Journal of pediatric urology
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Randomized Controlled Trial
The effect of virtual reality on Children's anxiety, fear, and pain levels before circumcision.
Circumcision is one of the oldest and most frequently performed surgical interventions in many societies across the world. Boys undergoing this procedure experience anxiety and fear during the preoperative period. In addition, postoperative pain in children is reported to be associated with anxiety and fear. ⋯ Distracting children using a VR intervention before circumcision decreased their anxiety and fear both before and after the surgery, and it was found that the pain symptoms were lower in the postoperative period.
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Randomized Controlled Trial
Effectiveness of caudal epidural block on interaoperative blood loss during hypospadias repair: A randomized clinical trial.
Intraoperative blood loss is considered to be an important issue in hypospadias surgery. Some studies have demonstrated the utility of caudal epidural block (CEB) in this regard among pediatric patients with hypospadias. Though there is evidence in favor of the use of CEB as the only anesthetic method for pediatric surgeries, it is usually used in combination with general anesthesia. In this form of use, it could have more favorable outcomes for both intra- and postoperative periods. There are few studies regarding the effectiveness of CEB on intraoperative blood loss. ⋯ The findings of current study indicated that caudal epidural anesthesia in addition to general anesthesia has a favorable effect on reducing blood loss during operation, operation time, and analgesic use. Our data confirm the findings of previous studies in this field. Further studies are recommended to evaluate the effect of this type of analgesia in other outcomes of hypospadias repair surgery. Our results could be used for revising existing surgical guidelines for better management of hypospadias.
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Randomized Controlled Trial Multicenter Study
The Swedish infant high-grade reflux trial: UTI and renal damage.
High-grade vesicoureteral reflux (VUR) in children is associated with recurrent urinary tract infection (UTI) and renal damage. Breakthrough UTI despite continuous antibiotic prophylaxis (CAP) during the first years of life is a matter of concern and evokes early intervention. We investigated whether early endoscopic treatment (ET) of VUR grade 4-5 can reduce the risk of UTI recurrence and renal scarring. ⋯ This study did not show any difference between ET and CAP in reducing the risk of UTI recurrence or renal deterioration. The rate of VUR resolution was higher in the ET group and VUR grade at follow-up correlated with both UTI recurrence and renal deterioration.
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Randomized Controlled Trial
Transcutaneous posterior tibial nerve stimulation in pediatric overactive bladder: A preliminary report.
Non-neurogenic overactive bladder (OAB) is a common problem in children that may affect their quality of life. Various methods of neuromodulation have been reported to treat refractory lower urinary tract dysfunction. Since most of these techniques are invasive, they are less applicable in children. ⋯ Transcutaneous PTNS is superior to placebo in treatment of non-neurogenic overactive bladder in children. In view of its effectiveness and acceptability we believe that transcutaneous PTNS should be part of pediatric urology armamentarium for treatment of OAB.
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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.