Journal Reviews
Preoperative use of testosterone prior to distal hypospadias repair
Preoperative hormonal stimulation has been utilised for >50 years in hypospadias surgery. Surgeons utilise testosterone (T) to increase penile size and glans width to try and improve clinical outcomes. However, a paucity of reliable data supporting its use has limited...
Fluoxetine for refractory night wetting in children – is it safe and effective?
Around 1-2% of teenagers above the age of 15 years and 2-6% of adults continue to wet the bed. Standard treatment often includes bladder advice, alarm therapy, desmopressin and anticholinergics. Tricyclic antidepressants (imipramine) can also be utilised. Unfortunately, most have...
Robot-assisted ureterocalicostomy
Ureterocalicostomy was first introduced by Neuwirt (1947) and further described by Jameson et al. (1957) as an alternative procedure for repair of pelviureteric junction (PUJ) obstruction associated with an intrarenal pelvis. Performing ureterocalicostomy for PUJ repair has been suggested in...
Scrotal antegrade sclerotherapy for the adolescent varicocele
The incidence of varicocele in adolescent males is around 15%. Treatment indications include symptoms (pain) and evidence of a smaller testis. Numerous surgical techniques are described but there is a lack of randomised controlled trials (RCT), specifically in adolescents. This...
Stenting prior to URS or ESWL – does it increase ED visits and opiate prescriptions?
Ureteral stents are used to bypass obstructive stones, to dilate the ureter in order to facilitate ureteroscopy (URS), and to maintain patency / low intrarenal pressure following stone surgery. However, there can be morbidity (pain / voiding symptoms). Tasian et...
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...
