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Which is better – laparoscopic or open paediatric pyeloplasty?
In an attempt to answer the above question, Gatti et al. undertook a randomised controlled trial between 2005 and 2014. All children aged 1 to 18 years of age requiring surgery for pelviureteric junction (PUJ) obstruction were enrolled. A total...
Predictive factors for conservative treatment failure in paediatric blunt renal trauma
Blunt renal trauma is managed conservatively in children in the vast majority of cases. Grade IV renal injury is also generally managed non-operatively although occasionally intervention is needed for a urinoma that fails to settle. These authors retrospectively looked at...
Surgery in disorders of sexual development with gender issues
After the initial consensus meeting of 10 years ago on disorders of sex development (DSD) with the introduction of the new terminology and classification there are still abundant controversial issues associated with the management of children with these conditions. This...
Relax and take note of this!
Children with neurogenic bladders are at risk of renal compromise through high detrusor pressures. Management aims to provide continence and preserve the upper tracts by increasing capacity and compliance though early clean intermittent catheterisation and anticholinergics. Intradetrusor botulinum toxin has...
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...What exactly is Hinman Syndrome?
Who was Hinman and what is Hinman Syndrome? Frank Hinman Junior (1915–2011) first described ‘Hinman syndrome’ in the 1970s – a condition also known as a ‘non-neurogenic neurogenic bladder’. He was a renowned American urologist, educator and skilful artist and...
Ipsilateral ureteroureterostomy: does function of the obstructed moiety matter?
Upper pole nephrectomy has been the traditional surgical management of children with poorly functioning upper pole moieties in duplex renal collecting systems having ureteral ectopia and ureterocele. However, ablative surgery confers a risk of functional loss to the remnant moiety...
Is surgical antibiotic prophylaxis necessary for paediatric orchiopexy?
With the rise of resistant organisms to most commonly used antibiotics, there is a plea for judicious use of antibiotics, especially for clean surgical procedures. Potential adverse events associated with antibiotic use include allergic reaction (including anaphylaxis), clostridium difficile infection,...
Hypospadias surgery complication rates
These authors identified all children undergoing NHS hypospadias surgery between 1999 and 2009 in England using the hospital episode statistic database and looked at repair types and complications. High-volume centres (24/75) were classified as such if they did more than...
Refluxing ureteral reimplantation
Obstructed megaureters may be managed with temporising stents, cutaneous ureterostomies, or in older children with ureteral reimplantation (usually if the child is over one year of age). Cutaneous ureterostomies have risks of stomal stenosis, infection and leakage problems over nappies...
Surgical management of DSD
The management of children with disorders of sex development (DSD) continues to be controversial. This editorial was written in response to a review article in the same edition on ‘Evidence regarding cosmetic and medically unnecessary surgery in infants’ by M...
