Causes of death among people with myelomeningocele: A multi-institutional 47-year retrospective study.

Purpose: This study aimed to analyze organ system-based causes and non-organ system-based mechanisms of death (COD, MOD) in people with myelomeningocele (MMC), comparing urological to other COD.

Methods: A retrospective review was performed of 16 institutions in Canada/United States of non-random convenience sample of people with MMC (born > = 1972) using non-parametric statistics.

Results: Of 293 deaths (89% shunted hydrocephalus), 12% occurred in infancy, 35% in childhood, and 53% in adulthood (documented COD: 74%).

Evaluating the perceptions of Canadian urology residents and program directors regarding the current training in genitourinary imaging.

Introduction: Competency in interpreting genitourinary (GU) imaging is an important skill for urologists; however, no nationally accredited GU imaging curriculum exists for Canadian urology residency training programs. The main objectives of our study were to 1) characterize GU imaging training in Canada; (2) evaluate residents' self-perceived competencies in interpreting GU imaging; (3) explore program directors' (PD) and residents' perceptions regarding the current imaging curriculum and suggestions for future directions.

Methods: From November to December 2022, a survey examining current imaging education in residency, perceived resident imaging knowledge, avenues for improvement in imaging education, and the role of point-of-care ultrasound within urology was distributed to all Canadian urology PDs and residents.

Extensive Pelvic Plexiform Neurofibroma Presenting As Clitoromegaly in a 3-Year-Old Female: Presentation and Management with MEK Inhibitor.

Plexiform neurofibroma (PN) involvement of the external genitalia in patients with neurofibromatosis type I (NF1) is a rare cause of nonhormonal clitoromegaly. We present a 3-year-old female with known NF1 who presented with clitoromegaly. She was identified with an extensive pelvic mass involving the bladder wall, perineum, labia, clitoris, rectum, and sacral foramina.

Contemporary management of pediatric high grade renal trauma: 10 year experience at a level 1 trauma centre.

Background: Current guidelines advocating the conservative management of renal injuries in children are primarily extrapolated from adult series due to a dearth of evidence in the pediatric population.

Objectives: The aim of this study was to review our experience in the management of pediatric high-grade renal trauma and to clarify the role of conservative management in this cohort of patients.

Study Design: The Alberta Trauma Registry (ATR) is a comprehensive web-based registry which functions to prospectively collect data on all trauma patients in the province who sustain a severe injury (i.

Mesenchymal stem cells ameliorate partial bladder outlet obstruction-induced epithelial-mesenchymal transition type II independent of mast cell recruitment and degranulation.

Introduction: Partial bladder outlet obstruction (pBOO) results in increased urinary storage pressure and significant morbidity. Increased pressure results in a sequence of programmed events: an initial inflammatory phase, smooth muscle hypertrophy, and fibrosis. Although epithelial-mesenchymal transition (EMT) and mast cell accumulation play intermediary roles in some fibrotic conditions, their role in pBOO has not yet been elucidated.

Intraperitoneal administration of mesenchymal stem cells is effective at mitigating detrusor deterioration after pBOO.

Partial bladder outlet obstruction (pBOO) results in bladder fibrosis that is initiated by an inflammatory cascade and the decompensation after smooth muscle hypertrophy. We have been using an animal model to develop the hypothesis that mesenchymal stem cells (MSCs) are able to mitigate this cytokine cascade and prevent bladder deterioration. We hypothesized that intraperitoneal administration of MSCs can produce the same effects as intravenously administered cells but may require higher dosing.

Neuropathic bladders: Investigation and treatment through their lifetime.

The child with a neuropathic bladder requires lifelong dedicated care. Just as each patient presents with unique physiology, each phase of their life presents varying challenges. The primary concern for our patients is their renal health, but continence and independence also play significant roles.

Initially Asymmetrical Function on MAG3 Renography Increases Incidence of Adverse Outcomes.

Purpose: To discriminate pathological from physiological hydronephrosis (99m)Tc-mercaptoacetyltriglycine (MAG3) diuretic renography is a fundamental imaging modality. Initial asymmetrical differential function or decreasing function on serial MAG3 scans is a classic surgical indication. However, prognostic evidence supporting this is limited.

Stem Cell Therapy: Current Applications and Potential for Urology.

Stem cell therapy holds the potential to revolutionize the treatment of a number of chronic conditions. Stem cells ability to home in on injured sites of the body, stimulate angiogenesis, tissue regeneration, immunomodulation, anti-inflammatory, and anti-fibrotic factors have attracted their use in the treatment of many conditions. Urology has registered one of the highest experimental successes using stem cell therapy.

Proteomic profile of an acute partial bladder outlet obstruction.

Introduction: Partial bladder outlet obstruction (pBOO) is a ubiquitous problem in urology. From posterior urethral valves to prostatic hypertrophy, pBOO results in significant morbidity and mortality. However, the pathophysiology is not completely understood.

Symptomatic versus asymptomatic pyeloplasties: A single institution review.

Introduction: Historically, pyeloplasties have been performed after symptoms and radiographic confirmation of an ureteropelvic junction obstruction (UPJO). However, with prenatal ultrasonography, the approach to patients has fundamentally changed. Increasingly, patients are diagnosed and treated before the advent of morbidity, based on imaging findings alone.

A modification of the TIP procedure for distal hypospadias: The burrowing technique.

Introduction: The tubularized incised plate urethroplasty (TIP) hypospadias repair is a commonly performed procedure for hypospadias. Multiple series document excellent cosmetic outcome in conjunction with low complication rates. We describe a modification that we have named the "burrowing technique.

The association between urinary continence and quality of life in paediatric patients with spina bifida and tethered cord.

Objective: To determine the association between urinary continence and quality of life (QoL) in a paediatric spina bifida population.

Methods: After appropriate ethics approval, a prospective study was initiated using multiple validated QoL instruments that were distributed to patients as they presented for their annual appointment at the Northern Alberta Spina Bifida Clinic (Edmonton, Alberta). General demographic information was collected and validated questionnaires were used.

Mimickers and tumours in the lower urinary tract: Do we need more efficient vigilance?

Lower urinary tract symptoms are common in pediatric urology, but an atypical presentation may portend significant pathophysiology. We present 5 cases of young males with a sudden change in urinary symptoms, which resulted in the discovery of a variety of benign bladder tumours. We present the clinical, radiologic and histologic findings of these cases emphasizing on mimickers in clinics.

Differential expression of class I small leucine-rich proteoglycans in an animal model of partial bladder outlet obstruction.

Purpose: Partial bladder outlet obstruction has been shown in a rat model to progress from inflammation to hypertrophy to fibrosis. Small leucine-rich proteoglycans are extracellular matrix components associated with collagen fibrillogenesis and resultant scar formation. Two such critical small leucine-rich proteoglycans are decorin and biglycan.

Priapism in an infant with sickle cell trait after cardiac transplant.

We report a case of priapism in a 6-month-old boy of African descent who had been receiving intravenous sildenafil, a phosphodiesterase-5 inhibitor. An orthotopic cardiac transplantation had been performed at 6 months of age, 2 months after he had received a Berlin heart. The pre-, peri-, and postoperative care required multiple transfusions, and postoperative pulmonary hypertension required treatment with intravenous sildenafil.

High risk of sleep disordered breathing in the enuresis population.

Purpose: Enuresis is 1 of the most common complaints facing pediatric urologists and it has significant implications with respect to quality of life. Although the pathophysiology is incompletely understood, there is growing evidence that sleep disordered breathing in children, including obstructive sleep apnea, has a fundamental role. There are also potentially fundamental differences between monosymptomatic enuresis, which may be a sleep disorder, and nonmonosymptomatic enuresis, which may relate to a primary bladder storage problem.

Papillary renal cell carcinoma: report of a rare entity in childhood with review of the clinical management.

We present the case of a 9-year-old boy who presents with gross hematuria and is subsequently diagnosed with a papillary (type 1) renal cell carcinoma. Management of renal cell carcinoma in the pediatric population represents a unique challenge, owing to the potential for a genetic predisposition and screening. Herein we discuss novel discoveries with respect to pediatric renal cell carcinoma and their potential impact on screening.

Foreskin management: Survey of Canadian pediatric urologists.

Objective: To study the approaches to foreskin management of pediatric urologists in Canada.

Design: An online questionnaire comprising several survey questions and clinical vignettes.

Setting: Canada.

Bladder outlet obstruction: progression from inflammation to fibrosis.

Objective: To investigate the progression of urodynamic changes, as well as histological and biochemical outcomes over a prolonged period of partial bladder outlet obstruction (pBOO) in an animal model with physiologically relevant pBOO.

Materials And Methods: Healthy, adult, female Fischer rats underwent surgical creation of a pBOO for either 2, 4, 8, or 13 weeks and were compared with sham-operated rats. Urodynamic measurements were used to compare bladder volumes and pressure.