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Antimuscarinics and behaviour in patients with spinal dysraphism
Since the 1980s patients with spinal dysraphism have had aggressive bladder management with clean intermittent catheterisation and anticholinergic therapy from early on in life. This strategy aims at improving lower and therefore upper urinary tract function thus decreasing the risk...
Age does not impact risk for urethroplasty complications after TIP repair of hypospadias
This paper is evidence of an increasing trend (especially in the USA) to lower the age at which hypospadias repair is undertaken. The current generalised best accepted age to repair hypospadias is between 6-18 months, which was reduced in the...
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...
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...
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....
Onabotulinum toxin A (BTX) not helpful for chronic scrotal pain
It is refreshing to read a report on negative outcomes as it reinforces the honesty that is often lacking with the well-known publication bias in medical publications. It is also not common to come across surgical randomised controlled trials (RCTs)...
Inguinal vs. scrotal orchidopexy
Undescended testes occur in 1-3% of newborns; the prevalence is even higher in premature babies. Traditionally the surgical approach has been inguinal orchidopexy, involving two incisions – inguinal and scrotal. In 1989, Bianchi and Squire proposed single scrotal incision orchidopexy...
A tale of two cities – hypospadias outcomes
As urologists, it is important to know our results. In terms of hypospadias surgery, which is commonly undertaken after the age of one year in the UK, long-term follow-up is required to fully acquire this knowledge. Long-term urinary outcomes and...
Is robotic pyeloplasty in the under-ones as good as open repair?
Pelviureteric junction obstruction (PUJO) is a common cause of paediatric hydronephrosis. Indications for intervention include reduced renal function (<40%), symptoms (urinary tract infection or pain) and increasing dilatation. Although the Anderson-Hynes open pyeloplasty (OP) has long been the gold standard...
Preoperative testosterone for hypospadias
Hypospadias affects around 1 in 400 boys. Glans width (GW) of <14mm has been shown to be an independent risk factor for urethroplasty complications following hypospadias repair. Testosterone (T) administration in prepubertal males increases both penile length and circumference. Its...
Hypospadias – how long should follow-up be?
The optimal duration of follow-up following childhood hypospadias repair (to detect complications) is ill-defined. Several surgeons recommend it to include assessment during puberty. Some may worry that ‘rapid penile growth’, ‘erectile forces’ and ‘sexual activity’ could potentially stress previously successful...
