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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...
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...
Biopsy should be considered for older boys (>10 years) undergoing orchidopexy for intra-abdominal testes
Cryptorchidism is associated with a 3 to 10-fold increase in malignancy and the age at which it is undertaken matters; the risk of testicular cancer is doubled in patients undergoing orchidopexy at 13 years of age compared to that treated...
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...
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...
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)...
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...
Should we let sleeping children lie?
Alarm therapy (AT) is a first line-treatment for nocturnal enuresis (NE) conditioning the child to wake in response to an auditory stimulus when wetting begins. It is currently unclear whether waking children and guiding them to urinate when the alarm...
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...
Long-term oncologic outcomes of salvage cryoablation for rrPC
Of patients undergoing radiotherapy (RT) for prostate cancer (PC), at least 15-20% will experience recurrence. Although salvage prostatectomy achieves durable oncological outcomes at 10 years, it is associated with significantly high morbidity. Thus, the majority of men with radio-recurrent prostate...
