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The current state of surgical practice for neonatal torsion

Perinatal testicular torsion may be subdivided into prenatal (73%) and postnatal (28%) up to 30 days post birth. Aetiology in the former is universally extra vaginal around the whole of the tunica vaginalis with testicular salvage rate of <5%. Postnatal...

Medical expulsive therapy for paediatric urolithiasis

Children who have kidney stones are likely to have recurrences. Many initial stones are treated conservatively allowing for spontaneous passage of small stones if possible. Doxazocin or tamsulosin are known to dilate the ureter and allow spontaneous passage of stones...

Bladder urothelial neoplasms in children

Urothelial bladder neoplasms are rare in children, occurring in 0.1-0.4% of the population before the age of 20. There are no current paediatric guidelines to their management. This study retrospectively reviews the files of patients from three tertiary centres between...

Cumulative incidence of outcomes and urologic procedures after augmentation cystoplasty

The authors of this paper describe the cumulative incidence of outcomes and surgical procedures following paediatric augmentation cystoplasties in the USA. They included all children <18 years over an 11-year period in their study and used the Pediatric Health Information...

‘Born in the USA’ – neonatal circumcision

In 2006, the British Association of Paediatric Urologists (BAPU) published a statement paper on the management of foreskin conditions (www.baps.org.uk/resources/management-foreskin-conditions). Non-therapeutic circumcisions (those to comply with religious or cultural practices) are not uniformly available on the NHS. Circumcisions for medical...

Frailty in urology – part 1

Part 2 of this topic can be found here Statement of the problem Clinical frailty carries an increased risk of poor health outcomes. The pathological process resulting in frailty is often overlooked and elucidating its aetiology and natural history are...

Endoscopic injection of bulking agent for recurrent paediatric epididymitis

Paediatric recurrent epididymitis is frequently observed in several urogenital conditions, and may result in deterioration of long-term fertility. The management of recurrent epididymitis is still a therapeutic challenge for paediatric urologists, and as yet there is no consensus for treatment....

BAPU consensus statement on the management of the neuropathic bladder

The summary of this paper states that a “consensus statement is not a guideline nor a method with which to establish what is best practice. It is a way of surveying practice and providing a benchmark for others to compare...

Needs of children with a chronic bladder in preparation for transfer to adult care

It is well recognised that transition from paediatric to adult practice is stressful for patients and parents. This paper describes a questionnaire-based study of 80 teenagers with chronic bladder disease (spina bifida exstrophy or other acquired neurogenic bladder condition) of...

Who should be taking care of the adolescent with testicular torsion?

From time to time (as paediatric surgeons), we receive referrals from regional hospitals to explore the testis in older boys. Given the time-critical nature of the condition, patients should benefit from assessment and surgery performed locally (when possible). Inter-hospital transfer...

Multidisciplinary consensus on the classification of prenatal and postnatal UT dilation classification system

There is a lack of evidence in the literature correlating prenatal and postnatal urinary tract (UT) dilation pathology because classification systems vary, differing descriptive terms are used, and because dilation is a dynamic process and uropathies present a spectrum of...

ESWL and URS for treatment of paediatric urolithiasis

Tejwani et al. have undertaken a comparative effectiveness study to characterise differences in procedure frequency, postoperative re-admissions and emergency room (ER) visits, and repeat treatment rates for children (≤18 years) with urolithiasis who underwent initial intervention with extracorporeal shock wave...