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An evaluation of ureteral diameter ratio and vesicoureteral reflux index in the treatment of primary vesicoureteral reflux

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Asian Journal of urology 2024年第3期11卷 437-442页

作者： Yusuf Atakan Baltrak Nebil Akdogan Mutlu Deger Volkan Izol Ibrahim Atilla Aridogan Nihat Satar division pediatric urology Department of UrologyMedical FacultyCukurova UniversityAdanaTurkey

Objective:Vesicoureteral reflux(VUR)index is a simple,validated tool that reliably predicts significant improvement and spontaneous resolution of primary reflux in *** aim of this study was to evaluate and compare the ureter diameter ratio(UDR)and VUR index(VURx)of patients treated with endoscopic injection(EI)and ureteroneocystostomy(UNC)methods in the pediatric age group due to primary ***:Patients under the age of 18 years old who underwent EI and UNC with the diagnosis of primary VUR between January 2011 and September 2021 were determined as the *** UDR was assessed using voiding cystourethrography,and the VURx score was determined prior to treatment based on hospital records included in the ***:A total of 255 patients,60(23.5%)boys and 195(76.5%)girls,with a mean age of 76.5(range 13.0e204.0)months,were included in the *** was applied to 130(51.0%)patients and UNC was applied to 125(49.0%)patients due to primary *** optimum cut-off for the distal UDR was obtained as 0.17 with sensitivity and specificity of 73.0%and 63.0%,*** positive and negative predictive values were 66.0%and 70.0%,***:When the UDR and VURx score are evaluated together for the surgical treatment of primary VUR in the pediatric age group,it is thought that it may be useful in predicting the clinical course of the disease and evaluating surgical treatment options.

关键词： Distal ureter diameter ratio Vesicoureteral reflux Vesicoureteral reflux index management Vesicoureteral reflux index

Benign penile skin anomalies in children:a primer for pediatricians

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World Journal of pediatrics 2015年第4期11卷 316-323页

作者： Marco Castagnetti Mike Leonard Luis Guerra Ciro Esposito Marcello Cimador Section of pediatric urology Urology UnitUniversity Hospital of PadovaPaduaItaly Department of Surgery Division of Pediatric UrologyChildren's Hospital of Eastern OntarioUniversity of OttawaOttawaONCanada Department of pediatrics Federico II University of NaplesItaly Section of pediatric urology and pediatric Surgery Unit Department for Mother&Child Care and UrologyUniversity of PalermoPalermoItaly

Background:Abnormalities involving the skin coverage of the penis are diffi cult to defi ne,but they can significantly alter penile appearance,and be a cause of parental *** sources:The present review was based on a non-systematic search of the English language medical literature using a combination of key words including"penile skin anomalies"and the specific names of the different ***:Conditions were addressed in the following order,those mainly affecting the prepuce(phimosis,balanitis xerotica obliterans,balanitis,paraphimosis),those which alter penile configuration(inconspicuous penis and penile torsion),and lastly focal lesions(cysts,nevi and vascular lesions).Most of these anomalies are congenital,have no or minimal influence on urinary function,and can be detected on clinical *** improvement is *** the majority of cases undergoing surgery,the potential psychological implications of genital malformation on patient development are the main reason for treatment,and the age generally recommended for surgery is after 12 months of ***:This review provides the pediatrician with a handy tool to identify the most common penile skin anomalies,counsel parents adequately,make sensible and evidence based choices for management,and recognize complications or untoward outcomes in patients undergoing surgery.

关键词： balanitis xerotica obliterans foreskin penis phimosis

Comparison of perioperative outcomes between laparoscopic and open partial splenectomy in children and adolescents

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World Journal of Gastrointestinal Surgery 2021年第9期13卷 979-987页

作者： Mohamed Makansi Martin Hutter Till-Martin Theilen Henning C Fiegel Udo Rolle Stefan Gfroerer Department of pediatric Surgery and pediatric urology University Hospital FrankfurtFrankfurt am Main 60590Germany Department of pediatric Surgery and pediatric urology Helios Clinic Berlin-BuchBerlin 13125Germany

BACKGROUND In order to avoid consequences of total splenectomy,partial splenectomy(PS)is increasingly *** purpose of this study was to compare perioperative outcomes of laparoscopic PS(LPS)and open PS(OPS)in children and *** To compare perioperative outcomes of patients with LPS and *** After institutional review board approval,a total of 26 patients that underwent LPS or OPS between January 2008 and July 2018 were identified from the database of our tertiary referral *** total,10 patients had LPS,and 16 patients underwent *** loss was calculated by Mercuriali’s *** scores,analgesic requirements and complications were *** Wilcoxon rank sum test was used for *** compare categorical variables,Fisher’s exact test was *** LPS was performed in 10 patients;16 patients had ***(except for body mass index and duration of follow-up),indicating primary disease,preoperative spleen size and postoperative spleen volume,perioperative hematological parameters,postoperative pain scores,analgesic requirements,adverse events according to the Clavien-Dindo classification and the comprehensive complication index,median time from operation to initiation of feeds,median time from operation to full feeds,median time from operation to mobilization and median length of hospital stay did not differ between LPS and ***(range)operative time(min)was longer in LPS compared to the OPS group[185(135-298)vs 144(112-270),respectively;P=0.048].Calculated perioperative blood loss(mL of red blood cell count)was higher in the LPS group compared to OPS[87(-45-777)vs-37(-114-553),respectively;P=0.039].CONCLUSION This is the first study that compared outcomes of LPS and *** operative approaches had comparable perioperative *** appears to be a viable alternative to OPS.

关键词： Laparoscopic vs open Laparoscopy Partial splenectomy Perioperative outcome Children Adolescents

Robot-assisted extravesical ureteral reimplantation with ureteral tailoring and dismembering for complex obstructed megaureter

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Asian Journal of urology 2023年第1期10卷 101-102页

作者： Ciro Esposito Lorenzo Masieri Giuseppe Autorino Maria Escolino division of pediatric Surgery Federico II University of NaplesNaplesItaly division of pediatric urology Meyer Children HospitalFlorenceItaly

Dear Editor,The advantages of robotic technology including improved dexterity and visualization are particularly evident in challenging reconstructive procedures of the lower urinary tract[1,2].A recent literature review confirmed the feasibility and efficacy of robot-assisted ureteral reimplantation in case of complex anatomy or prior surgery[3].Intra-corporeal ureteral tapering and dismembering are also feasible options using robot-assisted surgery[4].

关键词： ureteral anatomy surgery

Efficacy and safety of desmopressin on frequency and urgency in female patients with overactive bladder and nocturia, current clinical features and outcomes: A systematic review

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Asian Journal of urology 2022年第1期9卷 27-34页

作者： Bara Barakat Knut Franke Matthias May Ulrich Gauger Thomas-Alexander Vogeli Hospital Viersen Department of Urology and Pediatric UrologyViersenGermany Hospital St.Elisabeth Department of UrologyStraubingGermany Institute for Medical Statistics BerlinGermany University Hospital RWTH Aachen Department of Urology and Pediatric UrologyAachenGermany

Objective To evaluate the efficacy and safety of desmopressin on frequency and urgency in female patients with overactive bladder(OAB)and *** A selective database search was conducted to validate the effectiveness of desmopressin in patients with OAB and *** Reporting Items for Systematic Reviews and Meta-Analyses guidelines were *** meta-analysis included 378 women(five studies)with *** clinical outcomes and adverse events were *** The treatment strategy of all the studies included can be divided into three categories:(1)The effect of desmopressin compared with baseline,(2)desmopressin compared with placebo,and(3)desmopressin and anticholinergic combination versus desmopressin *** was a significant(50%)reduction in nocturia and urgency episodes after using desmopressin *** desmopressin and anticholinergic led to a decrease in the frequency of nocturia voids when only using anticholinergic(65%vs.33.2%).The time increased in the middle to the first nightly voids in the combination arm(65.11 min;p=0.045).The mean incidence(standard deviation)of leak-free episodes was higher under desmopressin than under placebo in the first 4 h(62%[35%]vs.48%[40%])and in the first 8 h(55%[37%]vs.40%[41%]).The safety profile was comparable between *** Available data indicate that desmopressin is efficacious in significantly reducing nighttime urine production,episodes of nocturia,and urgency *** affectivity of the combination therapy was very high with least side effects for the treatment of OAB/nocturnal polyuria.

关键词： Overactive bladder Nocturia Desmopressin Urinary urgency Lower urinary tract

The impact of autophagy in spermiogenesis

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Asian Journal of Andrology 2017年第6期19卷 617-618页

作者： Nihan Ozturk Klaus Steger Undraga Schagdarsurengin Clinic of urology Pediatric Urology and AndrologySection Molecular Andrology Justus-Liebig-UniversityGiessen Schubertstrasse 81 35392 GiessenGermany.

Autophagy is an evolutionarily .conserved self-digestion process whichis essential to keep basal homeostasis in a cell. During this process, degradation and recycling of many cytoplasmic components including the long-lived, unnecessary or aggregated proteins and damaged organelles is achieved through lysosomal machinery. Autophagy has a critical role for lower eukaryotic organisms such as yeast to survive and adapt to nutrient starvation conditions. In addition to this primary function, autophagy appears as a crucial mechanism for cell differentiation and development enabling the cells to modify their content and morphology in response to environmental and hormonal cues. A recent study by Shang et all shed more light on the molecular mechanisms of how autophagy regulates spermiogenesis.

关键词： impact autophagy spermiogenesis

Comparison of outcomes between complete and incomplete congenital duodenal obstruction

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World Journal of Gastroenterology 2019年第28期25卷 3787-3797页

作者： Stefan Gfroerer Till-Martin Theilen Henning C Fiegel Anoosh Esmaeili Udo Rolle Department of pediatric Surgery and pediatric urology University Hospital Frankfurt Frankfurt 60590 Germany Department of pediatric Cardiology University Hospital Frankfurt Frankfurt 60590 Germany

BACKGROUND Congenital duodenal obstruction (CDO) can be complete (CCDO) or incomplete (ICDO). To date there is no outcome analysis available that compares both subtypes. AIM To quantify and compare the association between CCDO and ICDO with outcome parameters. METHODS We retrospectively reviewed all patients who underwent operative repair of CCDO or ICDO in our tertiary care institution between January 2004 and January 2017. The demographics, clinical presentation, preoperative diagnostics and postoperative outcomes of 50 patients were compared between CCDO (n = 27;atresia type 1-3, annular pancreas) and ICDO (n=23;annular pancreas, web, Ladd′s bands). RESULTS In total, 50 patients who underwent CDO repair were enrolled and followed for a median of 5.2 and 3.9 years (CCDO and ICDO, resp.). CCDO was associated with a significantly higher prenatal ultrasonographic detection rate (88% versus 4%;CCDO vs ICDO, P<0.01), lower gestational age at birth, lower age and weight at operation, higher rate of associated congenital heart disease (CHD), more extensive preoperative radiologic diagnostics, higher morbidity according to Clavien-Dindo classification and comprehensive complication index (all P≤0.01). The subgroup analysis of patients without CHD and prematurity showed a longer time from operation to the initiation of enteral feeds in the CCDO group (P<0.01). CONCLUSION CCDO and ICDO differ with regard to prenatal detection rate, gestational age, age and weight at operation, rate of associated CHD, preoperative diagnostics and morbidity. The degree of CDO in mature patients without CHD influences the postoperative initiation of enteral feeding.

关键词： Congenital duodenal obstruction Duodenal atresia Duodenal stenosis Prenatal ultrasonographic detection rate Clinical presentation Preoperative diagnostics Adverse events Outcome

Application and efficacy of reconstructing forked corpus spongiosum in distal/midshaft hypospadias repair

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Asian Journal of Andrology 2021年第1期23卷 47-51页

作者： Bin Zhang Yun-Li Bi Shuang-Sui Ruan Department of pediatric urology Children's Hospital of Fudan UniversityShanghai 201102China

We reviewed our experience in reconstructing forked corpus spongiosum(FCS)in distal/midshaft hypospadias repair and analyzed the efficacy of this surgical *** August 2013 to December 2018,137 consecutive cases of distal/midshaft hypospadias operated by the same surgeon in urology Department,Children’s Hospital of Fudan University(Shanghai,China),were retrospectively ***-four patients who underwent routine tubularized incised plate(TIP)or onlay island flap(ONLAY)surgery were included in the nonreconstructing group,and 73 patients who underwent reconstructing FCS during TIP or ONLAY surgery were included as the reconstructing ***-eight cases underwent TIP,and 26 underwent ONLAY in the nonreconstructing group,with a median follow-up of 44(range:30-70)***-seven cases underwent TIP,and 46 underwent ONLAY in the reconstructing group,with a median follow-up of 15(range:6-27)*** the nonreconstructing/reconstructing groups,the mean age at the time of surgery was 37.55(standard deviation[s.d.]:29.65)/35.23(s.d.:31.27)months,the mean operation duration was 91.95(s.d.:12.17)/93.84(s.d.:14.91)min,the mean neourethral length was 1.88(s.d.:0.53)/1.94(s.d.:0.53)cm,and the mean glans width was 11.83(s.d.:1.32)/11.56(s.d.:1.83)***(18.8%)/5(6.8%)postoperative complications occurred in the nonreconstructing/reconstructing *** included fistula(5/2),glans dehiscence(3/0),diverticulum(1/2),residual chordee(3/0),and meatus stenosis(0/1)in each *** was a significant difference in the overall rate of complications(P=0.035).These results indicate that the technique of reconstructing FCS provides excellent outcomes with fewer complications in distal/midshaft hypospadias repair.

关键词： complications distal/midshaft hypospadias forked corpus spongiosum glans tilt

Analysis of trends in testicular atrophy index values with age in patients with unilateral palpable cryptorchidism

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Asian Journal of Andrology 2022年第5期24卷 500-502页

作者： Pei-Qiang Li Yan Huang Fu-Yun Liu Department of pediatric urology The Third Affiliated Hospital of Zhengzhou UniversityZhengzhou 450052China

Cryptorchidism affects the growth of testicular *** volume is associated with reproductive *** testicular atrophy index evaluates the degree of damage caused by cryptorchidism,but it remains unclear whether changes in testicular atrophy index are related to *** selected patients who underwent surgery for unilateral palpable *** volume was measured using *** testicular atrophy indices of the undescended testes were then reviewed,and their correlation with age was *** studied 228 cases(age range:6–53 months).Scatter plots were constructed,and Loess curves were fitted,revealing a turning point at 24 months of *** patients were divided into age groups of 6–24 months and 25–53 *** testicular volume of the cryptorchid side was smaller than that of the normal side in both groups(both P<0.001).In the 6–24-month group,the testicular atrophy index was positively correlated with age,testicular volume on the cryptorchid side was not correlated with age,and testicular volume was positively correlated with age on the normal *** the 25–53-month group,testicular atrophy index and testicular volumes on either side were not correlated with age.A palpable unilateral cryptorchid testis is smaller than the contralateral *** testicular atrophy index increases with age between 6 months and 24 months,but not between 25 months and 53 *** volume increased with age on the normal side between 6 months and 24 months,but not on the cryptorchid *** in testicular atrophy index with age contribute to the decision of operation time.

关键词： cryptorchidism testicular atrophy index testicular volume