Evaluating the likelihood of pediatric sacral nerve stimulator explantations due to cure or complications: a survival analysis of 13-year institutional cohort.

Introduction: Sacral neuromodulation (SNM) is a treatment option for children with refractory bladder and bowel dysfunction. Prior investigations have shown children may achieve cure of their symptoms following SNM implants and subsequently have their devices explanted. Herein, we present a 13-year experience of pediatric SNM placements and evaluate the likelihood of SNM explantation for any cause, for symptom resolution or complications.

Cutaneous vesicostomy: Effects on future bladder outcomes in patients with spinabifida.

Introduction: Initial management of neuropathic bladder in spina bifida (SB) is conservative, but some can develop progressive hydronephrosis, vesicoureteral reflux (VUR), and recurrent urinary tract infections (UTI). Cutaneous vesicostomy (CV) is a viable intermediate option in these patients. However, there is no consensus on whether bladder augmentation is necessary at time of CV reversal.

Predicting progression to renal replacement therapy in children with posterior urethral valves: international validation of the secondary use of the posterior urethral valve risk of chronic kidney disease (PURK) score.

Introduction: Congenital lower urinary tract obstruction due to posterior urethral valves (PUV) often results in chronic kidney disease (CKD) and renal replacement therapy (RRT). The Posterior Urethral Valve Risk of Chronic Kidney Disease (PURK) score, a validated prognostic tool, uses clinical variables at presentation to predict development of CKD stage 3 or higher. However, its role in predicting progression to RRT remains unexplored.

Assessing the risk of voiding dysfunction in children with ureteroceles: A systematic review and meta-analysis.

Introduction: Ureterocele is a congenital anomaly potentially associated with voiding dysfunction (VD), often requiring surgical intervention. While surgery aims to relieve obstruction and preserve renal function, postoperative VD and related complications remain significant concerns.

Objectives: This systematic review aims to evaluate the prevalence of VD and associated outcomes in children following ureterocele surgery.

Day-to-Day Activity Avoidance in the Context of Urinary and Fecal Incontinence: Preliminary Results from Young Adults with Spina Bifida in an Ecological Momentary Assessment Study.

Background: Studies suggest that young adults with spina bifida (YASB) often avoid important daily activities (ADL) due to urinary (UI) and fecal (FI) incontinence, but no research has prospectively examined how often ADL avoidance occurs, or the context in which it occurs. We used ecological momentary assessment (EMA) over 30 days to describe the frequency of avoidance, the activities YASB most commonly avoid, and the preliminary association of daily avoidance with affect, incontinence anxiety and health-related quality of life (HRQoL).

Method: We analyzed a subsample of YASB participants (18 - 27 years; N=23 of total 88 participants) who completed a larger 30-day prospective EMA study examining the daily prevalence and context of UI and FI in adults with SB.

Evaluating Decisional Regret in Adults with Spina Bifida Regarding Childhood Surgeries for Neurogenic Bladder and Bowel.

Purpose: To assess decisional regret (DR) among people with spina bifida (SB) regarding decisions caregivers made to manage their neurogenic bladder and bowel as children.

Materials And Methods: Consecutive adults with SB were surveyed at clinic appointments. For history of childhood bladder reconstruction, we analyzed whether demographics, procedural type, complications, revisions, and functional outcomes affected DR.

Attaining competency and proficiency in pediatric robot-assisted laparoscopic ureteric reimplantation: a learning curve configuration using cumulative sum analysis.

Objectives: Robot-assisted laparoscopic ureteric reimplantation (RALUR) is a minimally invasive procedure for treating vesicoureteral reflux (VUR) and congenital megaureter. Despite its benefits, the adoption of RALUR involves a significant learning curve. This study aims to evaluate the learning curve of a fellowship-trained surgeon performing RALUR using cumulative sum (CUSUM) analysis.

Evaluating the trainee impact on robotic surgery learning curves: a CUSUM analysis of large series pediatric robot-assisted laparoscopic pyeloplasty.

Robot-assisted laparoscopic pyeloplasty (RALP) is a minimally invasive treatment for ureteropelvic junction obstruction (UPJO). The learning curves for RALP have been well-documented, primarily in post-fellowship surgeons, but the impact of trainee involvement during fellowship training remains unclear. This study aims to (1) establish a large series post-fellowship single surgeon learning curve and (2) analyze the impact of annual trainee involvement on surgical proficiency using cumulative sum (CUSUM) analysis.

Preliminary analysis of the Female Genital Self-Image Scale (FGIS-4) and the Male Genital Self-Image Scale (MGIA-5) in an international sample of adults with spina bifida.

Introduction: Common chronic health conditions associated with spina bifida (SB) may impact sexual health among adults in this population, including genital self-image (GSI), but no studies explore this topic.

Aim: The primary aim of this study was to provide a preliminary psychometric assessment of the four-item Female Genital Self-Image Scale (FGSIS-4) and the five-item Male Genital Self-Image Scale (MGSIS-5) for use among adults with SB. A secondary aim was to describe the association of GSI with key demographic, health, and sexual experience characteristics.

Addressing inequities in cryptorchidism care: The impact of social determinants on timely & true undescended testis referrals - A six-year study from a high-volume referral center.

Introduction: The American Urological Association (AUA) recommends urology referral and surgery for undescended testicle (UDT) before 18 months of age, but it has been shown that many referrals occur later, influenced by social factors.

Objective: This study aims to identify key social factors that impact UDT referral timing and appropriateness.

Study Design: Pediatric patients referred to our institution for UDT management from 2018 to 2023 were analyzed.

Daily Experiences of Urinary and Fecal Incontinence in Young Adults with Spina Bifida: Preliminary Results from an Ecological Momentary Assessment Study.

Background: Urinary (UI) and fecal (FI) incontinence are prevalent secondary chronic conditions among young adults with spina bifida (YASB). UI and FI decrease daily functioning for YASB, but no research has prospectively examined characteristics of UI and FI among YASB. We used ecological momentary assessment (EMA) over 30 days to describe the prevalence, episode-specific characteristics and negativity associated with UI and FI among a cohort of YASB.

Adaptation of the German language version of the QUAlity of life assessment of spina bifida for adults (QUALAS-A-G).

Introduction: Spina bifida (SB) affects almost all activities in daily life and therefore also health-related quality of life (HRQOL). To assess the HRQOL of adults with SB, a self-reported QUAlity of Life Assessment of Spina bifida in Adults (QUALAS-A) was validated in English. The purpose of this study was to develop and validate a German version of QUALAS-A.

Adherence to follow-up ten years after hypospadias repair.

Introduction: Periodic follow-up prior to and after puberty to evaluate for long-term sequalae following hypospadias repair is commonly recommended. Few studies have evaluated this follow-up, especially into adulthood. This study aimed to evaluate adherence to routine postoperative follow-up appointments over 10 years following elective hypospadias repair.

Day-to-day variations and effects of urinary and fecal incontinence among adults with spina bifida: An ecological momentary assessment diary pilot study.

Background: No studies have evaluated the day-to-day variations in urinary incontinence (UI) and fecal incontinence (FI) among adults with spina bifida (SB). We aimed to 1) describe variations in UI/FI over 30 days, 2) assess factors associated with anxiety about incontinence, and 3) correlate anxiety about incontinence and health-related quality of life (HRQOL) among adults with SB (exploratory).

Methods: Adults with SB participated in a larger 30-day smartphone-based ecological momentary assessment (EMA) study of well-being and incontinence.

End-stage and chronic kidney disease in classic bladder exstrophy: A retrospective muti-institutional cohort study.

Introduction: While most children with classic bladder exstrophy (CBE) are born with normal kidneys, some experience renal deterioration in adulthood. Little is known about the incidence of end-stage and chronic kidney disease (ESKD and CKD, respectively) in this population. Our group has recently published on surgical outcomes in a multi-institutional cohort of 216 people with CBE.

Use and Disuse of Catheterizable Channels as the Primary Method of Emptying the Neuropathic Bladder: A Single Institutional Cohort Study.

Purpose: We aimed to assess long-term use of continent catheterizable urinary channels (CCCs) and explore potential risk factors of disuse.

Materials And Methods: People undergoing appendicovesicostomy and Monti procedures at our institution were retrospectively reviewed (1991-2023). The main outcome was CCC disuse (not intermittently catheterizing channels as the primary method of bladder emptying).

Experiences and preferences of women with CAH and parents about disclosure of childhood surgery.

Introduction: Complete disclosure of childhood genital surgery to patients with congenital adrenal hyperplasia (CAH) is a critical part of CAH care. There are no guidelines or uniform recommendations on the timing and content of surgical disclosure discussions.

Objective: Our objective was to describe the experiences and preferences of females with CAH and parents of females with CAH who underwent childhood genital surgery regarding surgical disclosure.

Urology HEIRS: A Feasibility and Acceptability Study for Video-Based Research on Physician-Family Communication in Pediatric Urology Visits.

Purpose: Patient- and family-centered communication is essential to health care equity. However, less is known about how urologists implement evidence-based communication and dynamics involved in caring for diverse pediatric patients and caregivers. We sought to evaluate the feasibility and acceptability using video-based research to characterize physician-family communication in pediatric urology.

Usability testing of the Set Brave Goals app, a continence goal-selection app for children with spina bifida.

Introduction: The Set Brave Goals app is the first digital health app (DHA) aimed at helping children with spina bifida (SB) aged 8-17 years old to select and track their urinary and fecal continence goals. Developed by children, parents, providers and researchers, its usability, or appropriateness to a purpose ("user-friendliness"), remains unknown. In an alpha testing stage, our aim was to determine the usability of the app prior to clinical use.

Linguistic, Content and Face Validity of the Swedish Version of a Quality-of-Life Assessment for Children, Teenagers and Adults with Spina Bifida.

Spina bifida includes a spectrum of different neural tube defects. Myelomeningocele is the most serious type and is associated with a risk of paralysis and sensory dysfunction below the affected level, bladder/bowel dysfunction, brain dysmorphology, and impaired health-related quality of life (HRQoL). The aim of this study was to describe the establishment of linguistic, content and face validity of the Swedish version of a Quality-of-Life Assessment for children (QUALAS-C, = 10 items), teenagers (QUALAS-T, = 10 items) and adults with spina bifida (QUALAS-A, = 15 items) based on the original US English versions.

Parental decision regret after pediatric urologic surgeries compared to decisions of everyday life.

Introduction: Parents are at risk of decision regret (DR) for decisions affecting their children. The Decision Regret Scale (DRS) measures medical DR but lacks context outside of healthcare.

Objective: To compare parental DR 1) between common pediatric urologic surgeries and everyday decisions and 2) with preference to make a different choice.

Prevalence of sexual abuse and intimate partner violence in adults with spina bifida.

Background: People with disabilities and chronic medical conditions are known to be at higher risk of sexual abuse (SA) and intimate partner violence (IPV). People with spina bifida (SB) are vulnerable, but little is known about the prevalence of abuse in this population.

Objective: To evaluate the prevalence and risk factors of SA and IPV in adults with SB.

Accuracy in reporting incontinence in adults with spina bifida: A pilot study.

Background: The accuracy of self-reported urinary incontinence (UI) and fecal incontinence (FI) among adults with spina bifida (SB) is unknown. We aimed to quantify the accuracy of self-reported recall incontinence in the last 4 weeks using prospective diary data.

Methods: Adults with SB were enrolled via patient advocacy groups in a larger 30-day smartphone-based ecological momentary assessment study of daily well-being and incontinence.