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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...

The risk of failure after primary orchidopexy

Surgical standards for revalidation are growing in the UK. For paediatric surgery, primary orchidopexy is thought to be one procedure that could be used as a ‘plumb line’ for this. These authors looked at 1538 boys who underwent 1886 orchidopexies...

The GMS hypospadias score

Hypospadias surgery has been carried out for decades. Descriptive parameters for hypospadias severity are variable and difficult to reproduce. The severity of abnormalities lies along a continuous spectrum. The paediatric urological fraternity is attempting to develop more reliable comparators for...

Outcomes of preserving the foreskin during distal hypospadias

Hypospadias surgery continues to tax the minds of paediatric urologists. Increasingly distal hypospadias surgery is becoming more and more conservative (in some cases, carrying out only foreskin reconstruction and leaving a mild hypospadias) and the role of foreskin reconstruction as...

Health-related quality of life in men with corrected hypospadias

More and more studies on long-term outcomes of paediatric operations are being published, many of which concentrate on health-related quality of life (HRQol) scores. This paper compared 45 men with corrected hypospadias (mean age 26.2 years +/- 5.1 years) with...

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...

Barriers to use of semen analysis in the adolescent with a varicocele

This paper tries to address the question of identifying the cause of the difficulty in obtaining a semen analysis (SA) in adolescents with a varicocele in order to try to find improved strategies in giving patient advice, treatment and care....

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...

TIP hypospadias repair

This paper by one of the current international leaders in hypospadias surgery looks at the outcome of over 1800 consecutive hypospadias repairs using the tubularised incised plate (TIP) repair, beginning from the first original operation through to sequential modifications over...

Torsion of spermatic cord in children

This is an excellent review of ‘testicular’ torsion - which is said to occur in 1:4000 under 25-year-olds. Two age periods (adolescence and neonatal) are identified as having peak incidence. Acute torsion represents 27% of children with acute scrotum. The...