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  1. 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
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. 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
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. 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
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. 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
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. 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
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: Voiding Cystourethrogram in Children With Unilateral Multicystic Dysplastic Kidney: Is It Still necessary?

    Blachman-Braun, Ruben / Camp, Michelle M / Becerra, Maria F / Guevara, Christian G / Velasquez, Maria C / Moscardi, Paulo R M / Ballesteros, Natalia / Gosalbez, Rafael / Labbie, Andrew S / Castellan, Miguel A / Restrepo, Ricardo / Alam, Alireza

    Urology

    2020  Volume 139, Page(s) 156–160

    Abstract: Objective: To evaluate the value of the voiding cystourethrogram (VCUG) in children with multicystic dysplastic kidney (MCDK) who have a normal versus abnormal contralateral kidney and bladder ultrasound (US), and assess the risk of having ... ...

    Abstract Objective: To evaluate the value of the voiding cystourethrogram (VCUG) in children with multicystic dysplastic kidney (MCDK) who have a normal versus abnormal contralateral kidney and bladder ultrasound (US), and assess the risk of having vesicoureteral reflux (VUR) or urinary tract infection (UTI) based on the US results.
    Methods: A retrospective chart review including children with unilateral MCDK with postnatal US and VCUG available at our institution between January 2008 and September 2017 was performed. Analysis was done to find association between abnormal contralateral US and contralateral VUR and UTI.
    Results: One hundred and fifty-six children were analyzed; 118(75.6%) patients had a normal contralateral kidney US, while 38(24.4%) had abnormal US. The rate of severe contralateral VUR (grade IV and V) was 2 (1.7%) and 5 (13.2%) in children with normal and abnormal contralateral US, respectively. The risk analysis demonstrated a significant association between severe VUR on the contralateral kidney and an abnormal contralateral US (odds ratio = 7.73; 95%CI: 1.43-41.81; P = 0.018) and no significant association with UTI (odds ratio = 1.58; 95%CI: 0.50-4.94; P = 0.435).
    Conclusion: Our data suggests, the rate of severe contralateral VUR in children with unilateral MCDK and normal contralateral kidney is low. VCUG should be considered for infants with proven MCKD and alterations on the contralateral kidney on US. Following patients with MCDK and normal contralateral kidney without the use of VCUG is a reasonable approach, unless there is development of signs and symptoms of recurrent UTI or deterioration of the renal function. We found that abnormal contralateral kidney US was associated with severe VUR.
    MeSH term(s) Child ; Female ; Follow-Up Studies ; Humans ; Infant ; Kidney/diagnostic imaging ; Male ; Multicystic Dysplastic Kidney/complications ; Multicystic Dysplastic Kidney/diagnosis ; Multicystic Dysplastic Kidney/physiopathology ; Risk Assessment/methods ; Risk Factors ; Ultrasonography/methods ; Ureter/diagnostic imaging ; Urinary Bladder/diagnostic imaging ; Urinary Tract Infections/diagnosis ; Urinary Tract Infections/etiology ; Urinary Tract Infections/prevention & control ; Urodynamics ; Urography/methods ; Vesico-Ureteral Reflux/diagnosis ; Vesico-Ureteral Reflux/etiology
    Language English
    Publishing date 2020-02-18
    Publishing country United States
    Document type Journal Article
    ZDB-ID 192062-5
    ISSN 1527-9995 ; 0090-4295
    ISSN (online) 1527-9995
    ISSN 0090-4295
    DOI 10.1016/j.urology.2020.02.005
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article ; Online: First clinical use of an omental pedicle flap for the surgical correction of a high intra-abdominal testicle.

    Earle, Steven A / Marshall, Deirdre M / Labbie, Andrew S

    Plastic and reconstructive surgery

    2008  Volume 121, Issue 4, Page(s) 231e–232e

    MeSH term(s) Cryptorchidism/surgery ; Humans ; Male ; Omentum/transplantation ; Surgical Flaps
    Language English
    Publishing date 2008-04
    Publishing country United States
    Document type Case Reports ; Journal Article
    ZDB-ID 208012-6
    ISSN 1529-4242 ; 0032-1052 ; 0096-8501
    ISSN (online) 1529-4242
    ISSN 0032-1052 ; 0096-8501
    DOI 10.1097/01.prs.0000305392.56112.94
    Database MEDical Literature Analysis and Retrieval System OnLINE

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