Zinner syndrome with contralateral hydronephrosis: A rare congenital condition.

Zinner Syndrome (ZS) is a rare congenital genitourinary abnormality defined by seminal vesicle cysts, ejaculatory duct obstruction, and unilateral renal dysplasia or agenesis. Patients can be asymptomatic, while others experience pain, urinary or ejaculatory symptoms and infertility. A patient that presented with painless gross hematuria was found to have a large pelvic cystic structure, an absent left kidney, multiple fluid collections in the region of the left seminal vesicle and right hydronephrosis.

Clostridium difficile: What is the risk?

Introduction: Clostridium difficile infections (CDIs) are rising among pediatric patients in the community and hospital setting. Children undergoing transplants and bowel surgery are at a higher risk, while renal surgery has a lower risk. We hypothesize children undergoing pediatric urologic procedures are uncommonly diagnosed with postoperative CDI.

Syndromic Wilms tumor: a review of predisposing conditions, surveillance and treatment.

Predisposing syndromes associated with an increased risk of Wilms tumor (WT) are responsible for 9-17% of all cases of the malignancy. Due to an earlier age at WT diagnosis and an increased incidence of bilateral and metachronous disease, management of syndromic WT warrants a distinct approach from that of non-syndromic WT. This review of English-language manuscripts about WT focuses on the most common syndromes, surveillance protocols and current treatment strategies.

Do current scientific reports of hydronephrosis make the grade?

Background: In December 2014, Nguyen et al. introduced the Upper Tract Dilation (UTD) classification scheme, hoping to unify multiple disciplines when describing ultrasound imaging of congenital hydronephrosis. We hypothesized that the academic community has been slow to adopt its use in publications.

Using a Decision Tree to Guide Bowel Management in Spina Bifida.

Background: When born with spina bifida, there are numerous neurologic disorders that accompany this birth defect, including neurogenic bowel. Proactive, systematic, and rational approaches can lead to continence and a more functional lifestyle [1].

Methods: Based on the evidence in the literature and expert experience, our approach to bowel management was developed as a step by step, individualized approach.

Workplace Bullying of Urology Residents: Implications for the Patient and Provider.

Objective: To elucidate whether urology residents in the United States feel bullied by nurses, how respected they feel at work, and whether this impacts personal and patient care.

Methods: We distributed an Institutional Review Board-approved online, validated, revised Negative Acts Questionnaire to US urology residents in their first year or above. We evaluated bullying through scoring work (total range 5-25), person (total range 9-45), and physical intimidation (total range 3-15) related bullying domains.

Differences in early career operative experiences among pediatric urologists.

Introduction: Previous research suggests that pediatric urologists feel well trained by their fellowship for cases encountered early in their career. We questioned the complexity and diversity of cases new pediatric urologists were actually performing.

Objective: The aim was to identify the frequency with which newly trained pediatric urologists are performing various procedures, investigate which factors are associated with case complexity and diversity, and evaluate for differences between male and female surgeons.

Bladder Management and Continence Outcomes in Adults with Spina Bifida: Results from the National Spina Bifida Patient Registry, 2009 to 2015.

Purpose: Most children with spina bifida now survive into adulthood, although most have neuropathic bladder with potential complications of incontinence, infection, renal damage and diminished quality of life. In this study we sought to 1) describe contemporary bladder management and continence outcomes of adults with spina bifida, 2) describe differences from younger individuals and 3) assess for association with socioeconomic factors.

Materials And Methods: We analyzed data on bladder management and outcomes in adults with spina bifida from the National Spina Bifida Patient Registry.

Bowel management and continence in adults with spina bifida: Results from the National Spina Bifida Patient Registry 2009-15.

Introduction: Advances in care have allowed most children with spina bifida (SB) to live to adulthood. The majority have neuropathic bowel dysfunction (NBD), resulting in constipation, incontinence, and diminished quality of life. We sought to 1) describe contemporary NBD management and continence outcomes of adults with SB; 2) describe differences from younger patients; and 3) assess for association with socio-economic factors.

Transitional Urology for Male Adolescents: What Adult Urologists Should Know.

In recent years, there has been increasing interest in transitional urology, or how to best prepare patients with major congenital urologic diseases, such as bladder exstrophy and neuropathic bladder, to manage their own health care with adult urologists. However, common pediatric urologic conditions may be encountered by the adult urologist with more regularity. This review focuses on three relatively common conditions which may be identified in childhood, the consequences from which a patient may seek help from an adult urologist: cryptorchidism, varicocele, and Klinefelter syndrome.

Treatment patterns, testicular loss and disparities in inpatient surgical management of testicular torsion in boys: a population-based study 1998-2010.

Objectives: To examine temporal trends in inpatient testicular torsion (TT) treatment and testicular loss (TL), and to identify risk factors for TL using a large nationally representative paediatric cohort, stratified to established high prevalence TT cohorts (neonatal TT [NTT]; age <1 years) and adolescent TT (ATT; age 12-17 years).

Methods: Boys (age ≤17 years, n = 17 478) undergoing surgical exploration for TT were identified within the Nationwide Inpatient Sample (1998-2010). Temporal trends in inpatient TT management (salvage surgery vs orchiectomy) and TL were examined using estimated annual percent change methodology.

Complexities of Müllerian Anatomy in 46XX Cloacal Exstrophy Patients.

Study Objective: To characterize Müllerian anatomy in 46,XX cloacal exstrophy patients.

Design: Retrospective review of prospectively maintained, institutionally approved exstrophy-epispadias-cloacal exstrophy database.

Setting: Tertiary care, high-volume exstrophy center (Division of Pediatric Urology, The Johns Hopkins Hospital, Baltimore, Maryland).

Presentation of a Clitoral Mass in a Prepubescent Female: A Case Report and Discussion of the Evaluation.

Clitoral masses are rare. We present a case report of a prepubescent female with a periclitoral mass.

Practice patterns and outcomes of pediatric partial nephrectomy in the United States: Comparison between pediatric urology and general pediatric surgery.

Background: In the United States, both pediatric urologists (PUROs) and general pediatric surgeons (GPSs) perform nephrectomies in children, with PUROs performing more nephrectomies overall, most commonly for benign causes. GPSs perform more nephrectomies for malignant causes. We questioned whether the same trends persisted for partial nephrectomy.

National practice patterns and outcomes of pediatric nephrectomy: comparison between urology and general surgery.

Purpose: In adults nephrectomy is under the purview of urologists, but pediatric urologists and pediatric general surgeons perform extirpative renal surgery in children. We compared the contemporary performance and outcome of all-cause nephrectomy at pediatric hospitals as performed by pediatric urologists and pediatric general surgeons.

Materials And Methods: We queried the Pediatric Health Information System to identify patients 0 to 18 years old who were treated with nephrectomy between 2004 and 2013 by pediatric urologists and pediatric general surgeons.

Intracranial anomalies and cloacal exstrophy--is there a role for screening?

Background/purpose: Cloacal exstrophy (CE) is a severe multi-system congenital defect. While spina bifida is a defining feature of cloacal exstrophy, patients are not routinely screened for intracranial anomalies (ICAs). We sought to better characterize this risk of ICA in the CE patient.

Evaluation of children with urinary tract infection--impact of the 2011 AAP guidelines on the diagnosis of vesicoureteral reflux using a historical series.

Objective: To clarify the impact of the updated American Academy of Pediatrics guidelines for the evaluation of children presenting with initial febrile urinary tract infection (UTI) on the diagnosis of vesicoureteral reflux (VUR) in children with normal renal sonograms.

Materials And Methods: Children with VUR followed between 2002 and 2004 were evaluated using criteria specified in the AAP guidelines. A total of 49 children (42 girls) who were 2-24 months of age at diagnosis of VUR made following initial febrile UTI were included.

The fate of the complete female epispadias and exstrophy bladder--is there a difference?

Purpose: Complete female epispadias, which occurs much more rarely than classic bladder exstrophy in females, is thought to have a more benign clinical course. We hypothesized that patients with complete female epispadias are more likely to have a larger bladder capacity and achieve voiding continence than females with classic bladder exstrophy.

Materials And Methods: After obtaining institutional review board approval, females with complete female epispadias or classic bladder exstrophy were identified from an institutionally approved prospective database.