The Journal of urology
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The Journal of urology · Oct 2013
Comparative StudyProspective systematic intervention to reduce patient exposure to radiation during pediatric ureteroscopy.
After prospective measurement of radiation exposure during pediatric ureteroscopy for urolithiasis, we identified targets for intervention. We sought to systematically reduce radiation exposure during pediatric ureteroscopy. ⋯ After systematic evaluation of our practices and implementation of a fluoroscopy quality checklist, there were dramatic decreases in radiation doses to children during ureteroscopy.
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The Journal of urology · Oct 2013
Comparative StudyUrinary NGAL levels correlate with differential renal function in patients with ureteropelvic junction obstruction undergoing pyeloplasty.
Recent investigations described the use of NGAL, a sensitive biomarker for kidney injury, in the setting of ureteropelvic junction obstruction. We prospectively evaluated urinary NGAL levels in the affected renal pelvis and bladder of children with ureteropelvic junction obstruction undergoing unilateral dismembered pyeloplasty. Our hypothesis was that higher NGAL in the kidney and bladder would correlate with decreased ipsilateral differential function. ⋯ Bladder NGAL is increased in children with ureteropelvic junction obstruction. Renal pelvic and bladder normalized urinary NGAL levels correlate inversely with the relative function of the affected kidney in cases of unilateral ureteropelvic junction obstruction.
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The Journal of urology · Oct 2013
Comparative StudyPediatric resident exposure to urology: identifying a need.
We evaluated current trends of pediatric urology exposure during the 3-year pediatric residency period nationwide. We also evaluated the opinions of urology and pediatric residency program directors regarding the need for additional exposure to pediatric urology. ⋯ These results show the desire on the part of urology and pediatric residency program directors for pediatric residents to have greater exposure to pediatric urology, particularly didactic and bedside teaching in the management of pediatric urological disorders. Increasing pediatric resident exposure to pediatric urological pathology and treatment during training would have a positive impact on the subsequent diagnosis and care of pediatric urological conditions.
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The Journal of urology · Oct 2013
Tumor lesion diameter on diffusion weighted magnetic resonance imaging could help predict insignificant prostate cancer in patients eligible for active surveillance: preliminary analysis.
We analyzed the pathological outcomes of candidates for active surveillance according to tumor lesion diameter on diffusion weighted magnetic resonance imaging. ⋯ Our analysis demonstrates that the simple measurement of the diameter of suspicious tumor lesions on diffusion weighted magnetic resonance imaging could improve the prediction of insignificant prostate cancer in candidates for active surveillance.
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The Journal of urology · Oct 2013
National trends in augmentation cystoplasty in the 2000s and factors associated with patient outcomes.
Augmentation cystoplasty is a major surgery performed by pediatric urologists. We evaluated national estimates of children undergoing augmentation cystoplasty in the United States for trends during the 2000s, and analyzed patient and hospital factors associated with outcomes. ⋯ The estimated number of augmentation cystoplasties performed in children in the United States decreased by 25% in the 2000s, and mean length of stay decreased by 1 day. The cause of the decrease is multifactorial but could represent changing practice patterns in the United States. Of the patients 30% had a potential complication during hospitalization after augmentation cystoplasty. Older age and bladder exstrophy-epispadias complex diagnosis were associated with greater length of stay and increased odds of having any complication.