Journal of pediatric urology
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Clinical Trial
Prospective study of enhanced recovery after surgery protocol in children undergoing reconstructive operations.
Enhanced recovery after surgery (ERAS) protocol is a set of peri-operative strategies to increase speed of recovery. ERAS is well established in adults but has not been well studied in children. ⋯ ERAS decreased length of stay and 90-day complications after pediatric reconstructive surgery without increased re-admissions, re-operations or ED visits. A multicenter study will be required to confirm the potential benefits of adopting ERAS.
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Multicenter Study
Variation in the use of laparoscopy with inguinal hernia repairs in a sample of pediatric patients at children's hospitals.
Metachronous contralateral inguinal hernias (MCH) occur in approximately 10% of pediatric patients following unilateral inguinal hernia repairs (UIHR). Laparoscopic evaluation of the contralateral internal ring is a method of identifying high-risk individuals for prophylactic contralateral exploration and repair. ⋯ Variation existed in the use of laparoscopy during inguinal hernia repairs and associated costs within the current sample from children's hospitals in the United States. The additional costs of laparoscopic evaluation must be considered against the clinical utility and therapeutic consequences of identifying individuals with a higher risk of metachronous contralateral inguinal hernia.
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Parasacral transcutaneous electrical nerve stimulation (TENS) has emerged as an effective treatment for overactive bladder (OAB) in view of its high success rates in improving lower urinary tract symptoms and constipation, with no direct side effects. However, the clinical characteristics associated with the outcomes remain to be established. ⋯ Nocturnal enuresis was the only symptom associated with a poor outcome following parasacral TENS treatment in children with OAB.
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There is growing interest in the general activities of a pediatric urologist, whose specialty remains young in the spectrum of modern, organized medicine. Unplanned activities, which are more commonly referred to as consultations, can represent significant additional workload for the urologist seeing scheduled clinic patients or completing elective operative cases. ⋯ The pediatric urology service averaged about one formal consultation per day, with the most common diagnoses being hydronephrosis, urinary tract infection, urolithiasis, testicular torsion, and retention. One third of consults required intervention. Improved understanding of pediatric urology consultation would be helpful to facilitate physician education and improve service efficiency in the hospital setting.