Journal of pediatric urology
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Elevated body mass index (BMI) is a well-known risk factor for perioperative complications in adults, but has not been investigated in children undergoing urologic procedures. Given the low rate of complications associated with urologic surgery, a large sample is required for their characterization, but BMI is frequently not available in administrative databases. Here we report results from the first nationally based, prospectively assembled cohort analyzed with respect to the association of BMI with 30-day postoperative events for pediatric urologic procedures. ⋯ BMI in the pediatric NSQIP urologic population was found to be associated with overall complication after adjustment for case type and preoperative comorbidity in a large national sample assembled for assessment of perioperative outcomes. An exploratory analysis uncovered more than two-fold increase in odds of wound complication in obese/overweight patients compared with a normal weight referent population. These results may be useful in preoperative counseling patients regarding perioperative risk.
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Idiopathic testicular/groin pain can be a difficult entity for children, their families, and caregivers. The role of interdisciplinary pain management has previously been demonstrated in treating chronic orchialgia at the present pediatric pain clinic. ⋯ Collaboration and early referral for interdisciplinary pain management as one of these multidisciplinary approaches may help to coordinate care and ease patient suffering.
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Regional anesthesia is often used in combination with general anesthesia for pediatric surgery, however, it is unknown if adjunctive regional blocks are beneficial to children undergoing urologic laparoscopic or robot-assisted laparoscopic (RAL) procedures. ⋯ Administration of caudal blocks should be considered for children of suitable age undergoing RAL surgery involving either the upper or lower urinary tract.
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Randomized Controlled Trial Comparative Study
Effect of two surgical circumcision procedures on postoperative pain: A prospective, randomized, double-blind study.
Male circumcision (MC) is one of the most commonly used surgical procedures worldwide for medical and traditional reasons. No studies have compared the postoperative pain advantages of conventional techniques (i.e., sleeve and dorsal slit). ⋯ The sleeve technique provides lower pain scores and a reduced incidence of agitation after elective MC.
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Multicenter Study
Sexual function in adult patients with classic bladder exstrophy: A multicenter study.
The bladder exstrophy-epispadias complex (BEEC) comprises a spectrum of congenital anomalies that represents the severe end of urorectal malformations, and has a profound impact on continence as well as sexual and renal functions. ⋯ To improve the quality of life of patients with BEEC/BE, treatment and follow-up should emphasize physical but also psychological care in these patients. Physicians should further re-evaluate their preconceptions and should take care of the patients throughout their lives.