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Article ; Online: December 2023 edition of Dialogues in Pediatric Urology - Society for Fetal Urology Spring 2023 case reports.

Storm, Douglas W

2024 Volume 20, Issue 2, Page(s) 156

MeSH term(s)	Child ; Humans ; Urology ; Hydronephrosis ; Fetus
Language	English
Publishing date	2024-02-02
Publishing country	England
Document type	Case Reports ; Editorial
ZDB-ID	2237683-5
ISSN	1873-4898 ; 1477-5131
ISSN (online)	1873-4898
ISSN	1477-5131
DOI	10.1016/j.jpurol.2024.02.001
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Article ; Online: Dialogues in pediatric urology May 2023.

Storm, Douglas W

Journal of pediatric urology

2023 Volume 19, Issue 5, Page(s) 543–544

Language	English
Publishing date	2023-07-29
Publishing country	England
Document type	Editorial
ZDB-ID	2237683-5
ISSN	1873-4898 ; 1477-5131
ISSN (online)	1873-4898
ISSN	1477-5131
DOI	10.1016/j.jpurol.2023.07.020
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Article ; Online: Response to letter to the editor re what is the angle of a banana? The difficulty in reliable assessment of hypospadias chordee.

Cooper, Christopher S / Lockwood, Gina M / Edwards, Angelena B / Storm, Douglas W

Journal of pediatric urology

2023 Volume 19, Issue 5, Page(s) 578

MeSH term(s)	Male ; Humans ; Hypospadias/surgery ; Musa ; Penile Diseases ; Penis
Language	English
Publishing date	2023-03-16
Publishing country	England
Document type	Letter ; Comment
ZDB-ID	2237683-5
ISSN	1873-4898 ; 1477-5131
ISSN (online)	1873-4898
ISSN	1477-5131
DOI	10.1016/j.jpurol.2023.03.008
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Article ; Online: Reply by the Author.

Storm, Douglas W

Urology

2017 Volume 102, Page(s) 268–269

Language	English
Publishing date	2017-04
Publishing country	United States
Document type	Letter
ZDB-ID	192062-5
ISSN	1527-9995 ; 0090-4295
ISSN (online)	1527-9995
ISSN	0090-4295
DOI	10.1016/j.urology.2016.12.053
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Article ; Online: Editorial Comment.

Storm, Douglas W

The Journal of urology

2016 Volume 195, Issue 4 Pt 1, Page(s) 1092

Language	English
Publishing date	2016
Publishing country	United States
Document type	Journal Article ; Comment
ZDB-ID	3176-8
ISSN	1527-3792 ; 0022-5347
ISSN (online)	1527-3792
ISSN	0022-5347
DOI	10.1016/j.juro.2015.11.080
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Article ; Online: What is the angle of a banana? The difficulty in reliable assessment of hypospadias chordee.

Cooper, Christopher S / Lockwood, Gina M / Edwards, Angelena B / Perry, Sarah S / Storm, Douglas W

Journal of pediatric urology

2023 Volume 19, Issue 5, Page(s) 568–573

Abstract: Introduction: The degree of chordee associated with hypospadias impacts operative management. Unfortunately, poor inter-observer reliability in assessing chordee by multiple methods in vitro has been demonstrated. This variability may be related to the ... ...

Abstract	Introduction: The degree of chordee associated with hypospadias impacts operative management. Unfortunately, poor inter-observer reliability in assessing chordee by multiple methods in vitro has been demonstrated. This variability may be related to the fact that chordee is not a discrete angle, but rather an arc-like curvature similar to that of a banana. On an attempt to improve this variability, we assessed the inter-rater reliability of a novel method of chordee measurement and compared it to measurements with a goniometer both in vitro and in vivo. Materials and methods: In vitro assessment of curvature was performed using 5 bananas. In vivo chordee measurement was performed during 43 hypospadias repairs. On in vitro and in vivo cases, chordee was assessed independently by faculty and resident physicians. Angle assessment was performed in a standard manner with a goniometer and with a smartphone app using ruler measurements of the length and width of the arc (Summary Figure). The proximal and distal aspect of the arc to be measured was marked on the bananas, whereas the penile measurements were taken from the penoscrotal to the sub-coronal junctions. Results: In vitro banana assessment demonstrated strong intra- and inter-rater reliability for length (0.89 and 0.88, respectively) and width measurements (0.97 and 0.96). The calculated angle demonstrated an intra- and inter-rater reliability of 0.67 and 0.67. The banana goniometer/protractor measurements were weak with an intra-rater and inter-rater reliability of 0.33 and 0.21. With hypospadias chordee, the inter-rater reliability was strong for length and width measurements (0.95 and 0.94) and 0.48 for calculated angle. The inter-rater reliability of the goniometer angle was 0.96. Further assessment of inter-rater goniometer reliability was performed relative to degree of chordee as characterized by faculty. The inter-rater reliability for ≤15°, 16-30, and ≥30° was 0.68 (n = 20), 0.34 (n = 14), and 0.90 (n = 9), respectively. When the goniometer angle was classified as ≤15, 16-30, or ≥30° by one physician, it was classified outside of this range by the other physician 23%, 47%, and 25% of the time, respectively. Discussion: Our data demonstrate significant limitations of the goniometer for assessing chordee in vitro and in vivo. We were unable to demonstrate significant improvement in chordee assessment using arc length and width measurements to calculate radians. Conclusions: Reliable and precise techniques for measuring hypospadias chordee remain elusive and draw into question the validity and usability of management algorithms employing discrete values.
MeSH term(s)	Male ; Humans ; Hypospadias/diagnosis ; Hypospadias/surgery ; Musa ; Reproducibility of Results ; Urethra/surgery ; Plastic Surgery Procedures
Language	English
Publishing date	2023-02-08
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2237683-5
ISSN	1873-4898 ; 1477-5131
ISSN (online)	1873-4898
ISSN	1477-5131
DOI	10.1016/j.jpurol.2023.02.003
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Article ; Online: Decisional conflict in American parents regarding newborn circumcision.

Botkin, Hannah / Juhr, Denise / Storm, Douglas W / Cooper, Christopher S / Edwards, Angelena / Lockwood, Gina M

Journal of pediatric urology

2023 Volume 19, Issue 5, Page(s) 608–618

Abstract: Background: Decisional conflict surrounding the topic of circumcision in the newborn male is assumed in some parents but has not been quantified or qualified. It is known that parents often base their decision on cultural and social factors and that ... ...

Abstract	Background: Decisional conflict surrounding the topic of circumcision in the newborn male is assumed in some parents but has not been quantified or qualified. It is known that parents often base their decision on cultural and social factors and that physician discussions do affect ultimate decision-making. Information on parents' decision-making surrounding newborn circumcision and ways to mitigate conflict or uncertainty around the decision-making process is needed to better counsel them appropriately. Objectives: To identify the presence or absence of decisional conflict in parents-to-be deciding whether or not to circumcise their child as well as to identify determinants of this conflict to direct future educational measures. Study design: Parents presenting to obstetrics clinic as well as contacted by institutional email were recruited using convenience sampling and completed the validated Decisional Conflict Scale (DCS). A smaller subset of subjects were recruited via institutional email to complete semi-structured interviews regarding the decision-making process and specifically uncertainty regarding the decision. Descriptive statistics and unpaired t tests were used for analysis of survey data. For interview data, an iterative, grounded theory methodology was used. Results: 173 subjects completed the DCS. 12% of all participants had high decisional conflict. Intuitively, those who had not yet decided whether to circumcise had the highest proportion of high DCS (69%), followed by those who had decided to circumcise (9.3%) and those who had decided not to circumcise (1.7%). 24 subjects were interviewed, and based on their DCS scores and interview responses were classified as low, intermediate and high conflict. Three primary themes emerged delineating the high from low conflict groups. There were notable differences in the feelings of subjects regarding knowledge and feeling informed, the importance of particular values and clarity of the roles of these values in decision-making, and feelings of supported decision-making. These themes were used to create a visual model depicting the individual needs of each decision-maker (Fig. 1). Discussion: This study highlights the need for decision support for parents that is not only information-based but focuses on values clarity and supported decision-making. This study provides a jumping-off point for creation of shared decision-making tools directed at individual needs. The limitations of this study are a single institution design and homogeneous population, so when designing materials, additional unrecognized needs will likely be identified. Conclusion: A small, but real proportion of parents-to-be experience significant uncertainty around the decision to circumcise their newborn boys. Identified needs of parents include feeling informed, feeling supported and clarification of important values related to the problem.
MeSH term(s)	Humans ; Infant, Newborn ; Male ; Circumcision, Male ; Decision Making ; Emotions ; Parents ; Surveys and Questionnaires ; United States
Language	English
Publishing date	2023-05-27
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.2023.05.015
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Article ; Online: Editorial comment.

Storm, Douglas W

The Journal of urology

2013 Volume 190, Issue 1, Page(s) 227

MeSH term(s)	Anti-Bacterial Agents/administration & dosage ; Drug Resistance, Bacterial ; Female ; Humans ; Male ; Urinary Tract Infections/drug therapy ; Urinary Tract Infections/epidemiology
Chemical Substances	Anti-Bacterial Agents
Language	English
Publishing date	2013-07
Publishing country	United States
Document type	Comment ; Editorial
ZDB-ID	3176-8
ISSN	1527-3792 ; 0022-5347
ISSN (online)	1527-3792
ISSN	0022-5347
DOI	10.1016/j.juro.2013.01.113
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Article ; Online: A Child's urine is not sterile: A pilot study evaluating the Pediatric Urinary Microbiome.

Storm, Douglas W / Copp, Hillary L / Halverson, Thomas M / Du, Jingjie / Juhr, Denise / Wolfe, Alan J

Journal of pediatric urology

2022 Volume 18, Issue 3, Page(s) 383–392

Abstract: Introduction: A bladder microbiome (urobiome) exists in adults. Data supports the effects of the adult urobiome on urinary tract health with associations between dysbiotic urobiomes and lower urinary tract disorders. Understanding urobiome origin is ... ...

Abstract	Introduction: A bladder microbiome (urobiome) exists in adults. Data supports the effects of the adult urobiome on urinary tract health with associations between dysbiotic urobiomes and lower urinary tract disorders. Understanding urobiome origin is important since other microbiomes establish around birth and microbiome alterations are linked to disease development. However, the pediatric urobiome has not been well studied. Objectives: We sought to determine the age when the urobiome develops, compare the pediatric urobiome to microbiomes of adjacent urogenital niches, and compare the urobiomes between boys and girls and across age groups. Study design: Seventy-four children less than 18 years of age without recent antibiotic exposure were recruited, including 48 males and 26 females, aged 2 weeks to 209 months of age. Transurethral catheterized urine samples and samples from the perineum, urethra, vagina, and foreskin were collected. Specimens were assessed using the expanded quantitative urine culture protocol and by 16S rRNA gene sequencing. Dada2 was used to profile microbial compositions, and BLCA was used to identify microbial taxa. Results: Bacteria were detected in 90.5% of urine samples and identified in children as young as 2 weeks of age. Microbial communities and compositions of the female bladder and other urogenital niches (urethra, perineum, and vagina) differed significantly by age. Lactobacillus predominated the bladder, urethral, and vaginal microbiomes in post-pubertal girls. Compared to female urinary microbiomes, those of males differed less substantially. Only perineal microbiomes differed significantly by age, whereas male urethral and foreskin microbiomes did not differ significantly. Discussion: We identified that a urinary microbiome is established as early as infancy. In addition, the female urobiome changes throughout childhood, until the post-pubertal bacterial taxa becomes consistent with that seen in adult females. Whereas in boys, the urinary microbiome changed very little over time. In addition, the surrounding urogenital microbiomes differed less in boys as compared to females. Microbiomes established at a young age may have long-term influences on immune, metabolic, and neurobehavioral traits. The same may be true for the urobiome. Our study provides a foundation for future research to determine the influence of the pediatric urobiome on the development of urinary and even non-urinary disorders. Conclusions: A pediatric urobiome exists, with differences between males and females and can be detected at a young age with changes occurring throughout childhood. Similarities and differences are also seen between the pediatric urobiome and adjacent niches.
MeSH term(s)	Adolescent ; Adult ; Bacteria ; Child ; Female ; Humans ; Male ; Microbiota/genetics ; Pilot Projects ; RNA, Ribosomal, 16S/genetics ; Urethra ; Urinary Bladder ; Urine/microbiology
Chemical Substances	RNA, Ribosomal, 16S
Language	English
Publishing date	2022-03-04
Publishing country	England
Document type	Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	2237683-5
ISSN	1873-4898 ; 1477-5131
ISSN (online)	1873-4898
ISSN	1477-5131
DOI	10.1016/j.jpurol.2022.02.025
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Article ; Online: Implementation of electronic messaging protocol for pediatric urology preoperative scheduling: A pilot study.

Schubbe, Morgan E / Edman, Jeffrey / Williams, Julie / Cooper, Christopher S / Lockwood, Gina / Storm, Douglas W

Journal of pediatric urology

2022 Volume 18, Issue 6, Page(s) 789.e1–789.e6

Abstract: Introduction: Preparing patients for surgery is a task healthcare organizations strive to optimize. Electronic messaging (EM) provides an opportunity for streamlining components of this arduous process. Our study aims to evaluate our early experience in ...

Abstract	Introduction: Preparing patients for surgery is a task healthcare organizations strive to optimize. Electronic messaging (EM) provides an opportunity for streamlining components of this arduous process. Our study aims to evaluate our early experience in utilizing EM to provide preoperative information to pediatric urology patients. Objective: To assess the effectiveness of EM in preparing patients for pediatric urologic surgery. Study design: This study compared a 6-week pilot program of EM (Figure 1) with traditional nurse phone calls (NPC) in preoperative instruction of pediatric urology patients. The same preoperative instructional information was provided via either source. Data collected included time and resources used by the healthcare system and patient/parent satisfaction. Results: The EM group included 98 patients, while the NPC group included 212 patients. Case cancellation rate between the two cohorts was similar, with a 6.67% cancellation rate in the EM cohort and a 10.55% cancellation rate in the NPC cohort (z = -1.137, p = 0.25). There were 4 EM-related operating room delays with an average case delay of 31.5 min (5-60 min). Twenty-four (24%) EM patients/families required secondary phone calls, while 106 (50%) NPC required a follow up phone call (p < 0.01). 94% of EM participants recommended EM for future perioperative instructions. Accounting for the average case volume within our entire children's hospital, the average total daily cost for EM is $5.96/day, as compared to an average total cost of $87.78/day to perform NPC. This represents an estimated cost savings of $81.82 per day or $21,273.20 per year, based upon average total case volume at our institution. Discussion: In our initial experience, EM effectively communicates the necessary preoperative information to patients and/or families undergoing pediatric urology surgery. Our results demonstrate low case cancellation and delay rates and high patient/family satisfaction. Also demonstrated was the cost savings by replacing the NPC with EM. A great benefit of EM was the increased time it provided for nurses to perform other patient care duties, which is important given our current nationwide nursing shortage. Limitations of the study included a narrow scope assessing only pediatric urology patients as well as a short study period. Further studies will further define and refine the role of perioperative EM. Conclusion: Changing to an EM system for preoperative instructions in the pediatric urology population met with a high degree of patient satisfaction and decreased costs for healthcare systems without increasing case delay or cancellation rates.
MeSH term(s)	Humans ; Child ; Pilot Projects ; Urology ; Patient Satisfaction ; Patients ; Electronics
Language	English
Publishing date	2022-04-12
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.2022.04.003
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