The integral co-management role of the medical pediatric urologist: Improving the care of children with urological conditions.

Introduction: The complexities of modern medicine prompt a re-evaluation of traditional patient care models to enhance safety and quality. We implemented a one-year pilot Medical Pediatric Urology fellowship, jointly developed by Urology and Pediatric Hospital Medicine, where a pediatrician received postgraduate training in both specialties. This innovative program aimed to augment knowledge and expertise in non-surgical aspects of pediatric urology.

Turning the "Page" Again: Decreasing Inappropriate After-Hours Pages.

Objective: To decrease the number of inappropriate pages after-hours by 50%.

Methods: Over 9 weeks, after-hours pages to the on-call resident at University of Minnesota Department of Urology were documented. Pages were deemed "appropriate" or "inappropriate" by 3 independent reviewers.

A Scoping Review on Learning Health Networks Available in Pediatric Surgical Specialties.

Background: Learning health networks (LHN) are consortia of institutions that collaborate and embrace the elements of the learning health system (LHS), including quality improvement, education, research, and stakeholder involvement. Their ultimate goal is rapid information dissemination in clinical care. Pediatric surgical specialties perform unique yet high-impact procedures that could benefit from LHN, thereby improving surgical outcomes and care through LHS approaches.

A Comparison of Short Versus Long Course Intravenous Antibiotics When Treating Urinary Tract Infection in Infants <60 Days of Age.

Urinary tract infections (UTIs) are a common reason for hospitalization in infants younger than 60 days, and the optimal approach to intravenous (IV) antibiotic therapy upon UTI diagnosis in this cohort is unknown. We determined whether there was an association between IV antibiotic therapy duration (long [>3 days] vs short [≤3 days]) and treatment failure via a retrospective review of infants with confirmed UTIs receiving IV antibiotics at a tertiary referral center. A total of 403 infants were included; 39% were treated with ampicillin and cefotaxime, and 34% with ampicillin and gentamycin or tobramycin.

Scrotal flap phalloplasty as temporary neophallus in infants and children with penile agenesis: Multi-institutional experience and long-term follow-up.

Introduction: Aphallia is a rare congenital disorder pertaining to genotypic males. Early surgical creation of a neophallus is recommended to reinforce the child's male gender-identity, favoring proper psychosexual development. Modern microsurgical techniques used to create a neophallus in adults are not recommended in children due to the invasiveness and complexity of the procedures, along with high complication rates.

Ultrasonographical features of perinatal testicular torsion: an assessment of interobserver variability among radiologists and pediatric urologists.

Purpose: To retrospectively compare interpretations of Doppler ultrasound (US) in newborns with confirmed perinatal testicular torsion (PTT) by an experienced faculty (staff) pediatric radiologist (SPR), pediatric radiology fellow (PRF), pediatric urology fellow (PUF) and staff pediatric urologist (SPU).

Methods: US images of 27 consecutive males with PTT between May 2000 and July 2020 were retrieved. The testicles were classified as affected or non-affected by PTT.

Recurrent UPJ obstruction following paediatric pyeloplasty is associated with an initial <2.5cm incision open surgical approach.

Objectives: To determine the risk factors that affect surgical outcomes for pediatric pyeloplasty, and whether this may be related to the choice of operative approach.

Methods: A retrospective cohort study was performed to evaluate clinicodemographic and operative characteristics of children undergoing dismemberment pyeloplasty by 2 senior pediatric urologists in our tertiary institution between Jan 2008 - Dec 2017. Outcomes included overall complications, re-stenosis, and revision pyeloplasty based on clinic-radiological parameters.

Optimizing the surgical instrument tray to immediately increase efficiency and lower costs in the operating room.

Background: Surgical trays are often poorly configured and can be ongoing sources of frustration and excess costs. We conducted an observational study to determine if the use of a customized mathematical inventory optimization model would result in a greater reduction in the number of instruments on a surgical tray than a clinician review of the tray.

Methods: Utilization of instruments on the major orthopedic tray at a large academic hospital was documented over 80 procedures.

A Canadian national survey: Perspectives on routine pathological examination of hernia sacs after inguinal hernia and hydrocele repair among pediatric urologists, surgeons, and pathologists.

Background/objective: This study aims to understand perspectives on routine pathological examination of hernia sacs following pediatric inguinal hernia and hydrocele repair among Canadian pediatric urologists, surgeons, and pathologists.

Study Design: All active members of Pediatric Urologists of Canada (PUC), Canadian Association of Pediatric Surgeons (CAPS), and the divisional heads of anatomical pathology at the Canadian children's hospitals (AP) were invited to participate between June 2019 and January 2021 in an anonymous multiple-choice-based questionnaire.

Results: The response rates were 71% from PUC (24/34), 20% from CAPS (25/130), and 64% from AP (7/11).

Hospitalization following pediatric kidney transplantation: An international comparison among a Canadian pediatric transplant center, North American Pediatric Renal Trials and Collaborative Studies, and Cooperative European Pediatric Renal Transplant Initiative registry data.

Background: There are several databases across the world that collect pediatric KT data. We compare the hospitalization outcomes for pediatric KT recipients from a large Canadian transplant center (SickKids database; The Hospital for Sick Children Kidney Transplantation Institutional Database), United States (NAPRTCS), and Europe (CERTAIN registry).

Methods: An institutional retrospective review of KT was performed between 2000 and 2015.

Impact of native nephrectomy on hypertension outcomes in pediatric kidney transplant recipients: a 10-year institutional experience.

Objective: To assess the role native nephrectomy (NN) in hypertension-related outcomes for pediatric patients undergoing renal transplantation (RT).

Methods: Renal transplants (RT) performed at our institution between 2006 and 2015 were reviewed. RT recipients who underwent NN were compared to those who did not.

Randomized trial of prophylactic antibiotics vs. placebo after midshaft-to-distal hypospadias repair: the PROPHY Study.

Background: Use of prophylactic antibiotics after stented hypospadias repair is very common, but most research has not identified any clinical benefits of this practice. Only one study has found that postoperative prophylaxis reduces symptomatic urinary tract infections (UTIs). Data from the same trial suggested that prophylaxis may also reduce urethroplasty complications.

Omental Procedures During Peritoneal Dialysis Insertion: A Systematic Review and Meta-Analysis.

Objectives: Peritoneal dialysis (PD) is an option for ultrafiltration for patients with end-stage renal disease. Once placed, PD catheters may malfunction often due to omental wrapping. Omental procedures such as omentectomy and omentopexy may reduce this risk.