Paediatric chronic orchalgia

Testicular or scrotal / groin pain is common in children and often there is no apparent cause. This paper describes the authors’ experience over 10 years of boys >10 years seeking medical attention with testicular pain without anatomical abnormality or...

Refluxing ureteral reimplantation

Obstructed megaureters may be managed with temporising stents, cutaneous ureterostomies, or in older children with ureteral reimplantation (usually if the child is over one year of age). Cutaneous ureterostomies have risks of stomal stenosis, infection and leakage problems over nappies...

Buccal grafts for urethroplasty in pre-pubertal boys

Buccal mucosa graft (BMG) is often used as the primary graft in complex hypospadias surgery. It is not clear what the response of this BMG is during puberty androgen surge and whether or not differential penile growth occurs with secondary...

Impact of internal spermatic artery preservation during laparoscopic varicocelectomy

There is still considerable controversy about the optimal surgical treatment of adolescent varicocele. One of the dilemmas is whether or not to preserve the internal spermatic artery (ISA) when carrying out a laparoscopic Palomo procedure. This paper looks at retrospective...

Outcomes of VUR in children with non-neurogenic dysfunction treated with Deflux

The 2010 American Urological Association (AUA) guidelines on primary vesicoureteral reflux (VUR) state that children with VUR and lower urinary tract dysfunction are less likely to have the VUR resolve spontaneously than those with primary VUR alone (31% vs. 61%)....

Urachal anomalies in children: surgical or conservative treatment?

Urachal anomalies are rare with an incidence of 1:5000-8000 live births. There is still some controversy as to whether to treat them expectantly or surgically with published reports describing malignant changes in adulthood. These authors describe their retrospective series of...

Tamsulosin and spontaneous passage of ureteral stones in children

This was a retrospective analysis of data for five years from four institutions comparing stone passage rates in children with ureteric stones ≤10mm, aged 2-18, treated with tamsulosin vs. analgesia alone. The study identified 449 children, of whom 334 were...

Androgen insensitivity in patients with proximal hypospadias

A number of surgeons use preoperative androgen stimulation for a period of time prior to hypospadias surgery. The aim is to increase glans circumference, penile length and improve prepucial vascularisation pre-surgery. Data confirming the results of these aims is scarce....

Adolescents and adults in paediatric urology clinics

This elegant descriptive paper retrospectively reviewed cases seen in a paediatric urology clinic with respect to age, diagnosis and presentations in a major Brazilian city. Of 521 patients, 404 were <12 years old, 103 were between 12-18 and 14 were...

A novel approach to surgical management of the nutcracker phenomenon

The nutcracker phenomenon is defined as compression of the renal vein between the aorta and superior mesenteric artery and can present with loin pain, haematuria and a left-sided varicocele with treatment options including left renal vein transposition, superior mesenteric artery...

Priapism in children

I have to state a conflict of interest here for obvious reasons, being one of the authors. This paper reviews the English literature between 1980 and 2013 and summarises the clinical classification, aetiology, physiology and pathophysiology of paediatric priapism –...

Surgical management of DSD

The management of children with disorders of sex development (DSD) continues to be controversial. This editorial was written in response to a review article in the same edition on ‘Evidence regarding cosmetic and medically unnecessary surgery in infants’ by M...