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Article: Maternal risk factors for posterior urethral valves.

van der Zanden, Loes F M / Groen In 't Woud, Sander / van Rooij, Iris A L M / Quaedackers, Josine S L T / Steffens, Martijn / de Wall, Liesbeth L L / Schreuder, Michiel F / Feitz, Wout F J / Roeleveld, Nel

Frontiers in pediatrics

2023 Volume 11, Page(s) 1110117

Abstract: Introduction: Posterior urethral valves (PUV) is a congenital disorder causing an obstruction of the lower urinary tract that affects approximately 1 in 4,000 male live births. PUV is considered a multifactorial disorder, meaning that both genetic and ... ...

Abstract	Introduction: Posterior urethral valves (PUV) is a congenital disorder causing an obstruction of the lower urinary tract that affects approximately 1 in 4,000 male live births. PUV is considered a multifactorial disorder, meaning that both genetic and environmental factors are involved in its development. We investigated maternal risk factors for PUV. Methods: We included 407 PUV patients and 814 controls matched on year of birth from the AGORA data- and biobank and three participating hospitals. Information on potential risk factors (family history of congenital anomalies of the kidney and urinary tract (CAKUT), season of conception, gravidity, subfertility, and conception using assisted reproductive techniques (ART), plus maternal age, body mass index, diabetes, hypertension, smoking, and use of alcohol and folic acid) was derived from maternal questionnaires. After multiple imputation, adjusted odds ratios (aORs) were estimated using conditional logistic regression corrected for minimally sufficient sets of confounders determined using directed acyclic graphs. Results: A positive family history and low maternal age (<25 years) were associated with PUV development [aORs: 3.3 and 1.7 with 95% confidence intervals (95% CI) 1.4-7.7 and 1.0-2.8, respectively], whereas higher maternal age (>35 years) was associated with a lower risk (aOR: 0.7 95% CI: 0.4-1.0). Maternal preexisting hypertension seemed to increase PUV risk (aOR: 2.1 95% CI: 0.9-5.1), while gestational hypertension seemed to decrease this risk (aOR: 0.6 95% CI: 0.3-1.0). Concerning use of ART, the aORs for the different techniques were all above one, but with very wide 95% CIs including one. None of the other factors studied were associated with PUV development. Conclusion: Our study showed that family history of CAKUT, low maternal age, and potentially preexisting hypertension were associated with PUV development, whereas higher maternal age and gestational hypertension seemed to be associated with a lower risk. Maternal age and hypertension as well as the possible role of ART in the development of PUV require further research.
Language	English
Publishing date	2023-04-28
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2711999-3
ISSN	2296-2360
ISSN	2296-2360
DOI	10.3389/fped.2023.1110117
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Article ; Online: Compensatory Hypertrophy in Paediatric Patients with a Unilateral Ureteropelvic Junction Obstruction.

Groen In 't Woud, Sander / Reuver, Nieke / Feitz, Wout F J / Quaedackers, Josine S L T / Nijman, Rien / Steffens, Martijn / de Wall, Liesbeth L L / Roeleveld, Nel / Schreuder, Michiel F / van der Zanden, Loes F M

European urology open science

2021 Volume 34, Page(s) 10–16

Abstract: Background: Compensatory hypertrophy is common in children with solitary functioning kidney, but it is unknown whether it also develops in children with unilateral partial reduction of kidney function.: Objective: The aim of this study was to assess ... ...

Abstract	Background: Compensatory hypertrophy is common in children with solitary functioning kidney, but it is unknown whether it also develops in children with unilateral partial reduction of kidney function. Objective: The aim of this study was to assess whether children with a unilateral ureteropelvic junction obstruction (UPJO) show compensatory growth of the unaffected kidney. Furthermore, we investigated whether the length of the unaffected kidney was related to the degree of split kidney function lost and other possible risk factors. Lastly, we studied a possible relationship with signs of kidney injury. Design setting and participants: We retrospectively analysed clinical information from 194 children with a unilateral UPJO who participated in the Aetiologic research into Genetic and Occupational/environmental Risk factors for Anomalies in children (AGORA) data- and biobank. Data on kidney length, split kidney function, and other factors possibly associated with kidney length were extracted from electronic patient records. Outcome measurements and statistical analysis: Pearson's correlation coefficients between the split kidney function and unaffected kidney length were calculated. Multivariable logistic regression analyses were performed to identify factors associated with kidney length and signs of kidney injury. Results and limitations: Most children with a UPJO had an unaffected kidney length above the reference for age at the end of follow-up (median age 6.5 yr). A correlation with split kidney function was present only in children with a split kidney function of ≥60% in the unaffected kidney ( Conclusions: Compensatory growth was visible in most children with a UPJO after sufficient follow-up time and was correlated with split kidney function in children with a severe UPJO. Contralateral kidney length provided no clear prognostic value for developing kidney injury. Studies with more patients and additional biomarkers of kidney injury are needed to further personalise care. Patient summary: Children with obstruction of urine outflow in one kidney often had a larger contralateral kidney. However, the size of this kidney could not be used to predict which children would develop kidney injury.
Language	English
Publishing date	2021-10-27
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	3040546-4
ISSN	2666-1683 ; 2058-4881
ISSN (online)	2666-1683
ISSN	2058-4881
DOI	10.1016/j.euros.2021.09.008
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Article ; Online: Clinical and surgical consequences of the COVID-19 pandemic for patients with pediatric urological problems: Statement of the EAU guidelines panel for paediatric urology, March 30 2020.

Quaedackers, Josine S L T / Stein, Raimund / Bhatt, Nikita / Dogan, Hasan Serkan / Hoen, Lisette / Nijman, Rien J M / Radmayr, Christian / Silay, Mesrur Selcuk / Tekgul, Serdar / Bogaert, Guy

Journal of pediatric urology

2020 Volume 16, Issue 3, Page(s) 284–287

Abstract: The COVID-19-pandemic forces hospitals to reorganize into a dual patient flow system. Healthcare professionals are forced to make decisions in patient prioritization throughout specialties. Most pediatric urology pathologies do not require immediate or ... ...

Abstract	The COVID-19-pandemic forces hospitals to reorganize into a dual patient flow system. Healthcare professionals are forced to make decisions in patient prioritization throughout specialties. Most pediatric urology pathologies do not require immediate or urgent care, however, delay may compromise future renal function or fertility. Contact with patients and parents, either physical in safe conditions or by (video)telephone must continue. The Paediatric-Urology-Guidelines-panel of the EAU proposes recommendations on prioritization of care. Pediatric-Urology program directors must ensure education, safety and attention for mental health of staff. Upon resumption of care, adequate prioritization must ensure minimal impact on outcome.
MeSH term(s)	Betacoronavirus ; COVID-19 ; Child ; Child, Preschool ; Coronavirus Infections/epidemiology ; Coronavirus Infections/prevention & control ; Coronavirus Infections/transmission ; Europe ; Female ; Humans ; Infant ; Male ; Pandemics/prevention & control ; Patient Selection ; Pneumonia, Viral/epidemiology ; Pneumonia, Viral/prevention & control ; Pneumonia, Viral/transmission ; Practice Guidelines as Topic ; SARS-CoV-2 ; Urologic Diseases/surgery ; Urologic Surgical Procedures ; Urology
Keywords	covid19
Language	English
Publishing date	2020-04-09
Publishing country	England
Document type	Journal Article
ZDB-ID	2237683-5
ISSN	1873-4898 ; 1477-5131
ISSN (online)	1873-4898
ISSN	1477-5131
DOI	10.1016/j.jpurol.2020.04.007
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Article: Genome-wide association study in patients with posterior urethral valves.

van der Zanden, Loes F M / Maj, Carlo / Borisov, Oleg / van Rooij, Iris A L M / Quaedackers, Josine S L T / Steffens, Martijn / Schierbaum, Luca / Schneider, Sophia / Waffenschmidt, Lea / Kiemeney, Lambertus A L M / de Wall, Liesbeth L L / Heilmann, Stefanie / Hofmann, Aybike / Gehlen, Jan / Schumacher, Johannes / Szczepanska, Maria / Taranta-Janusz, Katarzyna / Kroll, Pawel / Krzemien, Grazyna /

Szmigielska, Agnieszka / Schreuder, Michiel F / Weber, Stefanie / Zaniew, Marcin / Roeleveld, Nel / Reutter, Heiko / Feitz, Wout F J / Hilger, Alina C

Frontiers in pediatrics

2022 Volume 10, Page(s) 988374

Abstract: Congenital lower urinary tract obstructions (LUTO) are most often caused by posterior urethral valves (PUV), a male limited anatomical obstruction of the urethra affecting 1 in 4,000 male live births. Little is known about the genetic background of PUV. ... ...

Abstract	Congenital lower urinary tract obstructions (LUTO) are most often caused by posterior urethral valves (PUV), a male limited anatomical obstruction of the urethra affecting 1 in 4,000 male live births. Little is known about the genetic background of PUV. Here, we report the largest genome-wide association study (GWAS) for PUV in 4 cohorts of patients and controls. The final meta-analysis included 756 patients and 4,823 ethnicity matched controls and comprised 5,754,208 variants that were genotyped or imputed and passed quality control in all 4 cohorts. No genome-wide significant locus was identified, but 33 variants showed suggestive significance (
Language	English
Publishing date	2022-09-27
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2711999-3
ISSN	2296-2360
ISSN	2296-2360
DOI	10.3389/fped.2022.988374
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Article ; Online: Clinical and surgical consequences of the COVID-19 pandemic for patients with pediatric urological problems

Quaedackers, Josine S.L.T. / Stein, Raimund / Bhatt, Nikita / Dogan, Hasan Serkan / Hoen, Lisette / Nijman, Rien J.M. / Radmayr, Christian / Silay, Mesrur Selcuk / Tekgul, Serdar / Bogaert, Guy

Journal of Pediatric Urology

2020 Volume 16, Issue 3, Page(s) 284–287

Keywords	Pediatrics, Perinatology, and Child Health ; Urology ; covid19
Language	English
Publisher	Elsevier BV
Publishing country	us
Document type	Article ; Online
ZDB-ID	2237683-5
ISSN	1477-5131
ISSN	1477-5131
DOI	10.1016/j.jpurol.2020.04.007
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Article ; Online: CDH12

van der Zanden, Loes F M / van Rooij, Iris A L M / Quaedackers, Josine S L T / Nijman, Rien J M / Steffens, Martijn / de Wall, Liesbeth L L / Bongers, Ernie M H F / Schaefer, Franz / Kirchner, Marietta / Behnisch, Rouven / Bayazit, Aysun K / Caliskan, Salim / Obrycki, Lukasz / Montini, Giovanni / Duzova, Ali / Wuttke, Matthias / Jennings, Rachel / Hanley, Neil A / Milmoe, Natalie J /

Winyard, Paul J D / Renkema, Kirsten Y / Schreuder, Michiel F / Roeleveld, Nel / Feitz, Wout F J

European urology open science

2021 Volume 28, Page(s) 26–35

Abstract: Background: Posterior urethral valves (PUVs) and ureteropelvic junction obstruction (UPJO) are congenital obstructive uropathies that may impair kidney development.: Objective: To identify genetic variants associated with kidney injury in patients ... ...

Abstract	Background: Posterior urethral valves (PUVs) and ureteropelvic junction obstruction (UPJO) are congenital obstructive uropathies that may impair kidney development. Objective: To identify genetic variants associated with kidney injury in patients with obstructive uropathy. Design setting and participants: We included 487 patients born in 1981 or later who underwent pyeloplasty or valve resection before 18 yr of age in the discovery phase, 102 PUV patients in a first replication phase, and 102 in a second replication phase. Outcome measurements and statistical analysis: Signs of kidney injury were defined as dialysis, nephrectomy, kidney transplantation, estimated glomerular filtration rate (eGFR) <60 ml/min/1.73 m Results and limitations: Despite the small and nonhomogeneous sample, we observed suggestive associations for six SNPs in three loci, of which rs6874819 in the Conclusions: This study identified Patient summary: We found that variants of the
Language	English
Publishing date	2021-04-24
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	3040546-4
ISSN	2666-1683 ; 2058-4881
ISSN (online)	2666-1683
ISSN	2058-4881
DOI	10.1016/j.euros.2021.04.001
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Article ; Online: Maternal dexamethasone and EEG hyperactivity in preterm fetal sheep.

Davidson, Joanne O / Quaedackers, Josine S L T / George, Sherly A / Gunn, Alistair Jan / Bennet, Laura

The Journal of physiology

2011 Volume 589, Issue Pt 15, Page(s) 3823–3835

Abstract: Maternal treatment with synthetic corticosteroids such as dexamethasone (DEX)significantly reduces neonatal morbidity and mortality, but its effects on the fetal brain remain unclear. In this study we evaluated the effects of DEX on EEG activity in ... ...

Abstract	Maternal treatment with synthetic corticosteroids such as dexamethasone (DEX)significantly reduces neonatal morbidity and mortality, but its effects on the fetal brain remain unclear. In this study we evaluated the effects of DEX on EEG activity in preterm fetal sheep. Ewes at 103 days gestation received two intramuscular injections of DEX (12 mg, n = 8) or saline vehicle (n = 7) 24 h apart. Fetal EEG activity was recorded from 6 h before until 120 h after the first injection (DEX-1). DEX-1 was associated with a marked transient rise in total EEG power, maximal at 12 h (P < 0.001), with a relative increase in delta and reduced theta, alpha and beta activity, resolving by 24 h. Continuous EEG records showed a shift to larger but less frequent transient waveforms (P < 0.001). Unexpectedly, evolving epileptiform activity, consistent with electrographic and clinical seizures, developed from 178 ± 44 min after DEX-1.Similar but smaller changes were seen after the second injection. Following the injections, total power returned to control values, but the proportion of alpha activity progressively increased vs. controls (P < 0.001), with reduced interburst interval duration and number (P < 0.001). No histological neural injury or microglial activation was seen. In summary, exposure to maternal dexamethasone was associated with dramatic, evolving low-frequency hyperactivity on fetal cortical EEG recordings, followed by sustained changes consistent with maturation of fetal sleep architecture. We postulate that these effects may contribute to improved neonatal outcomes.
MeSH term(s)	Animals ; Cerebellum/drug effects ; Cerebellum/physiology ; Dexamethasone/pharmacology ; Electroencephalography/drug effects ; Female ; Fetal Movement/drug effects ; Fetal Movement/physiology ; Fetus/drug effects ; Fetus/physiology ; Pregnancy ; Sheep ; Sleep/drug effects ; Sleep/physiology
Chemical Substances	Dexamethasone (7S5I7G3JQL)
Language	English
Publishing date	2011-06-06
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	3115-x
ISSN	1469-7793 ; 0022-3751
ISSN (online)	1469-7793
ISSN	0022-3751
DOI	10.1113/jphysiol.2011.212043
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Article ; Online: Are there any benefits of using an inlay graft in the treatment of primary hypospadias in children? A systematic review and metanalysis.

Silay, Mesrur Selcuk / 't Hoen, Lisette / Bhatt, Nikita / Quaedackers, Josine / Bogaert, Guy / Dogan, Hasan Serkan / Nijman, Rien J M / Rawashdeh, Yazan / Stein, Raimund / Tekgul, Serdar / Radmayr, Christian

Journal of pediatric urology

2021 Volume 17, Issue 3, Page(s) 303–315

Abstract: Introduction: Dorsal inlay graft urethroplasty (DIGU) has been described as an effective method for hypospadias repair with the proposed advantage of reducing the risk of complications. We aimed to systematically assess whether DIGU has any additional ... ...

Abstract	Introduction: Dorsal inlay graft urethroplasty (DIGU) has been described as an effective method for hypospadias repair with the proposed advantage of reducing the risk of complications. We aimed to systematically assess whether DIGU has any additional advantages over standard tubularized incised plate urethroplasty (TIPU) repair in children with primary hypospadias. Materials and methods: This systematic review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statement. The a priori protocol is available at the PROSPERO database (CRD42020168305). A literature search was conducted for relevant publications from 1946 until January 10, 2020 in seven different databases. Randomized controlled trials (RCTs), comparative studies (TIPU vs DIGU) and single arm case series (>20 cases) of DIGU were eligible for inclusion. Secondary hypospadias, two-stage repairs, disorders of sex development, significant curvature of >30°, and a mean or median follow-up of less than 12 months were excluded. Discussion: A total of 499 articles were screened and 14 studies (3 RCTs, 5 non-randomized studies (NRSs), and 6 case series) with a total of 1753 children (distal: 1334 (76%) and proximal: 419 (24%)) were found eligible. Mean follow-up of the studies was between 16 and 77 months. DIGU was found superior to TIPU in decreasing meatal/neourethral stenosis (p = 0.02, 95% CI 0.02-0.78). All other parameters were found comparable including overall complications, fistula and glans dehiscence rates. Success rates were similar among the groups ranging between 48% and 96% for DIGU and 43-96% in the TIPU group. The lack of standardization in the definition of complications and success was the major limitation of this study. Conclusions: Using an inlay graft during primary hypospadias repair decreases the risk of meatal/neourethral stenosis. However, current evidence does not demonstrate superiority of DIGU over TIPU in terms of treatment success and overall complication rates.
Language	English
Publishing date	2021-02-19
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	2237683-5
ISSN	1873-4898 ; 1477-5131
ISSN (online)	1873-4898
ISSN	1477-5131
DOI	10.1016/j.jpurol.2021.02.013
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Article ; Online: European Association of Urology and European Society for Paediatric Urology Guidelines on Paediatric Urinary Stone Disease.

Tekgül, Serdar / Stein, Raimund / Bogaert, Guy / Nijman, Rien J M / Quaedackers, Josine / 't Hoen, Lisette / Silay, M Selcuk / Radmayr, Christian / Doğan, Hasan Serkan

European urology focus

2021 Volume 8, Issue 3, Page(s) 833–839

Abstract: Context: Paediatric stone disease is an important clinically entity and management is often challenging. Although it is known that the condition is endemic in some geographic regions of the world, the global incidence is also increasing. Patient age and ...

Abstract	Context: Paediatric stone disease is an important clinically entity and management is often challenging. Although it is known that the condition is endemic in some geographic regions of the world, the global incidence is also increasing. Patient age and sex; the number, size, location, and composition of the stone; and the anatomy of the urinary tract are factors that need to be taken into consideration when choosing a treatment modality. Objective: To provide a general insight into the evaluation and management of urolithiasis in the paediatric population in the era of minimally invasive surgery. Evidence acquisition: A nonsystematic review of the literature on management of paediatric urolithiasis was conducted with the aim of presenting the most suitable treatment modality for different scenarios. Evidence synthesis: Because of high recurrence rates, open surgical intervention is not the first option for paediatric stone disease, except for very young patients with very large stones in association with congenital abnormalities. Minimally invasive surgeries have become the first option with the availability of appropriately sized instruments and accumulating experience. Extracorporeal shockwave lithotripsy (SWL) is noninvasive and can be carried out as an outpatient procedure under sedation, and is the initial choice for management of smaller stones. However, for larger stones, SWL has lower stone-free rates and higher retreatment rates, so minimally invasive endourology procedures such as percutaneous nephrolithotomy and retrograde intrarenal surgery are preferred treatment options. Conclusions: Contemporary surgical treatment for paediatric urolithiasis typically uses minimally invasive modalities. Open surgery is very rarely indicated. Patient summary: Cases of urinary stones in children are increasing. Minimally invasive surgery can achieve high stone-free rates with low complication rates. After stone removal, metabolic evaluation is strongly recommended so that medical treatment for any underlying metabolic abnormality can be given. Regular follow-up with imaging such as ultrasound is required because of the high recurrence rates.
MeSH term(s)	Child ; Humans ; Lithotripsy/methods ; Nephrolithotomy, Percutaneous/methods ; Urinary Calculi/surgery ; Urolithiasis/surgery ; Urology
Language	English
Publishing date	2021-05-26
Publishing country	Netherlands
Document type	Journal Article ; Review
ISSN	2405-4569
ISSN (online)	2405-4569
DOI	10.1016/j.euf.2021.05.006
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Article ; Online: EAU-ESPU guidelines recommendations for daytime lower urinary tract conditions in children.

Tekgul, Serdar / Stein, Raimund / Bogaert, Guy / Undre, Shabnam / Nijman, Rien J M / Quaedackers, Josine / 't Hoen, Lisette / Kocvara, Radim / Silay, Mesrur Selcuk / Radmayr, Christian / Dogan, Hasan Serkan

European journal of pediatrics

2020 Volume 179, Issue 7, Page(s) 1069–1077

Abstract: The objective is to review the literature related to lower urinary tract (LUT) conditions in children to conceptualize general practice guidelines for the general practitioner, pediatrician, pediatric urologist, and urologist. PubMed was searched for the ...

Abstract	The objective is to review the literature related to lower urinary tract (LUT) conditions in children to conceptualize general practice guidelines for the general practitioner, pediatrician, pediatric urologist, and urologist. PubMed was searched for the last 15-year literature by the committee. All articles in peer-review journal-related LUT conditions (343) have been retrieved and 76 have been reviewed extensively. Prospective trials were few and the level of evidence was low. Most of the recommendations have been done by committee consensus after extensive discussion of literature reports. History taking is an integral part of evaluation assessing day- and nighttime urine and bowel control, urgency, and frequency symptoms. Exclusion of any neurogenic and organic cause is essential. Uroflowmetry and residual urine determination are recommended in all patients to evaluate bladder emptying. Urodynamic studies are reserved for refractory or complicated cases. Urotherapy that aims to educate the child and family about bladder and bowel function and guides them to achieve normal voiding and bowel habits should initially be employed in all cases except those who have urinary tract infections (UTI) and constipation. Specific medical treatment is added in the case of refractory overactive bladder symptoms and recurrent UTIs.Conclusion: Producing recommendations for managing LUTS in children based on high-quality studies is not possible. LUTS in children should be evaluated in a multimodal way by minimal invasive diagnostic procedures. Urotherapy is the mainstay of treatment and specific medical treatment is added in refractory cases.What is Known:• Symptoms of the lower urinary tract may have significant social consequences and sometimes clinical morbidities like urinary tract infections and vesicoureteral reflux. In many children, however, there is no such obvious cause for the incontinence, and they are referred to as having functional bladder problems.What is New:• This review aims to construct a practical recommendation strategy for the general practitioner, pediatrician, pediatric urologist, and urologist for LUTS in children. Producing recommendations for managing LUTS in children based on high-quality studies is not possible. LUTS in children should be evaluated in a multimodal way by minimal invasive diagnostic procedures. Urotherapy is the mainstay of treatment and specific medical treatment is added in refractory cases.
MeSH term(s)	Child ; Combined Modality Therapy ; Humans ; Lower Urinary Tract Symptoms/diagnosis ; Lower Urinary Tract Symptoms/etiology ; Lower Urinary Tract Symptoms/therapy ; Urinary Incontinence/diagnosis ; Urinary Incontinence/etiology ; Urinary Incontinence/therapy ; Urinary Tract Infections/diagnosis ; Urinary Tract Infections/etiology ; Urinary Tract Infections/therapy ; Vesico-Ureteral Reflux/diagnosis ; Vesico-Ureteral Reflux/therapy
Language	English
Publishing date	2020-05-29
Publishing country	Germany
Document type	Journal Article ; Practice Guideline
ZDB-ID	194196-3
ISSN	1432-1076 ; 0340-6199 ; 0943-9676
ISSN (online)	1432-1076
ISSN	0340-6199 ; 0943-9676
DOI	10.1007/s00431-020-03681-w
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