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Article ; Online: Abdominal Evisceration: A Rare Complication of In Utero Vesicoamniotic Shunting.

Galvez, Cinthia / Isern, Samantha / Nassau, Daniel / Babastro, Yisel / Swirsky, Matthew / Castellan, Miguel / Labbie, Andrew / Gosalbez, Rafael

Urology

2022 Volume 168, Page(s) 201–204

Abstract: Vesicoamniotic shunting (VAS) is one of the most common surgical options in selected cases of severe fetal obstructive uropathy. Abdominal evisceration secondary to VAS has been reported in only eight cases. A pregnant woman underwent VAS due to lower ... ...

Abstract	Vesicoamniotic shunting (VAS) is one of the most common surgical options in selected cases of severe fetal obstructive uropathy. Abdominal evisceration secondary to VAS has been reported in only eight cases. A pregnant woman underwent VAS due to lower urinary tract obstruction with severe oligohydramnios. Abdominal evisceration was observed at birth. Subsequently, he underwent abdominal surgical repair and urethral dilations due to segmental urethral atresia. At 21-month-follow-up, the patient is breathing spontaneously, undergoing peritoneal dialysis, voiding small amounts of urine, and being fed via G-tube. Data from those previous case reports is systematically reviewed and compared with our case.
MeSH term(s)	Humans ; Pregnancy ; Male ; Infant, Newborn ; Female ; Fetal Diseases ; Retrospective Studies ; Urethral Diseases ; Urethral Obstruction/surgery
Language	English
Publishing date	2022-05-24
Publishing country	United States
Document type	Case Reports
ZDB-ID	192062-5
ISSN	1527-9995 ; 0090-4295
ISSN (online)	1527-9995
ISSN	0090-4295
DOI	10.1016/j.urology.2022.05.008
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Article: Correction: Neonatal Circumcision: What Are the Factors Affecting Parental Decision?

Guevara, Christian G / Achua, Justin K / Blachman-Braun, Ruben / Cabrera-Valencia, Isabella / Ransford, George A / Gosalbez, Rafael / Labbie, Andrew S / Castellan, Miguel A / Alam, Alireza

Cureus

2023 Volume 15, Issue 10, Page(s) c137

Abstract: This corrects the article DOI: 10.7759/cureus.19415.]. ...

Abstract	[This corrects the article DOI: 10.7759/cureus.19415.].
Language	English
Publishing date	2023-10-13
Publishing country	United States
Document type	Published Erratum
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.c137
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Article ; Online: Does preoperative screening VCUG affect the outcomes and complications of pyeloplasty in patients with ureteropelvic junction obstruction?

Suarez Arbelaez, Maria Camila / Khanna, Kashish / Raymo, Adele / Weber, Alexander / Lerendegui, Luciana / Nackeeran, Sirpi / Gosalbez, Rafael / Labbie, Andrew S / Castellan, Miguel A / Nassau, Daniel E / Alam, Alireza

Journal of pediatric urology

2023 Volume 20, Issue 1, Page(s) 76.e1–76.e7

Abstract: Introduction: The role of voiding cystourethrogram (VCUG) in evaluating vesicoureteral reflux (VUR) in patients with known ureteropelvic junction obstruction (UPJO) remains unclear. While VCUG is frequently performed, the incidence of concomitant VUR ... ...

Abstract	Introduction: The role of voiding cystourethrogram (VCUG) in evaluating vesicoureteral reflux (VUR) in patients with known ureteropelvic junction obstruction (UPJO) remains unclear. While VCUG is frequently performed, the incidence of concomitant VUR and UPJO is low, and VUR is often low-grade with high rates of spontaneous regression. Objective: To analyze the clinical relevance of VCUG in patients with UPJO by determining its incidence and studying the difference in clinical outcomes between patients with known, unknown, and negative VUR. Study design: Retrospective review of patients with UPJO who underwent pyeloplasty from 2012 to 2020 with <18 years-old, unilateral UPJO, postoperative follow-up of ≥2 months and had at least 1 renal ultrasound (US) after pyeloplasty. Results were compared among 3 groups: patients who underwent VCUG before pyeloplasty and were found to have VUR (group 1), patients who underwent VCUG before pyeloplasty without VUR (group 2), and patients who did not have a VCUG before pyeloplasty (group 3). Results: A total of 275 patients met the inclusion criteria, of which 21 patients were classified in group 1, 166 patients in group 2, and 88 patients in group 3 (Table). The age at preoperative VCUG was 14.7 ± 32.9 months in group 1 and 15.17 ± 35.8 months in group 2 (p = 0.960). Overall, the incidence of concomitant UPJO and VUR was 11.2%. In group 1 the initial VUR grade was 5 in 2 patients, 4 in 3, 3 in 5, 2 in 7, and 1 in 4 patients. Of these, only 1 patient required ureteral reimplantation after pyeloplasty. Post-pyeloplasty, no significant differences were observed in complications (p = 0.7436), length of follow up (p = 0.3212), SFU grade 4 hydronephrosis (p = 0.2247), postoperative UTIs (p = 0.1047) and pyeloplasty success rate (p = 0.4206) among the 3 groups. Despite the use of antibiotic prophylaxis being significantly different amongst the three groups (p < 0.001), it was not associated with a lower incidence of postoperative UTIs (group 1 p = 0.068, group 2 p = 0.486, group 3 p = 1). In patients with reflux, an increase in age was associated with a decrease in the rates of complications (p = 0.019). Conclusion: We found no significant difference in the outcomes in patients who had a preoperative VCUG as compared to those who did not. The preoperative diagnosis of VUR by VCUG changed the management in less than 1% of the study population and thus its role in patients with UPJO should be reevaluated.
MeSH term(s)	Humans ; Infant ; Adolescent ; Kidney ; Ureter/surgery ; Ureteral Obstruction/surgery ; Ureteral Obstruction/complications ; Vesico-Ureteral Reflux/complications ; Cystography/adverse effects ; Urinary Tract Infections/complications ; Retrospective Studies
Language	English
Publishing date	2023-09-26
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.2023.09.016
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Article ; Online: Long-Term Bowel Vaginoplasty With a Single Yang-Monti Tube.

Galvez, Cinthia / Raymo, Adele / Ransford, Andrew / Quezada-Pinedo, Hugo G / Nassau, Daniel E / Castellan, Miguel / Labbie, Andrew S / Alam, Alireza / Gosalbez, Rafael

Urology practice

2023 Volume 11, Issue 2, Page(s) 439–446

Abstract: Introduction: The bowel remains the favored tissue for neo-vaginoplasty (NeoVP) in pediatric patients with vaginal agenesis. In 2001, the first description of NeoVP using the Yang-Monti technique with a sigmoid double tubular flap was published. We ... ...

Abstract	Introduction: The bowel remains the favored tissue for neo-vaginoplasty (NeoVP) in pediatric patients with vaginal agenesis. In 2001, the first description of NeoVP using the Yang-Monti technique with a sigmoid double tubular flap was published. We present our experience of NeoVP with a single Yang-Monti tube (SYMT) flap and report on the use of different segments of colon. Methods: We conducted a retrospective review of patients who underwent NeoVP using a bowel SYMT between 2009 and 2021. The procedure was performed under open abdominal surgery by isolating 8 to 12 cm from the rectosigmoid, cecum, or ascending colon. Subsequently, this segment was detubularized near the mesenteric border, folded, and retubularized transversally, leaving the mesentery in a cephalic position. A channel was dissected in the pelvis to accommodate the NeoVP. Results: Seventeen patients were identified. The median age was 16 years old. The principal diagnosis was Mayer-Rokitansky's syndrome (47.1%). The median follow-up was 50 months. The mean harvested bowel length was 9 cm, and the sigmoid was the preferred site (65%). The cecum-ascending colon was used in 3 (17.6%) patients. Complications were recorded in 6 patients (35%). Of these 6 patients, 4 had introital stenosis. There was 1 case of urethrovaginal fistula and another of left hematometrocolpos. Satisfactory sexual function has been reported in sexually active individuals. Conclusions: We described our experience in NeoVP using a large bowel SYMT as a safe and effective technique. It allows decreased tension on the vascular pedicle and the use of shorter colon segments.
MeSH term(s)	Adolescent ; Child ; Female ; Humans ; Colon/surgery ; Colon, Sigmoid/surgery ; Plastic Surgery Procedures ; Surgical Flaps/surgery ; Vagina/surgery ; Retrospective Studies
Language	English
Publishing date	2023-12-28
Publishing country	United States
Document type	Journal Article
ISSN	2352-0787
ISSN (online)	2352-0787
DOI	10.1097/UPJ.0000000000000519
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Article: Staged ureteral reconstruction using the appendix in a complex pediatric patient.

Moscardi, Paulo Renato Marcelo / Blachman-Braun, Ruben / Labbie, Andrew / Castellan, Miguel

Urology case reports

2018 Volume 21, Page(s) 98–100

Language	English
Publishing date	2018-09-18
Publishing country	United States
Document type	Case Reports
ZDB-ID	2745459-9
ISSN	2214-4420
ISSN	2214-4420
DOI	10.1016/j.eucr.2018.08.016
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Article ; Online: Small Intestinal Submucosa for corporeal body grafting in patients with proximal hypospadias and severe chordee: Long term follow-up assessing erectile function and genital self-perception.

Guevara, Christian G / Suarez, Maria Camila / Raymo, Adele / Ransford, George A / Nassau, Daniel E / Alam, Alireza / Labbie, Andrew S / Castellan, Miguel A / Gosalbez, Rafael

Journal of pediatric urology

2022 Volume 18, Issue 6, Page(s) 758.e1–758.e7

Abstract: Background: Proximal hypospadias and severe ventral chordee are often challenging to repair. To preserve penile length in chordee repair, Small Intestinal Submucosa (SIS) corporal grafting is often performed with potential long-term complications ... ...

Abstract	Background: Proximal hypospadias and severe ventral chordee are often challenging to repair. To preserve penile length in chordee repair, Small Intestinal Submucosa (SIS) corporal grafting is often performed with potential long-term complications including recurrent curvature and erectile dysfunction (ED). There is a paucity of data evaluating sexual function in mid, late and post-pubertal patients. Objective: We aimed to assess long-term outcomes of genital self-perception and erectile function in mid, late and post-pubertal patients who underwent single-layer (1-ply) SIS corporal body grafting for correction of severe chordee. Study design: Patients with proximal hypospadias who underwent correction of severe chordee using SIS grafting between 2001 and 2015 were retrospectively identified. Patients were evaluated for erectile and sexual function using the modified erection hardness score (mEHS) and the modified sexual health inventory for men (mSHIM). Perceived function and straightness were measured with Hypospadias Objective Scoring Evaluation (HOSE). Penile self-perception was assessed using the Pediatric Penile Perception Score (PPPS). Results were compared to an age-matched healthy control group. Categorical variables were analyzed using Fisher's exact test, and continuous variables using paired and unpaired t-test and ANOVA. Results: Nineteen patients with proximal hypospadias who underwent correction of severe chordee using SIS grafting and 18 controls participated in the study with a median age of 17 years for both groups. In the mEHS, 12 (63.2%) hypospadias-patients and 14 (87.5%) controls rated their erections as completely hard and very rigid. In the mSHIM, 1 (5.2%) hypospadias-patient was classified as having moderate ED. A total of 16 hypospadias-patients (84%) and 16 controls (88.9%) reported being very satisfied or satisfied with the straightness of their penis. No significant difference was observed in the mEHS, mSHIM and PPPS between groups (p < 0.05). The straightness of the erection was rated lower by participants, than by the pediatric urologist. In the HOSE, 12 (63.2%) hypospadias-patients and 16 (88.9%) controls obtained an acceptable score. Discussion: Our findings indicate favorable long-term outcomes in ED and genital self-perception; only 5% of our population reported having a mild-moderate to moderate presentation of ED, and there were no reports of severe ED. The overall PPPS satisfaction rates were statistically similar for the control and hypospadias groups. The small sample population limits the significance of our findings. Conclusion: Corporal body grafting with 1-ply SIS suggests positive long-term outcomes in genital self-perception and erectile function, with mid, late and post-pubertal patients who underwent hypospadias repair having comparable results to age-matched healthy controls.
MeSH term(s)	Male ; Humans ; Child ; Adolescent ; Hypospadias/surgery ; Follow-Up Studies ; Retrospective Studies ; Erectile Dysfunction ; Penis/surgery ; Self Concept
Language	English
Publishing date	2022-06-30
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.2022.06.024
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Article ; Online: Pediatric Kidney Transplantation Outcomes in Children with Primary Urological Abnormalities Versus Nonurological Abnormalities: Long-Term Results.

Jahromi, Mona S / Velasquez, Maria C / Blachman-Braun, Ruben / Gosalbez, Rafael / Castellan, Miguel / Labbie, Andrew / Ciancio, Gaetano / Chandar, Jayanthi / Alam, Alireza

The Journal of urology

2019 Volume 203, Issue 2, Page(s) 406–412

Abstract: Purpose: We assessed renal function, graft survival rates and the risk of graft loss in children based on etiology with a focus on differences between urological causes from congenital anomalies of the kidney and urinary tract vs other causes of end ... ...

Abstract	Purpose: We assessed renal function, graft survival rates and the risk of graft loss in children based on etiology with a focus on differences between urological causes from congenital anomalies of the kidney and urinary tract vs other causes of end stage kidney disease. Materials and methods: A retrospective chart review was performed including patients younger than 18 years who underwent kidney transplantation at our institution from December 1984 to November 2010 with the last followup recorded in March 2018. Patient clinical characteristics, demographics and end stage kidney disease etiology were recorded. Patients were divided into the 2 groups of urological (congenital anomalies of the kidney and urinary tract) vs nonurological based on end stage kidney disease etiology, and survival analysis was performed. Results: Of 112 kidney transplant cases 90 (80.4%) were associated with nonurological causes and 22 (19.6%) with urological causes. Median (IQR) patient age at transplantation was 12 (7-15) years. Median graft survival time was not statistically different according to end stage kidney disease etiology (nonurological 12 years 95% CI 10.01-13.99 vs urological 16 years 95% CI 7.59-24.41, p=0.532). There was a significant risk of graft loss in patients with urinary tract infections after transplantation (HR 3.15, 95% CI 1.59-6.25, p=0.001). Conclusions: Children requiring transplantation due to urological causes have no disadvantage in graft survival compared to children with end stage kidney disease with other causes. Patients with urinary tract infection after transplantation had a higher rate of graft loss.
MeSH term(s)	Adolescent ; Child ; Female ; Humans ; Kidney Failure, Chronic/surgery ; Kidney Transplantation ; Male ; Postoperative Complications/epidemiology ; Retrospective Studies ; Time Factors ; Treatment Outcome ; Urinary Tract/abnormalities ; Urinary Tract/surgery
Language	English
Publishing date	2019-09-05
Publishing country	United States
Document type	Comparative Study ; Journal Article
ZDB-ID	3176-8
ISSN	1527-3792 ; 0022-5347
ISSN (online)	1527-3792
ISSN	0022-5347
DOI	10.1097/JU.0000000000000528
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Article: Predictive factors for early discharge (≤24 hours) and re-admission following robotic-assisted laparoscopic pyeloplasty in children.

Ransford, George A / Moscardi, Paulo / Blachman-Braun, Ruben / Ballesteros, Natalia / Guevara, Christian / Salvitti, Mariarita / Alam, Alireza / Kozakowski, Kristin / Gosalbez, Rafael / Labbie, Andrew / Castellan, Miguel

Canadian Urological Association journal = Journal de l'Association des urologues du Canada

2021 Volume 15, Issue 11, Page(s) E603–E607

Abstract: Introduction: Minimally invasive pyeloplasty (MIP) for correction of ureteropelvic junction obstruction in children has significantly improved the postoperative management of these patients. In this study, we sought to examine the factors associated ... ...

Abstract	Introduction: Minimally invasive pyeloplasty (MIP) for correction of ureteropelvic junction obstruction in children has significantly improved the postoperative management of these patients. In this study, we sought to examine the factors associated with early discharge (≤24 hours) in children who underwent robotic-assisted laparoscopic pyeloplasty (RALP). Methods: We performed a retrospective chart review of all children who underwent RALP from 2012-2018 in our center. Descriptive statistics and a non-adjusted risk analysis were performed to evaluate the factors associated with early discharge (≤24h), re-admission, and complications within the first 30 days after the procedure. Results: Eighty-nine patients out of 124 total pyeloplasties (72%) stayed ≤24 hours post-surgery. Of the variables analyzed, later cases were statistically associated with length of stay (LOS); the first 55 patients had a lower probability of being hospitalized for ≤24 hours (odds ratio [OR] 0.24, 95% confidence interval [CI] 0.09-0.64, p=0.004). Conclusions: RALP for children is associated with a high rate of early recovery, short hospital stay, and low re-admission and complication rates. Although not statistically significant, patients with shorter operative room time also had a shorter LOS. An increased LOS was observed in the initial patients of our series, and this is most likely explained by the initial learning curve of the team for the procedure itself and the more conservative postoperative management.
Language	English
Publishing date	2021-05-17
Publishing country	Canada
Document type	Journal Article
ZDB-ID	2431403-1
ISSN	1911-6470
ISSN	1911-6470
DOI	10.5489/cuaj.7062
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Article: Neonatal Circumcision: What Are the Factors Affecting Parental Decision?

Guevara, Christian G / Achua, Justin K / Blachman-Braun, Ruben / Cabrera-Valencia, Isabella / Ransford, George A / Gosalbez, Rafael / Labbie, Andrew S / Castellan, Miguel A / Alam, Alireza

Cureus

2021 Volume 13, Issue 11, Page(s) e19415

Abstract: Introduction: The American Academy of Pediatrics (AAP) guidelines state that the health benefits of circumcision outweigh the risks, but these benefits are not enough to recommend universal newborn circumcision. Therefore, it is the guardians' decision ... ...

Abstract	Introduction: The American Academy of Pediatrics (AAP) guidelines state that the health benefits of circumcision outweigh the risks, but these benefits are not enough to recommend universal newborn circumcision. Therefore, it is the guardians' decision to circumcise their son. In this study, we assess the factors that influence the decision-making process for newborn circumcision. Methods: A prospective study was done from January to April 2020 for newborn circumcision. AAP guidelines were used as an educational tool and given to the parents on the day of patient circumcision assessment. On procedure day, a self-reported survey regarding the reasons for circumcision and the usefulness of the guideline as an educational resource was given to guardians. Results: A total of 265 parents completed the survey. Of the study variables, the future health of the child and the circumcision status of the father were considered extremely important factors influencing the decision-making process for 168 (63.4%) and 90 (34%) guardians, respectively. The study showed that 226 (85.3%) of the parents found the AAP guidelines helpful whereas 39 (14.7%) did not. Conclusion: Overall results suggest that the health of the child and the father of the child being circumcised are the primary factors that influence the guardians' decision to circumcise their child. In addition, providing parents with an educational resource such as the AAP guidelines policy statement prior to circumcision may serve as a way to supplement the discussion between parents and providers.
Language	English
Publishing date	2021-11-09
Publishing country	United States
Document type	Journal Article
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.19415
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Article ; Online: Renal pelvis rupture in a kidney with ureteropelvic junction obstruction and extrarenal calyces.

Ransford, George / Young, Ezekiel / Castellan, Miguel / Labbie, Andrew

Journal of pediatric urology

2013 Volume 9, Issue 3, Page(s) e127–30

Abstract: The extrarenal calyx (ERC) is a rare congenital anomaly, associated with various other abnormalities of the urogenital system. We report a unique case of ERC in a solitary functioning kidney with a massively dilated pelvis that developed spontaneous ... ...

Abstract	The extrarenal calyx (ERC) is a rare congenital anomaly, associated with various other abnormalities of the urogenital system. We report a unique case of ERC in a solitary functioning kidney with a massively dilated pelvis that developed spontaneous rupture. A dismembered pyeloplasty was performed at the time of rupture. The patient did well post-operatively with a stable creatinine and stable SFU grade 2 hydronephrosis.
MeSH term(s)	Creatinine/blood ; Dilatation, Pathologic ; Extravasation of Diagnostic and Therapeutic Materials/etiology ; Female ; Fetal Diseases/diagnostic imaging ; Humans ; Hydronephrosis/diagnostic imaging ; Kidney/abnormalities ; Kidney/diagnostic imaging ; Kidney Diseases/blood ; Kidney Diseases/complications ; Kidney Diseases/surgery ; Kidney Pelvis/diagnostic imaging ; Kidney Pelvis/pathology ; Radionuclide Imaging ; Rupture, Spontaneous ; Tomography, X-Ray Computed ; Ultrasonography, Prenatal ; Ureter/pathology ; Ureteral Obstruction/blood ; Ureteral Obstruction/complications
Chemical Substances	Creatinine (AYI8EX34EU)
Language	English
Publishing date	2013-06
Publishing country	England
Document type	Case Reports ; Journal Article
ZDB-ID	2237683-5
ISSN	1873-4898 ; 1477-5131
ISSN (online)	1873-4898
ISSN	1477-5131
DOI	10.1016/j.jpurol.2012.12.018
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