Journal of pediatric urology
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To describe and evaluate our protocol for management of children≤4years old with obstructive calcular anuria (OCA) and acute renal failure (ARF) to improve selection of initial urinary drainage (ID) method and to facilitate subsequent definitive stone management (DSM) as studies discussing this special group of patients are still few. ⋯ Our protocol ensures adequate ID with minimal complications when using our selection criteria in children≤4 years in age with OCA and ARF. It also minimizes number of subsequent procedures to clear stones. Complications and success in insertion and drainage were equivalent in PCN and JJ groups.
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Parisian cutler Joseph-Frédéric-Benoît Charrière (1803-1876) contributed greatly to surgical disciplines with innovative tools, but his legacy is the gauge system he developed in 1842 that is still used for catheters, probes, and dilators. Sounding devices have been documented in the surgical armamentarium since 3000 BC, with practitioners such as Hippocrates, Galen, Celsus, and Al-Zahrawi espousing theories on sounding and the related topics of stones and urinary obstruction. ⋯ Most importantly he created the catheter scale that, despite not being favored in its country of origin, became an international standard and is known today as the French system. The classification of sounds, catheters, and bougies has undergone many variations throughout the years, but the French scale still holds in current medical practice as an accurate and nearly universal sizing tool.
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A major hurdle in management of any chronic pain syndrome is understanding the population in which it occurs. We describe our pediatric population of patients with peripubertal and postpubertal chronic orchialgia. ⋯ Many pediatric patients with chronic orchialgia have co-morbidities amenable to multidisciplinary collaborative coordination of care. Referral to pediatric pain clinic can be of significant benefit.
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Children with occult spinal dysraphism represent a wide spectrum of patients. Previous studies assessing urologic outcomes have in part been deficient due to the inability to appropriately categorize these patients and gather long-term follow-up data. In this study, a uniform set of patients that had occult spinal dysraphism with magnetic resonance imaging findings of a fatty filum terminale (FF) and/or low-lying cord (LLC) was identified. Utilizing long-term follow-up data, predictors for achieving urinary continence following tethered cord release (TCR) were determined. ⋯ Isolated cutaneous lesions and preoperative continence status are positive predictors for post-TCR continence. While pre- and post-TCR urodynamics do not predict continence status, their utility in preoperative work-up, monitoring for retethering, and long-term urologic follow-up requires further examination.