Relax and take note of this!

Children with neurogenic bladders are at risk of renal compromise through high detrusor pressures. Management aims to provide continence and preserve the upper tracts by increasing capacity and compliance though early clean intermittent catheterisation and anticholinergics. Intradetrusor botulinum toxin has...

Psychosocial distress in parents of children with DSD

Disorders of sex development (DSD) are a rare set of medical conditions with prevalence rates ranging between 1:00 to 1:5000 births. Secondary atypical genitalia is seen in a subset. Psychosocial aspects have until recently been understudied. We know that some...

Prenatal spina bifida repair – does it have urological benefits in the longer term?

At present, I have one patient under my care who underwent prenatal closure of his spina bifida defect. Only with time, will we be able to determine whether this intervention has been of benefit for him from a urological standpoint....

What should we do with the incidentally detected renal cyst in a child?

The introduction of routine prenatal screening in the early 1980s resulted in paediatric urologists being confronted with the dilemma of what to do with antenatally-detected urinary tract dilatation, many of whom, we now know, do not require long-term surveillance or...

Supranormal function on MAG-3 – what is its significance and how to predict?

Differential renal function (DRF) on MAG-3 scans is typically used in patients with pelvic ureteric junction obstruction (PUJ obstruction). Supranormal DRF is when the kidney with PUJO has higher DRF than the normal contralateral kidney. The authors in this study...

Early complications following ambulatory hypospadias repair

Most hypospadias repairs are undertaken on a day case ambulatory basis. Roth et al. have studied clinically significant events occurring within 30 days of operation. Data was obtained from the Paediatric Health Information System (PHIS), an administrative database that contains...

Evidence-based treatment of MCDK: a systematic review

The authors of this systematic review have not only aimed to establish the incidence of hypertension associated with a multicystic dysplastic kidney (MCDK) but have also tried to determine the malignancy risk associated with an MCDK and assess the rate...

Psychosocial and sexual outcomes after surgery for proximal hypospadias

Andersson et al. report the psychosocial and sexual outcomes for adolescents treated previously for proximal hypospadias. They hypothesised outcomes would be negatively affected compared to patients with distal hypospadias or age-matched controls (Swedish population registry). Participants answered a web-based questionnaire...

Ipsilateral ureteroureterostomy: does function of the obstructed moiety matter?

Upper pole nephrectomy has been the traditional surgical management of children with poorly functioning upper pole moieties in duplex renal collecting systems having ureteral ectopia and ureterocele. However, ablative surgery confers a risk of functional loss to the remnant moiety...

Comparing treatment modalities for transplant kidney VUR in the paediatric population

The management of Transplant kidney vesicoureteral reflux in the paediatric population is a heavily debated issue and Deflux® injection to manage VUR is both widely described in the literature and commonly practised. In this paper, these authors have put forth...

Does stable or decreasing hydronephrosis on ultrasound lead to stable or improved function on diuretic renography?

Antenatal hydronephrosis is noted in approximately 1% of all pregnancies. Persistent renal obstruction may lead to progressive loss of renal function. Renal ultrasound (USS) is the preferred modality for diagnosis and monitoring of paediatric hydronephrosis as it is non-invasive, non-ionising,...

Endoscopic injection of bulking agent for recurrent paediatric epididymitis

Paediatric recurrent epididymitis is frequently observed in several urogenital conditions, and may result in deterioration of long-term fertility. The management of recurrent epididymitis is still a therapeutic challenge for paediatric urologists, and as yet there is no consensus for treatment....