Can continence and volitional voiding be achieved in bladder exstrophy?

Bladder exstrophy is a challenge to the paediatric urologist; here in the UK, repairs are now undertaken at two centres in order to concentrate experience. The ultimate aim is to achieve urinary continence and volitional voiding. In this study, John...

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...

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...

Fertility preservation for paediatric patients

Paediatric patients are at risk for future infertility due to medical conditions and treatments. As the most well-known example, many patients undergoing oncological therapy are at risk of future infertility. In addition, those receiving immunosuppressive or stem cell transplant therapy...

Bladder cancer outcomes in patients with spina bifida

These authors carried out a systematic review using PubMed and a number of terms to pick up studies with an underlying diagnosis of myelomeningocele and bladder cancer, with exclusions of cord injury, tuberculosis, schistosomiasis, or prior ureterosigmoidostomy. Their aim was...

Bladder perforation after augmentation cystoplasty

Delayed bladder perforation is well recognised after augmentation cystoplasty (5-13% of patients) and adult urologists need to be aware of this and identify the best treatment at the time. Mortality rates and re-perforation rates can be up to 25% and...

The role of acupuncture in managing overactive bladder

Overactive bladder (OAB) affects 17% of American men and women and represents a burden in terms of both quality of life and finances. Alternative therapies may be sought for this condition as there is a high drop-out rate with regards...

Mindfulness-based stress reduction as a novel treatment for IC/PBS

Interstitial cystitis / painful bladder syndrome (IC / PBS) is not fully understood and is associated with significant morbidity. The objective of this study was to provide initial data to evaluate mindfulness-based stress reduction (MBSR) as a treatment for IC...

BAPU consensus statement on the management of the neuropathic bladder

The summary of this paper states that a “consensus statement is not a guideline nor a method with which to establish what is best practice. It is a way of surveying practice and providing a benchmark for others to compare...

Predictive factors for conservative treatment failure in paediatric blunt renal trauma

Blunt renal trauma is managed conservatively in children in the vast majority of cases. Grade IV renal injury is also generally managed non-operatively although occasionally intervention is needed for a urinoma that fails to settle. These authors retrospectively looked at...