Factors modulating the post-operative course in minimally invasive and open pediatric nephrectomy for non-malignant indications.

Purpose: Minimally-invasive nephrectomy reduces hospital stay and analgesic needs compared to open nephrectomy but involves longer operative times and higher costs. This study examines how pre-operative factors impact outcomes in pediatric nephrectomy for benign disease.

Materials And Methods: We analyzed pediatric total nephrectomy cases in the National Surgical Quality Improvement Program Pediatric database from 2013 to 2022, excluding those with malignancy, approach conversions, or missing data.

Utility of Preoperative Antimicrobial Prophylaxis in Hypospadias Repair: Results From National Surgical Quality Improvement Program Pediatric Registry.

Purpose: Literature supporting antimicrobial prophylaxis for hypospadias repairs is lacking, with largest studies including several hundred subjects. We sought to evaluate the association of a single dose of preoperative antibiotics in hypospadias repairs on postoperative outcomes using the National Surgical Quality Improvement Program Pediatric Registry.

Materials And Methods: The 2021 to 2022 National Surgical Quality Improvement Program Pediatric Registry was used to categorize hypospadias repairs into 3 groups-(1) 1-stage distal hypospadias repairs, (2) 1-stage proximal hypospadias repairs and second-/third-stage urethroplasties, and (3) repair of hypospadias complications.

Inhibition of hypoxia-inducible factor-prolyl hydroxylation protects from cyclophosphamide-induced bladder injury and urinary dysfunction.

Disruption of the blood-urine barrier can result in acute or chronic inflammatory bladder injury. Activation of the oxygen-regulated hypoxia-inducible factor (HIF) pathway has been shown to protect mucosal membranes by increasing the expression of cytoprotective genes and by suppressing inflammation. The activity of HIF is controlled by prolyl hydroxylase domain (PHD) dioxygenases, which have been exploited as therapeutic targets for the treatment of anemia of chronic kidney disease.

Renal Transplants Due to Congenital Anomalies of the Kidney and Urinary Tract (CAKUT) Have Better Graft Survival Than Non-CAKUT Controls: Analysis of Over 10,000 Patients.

Objective: To determine whether graft survival for patients with congenital anomalies of the kidney and urinary tract (CAKUT) is impaired compared to non-CAKUT counterparts.

Methods: The United States Renal Data System (USRDS) is a national data system that has collected information about end stage renal disease (ESRD) and renal transplantation since 1995. We identified 10,635 first-time renal transplant patients with ESRD attributed to a CAKUT diagnosis transplanted between 1995 and 2018, with follow-up of 7.

New-onset ESRD secondary to reflux nephropathy has decreased in incidence in the United States.

Introduction And Objective: Vesicoureteral reflux (VUR) has been associated with the development and progression of reflux nephropathy (RN). Management of VUR has become more conservative over time as therapies have not been reliably proven to prevent renal scarring. We sought to examine the incidence of end stage renal disease (ESRD) due to RN over recent decades in the United States.

Prospective Evaluation of Sacral Neuromodulation in Children: Outcomes and Urodynamic Predictors of Success.

Purpose: Sacral neuromodulation has been demonstrated to improve refractory bowel bladder dysfunction in children. The purpose of the current study was to determine whether results are durable in children after longer followup, whether children with a lower body mass index are at risk for device failure and whether pretreatment urodynamic evaluation can predict posttreatment outcome.

Materials And Methods: Pediatric patients with refractory bowel bladder dysfunction were enrolled following informed consent and followed prospectively.

Diagnosis of constipation does not correlate with trans-abdominal ultrasound of rectal distention.

Introduction: Constipation has been shown to have a significant impact on lower urinary tract symptoms (LUTS) in children, and treatment of constipation in children with bowel bladder dysfunction (BBD) has been shown to improve or completely resolve LUTS in many cases. Recent studies utilizing trans-abdominal ultrasound (US) to assess stool burden have correlated diagnosis of constipation with US appearance of rectal stool. An US scoring tool was published in 2008 to assess stool burden, showing linear correlation with constipation severity by symptom questionnaire in an outpatient pediatric constipation clinic population.

Bullying and lower urinary tract symptoms: why the pediatric urologist should care about school bullying.

Purpose: Bullying has become a social plague associated with various deleterious outcomes. We hypothesized that pediatric lower urinary tract symptoms could be associated with exposure to bullying.

Materials And Methods: We assessed exposure to school bullying via the Setting the Record Straight bullying questionnaire in children 8 to 11 years old being evaluated for lower urinary tract symptoms at our pediatric urology clinic.

Kinetic isotope effects support the twisted amide mechanism of Pin1 peptidyl-prolyl isomerase.

The Pin1 peptidyl-prolyl isomerase catalyzes isomerization of pSer/pThr-Pro motifs in regulating the cell cycle. Peptide substrates, Ac-Phe-Phe-phosphoSer-Pro-Arg-p-nitroaniline, were synthesized in unlabeled form, and with deuterium-labeled Ser-d3 and Pro-d7 amino acids. Kinetic data were collected as a function of Pin1 concentration to measure kinetic isotope effects (KIEs) on catalytic efficiency (kcat/Km).

Bladder perforation in augmentation cystoplasty during urodynamic investigation: a case report and review of the literature.

Background: Spontaneous bladder rupture is a known complication of augmentation cystoplasty. We report the second case of bladder rupture during filling cystometry many years after bladder augmentation and the first case occurring in a patient with an autoaugmentation cystoplasty. In addition, the management and outcome for a bladder perforation in an autoaugmentation cystoplasty will be discussed.

Transurethral placement of vaginal contraceptive device in a patient with neurogenic bladder: a case report and review of the literature.

Background: The NuvaRing is a vaginal contraceptive device that is placed and later removed by the user herself. Incorrect placement is a possible complication and seems an increased risk in patients with spinal cord abnormalities.

Case: A 21-year-old female with a history of a T7-8 level spinal cord injury at birth and subsequent neurogenic bladder dysfunction and bladder augmentation presented with an 8 month history of suprapubic pain, right hip pain and urgency unresponsive to antibiotic therapy.

Robot-assisted upper pole nephrectomy in adult patients with duplicated renal collecting systems.

Duplicated renal collecting systems are a common congenital anomaly, with patients usually presenting in childhood, rarely in adult life. To our knowledge, only one case of robot-assisted heminephrectomy in adults has been described. We reviewed the medical records of four adult patients with symptomatic unilateral duplicated collecting systems and nonfunctioning upper pole renal units (NFUPRU) who underwent robot-assisted laparoscopic heminephrectomy at our institutions.

Clinical practice: surgical approaches to urolithiasis in children.

The incidence of urolithiasis in children is increasing. Adequate knowledge of treatment modalities and surgical options is therefore essential for every pediatrician. Surgical approaches to urolithiasis in children continue to evolve with advancements in technology and sophistication of current equipment and techniques.

Serine-cis-proline and serine-trans-proline isosteres: stereoselective synthesis of (Z)- and (E)-alkene mimics by Still-Wittig and Ireland-Claisen rearrangements.

Two new amide isosteres of Ser-cis-Pro and Ser-trans-Pro dipeptides were designed and stereoselectively synthesized to be incorporated into potential inhibitors of the phosphorylation-dependent peptidylprolyl isomerase Pin1, an essential regulator of the cell cycle. The cis mimic, the (Z)-alkene isomer, was formed through the use of a Still-Wittig [2,3]-sigmatropic rearrangement, while the trans mimic, the (E)-alkene, was synthesized through the use of an Ireland-Claisen [3,3]-sigmatropic rearrangement. Starting from N-Boc-Ser(OBn)-N(OMe)Me, both mimics were synthesized in Boc-protected form suitable for peptide synthesis with an overall yield of 20% in 10 steps for the cis mimic and 13% in eight steps for the trans mimic.