Bowel preparation prior to reconstructive urologic surgery in pediatric myelomeningocele patients.

Introduction: Mechanical bowel preparation (MBP) has historically been the standard of care for patients undergoing reconstructive urologic surgery, including urinary diversion. To date, several studies have examined the role of mechanical bowel preparation in postoperative outcomes in pediatric patients undergoing augmentation cystoplasty. However, these patient populations have been heterogeneous in nature, with no studies dedicated to examining the role of MBP prior to reconstructive urologic surgery in pediatric patients with myelomenginoceles.

The Role of Prophylactic Antibiotics After Minimally Invasive Pyeloplasty With Ureteral Stent Placement in Children.

Objective: To determine whether children discharged with prophylactic antibiotics following laparoscopic pyeloplasty with indwelling ureteral stent have a decrease risk of postoperative urinary tract infections (UTIs) compared to those discharged without antibiotics.

Materials And Methods: A retrospective review of all minimally invasive pyeloplasties performed at our institution from January 2009 to March 2015 was conducted. Patients were discharged home with or without daily prophylactic-dose antibiotics continued until 3 days after ureteral stent removal per surgeon preference.

Intraperitoneal Bladder Perforation and Life-threatening Renal Failure in a Neonate Following Circumcision With the Plastibell Device.

We present the case of an infant who suffered intraperitoneal bladder perforation secondary to routine neonatal circumcision with the Plastibell device. On day-of-life 5, the patient presented with abdominal distention, vomiting, diarrhea, and severe acute renal failure. After removal of a distal meatal obstruction caused by the Plastibell device and open repair of the bladder defect, the patient had an uneventful recovery with rapid return of renal function.

The Clavien-Dindo Classification of Surgical Complications is Not a Statistically Reliable System for Grading Morbidity in Pediatric Urology.

Purpose: Although the Clavien-Dindo classification of surgical complications has been evaluated using adult surgical patients, it is being applied to pediatric populations. We hypothesized that this instrument is not well suited to children and sought to determine the reliability of the tool in a pediatric urological population.

Materials And Methods: We replaced adult surgical cases in the "Survey to Assess Acceptability and Reproducibility of the Classification" from the original Clavien-Dindo study with pediatric urology cases and mimicked original study methods.

Calyceal diverticulum with a large extra-renal extension in a 5-year-old child.

Calyceal diverticula are rare findings in children, often identified due to symptomatic presentation. We present the unique case of an incidentally found calyceal diverticula in a 5-year-old girl with a large extra-renal component, which was successfully excised in a robot-assisted laparoscopic procedure that was without complication.

Multi-institutional review of outcomes of robot-assisted laparoscopic extravesical ureteral reimplantation.

Purpose: We performed a multi-institutional assessment of the outcomes and complications of robot-assisted laparoscopic extravesical ureteral reimplantation for vesicoureteral reflux in children.

Materials And Methods: We retrospectively reviewed the records of patients who underwent robot-assisted laparoscopic extravesical ureteral reimplantation as done by 1 of 5 surgeons at Children's Medical Center, Dallas, Texas, or Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania, from 2010 to 2013. Procedure failure was defined as persistent vesicoureteral reflux on postoperative voiding cystourethrogram or radionuclide cystogram and/or the need for reoperation.

Sacral neuromodulation for the dysfunctional elimination syndrome: a 10-year single-center experience with 105 consecutive children.

Objective: To evaluate our initial experience using sacral neuromodulation via implanted pulse generator as a treatment for children with dysfunctional elimination syndrome and symptoms refractory to maximum medical therapy.

Materials And Methods: There were 105 consecutive patients who underwent a 2-stage procedure with a trial period (n = 89) or a single procedure (n = 16) for device implantation. They were followed up prospectively for a median of 2.

Febrile urinary tract infections after ureteroneocystostomy and subureteral injection of dextranomer/hyaluronic acid for vesicoureteral reflux--do choice of procedure and success matter?

Purpose: Despite success rates favoring ureteroneocystostomy over subureteral injection of dextranomer/hyaluronic acid for correction of vesicoureteral reflux, the reported incidence of postoperative febrile urinary tract infection favors the latter. We evaluated contemporary treatment cohorts for an association between correction of vesicoureteral reflux and risk of postoperative febrile urinary tract infection.

Materials And Methods: We retrospectively reviewed the records of 396 consecutive patients who underwent ureteroneocystostomy or subureteral injection of dextranomer/hyaluronic acid between 1994 and 2008.

Normal penile, scrotal, and perineal anatomy with reconstructive considerations.

A broad overview is provided of the normal anatomy of the male genitalia to offer the best surgical outcomes in cases related to congenital abnormalities, trauma, cancer-related extirpation, and aesthetics. Neural and vascular anatomy is discussed in depth due to its critical role in maintaining function and in assuring tissue viability.

Temporal trends in incidence of kidney stones among children: a 25-year population based study.

Purpose: We conducted a population based pediatric study to determine the incidence of symptomatic kidney stones during a 25-year period and to identify factors related to variation in stone incidence during this period.

Materials And Methods: The Rochester Epidemiology Project was used to identify all patients younger than 18 years who were diagnosed with kidney stones in Olmsted County, Minnesota from 1984 to 2008. Medical records were reviewed to validate first time symptomatic stone formers with identification of age appropriate symptoms plus stone confirmation by imaging or passage.

Reconstruction of the penis after surgery.

This article describes penile reconstruction after surgery. Patient considerations in reconstruction, reconstruction of varied urethral defects, general principles of urethroplasty, surgical techniques of urethral reconstruction, reconstruction of scrotal and testicular defects, reconstruction of the penile shaft, and timing of reconstruction are discussed. The use of local pedicled flaps in penile reconstruction, distant free tissue transfer in penile reconstruction, varied forms of prostheses, management of complications following penile reconstruction, postoperative care in penile reconstruction patient, and penile transplantation are described.