Fetal cystoscopy (FC) and vesicoamniotic shunting (VAS) in lower urinary tract obstruction (LUTO): a meta-analysis of long-term outcome and current technical limitations.

Purpose: To compare obstetrical, survival, and nephro-urological outcomes of fetuses diagnosed with lower urinary tract obstruction (LUTO) undergoing antenatal procedures by vesicoamniotic shunting (VAS) or fetal cystoscopy (FC).

Methods: This study was a literature search using MEDLINE, Scopus, Embase, and Cochrane reference lists. All studies reporting VAS and FC's effectiveness, complications, and technical issues in the prenatal treatment of LUTO were selected for a single-proportion meta-analysis.

Comparison of Three Different Staging Systems Capable of Predicting the Severity of Congenital Lower Urinary Tract Obstruction (LUTO) and Its Prognosis.

Lower urinary tract obstruction (LUTO) is a rare but severe fetal condition associated with significant morbidity and long-term renal risk. Several prenatal staging systems have been proposed to guide management and predict outcomes, yet their comparative prognostic value remains uncertain. This review provides a structured evaluation of three staging systems currently used in clinical practice: those proposed by Ruano, Fontanella, and Nassr.

Delayed diagnosis of isolated congenital H-type tracheoesophageal fistula: a case report of surgical repair supported by TachoSil as an adjunct in chronically inflamed tissues.

Background: H-type tracheoesophageal fistulas (TEFs) are rare congenital malformations characterized by an abnormal connection between the trachea and esophagus in the absence of esophageal atresia. These lesions may remain undiagnosed for years due to subtle and non-specific symptoms, often resulting in chronic pulmonary complications. Delayed diagnosis can contribute to the development of long-standing inflammation and fibrosis, which significantly complicates surgical intervention.

Endoscopic Sleeve Gastroplasty: a Proposal for a Minimal Invasive Endoscopic Approach to Adolescent Obesity.

Adolescent obesity is a growing global health concern, often refractory to conventional interventions. While bariatric surgery remains the most effective treatment, its invasiveness and long-term implications limit its use in pediatric patients. Endoscopic sleeve gastroplasty (ESG) has recently emerged as a minimally invasive alternative.

Advancing Neuroblastoma Surgery through the Clinical Integration of Virtual Reality and Indocyanine Green Fluorescence-Guided Imaging: A Case Report.

Background: Neuroblastoma, the most common extracranial solid tumor in children, requires meticulous surgical interventions due to its complex anatomical location and proximity to vital structures. Emerging technologies, such as virtual reality (VR) and indocyanine green (ICG) fluorescence-guided imaging, offer promising solutions to enhance surgical precision and outcomes. Despite their potential, their use in pediatric oncology remains underexplored.

Ureteral clipping for managing persistent urinary dribbling caused by ectopic ureters associated with non-functioning renal moieties in girls with complex duplex kidneys: a narrative review of the literature.

Background And Objective: Persistent urinary dribbling in girls with duplex renal systems and ectopic ureters originating from poorly functioning renal moieties represents a complex clinical problem in pediatric urology. The incontinence associated with these anomalies is socially distressing and often refractory to conservative management. Traditional surgical options, including upper pole heminephrectomy or ureteroureterostomy, are effective but may be associated with significant operative morbidity, particularly when renal function is negligible and surgical access is challenging.

Urological Manifestation of Mpox Virus: A Scoping Review.

Background: Mpox primarily presents with systemic and cutaneous symptoms. However, it can also lead to urological complications, necessitating specialized attention. The aim of this scoping review is to summarize the current evidence regarding the urological manifestations of Mpox, possible complications, and available treatments.

Virtual Reality for Preoperative Planning and Education in Pediatric Surgery: Preliminary Results for the Treatment of Congenital Malformations and Tumors.

Purpose: Virtual reality (VR) has emerged as a valuable tool in surgical planning, offering detailed anatomical spatial orientation and three-dimensional (3D) navigation. This study explores using virtual reality head-mounted display (VR-HMD) technology in preoperative planning for pediatric surgery, aiming to improve outcomes in treating congenital malformations and tumors while advancing surgical education.

Methods: A retrospective analysis was performed on pediatric patients diagnosed with congenital malformations and tumors who received treatment between 2021 and 2024 at the "V.

Toilet training achievements in children born with posterior urethral valves.

Objective: Boys born with posterior urethral valves (PUV) often experience bladder development issues due to urethral obstruction during gestation. Despite early surgical intervention, bladder dysfunction can persist, leading to detrusor overactivity and vesical overdistension. Successful toilet training is key in managing bladder function and controlling intravesical and upper urinary tract pressures.

Artificial Intelligence in Fetal Growth Restriction Management: A Narrative Review.

This narrative review examines the integration of Artificial Intelligence (AI) in prenatal care, particularly in managing pregnancies complicated by Fetal Growth Restriction (FGR). AI provides a transformative approach to diagnosing and monitoring FGR by leveraging advanced machine-learning algorithms and extensive data analysis. Automated fetal biometry using AI has demonstrated significant precision in identifying fetal structures, while predictive models analyzing Doppler indices and maternal characteristics improve the reliability of adverse outcome predictions.

Urological injuries complicating pregnancy-related hysterectomy: Analysis of risk factors and proposal to improve the quality of care.

Purpose: While strategies aimed at preventing urological injuries complicating hysterectomy for gynaecological indications and placenta accreta surgery have been proposed, a comprehensive model for pregnancy-related hysterectomy (PRH) is lacking. The aim of this study was to investigate risk factors for urological complications of obstetric hysterectomy, and to propose strategies to improve the quality of care.

Methods: This retrospective study of patients undergoing PRH was conducted in an academic centre between 2009 and 2022.

Indications and Outcomes of Fetal Cystoscopy for Lower Urinary Tract Obstruction: A Comprehensive Review.

Fetal lower urinary tract obstruction (LUTO) encompasses a spectrum of rare congenital anomalies affecting the fetal urinary system, leading to significant morbidity and mortality. This condition, arising from various anatomical anomalies such as posterior urethral valves (PUV), urethral atresia, and cloacal malformations, disrupts normal urine flow, resulting in secondary complications such as pulmonary hypoplasia and renal impairment. Current management strategies, including fetal vesicoamniotic shunting (VAS) and fetal cystoscopy, aim to alleviate obstruction and mitigate associated risks.

Efficacy of core biopsies for diagnosing inflammatory myofibroblastic tumors in pediatric patients: case series from a single tertiary referral center.

Background: Inflammatory myofibroblastic tumors (IMTs) are rare, often non-metastasizing neoplasms characterized by fibro/myofibroblastic spindle cells with varying infiltrates of plasma cells, lymphocytes, and/or eosinophils. Despite their generally indolent nature, IMTs can exhibit locally aggressive behavior and a significant tendency for local recurrence, making complete surgical resection the standard treatment approach. Accurate diagnosis can be challenging due to the overlap in imaging features with more aggressive tumors, necessitating preoperative biopsies to enable differential diagnosis and guide treatment decisions.

Modeling a biofluid-derived extracellular vesicle surface signature to differentiate pediatric idiopathic nephrotic syndrome clinical subgroups.

Idiopathic Nephrotic Syndrome (INS) is a common childhood glomerular disease requiring intense immunosuppressive drug treatments. Prediction of treatment response and the occurrence of relapses remains challenging. Biofluid-derived extracellular vesicles (EVs) may serve as novel liquid biopsies for INS classification and monitoring.

Virtual Reality Head-Mounted Display (HMD) and Preoperative Patient-Specific Simulation: Impact on Decision-Making in Pediatric Urology: Preliminary Data.

Aim Of The Study: To assess how virtual reality (VR) patient-specific simulations can support decision-making processes and improve care in pediatric urology, ultimately improving patient outcomes.

Patients And Methods: Children diagnosed with urological conditions necessitating complex procedures were retrospectively reviewed and enrolled in the study. Patient-specific VR simulations were developed with medical imaging specialists and VR technology experts.

Comprehensive meta-analysis of surgical procedure for congenital diaphragmatic hernia: thoracoscopic versus open repair.

Purpose: Previous studies have shown a higher recurrence rate and longer operative times for thoracoscopic repair (TR) of congenital diaphragmatic hernia (CDH) compared to open repair (OR). An updated meta-analysis was conducted to re-evaluate the surgical outcomes of TR.

Methods: A comprehensive literature search comparing TR and OR in neonates was performed in accordance with the PRISMA statement (PROSPERO: CRD42020166588).

Efficacy of Three Different Injection Techniques for the Endoscopic Treatment of Vesicoureteral Reflux (VUR) in Children: A Review of 10 Years of Experience.

Aim: To review our 10 years of experience with the endoscopic treatment of vesicoureteral reflux (VUR) in children, emphasizing the long-term efficacy of the "combined STING-HIT" technique.

Materials And Methods: A retrospective study was performed including all children with symptomatic VUR undergoing the cystoscopic injection of bulking agents from January 2013 to December 2022 in our pediatric tertiary referral center. Three different endoscopic techniques were adopted: the "combined STING-HIT" technique, the STING technique, and the HIT technique.

Long-term psychosexual adjustment of adults born with classic bladder exstrophy.

Background: In literature studies exploring long-term psychosexual development and intimacy of adults living with the complex genitourinary conditions associated with classic bladder exstrophy (BE) are scarce, with small sample sizes and lacking in methodology.

Objective: This study aims to examine areas of potential psychosexual distress in adults born with classic BE to develop targeted clinical interventions.

Study Design: The validated Sexrelation Evaluation Schedule Assessment Monitoring (SESAMO) questionnaire was administered to all BE patients aged ≥18 years operated on in our tertiary referral center during infancy.

The "V-I penoscrotal reconfiguration": A simple technique for the surgical treatment of congenital webbed penis.

Objectives: To describe a new penoscrotal reconfiguration technique, named "V-I penoscrotal reconfiguration" for the surgical reconstruction of a congenital webbed penis (CWP).

Methods: Twenty-one patients who underwent the "V-I penoscrotal reconfiguration technique" were included in this retrospective study. The CWP severity was assessed according to El-Koutby's classification.

Antenatal Determinants of Postnatal Renal Function in Fetal Megacystis: A Systematic Review.

: To evaluate the clinical usefulness of demographic data, fetal imaging findings and urinary analytes were used for predicting poor postnatal renal function in children with congenital megacystis. : A systematic review was conducted in MEDLINE's electronic database from inception to December 2023 using various combinations of keywords such as "luto" [All Fields] OR "lower urinary tract obstruction" [All Fields] OR "urethral valves" [All Fields] OR "megacystis" [All Fields] OR "urethral atresia" [All Fields] OR "megalourethra" [All Fields] AND "prenatal ultrasound" [All Fields] OR "maternal ultrasound" [All Fields] OR "ob-stetric ultrasound" [All Fields] OR "anhydramnios" [All Fields] OR "oligohydramnios" [All Fields] OR "renal echogenicity" [All Fields] OR "biomarkers" [All Fields] OR "fetal urine" [All Fields] OR "amniotic fluid" [All Fields] OR "beta2 microglobulin" [All Fields] OR "osmolarity" [All Fields] OR "proteome" [All Fields] AND "outcomes" [All Fields] OR "prognosis" [All Fields] OR "staging" [All Fields] OR "prognostic factors" [All Fields] OR "predictors" [All Fields] OR "renal function" [All Fields] OR "kidney function" [All Fields] OR "renal failure" [All Fields]. Two reviewers independently selected the articles in which the accuracy of prenatal imaging findings and fetal urinary analytes were evaluated to predict postnatal renal function.

Monoclonal Antibodies for Targeted Fluorescence-Guided Surgery: A Review of Applicability across Multiple Solid Tumors.

This study aims to review the status of the clinical use of monoclonal antibodies (mAbs) that have completed or are in ongoing clinical trials for targeted fluorescence-guided surgery (T-FGS) for the intraoperative identification of the tumor margins of extra-hematological solid tumors. For each of them, the targeted antigen, the mAb generic/commercial name and format, and clinical indications are presented, together with utility, doses, and the timing of administration. Based on the current scientific evidence in humans, the top three mAbs that could be prepared in a GMP-compliant bank ready to be delivered for surgical purposes are proposed to speed up the translation to the operating room and produce a few readily available "off-the-shelf" injectable fluorescent probes for safer and more effective solid tumor resection.