Journal Reviews
Hypospadias – how long should follow-up be?
The optimal duration of follow-up following childhood hypospadias repair (to detect complications) is ill-defined. Several surgeons recommend it to include assessment during puberty. Some may worry that ‘rapid penile growth’, ‘erectile forces’ and ‘sexual activity’ could potentially stress previously successful...
Is outpatient robotic surgery feasible in children?
Minimally invasive surgery has helped to achieve shorter hospitalisations, reduce postoperative pain and analgesia requirements and provides better cosmetic results. Robotic urological outpatient surgery has been examined in recent times in the adult population; here Neheman et al. look at...
Preoperative testosterone for hypospadias
Hypospadias affects around 1 in 400 boys. Glans width (GW) of <14mm has been shown to be an independent risk factor for urethroplasty complications following hypospadias repair. Testosterone (T) administration in prepubertal males increases both penile length and circumference. Its...
Biopsy should be considered for older boys (>10 years) undergoing orchidopexy for intra-abdominal testes
Cryptorchidism is associated with a 3 to 10-fold increase in malignancy and the age at which it is undertaken matters; the risk of testicular cancer is doubled in patients undergoing orchidopexy at 13 years of age compared to that treated...
Effects of orchidopexy upon testicular temperature
The undescended testis (cryptorchidism) is the most common correctable disorder in paediatric urology (1-4.6% of newborns). An important role of the scrotum is to keep the temperature of the testes 2-40C below core body temperature. Here, Shiraishi et al. from...
Is robotic pyeloplasty in the under-ones as good as open repair?
Pelviureteric junction obstruction (PUJO) is a common cause of paediatric hydronephrosis. Indications for intervention include reduced renal function (<40%), symptoms (urinary tract infection or pain) and increasing dilatation. Although the Anderson-Hynes open pyeloplasty (OP) has long been the gold standard...
Parental psychological intervention improves outcomes for children with night wetting
Bed wetting is a common disorder that can potentially limit social interactions (e.g., sleepovers) and have emotional implications for both the child and their family. Here, Sa et al. from Brazil, hypothesised that involving parents in the treatment and providing...
Inguinal vs. scrotal orchidopexy
Undescended testes occur in 1-3% of newborns; the prevalence is even higher in premature babies. Traditionally the surgical approach has been inguinal orchidopexy, involving two incisions – inguinal and scrotal. In 1989, Bianchi and Squire proposed single scrotal incision orchidopexy...
Homo digitalis during COVID-19?
The COVID-19 pandemic has affected all aspects of our lives. We have seen huge changes in the health service, medical practice and hospital working. Many urology meetings – national and international – were cancelled and seminars and courses have become...
‘Born in the USA’ – neonatal circumcision
In 2006, the British Association of Paediatric Urologists (BAPU) published a statement paper on the management of foreskin conditions (www.baps.org.uk/resources/management-foreskin-conditions). Non-therapeutic circumcisions (those to comply with religious or cultural practices) are not uniformly available on the NHS. Circumcisions for medical...
Assessing resolution of isolated hydronephrosis – is APPD superior to the SFU system?
Antenatal scanning detects urinary tract dilatation in 1-5% of pregnancies. Isolated hydronephrosis (i.e., that not due to secondary dilatation e.g. bladder dysfunction) is known to resolve or improve in most; some patients may, however, require intervention through deterioration of obstruction...
Hypospadias – detecting your complications
All hypospadias surgeons will encounter complications. They are estimated to occur in around 10% of distal hypospadias repairs and more than 50% for proximal forms. Some controversy exists regarding the length of follow-up needed to detect them. Some series have...
