Risk stratified approach to early intervention for renal colic

Existing guidance on this topic is based on older and smaller studies, and there remains variation in practice. This review of database outcomes of 1168 out of 3081 (38%) patients who underwent early intervention after presentation to nine Canadian emergency...

Delayed decompression of the infected obstructed kidney increases fatality

Well, we know this, I hear you all say. It is standard practice that the obstructed kidney with associated infection requires prompt decompression, and this is drilled into all UK trainees. It is surprising therefore that although we frequently deal...

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...

Comparison of pathological stage in patients treated with and without neoadjuvant chemotherapy for high-risk UTUC

High-risk upper tract urothelial carcinoma (UTUC) has been associated with poor survival outcomes. The authors evaluated the role of neoadjuvant chemotherapy in high-risk cases prior to radical nephroureterectomy (RNU) in terms of pathological stage of the final surgical specimen. A...

Bladder debris on ultrasound as a predictor for positive urine culture

One of the common ultrasound findings in children who undergo renal tract evaluation is ‘debris in the bladder’. The aetiology of bladder debris is varied and the likelihood that urinary debris represents positive urine culture is debatable. The authors of...

Ureteral clipping in children – longer term outcomes of a novel treatment

In this article, Lopes et al. report longer term outcomes of laparoscopic clipping of ureters of non-functioning kidneys or non-functioning renal moieties in duplex kidneys associated with ectopic ureter or obstructive ureteroceles. In 2014, their group published a promising preliminary...

Ureterocystostomy – novel surgery for the paediatric obstructed megaureter

Megaureter is a relatively common congenital urinary tract anomaly; obstructed non-refluxing megaureter is one variant. Initial management is conservative, with operative intervention reserved for symptomatic cases (recurrent pyelonephritis, pain, increasing dilatation or worsening renal function). Surgical options include cutaneous ureterostomy,...

Reliability of grading of VUR and other findings on VCUG

The gold standard for diagnosing VUR is still the voiding cycstogram (VCUG). These authors looked at the inter observer variability of grading of vesicoureteral reflux (VUR) using a VCUG and highlight the implications for treatment and prognosis as a results....

Which is better – laparoscopic or open paediatric pyeloplasty?

In an attempt to answer the above question, Gatti et al. undertook a randomised controlled trial between 2005 and 2014. All children aged 1 to 18 years of age requiring surgery for pelviureteric junction (PUJ) obstruction were enrolled. A total...

Emergency department revisits for patients with ureteral stones

The authors aimed to identify clinical predictors for emergency department (ED) revisits in patients diagnosed with ureteral stones. Patients presenting between 2010 and 2013 were included. Those who were admitted at the initial presentation were excluded. CT scans were reviewed...

ESWL and URS for treatment of paediatric urolithiasis

Tejwani et al. have undertaken a comparative effectiveness study to characterise differences in procedure frequency, postoperative re-admissions and emergency room (ER) visits, and repeat treatment rates for children (≤18 years) with urolithiasis who underwent initial intervention with extracorporeal shock wave...

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