Comorbidity of Obsessive-Compulsive Symptomatology and Bowel and Bladder Dysfunction in a Tertiary Children's Hospital: A Case Series.

Objective: To improve understanding of co-occurring obsessive-compulsive disorder (OCD) and bowel and bladder dysfunction (BBD) in an outpatient pediatric urology clinic setting. To provide a series of clinical care recommendations to enhance the identification and integrated medical and behavioral health treatment of these disorders.

Methods: Authors participated in a series of discussions to define the patient population and specific aims for the study.

The urological management of children with spinal cord injury.

Background: The urologic management of children with spinal cord injury (SCI) differs from that of the adult insofar as the care involves a developing organ system and will be ongoing for years. Preservation of renal function as well as prevention of urinary tract infection in concert with both bladder and bowel continence are the essential guiding principles.

Methods: This is a non-systematic review of the literature and represents expert opinion where data are non-existent.

Pelvic floor laxity: A not so rare but unrecognized form of daytime urinary incontinence in peripubertal and adolescent girls.

Introduction: Stress urinary incontinence (SUI) is common among older multiparous females but rarely reported in active, young girls.

Objectives: Our hypothesis is: physically active adolescent females develop pelvic floor laxity demonstrable on upright VCUG. Our objectives are to (1) increase awareness of SUI in young females, (2) test our hypothesis with an upright VCUG, and (3) report effectiveness of step-wise management.

The Megameatus, Intact Prepuce Variant of Hypospadias: Use of the Inframeatal Vascularized Flap for Surgical Correction.

Introduction: The megameatus intact prepuce (MIP) variant of hypospadias is a rare variant of hypospadias that is diagnosed either early at the time of circumcision or later as the foreskin is retracted. The true incidence of the anomaly is difficult to determine precisely as some patient never come to medical attention but is felt to under 5% of all cases of hypospadias. The purposes of this study are to review the embryology and clinical findings of MIP and then, in light of a personal experience, present a series of patients evaluated for MIP who were treated with a modification of the Mathieu technique.

The Efficacy of Congenital Penile Curvature Repair in Preadolescent Males: Early Outcomes.

Objective: To characterize the spectrum of congenital penile curvature without hypospadias evaluated at our institution, and to assess the efficacy of surgical repair in prepubescent boys.

Methods: The study group included 82 boys with a diagnosis of congenital penile curvature without hypospadias who elected for surgical repair from 2008 to 2010. We retrospectively reviewed clinical and operative characteristics and recorded surgical outcomes during the length of patients' follow-up at our institution.

Management of Proximal Hypospadias with 2-Stage Repair: 20-Year Experience.

Purpose: We describe our experience with 2-stage proximal hypospadias repair. We report outcomes, and patient and procedure characteristics associated with surgical complications.

Materials And Methods: We retrospectively studied patients with proximal hypospadias who underwent staged repair between January 1993 and December 2012.

The surgical management of male epispadias in the new millennium.

Male epispadias is a rare and challenging urologic condition. As part of the epispadias-exstrophy complex of genitourinary anomalies, it covers a broad spectrum with the mildest forms being the rarest. The anatomic classification into glanular, penile, and penopubic is based on the location of the urethral meatus.

Evaluation of a novel gel-based ureteral stent with biofilm-resistant characteristics.

Purpose: Current ureteral stents, while effective at maintaining a ureteral lumen, provide a substrate for bacterial growth. This propensity for biofilm formation may be a nidus for bacterial growth leading to infection and a reason for early removal of a stent before it is clinically indicated. A newly devised stent, composed of a highly hydrated, partially hydrolyzed polyacrylonitrile polymer, is believed to have bacterial resistant properties.

Incidental capture of rarely diagnosed pediatric tumor: an infant boy with clear cell sarcoma of the kidney.

Clear cell sarcoma of the kidney (CCSK) is an uncommon neoplasm that accounts for less than 5% of all pediatric renal tumors. Compared with Wilms' tumor, CCSK has a higher rate of relapse, greater propensity for bone metastasis, and poorer overall survival. We present the case of a 19-month-old boy with a large renal mass diagnosed incidentally by ultrasonography during surveillance for vesicoureteral reflux.

Variations in management of mild prenatal hydronephrosis among maternal-fetal medicine obstetricians, and pediatric urologists and radiologists.

Purpose: There are no current guidelines for diagnosing and managing mild prenatal hydronephrosis. Variations in physician approach make it difficult to analyze outcomes and establish optimal management. We determined the variability of diagnostic approach and management regarding prenatal hydronephrosis among maternal-fetal medicine obstetricians, pediatric urologists and pediatric radiologists.

The impact of electrocautery method on post-operative bleeding complications after non-newborn circumcision and revision circumcision.

Purpose: We evaluated post-operative bleeding complications in non-newborns following use of monopolar versus bipolar electrocautery for circumcision or revision circumcision.

Materials And Methods: We retrospectively reviewed sequentially performed cases of circumcision and revision circumcision performed by nine pediatric urologists at our institution from 2005 to 2010. In order to incorporate both the monopolar and bipolar electrocautery experience for a single surgeon employing bipolar technique, sequential cases from 2002 to 2010 were reviewed.

Bladder diverticula in children.

This review of bladder diverticula in children includes: historical aspects of the condition, its presentation and diagnosis, as well as management options. The purpose of the review is to provide a comprehensive and in-depth understanding of a relatively infrequent but clinically challenging urologic abnormality that may affect not only the bladder but also the upper urinary tract and kidney.

Robot-assisted laparoscopic excision of symptomatic retrovesical cysts in boys and young adults.

Purpose: We review our surgical experience with the management of retrovesical cystic anomalies using robot-assisted laparoscopic techniques.

Materials And Methods: We retrospectively reviewed the presentation, diagnosis and treatment of 6 patients 28 months to 22 years old with retrovesical cystic anomalies who underwent robot-assisted laparoscopic excision at our hospital between January 2006 and November 2010.

Results: Presenting signs and symptoms included urinary retention, lower urinary tract symptoms, abdominal pain and repeated epididymitis.

The predictive value of the first postnatal ultrasound in children with antenatal hydronephrosis.

Objective: To evaluate the effectiveness of the first postnatal ultrasound (US) in predicting the final postnatal diagnosis using a database of children followed prospectively for antenatal hydronephrosis, and to compare these findings with a systematic review of the literature.

Methods: The study involved 1441 children who had their radiological evaluation between 3 and 60 days of life, including an US, performed at our institution in 1998-2006. Univariate and multivariate analyses were performed.

The Society for Fetal Urology consensus statement on the evaluation and management of antenatal hydronephrosis.

The evaluation and management of fetuses/children with antenatal hydronephrosis (ANH) poses a significant dilemma for the practitioner. Which patients require evaluation, intervention or observation? Though the literature is quite extensive, it is plagued with bias and conflicting data, creating much confusion as to the optimal care of patients with ANH. In this article, we summarized the literature and proposed recommendations for the evaluation and management of ANH.

Ultrasound versus computerized tomography for evaluating urolithiasis.

Purpose: We prospectively evaluated the precision of ultrasound and computerized tomography to diagnose urinary stones in children and determined whether these differences in radiological findings have any impact on clinical management.

Materials And Methods: A total of 50 consecutive patients with suspected urolithiasis underwent computerized tomography and ultrasound. Two radiologists reviewed each study independently in blinded fashion.