Comparative study of open and robot-assisted approaches to ureteropelvic junction obstruction in children ≤ 12 months: A multi-institutional retrospective analysis.

Background: The utilization of robot-assisted laparoscopic pyeloplasty (RALP) for the surgical correction of ureteropelvic junction obstruction (UPJO) continues to increase. The aim of this study was to determine whether robot-assisted laparoscopic pyeloplasty (RALP) is a safe and equally efficacious procedure compared to open pyeloplasty (OP) in infants ≤12 months old.

Methods: All patients ≤12 months old who underwent RALP or OP between January 2012 and January 2021 at five participating centers were included in this study.

Does incontinence in a child with bladder exstrophy negatively affect caregivers? A mental health inventory survey.

Introduction: Urinary continence is a goal of bladder exstrophy epispadias complex (BEEC) surgical management. However, it is often not achieved until school age or later. Little is known about the mental health implications of this incontinence on caregivers and whether this should affect timing of surgical interventions to achieve continence.

Ureteroureterostomy as Definitive Intervention for Duplex Anomalies: A Mid-Term Analysis.

Objective: To provide a mid-term evaluation-defined as 3 to 10 years of post-operative follow up-of children with duplicated collecting systems undergoing ureteroureterostomy. In addition, a sub stratified analysis based on surgical approach is delivered to compare outcomes between the two approaches.

Materials And Methods: An IRB-approved single-institutional registry was retrospectively reviewed to identify all patients undergoing ureteroureterostomy (UU) for duplex renal anomalies between 2014 and 2020.

Comparison of open and robot-assisted repair for ureteropelvic junction obstruction: Outcomes and direct costs from a single-institution.

Introduction: Robot-assisted laparoscopic pyeloplasty (RALP) is commonly performed to repair ureteropelvic junction obstruction (UPJO), but concerns remain regarding its efficacy and safety, as well as its cost compared to open pyeloplasty (OP). We hypothesized that primary RALP is equally efficacious to OP, with comparable direct costs.

Methods: An IRB-approved single institutional registry was retrospectively reviewed to identify all patients undergoing primary OP and RALP between July 2012 and March 2020.

Genetic analysis of two bladder exstrophy populations of South Asian and North American origin.

Introduction: Bladder exstrophy-epispadias complex (BEEC) is a devastating congenital anomaly of the urinary tract and is associated with an increased risk of bladder cancer. The etiology of the BEEC is unknown, but a clear genetic component has been highlighted. Currently, all genetic studies suffer from small populations, limited to a European background.

Management of urachal anomalies in children: insights from a retrospective cohort study.

Introduction: While large and symptomatic urachal anomalies (UAs) often lead to surgical excision, urachal malignancy is rare, rendering prophylactic excision unwarranted. We hypothesize that in the pediatric population, the presentation of an infected UA is the predominant etiology leading to surgical intervention.

Methods: We retrospectively identified patients with UA from July 2012 to December 2021 evaluated in our urology outpatient.

Pediatric Robotic Assisted Laparoscopic Pyeloplasty.

Ureteropelvic junction obstruction (UPJO) is a common cause of hydronephrosis in the pediatric population. Management with an open dismembered pyeloplasty was first described by Anderson-Hynes in 1949; minimally invasive approaches have been increasingly utilized. In the subsequent text and accompanying video, we review the technique for dismembered robotic assisted laparoscopic pyeloplasty in the pediatric population.

Comparative Analysis of Efficacy and Complications of Robot-Assisted Open Dismembered Ureteral Reimplantation for Primary Obstructive Megaureter.

Dismembered ureteral reimplant (DUR) is done to treat primary obstructive megaureter (POM). To describe and compare outcomes between open dismembered ureteral reimplant (ODUR) robot-assisted laparoscopic dismembered ureteral reimplant (RALDUR). An IRB-approved registry was used to retrospectively identify all patients who underwent DUR for POM between 2015 and 2022.

Is robot-assisted appendicovesicostomy equivalent to the current gold standard open procedure? A comparative analysis.

Introduction: Robot-assisted Laparoscopic Appendicovesicostomy (RALAPV) is increasingly performed as a minimally invasive alternative to the open appendicovesicostomy (OPAV), but questions remain regarding the efficacy of the RALAPV compared to OPAV.

Objective: To assess and compare outcomes for non-augmented RALAPV to the open surgical approach.

Materials And Methods: An IRB approved prospective registry was retrospectively examined to abstract all patients who underwent APV without augment between 2012 and 2023.

The missed crossing vessel during open pyeloplasty: a potential advantage of the robot-assisted approach in children.

Objective: To investigate whether the panoramic view offered by robot-assisted laparoscopic pyeloplasty (RALP) reduces the likelihood of missing a crossing vessel compared to open pyeloplasty in cases where initial pyeloplasty fails.

Methods: A single institution redo-pyeloplasty database was reviewed for children treated between January 2012 to July 2023. Clinical history, imaging and operative details were reviewed to identify the etiology for the redo procedure.

Multi-Institutional Bladder Exstrophy Consortium After 8 Years: The Short- and Intermediate-Term Outcomes.

Purpose: Bladder exstrophy (BE) poses challenges both during the surgical repair and throughout follow-up. In 2013, a multi-institutional BE consortium was initiated, which included utilization of unified surgical principles for the complete primary repair of exstrophy (CPRE), real-time coaching, ongoing video capture and review of video footage, prospective data collection, and routine patient data analysis, with the goal of optimizing the surgical procedure to minimize devastating complications such as glans ischemia and bladder dehiscence while maximizing the rate of volitional voiding with continence and long-term protection of the upper tracts. This study reports on our short-term complications and intermediate-term continence outcomes.

Caudal anesthesia is not associated with post-operative complications following distal hypospadias repair.

Introduction: The use of caudal anesthesia at the time of hypospadias repair remains controversial as some prior studies have reported increased postoperative complication rates associated with caudal nerve block. However, these results have been called into question due to confounding factors and heterogeneous study groups.

Objective: Given the importance of identifying true risk factors associated with increased hypospadias complication rate, we examined our experience with caudal anesthesia limiting our analysis to distal repairs.

Caregiver distress: A mixed methods evaluation of the mental health burden of caring for children with bladder exstrophy.

Introduction: Caring for children with bladder exstrophy-epispadias complex (BEEC) exacts a long-term emotional toll on caregivers. Previous studies leave a gap in understanding the impact that caring for a child with BEEC has on caregivers in low- and middle-income countries (LMIC). We hypothesize that families and caregivers experience psychological distress that has long gone unaddressed.

Kidney function outcomes in patients after complete primary repair of bladder exstrophy and penopubic epispadias: Results from the international bladder exstrophy consortium.

Introduction: Historically, repair of bladder exstrophy (BE) is associated with compromise to the upper tracts; the single stage repair of BE was considered to exacerbate risks of kidney impairment.

Objective: We aim to evaluate the risk of upper urinary tract deterioration or chronic kidney disease after the complete primary repair of exstrophy (CPRE).

Study Design: As part of the U.

Repurposing tools: A peña stimulator as a tool to map the limits of dissection and continence zone during bladder exstrophy repair.

Introduction: The complete primary repair of bladder exstrophy (CPRE) aims to restore normal anatomy through complete mobilization and reapproximation of the bladder neck and proximal urethra.

Methods: The Peña stimulator has previously been used to identify musculature in the pelvis. The device is now used to distinguish intersymphyseal bands from pelvic floor and urethral sphincteric musculature during CPRE.