| 1. |
- Bauer, Stuart, et al.
(författare)
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Standardizing terminology in pediatric urology
- 2007
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Ingår i: Journal of Pediatric Urology. - : Elsevier BV. - 1477-5131 .- 1873-4898. ; 3:2, s. 163-163
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Tidskriftsartikel (populärvet., debatt m.m.)
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| 2. |
- Fossum, M., et al.
(författare)
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Autologous in vitro cultured urothelium in hypospadias repair{star, open}
- 2007
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Ingår i: Journal of Pediatric Urology. - : Elsevier BV. - 1477-5131 .- 1873-4898. ; 3:1, s. 10-18
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To treat severe hypospadias with a transplant of autologous in vitro cultured urothelial cells on acellular dermis. Patients and methods: During 2000-2002 six patients aged 14-44 months with severe hypospadias were treated surgically with autologous urothelial cell transplants. All were born with scrotal or perineal hypospadias and pronounced chordee. All patients were subjected to a two-staged procedure starting with repair of the chordee. Urothelial cell harvesting via bladder lavage was performed during the first operation. The neourethra was constructed by using a transplant with cultured urothelium in an on-lay fashion. Patients have been followed 3-5.5 years. Results: All six boys are voiding through their neourethra without straining and have no residual urine after micturition. Five patients are using a standing voiding position and present bell shaped, urinary flow curves. One developed a stricture treated conservatively with persisting good effect (after more than 5 years). Two developed a fistula requiring surgical correction that was uneventful. The last patient developed an obstruction in the proximal anastomosis that was treated with an internal urethrotomy. Cosmetic appearance is good in all cases with good parental satisfaction. Urethroscopy in all patients show a wide penile neourethra. Biopsies indicate a mucosal lining consisting of urothelial cells in three cases. Conclusion: This technique is feasible for treatment of a selected group of hypospadias where pronounced chordee and shortage of preputial and penile skin complicates the creation of a neourethra. It may have other clinical implications including disorders such as bladder exstrophy and cloacal malformations, as well as mutilating traumatic injuries or cancer therapy. © 2006 Journal of Pediatric Urology Company.
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| 3. |
- Holmdahl, Gundela, 1956, et al.
(författare)
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Hypospadias repair with tubularized incised plate. Is uroflowmetry necessary postoperatively?
- 2006
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Ingår i: Journal of pediatric urology. - : Elsevier BV. - 1873-4898 .- 1477-5131. ; 2:4, s. 304-7
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: Hypospadias repair with tubularized incised plate urethroplasty (TIP) produces good cosmesis, but is reported to result in a change in urinary stream postoperatively, with an obstructive pattern. The aim of this retrospective study was to determine whether early uroflowmetry is a good method for diagnosing neourethral stricture. PATIENTS AND METHOD: In 126 boys, primary TIP repair was performed between 1999 and 2003. Uroflowmetry was performed in potty-trained boys 2 months' postoperatively (68 boys) and both 2 and 12 months (38 boys) after TIP. Boys with obstructed flow and/or clinical symptoms were calibrated in their neourethra. RESULTS: Forty-nine percent of the boys with distal hypospadias and 87% of the proximal cases had a flow rate of less than 10 ml/s at uroflowmetry 2 months after TIP, but only 12/126 boys (10%) were considered to have a neourethral stricture. There was a spontaneous increase in maximum flow rate between 2 and 12 months after TIP repair both in patients who had been calibrated and in boys in whom no intervention had been performed. CONCLUSION: Early uroflowmetry appears to be unnecessary, as the voiding history appears to be just as good at alerting a suspicion of urethral stricture after TIP repair. There is a spontaneous normalization of the urinary flow in boys after TIP repair, but the need for long-term follow up beyond puberty is great, especially in cases of proximal hypospadias.
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| 4. |
- Jansson, Ulla-Britt, 1950, et al.
(författare)
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Life events and their impact on bladder control in children.
- 2007
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Ingår i: Journal of pediatric urology. - : Elsevier BV. - 1873-4898 .- 1477-5131. ; 3:3, s. 171-7
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To investigate the relationship between incidence and nature of life events within families and age of bladder control acquisition in healthy children. SUBJECTS AND METHODS: Thirty-five parents of 36, 6-year-old children were interviewed using the Coddington life events questionnaire. RESULTS: The children had experienced a total of 185 life events (mean 5, median 4.5, range 1-12) before the time of dryness. The most common were related to childcare/occupation of parent (51%), illness/injury/death (24%), family composition (16%) and living conditions (9%). There was a strong correlation between the number of life events and the age of dryness; the more life events and the older the child was when experiencing them, the later the child became dry. The only single event that was significantly associated with a later age of dryness was the birth of a sister or brother. In general, children had reacted positively (39%) or neutrally, but to 30% of events there was a negative reaction. There was a correlation between the reaction of the child and adaptation to the life event, and if the child had difficulty adapting to an event, that child became day dry at a later age. CONCLUSION: Although life events are a natural part of daily life, this study supports the conclusion that a large number of events and events to which the child has difficulty adapting can be of importance for the age of acquisition of bladder control.
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| 5. |
- Lundblad, Barbro, 1947, et al.
(författare)
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Experiences of children treating functional bladder disturbances on schooldays.
- 2007
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Ingår i: Journal of pediatric urology. - : Elsevier BV. - 1873-4898 .- 1477-5131. ; 3:3, s. 189-93
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: After clinical urotherapeutic guidance, schoolchildren suffering from functional bladder disturbances are expected to manage treatment at school. To comply with treatment instructions the children have to visit the toilet at least every 3h, find the sitting position facilitating relaxation of the pelvic floor, and then empty the bladder as completely as possible. They often blame failing to comply on their experiences of the school toilet. We describe the experiences of children treating functional bladder disturbances on schooldays. METHOD: The study consisted of open-ended interviews of 20 schoolchildren aged 8-14years undergoing treatment for functional bladder disturbances, and qualitative content analysis was performed. RESULTS: Conflicting rules, a risky toilet environment and uncertainty concerning social support at school were experienced. The children had difficulty in reconciling treatment compliance with their psychological needs. They used various tricks to avoid disclosing their bladder disturbances and enabling postponement of toilet visits. Most children gave their psychological needs priority over carrying out treatment. CONCLUSION: The physical and social school environment was not adapted to these children's needs.
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| 6. |
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| 7. |
- Wahll, Louise, et al.
(författare)
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Is the mode of occurrence of vesicoureteral reflux correlated to bladder function and spontaneous resolution?
- 2009
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Ingår i: Journal of pediatric urology. - : Elsevier BV. - 1873-4898 .- 1477-5131. ; 5:3, s. 170-7
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: To investigate whether mode of occurrence of vesicoureteral reflux (VUR), during micturition (M), during filling without increase in pressure (passive, P) or in response to an overactive contraction (OA), can be explained by differences in bladder function. Also, to study if the mode of occurrence of VUR can predict spontaneous resolution. MATERIALS AND METHODS: There were 93 infants (68 boys and 25 girls) with VUR (grade III-V) included. Videocystometry was performed at median ages 5, 22 and 32 months registering grade and mode of reflux and bladder function characteristics. RESULTS: Mode of occurrence of reflux changed with age. During infancy P, OA and M reflux comprised almost equal parts. At follow up, P reflux had increased and both OA and M reflux had decreased. This was partly due to a significantly higher probability of spontaneous resolution for M than P reflux, at 40 months (42 vs 18%). P and M reflux were significantly correlated to bladder function characteristics. P reflux was seen in children with high bladder capacity and occurred early in filling. Other predictors were higher age within the respective group and female sex. M reflux was correlated to lack of residual urine, low bladder capacity and absence of overactivity. Other indicators were male sex and low-grade reflux. CONCLUSIONS: P and M reflux correlate to different bladder patterns: P with high bladder capacity and M with low bladder capacity and without signs of bladder dysfunction. M seems to be benign with a higher resolution rate.
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| 8. |
- Stenberg, Arne, et al.
(författare)
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Treatment of vesicoureteral reflux in children using stabilized non-animal hyaluronic acid/dextranomer gel (NASHA/DX) : A long-term observational study
- 2007
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Ingår i: Journal of Pediatric Urology. - : Elsevier BV. - 1477-5131. ; 3:2, s. 80-85
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: Vesicoureteral reflux (VUR) can be treated with open surgery, antibiotic therapy or endoscopic injection. A goal in children is to reduce the incidence of febrile urinary tract infections (UTIs). The present long-term observational study investigated outcomes and experiences of endoscopic treatment with stabilized non-animal hyaluronic acid/dextranomer, NASHAtrade mark/Dx. PATIENTS AND METHODS: Children treated with NASHA/Dx between 1993 and 1998 were sent a questionnaire by mail in 2005. Patients included in the study (n=231) had VUR grade III-V before treatment and grade 0-II afterwards. Patients completed 21 questions, with parental assistance if required. The questionnaire assessed clinical outcome, and the attitudes of both patients and their parents to their experiences of treatment with NASHA/Dx gel. Patients reporting UTI after treatment were contacted and their records analyzed. RESULTS: Questionnaires were completed by 179 eligible patients. Most (72%) received a single injection of NASHA/Dx gel, and all experienced febrile UTI before treatment. After treatment, 45 patients (25%) experienced UTI; 25 of these reported fever. Patient records and telephone interviews revealed no evidence of febrile UTI in 19 cases; febrile UTI was confirmed in six cases, an incidence of 3.4%. When asked about the worst aspect of VUR treatment, 9% indicated treatment with NASHA/Dx compared to 19% for medication and 72% for voiding cystourethrogram (VCUG); parent-rated responses were 19%, 24% and 57%, respectively. CONCLUSIONS: Endoscopic treatment with NASHA/Dx gel was associated with a low number of febrile UTIs following treatment, viewed positively and considered less bothersome than medication or VCUG. These findings support this treatment as a primary intervention for VUR.
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