Urological outcome with the use of salvage continent vesicostomy in pediatric reconstructive surgery. A single tertiary center experience.

Purpose: To report our experience and results in terms of complications, reoperation rate and urinary continence with the Salvage Continent Vesicostomy (SCV) technique in pediatric patients with history or need of enterocystoplasty and absent appendix.

Methods: Retrospective review of all patients with a history of a continent catheterizable channel surgery performed in our institution between June 2016 and January 2022. Only patients with a SCV surgery with a minimum 6-month post operative follow up were included in this cohort and divided in group 1 (history of previous bladder augmentation) and group 2 (simultaneous bladder augmentation and SCV).

Multicenter retrospective study on benign testicular tumors in children: save as much as you can……please.

Background: Testicular tumors (TT) are infrequent in pediatric patients, representing 1% of pediatric solid tumors; benign testicular tumors (BTT) are the most common. We present a multicenter study aiming to describe the incidence, histology and surgical technique of BTT, with special emphasis on which approach could present better outcomes.

Methods: The records of pediatric patients diagnosed with BTT between 2005 and 2020 from 8 centers in 5 different countries in Latin-America, were reviewed.

Latitudes and attitudes: A multinational study of laparoscopic pyeloplasty in children.

Purpose: The Anderson-Hynes technique has been the treatment of choice for primary ureteropelvic junction obstruction in children. Laparoscopic approach has shown similar outcomes to open, with advantages of shorter hospital stay and less pain. We reviewed the experience of 11 geographically diverse, tertiary pediatric urology institutions focusing on the outcomes and complications of laparoscopic pyeloplasty.

Multicenter comparative study of open, laparoscopic, and robotic pyeloplasty in the pediatric population for the treatment of ureteropelvic junction obstruction (UPJO).

Introduction: Dismembered open pyeloplasty described by Anderson and Hynes is the "gold standard" for the treatment of ureteropelvic junction obstruction. The aim of our study was to compare the results of open (OP) vs laparoscopic (LP) vs robotic (RALP) pyeloplasty.

Material And Methods: A multicenter prospective review was conducted of pyeloplasty surgeries performed at five high-volume centers between 2014 and 2018.

Nephro-urological outcomes of a proactive management of children with spina bifida in their first 5 Years of life.

Introduction: The proactive management of spina bifida (SB), especially of its severe form, myelomeningocele (MMC), has contributed to decreasing chronic kidney disease (CKD). The objective of this study is to present the evolution of 5-year-old patient with MMC followed from birth with a proactive approach.

Material And Methods: This retrospective study included 55 cases with MMC of up to 5 years of age.

"Epstein-Barr virus associated smooth muscle tumour as an unusual cause of ureteric graft obstruction in a child".

Background: Epstein-Barr virus (EBV) is a DNA virus with oncogenic potential, especially in immunocompromised patients. EBV can promote smooth muscle proliferation, resulting in EBV-associated smooth muscle tumors (EBV-SMT).

Methods: We report a case of a 10-year-old child with end-stage renal disease secondary to hypoplastic crossed and fused kidneys who underwent kidney transplantation.

Burnout syndrome in pediatric urology: A perspective during the COVID-19 pandemic - Ibero-American survey.

Introduction: Burnout syndrome is a major cause of decreased life quality, mental health, and productivity for physicians. It is strongly related to work overload and has been a scarcely studied topic in pediatric urology. During the COVID-19 pandemic, authorities' recommendations have led to big changes in pediatric urology practice worldwide.

Laparoscopic Upper-pole Heminephrectomy for the Management of Duplex Kidney: Outcomes of a Multicenter Cohort.

Objective: To analyze the outcomes of patients undergoing upper-pole heminephrectomy surgery and to assess the different variables that may have an impact on outcome, specifically regarding morbidity and the need for further surgeries.

Materials And Methods: A retrospective study of patients who underwent laparoscopic upper-pole heminephrectomy for a nonfunctional moiety between August 2007 and December 2019 was conducted at 3 centers. A total of 130 patients met the inclusion criteria.

Simultaneous bilateral endoscopic surgery in a pediatric patient: Description of a NOVEL technique.

Introduction: Simultaneous bilateral endoscopic surgery (SBES) is the performance of a percutaneous nephrolithotomy (PCNL) on one side and a retrograde intrarenal surgery (RIRS) on the other kidney simultaneously.

Objective: Our aim is to report through a video the surgical technique and the step-by-step details of a SBES performed in a pediatric patient.

Patients And Methods: A 12-year-old male patient with bilateral upper tract urolithiasis.

Outcomes of event-free survival in patients with Wilms tumor undergoing preoperative chemotherapy. Analysis of lymph-node yield in a single-center cohort.

Introduction: The clinical value of lymph node sampling in Wilms tumor (WT) lies in its ability to accurately determine lymph node (LN) involvement. LN yield (LNY) is used as a valuable tool to measure LN retrieval, and a minimum of 6 LNs is one of the current recommendations. In patients who are managed with the SIOP strategy, preoperative chemotherapy decreases the retrieval of LN during surgery resulting in lower LNY values.

Bladder Volume Assessment in Pediatric Patients With Neurogenic Bladder: Is Ultrasound an Accurate Method?

Objective: To define the accuracy of ultrasound to determine bladder volume in pediatric patients with neurogenic bladder (NB).

Methods: Retrospective analysis of children with NB in treatment with urethral clean intermittent catheterization.

Exclusion Criteria: bladder surgeries, and catheterization through a channel different than urethra.

The Impact of Adjuvant Sirolimus Therapy in the Surgical Management of Scrotal Slow-Flow Vascular Malformations.

Objective: To describe the effects of oral sirolimus administered before and after surgical resection of slow-flow vascular malformations of the scrotum in pediatric patients.

Methods: Retrospective review of 3 patients presenting with complex lymphatic-venous malformations of the scrotum who received adjuvant oral sirolimus 3 months before and 3 months after surgical resection. Demographic data, clinical course, imaging findings, and management strategies were reviewed for each patient.

Garrahan U-Stitch laparoscopic appendicovesicostomy - Making surgery easier.

Appendicovesicostomy is an established continent urinary conduit. The development of minimally invasive techniques and the reduction of operative time instigated the search for new techniques. In this video we show the laparoscopic transabdominal technique for appendicovesicostomy using U-stitch technique as proposed by Santiago Weller et al.

Efficacy and safety of Mirabegron as adjuvant treatment in children with refractory neurogenic bladder dysfunction.

Introduction: When patients with neurogenic bladder become refractory, there are different alternatives, such as the use of β3-adreceptor agonists. The aim of the present study is to evaluate efficacy and safety of Mirabegron as adjuvant treatment.

Material And Methods: 37 patients under 18 years of age who underwent Mirabegron were retrospectively studied.

Pediatric Urodynamic Study Without a Preprocedural Urine Culture, Is It Safe in Clinical Practice?

Objective: To prove that incidence of UTI after a pediatric urodynamic study (UDS) is low, and that patients without urine culture (UC) analysis prior to a UDS will not have a significant increase in the incidence of UTI (post-UDS UTI).

Methods: Prospective cohort study including consecutive pediatric patients undergoing UDS in a single center for 1 year. Patients were divided in 2 groups: (G1) UDS with a previous negative UC and (G2) UDS without a previous UC analysis.

Long-term urological assessment and management of cloaca patients: A single tertiary institution experience.

Purpose: Preserving renal function and achieving urinary continence are the most important urological goals in the management of cloaca patients. Many prognostic factors have been described, such as the length of the common channel (CC) and urethra, the presence of spinal dysraphism, and associated urological anomalies. The aim of this study was to analyze urinary continence status and need for reconstructive procedures and their correlation with urological risk factors in a series with a long-term follow-up.

The effect of the Covid-19 Pandemic on pediatric urology.

Medical and surgical priorities have changed dramatically at the time of this pandemic. Scientific societies around the World have provided rapid guidance, underpinned by the best knowledge available, on the adaptation of their guidelines recommendations to the current situation. There are very limited scientific evidence especially in our subspecialty of pediatric urology.

Laparoscopic Nephro-Sparing Surgery of a Reninoma Tumor in a Pediatric Patient.

Objetive: Reninoma, or juxtaglomerular cell tumor, is a benign neoplasm which causes severe hypertension with elevated plasma renin activity. Usually, it is well localized on computed tomography scan or magnetic resonance images, and complete resection of the tumor with renal function preservation is the optimal treatment. To describe the technique of a transperitoneal nephron-sparing laparoscopic surgery in a pediatric patient.

Laparoscopic total nephrectomy for Wilms tumor: Towards new standards of care.

Introduction: Laparoscopic total nephrectomy (LN) in malignant pediatric tumors remains controversial. For selected patients undergoing pre-operative chemotherapy in referral centers, LN has so far shown comparable results to the standard open technique.

Purpose: To describe the inclusion criteria and preliminary results of laparoscopic nephrectomies (LN) for the treatment of unilateral Wilms tumors (WT).

Initial urological evaluation and management of children with neurogenic bladder due to myelomeningocele.

Introduction: The proactive management of children with myelomeningocele (MMC) has contributed to decreasing their progression to end-stage renal disease, thanks to early urological evaluation and timing implementation of treatments.

Objective: To demonstrate that early urological evaluation of the urinary tract in MMC shows functional alterations in most cases, and that it requires medical intervention, even when in some cases the complementary imaging studies do not show any abnormalities.

Material And Methods: A retrospective study including 60 patients aged <1 year with MMC who were followed by a multidisciplinary team.

Comparative, Prospective, Case-Control Study of Open versus Laparoscopic Pyeloplasty in Children with Ureteropelvic Junction Obstruction: Long-term Results.

Introduction: We compare open pyeloplasty (OP) versus laparoscopic pyeloplasty (LP) in children in a multicenter, prospective, case-control study.

Materials And Methods: From May 2007 to March 2009, a program was established at Hospital Garrahan, the reference center, to perform LP with a mentoring surgeon that would attend the institution once a month. Every new case of ureteropelvic junction obstruction (UPJO) diagnosed in the reference institution was offered to participate in the study.

The use of polyacrylate-polyalcohol copolymer hydrogel in the endoscopic treatment of primary vesicoureteral reflux in children.

Background/purpose: It is still under discussion which is the best tissue augmenting substance for the endoscopic treatment of children with vesicoureteral reflux (VUR). We describe our preliminary experience (September 2009-November 2011) with polyacrylate-polyalcohol copolymer hydrogel (PPCH).

Methods: This is an observational, descriptive, prospective study which included 81 female and male patients (age 1-14 years) diagnosed with unilateral (n=45) and bilateral (n=36) primary VUR comprising a total of 117 refluxing renal units (RRU).

Multicenter survey of endoscopic treatment of vesicoureteral reflux using polyacrylate-polyalcohol bulking copolymer (Vantris).

Objective: To evaluate an outcome of endoscopic correction of vesicoureteral reflux (VUR) using Vantris (Promedon, Cordoba, Argentina) in terms of its effectiveness and morbidity in a multicenter study.

Materials And Methods: From 2009 to 2013, 611 patients (210 boys and 401 girls) with a mean age of 3.56 years (range, 1 month-18 years) were treated at 7 centers worldwide endoscopically with Vantris injection.

Repeated injections of intradetrusor onabotulinumtoxinA as adjunctive treatment of children with neurogenic bladder.

Aim: To evaluate the effects of repeated injections of onabotulinumtoxinA in children with neurogenic bladders refractory to conventional treatment.

Patients And Methods: A total of 26 children with neurogenic bladder were prospectively studied. Some patients received up to four repeat injections.