-mm port site was extended to accommodate the smallest commercially available triport, and orchiopexy was performed.

Later toilet training is associated with urge incontinence in children.

Objective: The objective of this study was to determine if later toilet training is associated with urge incontinence in children.

Methods: We used a case-control study design to yield level 2 evidence.

Results: Initiation of toilet training after 32 months of age was associated with urge incontinence (P=0.

Nocturnal enuresis and overweight are associated with obstructive sleep apnea.

Objective: The objective of this study was to examine the relationship of obstructive sleep apnea (OSA), body weight (BMI percentage [BMI%]), and monosymptomatic nocturnal enuresis (MNE) in children.

Methods: A case-control study design was used. All children were 5 to 15 years of age; case patients were recruited from a comprehensive sleep disorders center (n = 149), and control subjects were recruited from a general pediatric practice in the same catchment area (n = 139).

Bladder outlet obstruction in male cystinuria mice.

Background: Cystinuria is the most common inherited cause of urinary tract stones in children. It can lead to obstructive uropathy, which is a major cause of renal failure. Genetic studies have identified two genes, SLC3A1 and SLC7A9, to be directly involved in cystine stone formation.

Pediatric single-port-access nephrectomy for a multicystic, dysplastic kidney.

Major urologic surgery via a single port has emerged as the latest progression in laparoscopy and robotics. While current literature highlights the single-port approach to the surgical treatment of cholecystitis, appendicitis and varicoceles, this technique has never been employed to perform a nephrectomy on a child. We herein report a case of a pediatric patient who underwent nephrectomy via single-port-access.

Persistent motor deficits predict long-term bladder dysfunction in children following acute transverse myelitis.

Purpose: We determined whether motor and bladder recovery are correlated in children with acute transverse myelitis.

Materials And Methods: From 1995 to 2004, 14 children (8 males and 6 females) with acute transverse myelitis were retrospectively evaluated to determine if there was a correlation between motor and bladder recovery following disease onset.

Results: During the acute phase of the disease, all patients experienced lower extremity motor deficit and bladder dysfunction.

Accreditation Council for Graduate Medical Education competency-based on-line computer course in pediatric oncology for urology residents.

Objective: To develop an on-line course in pediatric urology for our urology residents, to expose residents to required pediatric urology content within the confines of an 80-hour work week.

Methods: An on-line, Accreditation Council for Graduate Medical Education competency-based course in pediatric urology was designed using a commercially based platform.

Results: The computer-based teaching course was flexible and provided virtually limitless opportunities for course design, structure, and content.

Pediatric renal pseudocyst due to pancreatitis.

A renal pseudocyst due to pancreatitis should be suspected when a child with pancreatitis develops flank pain. Percutaneous drainage of the pseudocyst provides effective treatment of this rare condition.

Nonoperative management of abdominoscrotal hydroceles in an infant.

Early surgery is recommended for infant abdominoscrotal hydrocele because spontaneous resolution has not been reported. We present a 6-month-old boy with bilateral abdominoscrotal hydrocele, who did not undergo surgery because of a hematologic condition. After 1 year, the abdominal portion of both hydroceles resolved, leaving simple bilateral scrotal hydroceles.

Breastfeeding during infancy may protect against bed-wetting during childhood.

Objective: Our goal was to test the hypothesis that children who exhibit bed-wetting during childhood were less likely to be breastfed during infancy compared with normal controls.

Methods: A case-control study was conducted in a pediatric continence center and a general pediatric practice. Cases (n = 55) were recruited from the continence center and defined as children 5 to 13 years of age who experienced lifetime involuntary voiding of urine during nighttime sleep at least 2 times a week in the absence of defects of the central nervous system or urinary tract.

The effect of surgeon volume and hospital characteristics on in-hospital outcome after ureteral reimplantation in children.

The aim of this study was to examine the association between surgeon and hospital characteristics on in-hospital outcome after ureteral reimplantation in children. Patients<18 years undergoing vesicoureteral reimplantation (n=3,109) were identified in Kids' Inpatient Database, an administrative database containing discharge records from 27 states during 2000 in the US. Based on patient volume in 2000, surgeons were designated as low volume (<11 procedures), medium volume (11-20 procedures) and high volume (>20 procedures) surgeons.

Management of obstructing fungal pyelonephritis in infants.

This case report and literature review suggest that infants with renal obstruction due to Candida albicans pyelonephritis often require drainage, in addition to systemic antifungal agents, to treat the infection.

Bladder rupture in premature infant during voiding cystourethrography.

We report what we believe to be the youngest patient with bladder rupture during voiding cystourethrography. If voiding cystourethrography needs to be done in a premature infant, the filling pressures should be minimized, multiple filling cycles should be avoided, and the voiding pressures should be minimized by using a small, balloon-less catheter.