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  1. Article ; Online: Palliative Care for Pediatric Urology.

    Li, Oscar / Lee, Royce / Boss, Renee D / Wang, Ming-Hsien

    Journal of pain and symptom management

    2024  

    Abstract: Palliative care in the field of urology has largely been limited to adult oncologic conditions. Although there is a plethora of established literature suggesting the advantageous impact of palliative care, there is limited integration of palliative care ... ...

    Abstract Palliative care in the field of urology has largely been limited to adult oncologic conditions. Although there is a plethora of established literature suggesting the advantageous impact of palliative care, there is limited integration of palliative care in adult urology. This underutilization is further exacerbated in pediatric urology, and palliative care in pediatric urology remains an underexplored area despite the prevalence of several life-limiting conditions in this patient population. This paper highlights the potential need for palliative care intervention in a variety of urologic conditions in the pediatric population, including congenital lower urinary tract obstruction, neurogenic bladder dysfunction, exstrophy-epispadias complex, and congenital bilateral renal agenesis. Each condition poses unique challenges that can be addressed with the inclusion of a palliative care team, including decision-making spanning prenatal-neonatal-pediatric periods, acute and chronic symptom management, family relations, body image issues, risk of recurrent hospitalizations and surgeries, and potentially fatal complications. Alongside standard urologic interventions, palliative care can serve as an additional means of addressing physical and psychosocial symptoms experienced by pediatric urology patients to enhance the quality of life of patients and their families.
    Language English
    Publishing date 2024-03-22
    Publishing country United States
    Document type Journal Article
    ZDB-ID 639142-4
    ISSN 1873-6513 ; 0885-3924
    ISSN (online) 1873-6513
    ISSN 0885-3924
    DOI 10.1016/j.jpainsymman.2024.03.021
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  2. Article: When to address form and when to address function: Timing of surgical reconstruction for a patient with 46 XY DSD.

    Li, Oscar / Gabrielson, Andrew / Wang, Ming-Hsien

    Urology case reports

    2023  Volume 51, Page(s) 102572

    Abstract: Differences of sexual development (DSD) refers to congenital conditions characterized by discordant appearances of external genitalia with respect to sex chromosomes. We present a case of a 46 XY DSD adolescent with bilateral undescended testes and ... ...

    Abstract Differences of sexual development (DSD) refers to congenital conditions characterized by discordant appearances of external genitalia with respect to sex chromosomes. We present a case of a 46 XY DSD adolescent with bilateral undescended testes and severe scrotolabial anomalies who was lost to follow-up for several years who recently presented with "recurrent UTIs." Although the patient desired immediate reconstruction to void while standing, shared-decision making was used to first address his bilateral cryptorchidism, with plans to delay other reconstruction until the patient is older. Pediatric patients with DSD have complicated medical and surgical problems and require a collaborative multidisciplinary team.
    Language English
    Publishing date 2023-09-21
    Publishing country United States
    Document type Case Reports
    ZDB-ID 2745459-9
    ISSN 2214-4420
    ISSN 2214-4420
    DOI 10.1016/j.eucr.2023.102572
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  3. Article: Persistent Urinary Incontinence: A Case Series of Missed Ectopic Ureters.

    Wang, Ming-Hsien

    Urology case reports

    2015  Volume 3, Issue 6, Page(s) 223–225

    Abstract: Ectopic ureter is a rare cause of urinary incontinence in children. Symptomatic cases are unlikely to resolve spontaneously, and incontinence are often associated with significant psychological impact on these children. This case series of 2 older ... ...

    Abstract Ectopic ureter is a rare cause of urinary incontinence in children. Symptomatic cases are unlikely to resolve spontaneously, and incontinence are often associated with significant psychological impact on these children. This case series of 2 older children with missed ectopic ureters by the urologic community outline workup for persistent urinary incontinence, with emphasis on history, physical, embryology review, and radiographic evaluations.
    Language English
    Publishing date 2015-08-25
    Publishing country United States
    Document type Case Reports
    ZDB-ID 2745459-9
    ISSN 2214-4420
    ISSN 2214-4420
    DOI 10.1016/j.eucr.2015.07.003
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  4. Article: Is There Hope for Renal Growth on Imaging Studies Following Ureteral Reimplant for Boys With Fetal Hydronephrosis and Urinary Reflux?

    Wang, Ming-Hsien

    Urology case reports

    2015  Volume 3, Issue 4, Page(s) 114–116

    Abstract: Reflux nephropathy is thought to be the etiology for renal maldevelopment. We present two boys with fetal hydronephrosis and sterile vesicoureteral reflux (VUR). There was lack of renal growth of the refluxing renal units on surveillance renal ultrasound. ...

    Abstract Reflux nephropathy is thought to be the etiology for renal maldevelopment. We present two boys with fetal hydronephrosis and sterile vesicoureteral reflux (VUR). There was lack of renal growth of the refluxing renal units on surveillance renal ultrasound. Parents elected to undergo open ureteral reimplants. Post-surgical ultrasounds demonstrated improved renal growth.
    Language English
    Publishing date 2015-05-16
    Publishing country United States
    Document type Case Reports
    ZDB-ID 2745459-9
    ISSN 2214-4420
    ISSN 2214-4420
    DOI 10.1016/j.eucr.2015.04.004
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  5. Article ; Online: Does prophylactic antibiotics post pediatric pyeloplasty reduce the incidence of febrile UTIs?

    Sheth, Kunj / Puttmann, Kathleen / Nichols, Paige / King, Jordon C / Zhu, Huirong / Ryan, Sheila / Gabrielson, Andrew T / Wang, Ming-Hsien

    BMC urology

    2023  Volume 23, Issue 1, Page(s) 133

    Abstract: Purpose: The use of postoperative prophylactic antibiotics in pediatric upper urinary tract reconstruction remains controversial. In this study, we examined whether low dose antibiotics administered following pediatric pyeloplasty reduce the incidence ... ...

    Abstract Purpose: The use of postoperative prophylactic antibiotics in pediatric upper urinary tract reconstruction remains controversial. In this study, we examined whether low dose antibiotics administered following pediatric pyeloplasty reduce the incidence of febrile urinary tract infections at our institution. As a secondary outcome, in those patients with infection, additional analysis was performed to better quantify which patient population benefits the most from low dose prophylactic antibiotics.
    Methods: Institutional review board approval (IRB) was obtained. All methods were carried out in accordance with relevant guidelines and regulations. A retrospective study was performed in patients who underwent pyeloplasty (2011-2017) at our institution. Surgical approach (laparoscopic versus robotic assisted versus open, with or without internal JJ ureteral stent) were based on surgeon preference. Patients of 8 fellowship trained pediatric urologists were included in the study period. Patients with prior history of urologic interventions or other congenital genitourinary tract abnormalities were excluded. Demographics (age, gender, ethnicity, insurance status), prior history of culture proven urinary tract infection, surgical details (administration of perioperative antibiotics), and postoperative outcomes including; 1) re-admission 30 days post-surgery, 2) any urine cultures collected due to suspected urinary tract infection.
    Results: A total of 209 patients (149 boys, 60 girls) met our inclusion criteria with 55/209 (26%) receiving postoperative prophylactic antibiotics. The average age was 6 years (range: 2 months-18 years). Indwelling ureteral stent was used in 176 (84%) patients. Eleven patients (5%) had a culture-proven urinary tract infection within 30-days postoperatively. No significant differences were seen in postoperative complications or incidence of urinary tract infection when comparing surgical approaches, +/- ureteral stent, or the use of antibiotics. Secondary analysis noted statistically significant increase in post-operative urinary tract infection in younger children (2.8 v. 6.2 years, p = 0.02), those patients who had a positive preoperative urine culture (8/11, p = 0.01) and those with public health insurance (p = 0.038).
    Conclusion: The incidence of postoperative urinary tract infection following pyeloplasty in our cohort was relatively low. There was a higher incidence of urinary tract infection in patients less than 3 years old. The use of antibiotics in patients post pyeloplasty did not appear to affect the incidence of post-operative urinary tract infection, however, they may have a role in children who have not yet potty trained and in patients with positive preoperative urine culture.
    MeSH term(s) Male ; Female ; Humans ; Child ; Infant ; Child, Preschool ; Retrospective Studies ; Incidence ; Ureter/surgery ; Urinary Tract Infections/epidemiology ; Urinary Tract Infections/prevention & control ; Urinary Tract Infections/etiology ; Anti-Bacterial Agents/therapeutic use ; Postoperative Complications/epidemiology ; Postoperative Complications/prevention & control ; Urologic Surgical Procedures/methods
    Chemical Substances Anti-Bacterial Agents
    Language English
    Publishing date 2023-08-08
    Publishing country England
    Document type Journal Article
    ZDB-ID 2059857-9
    ISSN 1471-2490 ; 1471-2490
    ISSN (online) 1471-2490
    ISSN 1471-2490
    DOI 10.1186/s12894-023-01301-x
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  6. Article ; Online: Reply by Authors.

    Gabrielson, Andrew T / Galansky, Logan / Sholklapper, Tamir / Crigger, Chad / Patel, Hiten D / Harris, Kelly / Haney, Nora / Jing, Yuezhou / Wang, Ming-Hsien / Wu, Charlotte / Gearhart, John P / Di Carlo, Heather N

    The Journal of urology

    2024  Volume 211, Issue 1, Page(s) 47

    Language English
    Publishing date 2024-01-01
    Publishing country United States
    Document type Journal Article
    ZDB-ID 3176-8
    ISSN 1527-3792 ; 0022-5347
    ISSN (online) 1527-3792
    ISSN 0022-5347
    DOI 10.1097/JU.0000000000003764.04
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  7. Article ; Online: Surgical management of meatal stenosis with meatoplasty.

    Wang, Ming-Hsien

    Journal of visualized experiments : JoVE

    2010  , Issue 45

    Abstract: Meatal stenosis is a common urologic complication after circumcision. Children present to their primary care physicians with complaints of deviated urinary stream, difficult-to-aim, painful urination, and urinary frequency. Clinical exam reveals a ... ...

    Abstract Meatal stenosis is a common urologic complication after circumcision. Children present to their primary care physicians with complaints of deviated urinary stream, difficult-to-aim, painful urination, and urinary frequency. Clinical exam reveals a pinpoint meatus and if the child is asked to urinate, he will usually have an upward, thin, occasionally forceful urinary stream with incomplete bladder emptying. The mainstay of management is meatoplasty (reconstruction of the distal urethra /meatus). This educational video will demonstrate how this is performed.
    MeSH term(s) Child ; Circumcision, Male/adverse effects ; Humans ; Male ; Reconstructive Surgical Procedures/methods ; Urethral Stricture/surgery ; Urologic Surgical Procedures, Male/methods
    Language English
    Publishing date 2010-11-30
    Publishing country United States
    Document type Journal Article ; Video-Audio Media
    ZDB-ID 2259946-0
    ISSN 1940-087X ; 1940-087X
    ISSN (online) 1940-087X
    ISSN 1940-087X
    DOI 10.3791/2213
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  8. Article ; Online: Effectiveness of Liposomal Bupivacaine With Bupivacaine Hydrochloride vs Bupivacaine Hydrochloride Alone as a Local Anesthetic for Children Undergoing Ambulatory Urologic Surgery: The Baby ORIOLES Randomized Clinical Trial.

    Gabrielson, Andrew T / Galansky, Logan / Sholklapper, Tamir / Crigger, Chad / Patel, Hiten D / Harris, Kelly / Haney, Nora / Jing, Yuezhou / Wang, Ming-Hsien / Wu, Charlotte / Gearhart, John P / Di Carlo, Heather N

    The Journal of urology

    2023  Volume 211, Issue 1, Page(s) 37–47

    Abstract: Purpose: We sought to determine if the addition of liposomal bupivacaine to bupivacaine hydrochloride improves opioid-free rate and postoperative pain scores among children undergoing ambulatory urologic surgery.: Materials and methods: A prospective, ...

    Abstract Purpose: We sought to determine if the addition of liposomal bupivacaine to bupivacaine hydrochloride improves opioid-free rate and postoperative pain scores among children undergoing ambulatory urologic surgery.
    Materials and methods: A prospective, phase 3, single-blinded, single-center randomized trial with superiority design was conducted in children 6 to 18 years undergoing ambulatory urologic procedures between October 2021 and April 2023. Patients were randomized 1:1 to receive dorsal penile nerve block (penile procedures) or incisional infiltration with spermatic cord block (inguinal/scrotal procedures) with weight-based liposomal bupivacaine plus bupivacaine hydrochloride or bupivacaine hydrochloride alone. The primary outcome was opioid-free rate at 48 hours. Secondary outcomes included parents' postoperative pain measure scores, numerical pain scale scores, and weight-based opioid utilization at 48 hours and 10 to 14 days.
    Results: We randomized 104 participants, with > 98% (102/104) with complete follow-up data at 48 hours and 10 to 14 days. At interim analysis, there was no significant difference in opioid-free rate at 48 hours between arms (60% in the intervention vs 62% in the control group; estimated difference in proportion -1.9% [95% CI, -20%-16%];
    Conclusions: The addition of liposomal bupivacaine to bupivacaine hydrochloride did not significantly improve opioid-sparing effect or postoperative pain compared with bupivacaine hydrochloride alone among children ≥ 6 years undergoing ambulatory urologic surgery.
    MeSH term(s) Adolescent ; Child ; Humans ; Male ; Analgesics, Opioid ; Anesthetics, Local ; Bupivacaine/therapeutic use ; Liposomes ; Pain, Postoperative/prevention & control ; Prospective Studies
    Chemical Substances Analgesics, Opioid ; Anesthetics, Local ; Bupivacaine (Y8335394RO) ; Liposomes
    Language English
    Publishing date 2023-10-23
    Publishing country United States
    Document type Randomized Controlled Trial ; Clinical Trial, Phase III ; Journal Article
    ZDB-ID 3176-8
    ISSN 1527-3792 ; 0022-5347
    ISSN (online) 1527-3792
    ISSN 0022-5347
    DOI 10.1097/JU.0000000000003764
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  9. Article ; Online: Reply by the authors.

    Massanyi, Eric Z / Wang, Ming-Hsien

    Urology

    2014  Volume 83, Issue 3, Page(s) 681–682

    MeSH term(s) Female ; Humans ; Male ; Ultrasonography ; Urinary Tract Infections/complications ; Vesico-Ureteral Reflux/complications ; Vesico-Ureteral Reflux/diagnostic imaging
    Language English
    Publishing date 2014-03
    Publishing country United States
    Document type Letter ; Comment
    ZDB-ID 192062-5
    ISSN 1527-9995 ; 0090-4295
    ISSN (online) 1527-9995
    ISSN 0090-4295
    DOI 10.1016/j.urology.2013.12.001
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  10. Article ; Online: Safety and Efficacy of Long-Acting Liposomal Bupivacaine Plus Bupivacaine Hydrochloride for Dorsal Penile Block During Ambulatory Pediatric Urologic Surgery.

    Gabrielson, Andrew T / Galansky, Logan / Sholklapper, Tamir / Florissi, Isabella / Crigger, Chad / Harris, Kelly / Haney, Nora / Patel, Hiten D / Wang, Ming-Hsien / Wu, Charlotte / Gearhart, John P / Di Carlo, Heather N

    Urology

    2023  Volume 176, Page(s) 190–193

    Abstract: This study evaluates the tolerability and efficacy of preoperative dorsal penile nerve block with Exparel plus bupivacaine hydrochloride in children>6 years old undergoing ambulatory urologic surgery. We demonstrate that the drug combination is well- ... ...

    Abstract This study evaluates the tolerability and efficacy of preoperative dorsal penile nerve block with Exparel plus bupivacaine hydrochloride in children>6 years old undergoing ambulatory urologic surgery. We demonstrate that the drug combination is well-tolerated, with appropriate analgesic efficacy in the recovery room as well as at 48-hour and 10-14 day follow-up periods. These preliminary data justify the need to perform a prospective, randomized trial comparing Exparel plus bupivacaine hydrochloride to other common local anesthetic regimens used in pediatric urologic surgery.
    MeSH term(s) Humans ; Child ; Bupivacaine ; Prospective Studies ; Pain, Postoperative/drug therapy ; Pain, Postoperative/prevention & control ; Anesthetics, Local ; Analgesics
    Chemical Substances Bupivacaine (Y8335394RO) ; Anesthetics, Local ; Analgesics
    Language English
    Publishing date 2023-03-28
    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.2023.01.056
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