Sonographically Determined Fecal Width: An Objective Indicator of Management of Bladder and Bowel Dysfunction in Children.

Objective: To test whether sonographically determined fecal width (SDFW) correlates with symptom improvement in a population of children with bladder and bowel dysfunction (BBD) managed with standard urotherapy (SU), even for those patients lacking initial bowel complaints.

Methods: We retrospectively analyzed 200 pediatric BBD patients managed with SU for at least 3 months. Self-reported symptom improvement (complete, partial, no response) following International Children's Continence Society guidelines was tabulated.

Dermoid Cyst in a Multicystic Dysplastic Kidney: A Case Report and Literature Review.

Most multicystic dysplastic kidneys (MCDKs) are discovered prenatally. There is no consensus regarding initial workup and appropriate follow-up. We present a 9-year-old female who was fetally diagnosed with a MCDK and without follow-up returned with an 18-cm multicystic mass.

En Bloc Retroperitoneoscopic Removal of Horseshoe Kidney for End-stage Renal Disease.

Horseshoe kidney (HSK) is the most common renal fusion anomaly. There have been reports of an association of HSKs with medical renal disease. We report a case of a child with nephrotic-range proteinuria and a HSK.

Randomized, double-blind, placebo-controlled trial of polyethylene glycol (MiraLAX®) for urinary urge symptoms.

Objective: Polyethylene glycol (PEG) is common first-line therapy for urinary symptoms despite minimal evidence-based support. We performed a randomized, double-blind, placebo-controlled study of PEG for initial treatment of overactive bladder (OAB) symptoms in children.

Patients And Methods: Patients aged >3 years underwent baseline urinary symptom questionnaire (USQ, scored 0-16), bowel symptom questionnaire (scored 0-20) and abdominal X-ray (KUB).

Outpatient 'mini' percutaneous cystolithotomy following complex lower urinary tract reconstruction.

Purpose: To present our initial experience with "mini" percutaneous cystolithotomy performed as an outpatient procedure in patients with neurogenic bladders.

Materials & Methods: Over the last 6 years, patients with neurogenic bladders and bladder calculi were managed with outpatient percutaneous cystolithotomy. All but 1 had previously undergone appendicovesicostomy (APV) creation.

Nephrectomy for hypertension in pediatric patients with a unilateral poorly functioning kidney: a contemporary cohort.

Purpose: A unilateral poorly or non-functioning kidney is a cause of hypertension in children. We report the outcomes of pediatric patients with unilateral renal parenchymal disease who underwent nephrectomy for hypertension.

Materials And Methods: Consecutive hypertensive children undergoing nephrectomy with a unilateral poorly or non-functioning kidney were retrospectively reviewed; preoperative and postoperative clinical variables were analyzed.

Pediatric testicular torsion: demographics of national orchiopexy versus orchiectomy rates.

Purpose: While the timely diagnosis and management of pediatric torsion can lead to testicular salvage, limited data exist on rates of orchiopexy vs orchiectomy and associated factors. Thus, we examined the Pediatric Health Information System database for torsion outcomes and demographics at American pediatric hospitals.

Materials And Methods: Using the Pediatric Health Information System database we performed a 7-year retrospective cohort study in children 1 to 17 years old with a primary ICD-9 diagnosis of torsion, assessing CPT codes for orchiopexy and orchiectomy.

Wilms tumor: preoperative risk factors identified for intraoperative tumor spill.

Purpose: We identified preoperative parameters associated with increased risk of intraoperative Wilms tumor spill.

Materials And Methods: We retrospectively reviewed an institutional database of patients diagnosed with Wilms tumor between 2000 and 2008. Inclusion criteria consisted of available abdominal computerized tomogram and pathological stage I to IV disease.

Comparison of bladder outlet procedures without augmentation in children with neurogenic incontinence.

Purpose: We compared continence results of the bladder neck sling vs the Leadbetter-Mitchell bladder neck procedure plus fascial sling in children with neurogenic urinary incontinence.

Materials And Methods: We compared consecutive patients who received a 360-degree tight bladder neck sling to subsequent, similar patients who underwent a Leadbetter-Mitchell bladder neck procedure plus fascial sling involving a 50% reduction in bladder neck and proximal urethral diameter before a 360-degree tight sling. All patients underwent simultaneous appendicovesicostomy and none had undergone prior or simultaneous augmentation.

Loss of Insl3: a potential predisposing factor for testicular torsion.

Purpose: The testicular hormone Insl3 is critical for mouse gubernacular development. Knockout mice exhibit bilateral intra-abdominal cryptorchidism with absent gubernaculum. Prior studies described torsion of the vas deferens in Insl3 mutant mice.

Detrusor compliance changes after bladder neck sling without augmentation in children with neurogenic urinary incontinence.

Purpose: We reviewed preoperative, and initial and final postoperative urodynamic testing in consecutive children undergoing bladder neck sling without augmentation for neurogenic urinary incontinence to determine if progressive loss of compliance occurs.

Materials And Methods: We assessed consecutive patients with neurogenic outlet incompetence who underwent 360-degree tight fascial wrap around the bladder neck with appendicovesicostomy but no augmentation. This population comprised all patients undergoing outlet surgery between 2002 and 2007.

Cold knife valvulotomy for posterior urethral valves using novel optical urethrotome.

Objectives: To present our results after valve ablation using a novel cold knife urethrotome.

Methods: Eleven consecutive male patients with posterior urethral valves underwent cold knife valvulotomy using a modified optical pediatric urethrotome. Patients were assessed both pre- and postoperatively using serum creatinine, voiding cystourethrography, and renal/bladder ultrasonography.

Testicular infarction in a 12-year-old boy with Wegener's granulomatosis.

We present the case of a 12-year-old boy with testicular infarction secondary to Wegener's granulomatosis. Scrotal exploration revealed no evidence of testicular torsion. The testis was left in place, and, after systemic therapy, partial reperfusion was present.

Resorbable extracellular matrix grafts in urologic reconstruction.

Purpose: There is an increasingly large body of literature concerning tissue-engineering products that may be used in urology. Some of these are quite complex (such as multilayer patient-specific cell-seeded implants) yet the most simple and successful products to date are also the most uncomplicated: resorbable acellular extra-cellular matrices (ECMs) harvested from animals. ECMs have been used in a variety of difficult urologic reconstruction problems, and this review is intended to summarize this complex literature for the practicing urologist.