Parenchymal echo texture predicts testicular salvage after torsion: potential impact on the need for emergent exploration.

Purpose: In the setting of signs and symptoms of testicular torsion the absence of diastolic flow and/or color flow on Doppler ultrasound has traditionally prompted emergent scrotal exploration. This practice emanates largely from the difficulty on ultrasound of distinguishing salvageable torsed testes from those that are not salvageable. We identified ultrasound findings predictive of testicular viability or the lack thereof.

Neonatal torsion: a 14-year experience and proposed algorithm for management.

Purpose: Management of neonatal torsion is controversial, since the likelihood of testicular salvage and metachronous contralateral torsion must be weighed against the risk of neonatal anesthesia. We reviewed a large series of such cases and stratified neonatal torsion based on time of presentation to determine the potential for testicular salvage. To our knowledge this is the largest series of its kind in the literature.

Lymphatic-sparing laparoscopic varicocelectomy versus microscopic varicocelectomy: is there a difference?

Objectives: The ideal operation for the adolescent varicoceles has been debated for many years as new techniques or advances in existing technology develop. It is well acknowledged that the Palomo procedure has a negligible recurrence rate but a very high postoperative hydrocele rate compared with a microscopic varicocelectomy (MV). We sought to determine whether lymphatic-sparing laparoscopic varicocelectomy (LSLV) could provide similar negligible recurrence rates as the Palomo approach with the negligible postoperative hydrocele rate seen with MV.

Endoscopic injection of bulking agents in children with incontinence: dextranomer/hyaluronic acid copolymer versus polytetrafluoroethylene.

Purpose: Treating pediatric incontinence can be challenging. Many surgical procedures are available with variable success and complications. Endoscopic injection of bulking agents into an incompetent bladder neck was first described using Teflon and most currently using Deflux.

Bladder function associated with posterior urethral valves after primary valve ablation or proximal urinary diversion in children and adolescents.

Purpose: We retrospectively reviewed 2 series of patients with posterior urethral valves treated initially with valve ablation preceded by bilateral cutaneous ureterostomies or valve ablation alone to evaluate and compare bladder function behavior of each treatment group.

Materials And Methods: From 1970 to 1983, 19 males 22 days to 21 months old with posterior urethral valves were treated with 1 of 2 initial surgical approaches, including upper tract diversion, delayed undiversion and ablation in 11 (group 1), and primary valve ablation only in 8 (group 2). Median patient age at the time of cutaneous urinary diversion and primary valve ablation for groups 1 and 2 was 7 and 9 months, respectively.

The "long Snodgrass": applying the tubularized incised plate urethroplasty to penoscrotal hypospadias in 1-stage or 2-stage repairs.

Purpose: The technique of tubularized incised plate urethroplasty (Snodgrass modification) has gained wide acceptance for hypospadias repair. The reported experience with this surgical modification has been primarily in cases of distal hypospadias. We applied this technique to cases of penoscrotal hypospadias and incised the urethral plate for its entire distance.

Biofeedback therapy expedites the resolution of reflux in older children.

Purpose: In older children the spontaneous resolution rate of low grade vesicoureteral reflux is low and currently its management is controversial in regard to surgery versus prophylaxis versus observation alone. Bladder dysfunction in children with neurogenic bladders and to a less declarative degree in neurologically intact children has a role in the etiology or persistence of reflux. We determine the impact of biofeedback therapy on neurologically intact children with vesicoureteral reflux and detrusor-sphincter dyssynergia.