Long-term Urological Outcomes in Pelvic Genitourinary Rhabdomyosarcoma: A 48-Year Single-center Experience.

Purpose: Multimodal therapy has improved survival in genitourinary rhabdomyosarcoma, a rare pediatric cancer. However, little is reported regarding postoperative complications and long-term urinary and sexual function and quality of life.

Materials And Methods: We reviewed records from 1970-2018 to identify patients with genitourinary rhabdomyosarcoma of the bladder, prostate, pelvis, vagina, and uterus.

The duplicated collecting system of the urinary tract: embryology, imaging appearances and clinical considerations.

Duplication anomalies of the urinary collecting system are common and can be discovered and characterized with multiple imaging modalities. The embryology, imaging manifestations and clinical ramifications of duplicated ureters and renal collecting systems vary from a normal anatomical variant to urological pathology and are discussed and illustrated in this review.

Management of Proximal Hypospadias with 2-Stage Repair: 20-Year Experience.

Purpose: We describe our experience with 2-stage proximal hypospadias repair. We report outcomes, and patient and procedure characteristics associated with surgical complications.

Materials And Methods: We retrospectively studied patients with proximal hypospadias who underwent staged repair between January 1993 and December 2012.

Use of buccal mucosa grafts for urethral reconstruction in children: a retrospective cohort study.

Background: The use of buccal mucosa grafts (BMG) for urethral reconstruction has increased in popularity over the last several decades. Our aim was to describe our institutional experience with and outcomes after BMG urethroplasty.

Methods: We conducted a retrospective cohort study of boys undergoing BMG urethral reconstruction.

New contralateral vesicoureteral reflux after unilateral ureteral reimplantation: predictive factors and clinical outcomes.

Purpose: Although unilateral ureteral reimplantation for vesicoureteral reflux is highly successful, new contralateral reflux will develop postoperatively in some patients. We examined predictors and clinical outcomes of postoperative contralateral vesicoureteral reflux.

Materials And Methods: We reviewed patients who underwent nontapered unilateral reimplantation for primary vesicoureteral reflux graded on a 3-point scale at our institution from January 1990 to December 2002, and identified those with subsequent contralateral vesicoureteral reflux.

B7-h1 as a biomarker for therapy failure in patients with favorable histology Wilms tumor.

Purpose: A minority of children with Wilms tumor will experience tumor recurrence. In a previous pilot study we found an association between expression of an immune costimulatory molecule, B7-H1, and tumor recurrence in favorable histology Wilms tumor. We sought to verify the prognostic value of B7-H1 as a biomarker in favorable histology Wilms tumor.

Development and initial validation of a scoring system to diagnose testicular torsion in children.

Purpose: Testicular torsion is a surgical emergency requiring prompt intervention. Although clinical diagnosis is recommended, scrotal ultrasound is frequently ordered, delaying treatment. We created a scoring system to diagnose testicular torsion, decreasing the indication for ultrasound.

Postnatal longitudinal evaluation of children diagnosed with prenatal hydronephrosis: insights in natural history and referral pattern.

Objectives: Clinical significance and management of prenatal hydronephrosis (PNH) are sources of debate. Existing studies are flawed with biased cohorts or inconsistent follow-up. We aimed to evaluate the incidence of pathology in a large cohort of PNH and assess the biases and outcomes of this population.

Variations in management of mild prenatal hydronephrosis among maternal-fetal medicine obstetricians, and pediatric urologists and radiologists.

Purpose: There are no current guidelines for diagnosing and managing mild prenatal hydronephrosis. Variations in physician approach make it difficult to analyze outcomes and establish optimal management. We determined the variability of diagnostic approach and management regarding prenatal hydronephrosis among maternal-fetal medicine obstetricians, pediatric urologists and pediatric radiologists.

A novel method of evaluating ureteropelvic junction obstruction: dynamic near infrared fluorescence imaging compared to standard modalities to assess urinary obstruction in a swine model.

Purpose: Dynamic near infrared fluorescence imaging of the urinary tract provides a promising way to diagnose ureteropelvic junction obstruction. Initial studies demonstrated the ability to visualize urine flow and peristalsis in great detail. We analyzed the efficacy of near infrared imaging in evaluating ureteropelvic junction obstruction, renal involvement and the anatomical detail provided compared to conventional imaging modalities.

Protective locus against renal scarring on chromosome 11 in affected sib pairs with familial vesicoureteral reflux identified by single nucleotide polymorphism linkage analysis.

Purpose: We identified the loci associated with renal scarring risk and protection in affected sib pairs with familial vesicoureteral reflux.

Materials And Methods: A genome-wide analysis of vesicoureteral reflux with high density single nucleotide polymorphisms was conducted in 43 families with 2 or more affected children. A total of 43 probands and 58 affected siblings were included in the analysis.

Clinical outcomes and long-term resolution in patients with persistent vesicoureteral reflux after open ureteral reimplantation.

Purpose: Success rates of ureteral reimplantation for primary vesicoureteral reflux are high. Few studies document the natural history of children with persistent vesicoureteral reflux. We reviewed their clinical outcomes and long-term resolution.

Development and initial validation of a disease specific quality of life survey for children with vesicoureteral reflux.

Purpose: Vesicoureteral reflux is believed to be a largely asymptomatic condition. However, previous studies have failed to assess the precise impact of vesicoureteral reflux on quality of life. We created and validated a survey for assessment of quality of life in children with vesicoureteral reflux.

A comparative direct cost analysis of pediatric urologic robot-assisted laparoscopic surgery versus open surgery: could robot-assisted surgery be less expensive?

Background And Purpose: Cost in healthcare is an increasing and justifiable concern that impacts decisions about the introduction of new devices such as the da Vinci(®) surgical robot. Because equipment expenses represent only a portion of overall medical costs, we set out to make more specific cost comparisons between open and robot-assisted laparoscopic surgery.

Materials And Methods: We performed a retrospective, observational, matched cohort study of 146 pediatric patients undergoing either open or robot-assisted laparoscopic urologic surgery from October 2004 to September 2009 at a single institution.

Vesicoureteral reflux: current trends in diagnosis, screening, and treatment.

Context: Vesicoureteral reflux (VUR) is present in approximately 1% of children in North America and Europe and is associated with an increased risk of pyelonephritis and renal scarring. Despite its prevalence and potential morbidity, however, many aspects of VUR management are controversial.

Objective: Review the evidence surrounding current controversies in VUR diagnosis, screening, and treatment.

Long-term incidence of urinary tract infection after ureteral reimplantation for primary vesicoureteral reflux.

Objective: To determine the incidence of urinary tract infection (UTI) after ureteral reimplantation (UR) for primary vesicoureteral reflux (VUR).

Materials And Methods: In this retrospective review, the pyelonephritis-free survival of patients with primary VUR who underwent open UR from January 1990 to December 2002 was assessed using a Cox proportional hazards analysis.

Results: 1076 patients underwent open UR for primary VUR.

Durability of antireflux effect of ureteral reimplantation for primary vesicoureteral reflux: findings on long-term cystography.

Objective: To evaluate the long-term durability of successful ureteral reimplantation (UR) for vesicoureteral reflux (VUR) through a review of late cystography (LC) findings.

Materials And Methods: We performed a retrospective chart review of all children with primary VUR who underwent successful open UR (grade 0 VUR into the reimplanted ureter[s] on initial cystogram) at our institution from January 1990 to December 2002. We identified successful UR patients who underwent LC ≥ 1 year after UR and reviewed the results for the presence of recurrent VUR into the reimplanted ureter(s).

Hydronephrosis following ureteral reimplantation: when is it concerning?

Objectives: Hydronephrosis without obstruction is common prior to ureteral reimplant, especially in patients with high-grade VUR. Consequently, when hydronephrosis is present post-operatively, it is unclear when it should be concerning. We evaluated the finding of hydronephrosis in children undergoing reimplantation and its evolution following surgery.

Development and implementation of a photographic atlas for parental instruction and guidance after outpatient penile surgery.

Objective: To develop and evaluate a visual tool to assist parents in assessing healing after surgical circumcision or revision circumcision (SCRC).

Methods: Among children undergoing SCRC, photographs were taken on postoperative days 0-1-2-3-5-7-10-14-21, and compiled into an atlas. Atlas utility was assessed during two 1-month periods.

Robot-assisted laparoscopic excision of symptomatic retrovesical cysts in boys and young adults.

Purpose: We review our surgical experience with the management of retrovesical cystic anomalies using robot-assisted laparoscopic techniques.

Materials And Methods: We retrospectively reviewed the presentation, diagnosis and treatment of 6 patients 28 months to 22 years old with retrovesical cystic anomalies who underwent robot-assisted laparoscopic excision at our hospital between January 2006 and November 2010.

Results: Presenting signs and symptoms included urinary retention, lower urinary tract symptoms, abdominal pain and repeated epididymitis.

Genome gender diversity in affected sib-pairs with familial vesico-ureteric reflux identified by single nucleotide polymorphism linkage analysis.

Unlabelled: Study Type - Aetiology (case series) Level of Evidence 4 What's known on the subject? and What does the study add? Genetic linkage to distinguish loci for VUR has been previously described in several autosomal chromosomes. Although there are numerous explanations for the dissimilar findings, e.g.

Gender assignment for newborns with 46XY cloacal exstrophy: a 6-year followup survey of pediatric urologists.

Purpose: Gender assignment for newborns with ambiguous genitalia remains a challenge. An initial survey of colleagues on this subject was performed in 2004. Our objective was to understand the basis for the attitudes and practices of pediatric urologists in regard to gender assignment for 46XY cloacal exstrophy in a 6-year followup survey.

Analysis of indications for ureteral reimplantation in 3738 children with vesicoureteral reflux: a single institutional cohort.

Purpose: No method exists for predicting which child with vesicoureteral reflux (VUR) will have surgery. Our goals were to analyze practice patterns at a major pediatric center and to identify factors predisposing children to surgery for specific indications.

Materials And Methods: We analyzed a cohort of 3738 children presenting with primary VUR (1996-2005).

Bladder neck reconstruction is often necessary after complete primary repair of exstrophy.

Purpose: A major goal of bladder exstrophy management is urinary continence, often using bladder neck reconstruction. We report our experience with bladder neck reconstruction after complete primary repair of exstrophy.

Materials And Methods: Patient history, ultrasound, voiding cystourethrogram, examination using anesthesia and urodynamics were performed during a prospective evaluation.

Quality of life in children with vesicoureteral reflux as perceived by children and parents.

Purpose: Significant research has been dedicated to the management of vesicoureteral reflux (VUR). However, few studies have been published to evaluate the impact of this disease on quality of life. The aim of this study was a prospective examination of the health-related quality of life (HRQoL) in children with VUR who have either been treated medically (antibiotics or surveillance) or by ureteral reimplant (UR) using a validated patient satisfaction survey.