Upper or lower tract approach for duplex anomalies? A bi-institutional comparative analysis of robot-assisted approaches.

Optimal management of duplication anomalies may include an upper or lower tract surgical approach. In the contemporary era, the robot-assisted laparoscopic heminephrectomy (RALHN) and robot-assisted laparoscopic ipsilateral ureteroureterostomy (RALIUU) are viable interventions predicated on clinical, institutional and surgeon preferences. We present a multi-institutional comparative analysis aiming to compare the outcomes of RALHN and RALIUU to see if either of the approaches confers an advantage over the other in treating duplex renal anomalies needing intervention.

Reducing post-operative opioids in children undergoing outpatient urologic surgery: A quality improvement initiative.

Introduction: Opioid prescriptions have been implicated as one of the proximate causes of the national opioid epidemic. Children and adolescents and their families are at risk for increased opioid exposure through prescriptions after surgery. In pediatric urologic surgery, indications for postoperative opioids can vary widely and a focus on opioid stewardship is important to reduce potential harms.

Kaposiform Hemangioendothelioma with Kasabach-Merritt Phenomenon in a Neonate - Role of Dual Therapy: A Case Report and Review of Literature.

Kaposiform hemangioendothelioma (KHE) represents a rare, borderline vascular tumor with locally aggressive behavior. They are often associated with a potentially life-threatening coagulopathy known as Kasabach-Merritt phenomenon (KMP). Due to heterogeneous nature of the vascular lesion and lack of standardized treatment protocols, these patients pose a diagnostic dilemma and therapeutic challenge with morbidity and potential mortality.

Calyceal diverticula in children: laparoscopic marsupialization is the optimal intervention.

Background: Calyceal diverticula (CD) are abnormally dilated calyces caused by a narrowed infundibulum. Although rare, with incidence rates previously reported between 0.21% and 0.

Intralesional Sclerotherapy with Bleomycin in Lymphatic Malformation of Tongue an Institutional Experience and Outcomes.

Introduction: The management of lymphatic malformations (LMs) continues to improve with advancement in molecular genetics, imaging, and treatment options. However, the management of tongue LMs remains a challenge due to the location, function involved, and long-term disabilities. We propose injection sclerotherapy with bleomycin in the management of spectrum of tongue LMs.

Pediatric empyema thoracis management: should the consensus be different for the developing countries?

Background: Despite the available consensus, intrapleural fibrinolytic therapy (IFT) in pediatric empyema is grossly underutilized in the Indian subcontinent where the disease burden is huge. Possible reasons may be epidemiological differences and physician bias. There is a paucity of literature from developing countries on the use of IFT in pediatric empyema thoracis.

Robotic surgery in infants and children: an argument for smaller and fewer incisions.

Purpose: Robotic-assisted laparoscopic (RAL) surgery has gained momentum in pediatric urology. Technological adaptations such as the development of 5 mm instruments have led to robotic procedures being performed on younger children and those having smaller body habitus, with improved cosmesis. However, concerns have been raised regarding decreased intra-abdominal working space and the absence of monopolar curved scissors (hot endoshears) when using 5 mm instruments.

The Robot-Assisted Extravesical Anti-reflux Surgery: How We Overcame the Learning Curve.

Management of vesicoureteral reflux (VUR) has evolved over the past several decades, with a trend toward a decrease in surgical management. In spite of this, ureteral reimplantation remains a commonly performed procedure by pediatric urologists in selected cases. Although the basic tenets of the ureteral reimplant procedure remain the same, the extra- vs.

Approaches to Eliminate Radiation Exposure in the Management of Pediatric Urolithiasis.

Purpose Of Review: Traditional management of pediatric urolithiasis has been associated with a significant amount of radiation exposure. The steady increase in pediatric urolithiasis in recent years has raised concerns of long-term consequences in this special population. This review seeks to highlight the newer insights towards eliminating radiation exposure in pediatric urolithiasis from contemporary literature.

Penile Dislocation with Inversion: A Rare Complication of Blunt Pelvic Injury.

Penile injuries in children are usually uncommon and are predominantly associated with pelvic trauma or as postcircumcision injuries. The authors present a rare case of penile dislocation with penile inversion in a 5-year-old child occurring due to blunt pelvic injury. The child presented 3 months after pelvic injury with a suprapubic catheter for urinary diversion and absent penis with only penile skin visible.