The association between problematic media use, sleep disturbances, and enuresis in children.

Redefining transition: Self-efficacy in urologic care.

Identifying predictors of failure in pediatric retrograde intrarenal surgery: Why stone volume matters.

Cystoscopy is a cornerstone of pediatric urology, enabling direct visualization of the bladder and ureteral orifices during diagnostic and therapeutic procedures. We describe the MEATIC technique, based on intravesical instillation of iodinated contrast during cystoscopy. Because of its higher density compared with urine and blood, the contrast forms a dependent layer at the bladder base, creating a clear optical interface at the trigone. This facilitates identification of ureteral orifices and visualization of ureteral jets, particularly to confirm ureteral patency after subureteric bulking-agent injection. The technique may also improve visualization in selected cases of gross hematuria. No complications were observed overall.

Pediatric enuresis is a frequent reason for referral to pediatric urology clinics; however, the real-world effectiveness of available therapies is limited by high treatment dropout. Despite multiple validated interventions, adherence patterns and predictors of dropout remain poorly characterized. To quantify treatment dropout rates in pediatric enuresis and identify clinical predictors of dropout across enuresis phenotypes in a tertiary care setting. We conducted a retrospective cohort study including children aged 5-18 years treated for enuresis between 2019 and 2024 at a tertiary pediatric hospital. Patients were classified according to the International Children's Continence Society principles into clinically relevant phenotypes. Treatment dropout was defined as failure to initiate, continue, or complete prescribed therapy, or absence from scheduled follow-up without documented resolution or formal discharge. Multivariate logistic regression was used to identify independent predictors of dropout. A total of 961 patients were included. Overall treatment dropout occurred in 51.4% of cases, with significant variation among clinical phenotypes (p = 0.003). Bladder bowel dysfunction (BBD) accounted for the largest absolute number of dropouts, whereas secondary enuresis showed the highest relative dropout rate. Lack of early clinical improvement was the strongest independent predictor of treatment dropout. Age showed a small but statistically significant association, whereas sex and BBD phenotype were not independently associated with attrition after adjustment. Treatment dropout affects more than half of children undergoing management for enuresis in a tertiary referral setting. Lack of early clinical improvement was the strongest predictor of attrition. Reducing dropout will likely require structured early reassessment, realistic-expectation counseling, and adherence-support strategies targeted to higher-risk patients.

Factors Associated With Pediatric Testicular Torsion Leading to Orchiectomy.

Posterior urethral valves (PUV) are the most common cause of congenital bladder outlet obstruction in boys and may result in long-term impairment of both bladder and renal function. In addition to the obstructive process itself, concomitant congenital anomalies may further influence renal outcome. This study aimed to evaluate the spectrum of associated congenital anomalies in children with PUV and to examine their relationship with clinically significant chronic kidney disease (CKD) during follow-up. This retrospective single-center observational study included 103 boys with cystoscopically confirmed PUV who were diagnosed and followed at the Pediatric Urology Clinic of Eskişehir Osmangazi University Faculty of Medicine between January 2014 and December 2024. Patients with incomplete records or follow-up shorter than 12 months were excluded. Demographic characteristics, antenatal findings, presenting symptoms, vesicoureteral reflux (VUR), associated anomalies, imaging findings, interventions, bladder assessment findings, and renal outcomes were reviewed. Descriptive statistical analysis was performed. Clinically significant CKD was defined as persistent estimated glomerular filtration rate (eGFR) < 90 mL/min/1.73m² for more than 3 months, corresponding to CKD stage ≥ 2. The median age at diagnosis was 2.4 years. Antenatal hydronephrosis and/or hydroureteronephrosis was present in 42 patients (40.8%), and concomitant VUR was detected in 39 (37.9%). Associated anomalies included hypospadias in 7 patients (6.8%), ureteropelvic junction obstruction in 7 (6.8%), renal hypodysplasia in 5 (4.9%), spina bifida in 5 (4.9%), anorectal malformation in 4 (3.9%), and trisomy 21 in 1 (1.0%). During follow-up, 8 patients (7.8%) developed CKD stage ≥ 2. Most of these patients had antenatal hydronephrosis, high-grade VUR, dysplastic or non-functioning kidneys, or additional congenital anomalies. In this cohort, clinically significant CKD developed in a minority of children with PUV, but adverse renal outcome was concentrated in patients with severe upper urinary tract abnormalities and additional congenital anomalies. High-grade VUR, reduced functional renal mass, and complex associated anomalies appear to be important markers of poor renal prognosis. Careful long-term multidisciplinary follow-up remains essential in this patient group.

Although hypospadias is a common condition and pediatric urology fellowship training programs exist, they have recently been described as insufficient to mediate the necessary skills to master hypospadias surgery. Simulation-based education is increasingly promoted, but training is limited by simulators that typically focus on a single surgical technique. We aimed to develop and demonstrate a single adaptable simulator capable of simulating the six commonly used single-stage hypospadias repair methods. A model made from lamb tenderloin and chicken skin was used to simulate the six most common single-stage repair techniques: The Meatal-based Flap (Mathieu), the Tubularized Preputial Island Flap, the Island Onlay, the Meatal Advancement and Glanduloplasty (MAGPI) technique, the Koyanagi-Nonomura technique, and the Yoke repair technique. Simple adaptations were employed to modify the model, including sulcus and meatal repositioning, as well as suture- and resection-based skin adaptations. The model could be adapted to simulate six major hypospadias correction techniques on one single platform. The model required minimal resources and preparation, making it accessible and cost-effective. With the animal tissue model presented, the simulation of six commonly used single-stage reconstruction techniques on one adaptable, easily accessible platform becomes possible. Formal validation studies are warranted prior to their incorporation into standardized training curricula.

Feasibility of implementation, diagnostic accuracy, and end-user impact of an electronic health record (EHR)-based ureteral stent tracking tool in a pediatric population.

An introductory practical guide to secondary data analysis in pediatric urology.

ObjectiveTo evaluate whether a doctor-led interdisciplinary intervention integrating immersive virtual reality (VR) panoramic preview and interactive medical games is associated with reduced perioperative fear and anxiety, improved medical compliance, and enhanced parental satisfaction in children aged 5–12 years undergoing elective pediatric urological surgery.MethodsA retrospective cohort study was conducted on 120 eligible children treated between January and December 2024. Participants were divided into a control group receiving conventional preoperative education and nursing care (n=60) and a research group receiving additional VR and medical game intervention (n=60). Propensity score matching (PSM) was applied to balance potential baseline confounding factors. Fear was assessed with the Children’s Medical Fear Scale (CMFS) (0–4 points per item, 5-level scoring, Cronbach’s α=0.852). Anxiety was measured with the Spence Children’s Anxiety Scale–Short Version (SCAS-S) (1–4 points per item, 4-level scoring, Cronbach’s α=0.83). Medical compliance and parental satisfaction were also evaluated as secondary outcomes.ResultsAfter intervention, the research group demonstrated significantly lower CMFS (18.5±3.2 vs. 25.8±4.5) and SCAS-S (22.3±4.1 vs. 30.7±5.3) scores, higher medical compliance rate (93.3% vs. 75.0%), and greater parental satisfaction compared with the control group (all P<0.05).ConclusionThe doctor-led combined VR and medical game intervention is associated with reduced perioperative fear and anxiety, improved medical compliance, and enhanced family satisfaction, showing promising clinical value for perioperative psychological management in pediatric urological surgery.

Missed outpatient appointments: Who's missing out and Why?

Genital surgery in children with differences of sex development (DSD): Strengths and concerns across diverging regulations in four European countries.

A modified stomal construction technique to reduce incidence of stomal stenosis in continent catheterizable channels.

Genomic medicine is becoming increasingly relevant to pediatric urology. Developing an understanding of which children might benefit from genomic testing and how genomic results might impact clinical decision-making will become a necessary skill in the next few years. A genetic diagnosis can provide certainty, prompt screening of other organ systems, guide treatment and surveillance, enable testing of family members and inform reproductive counselling. In this review, we provide an overview of several monogenic conditions that might be encountered in the pediatric urology clinic and guidance on when to refer for genomic testing. We discuss monogenic congenital uropathies and how knowledge of the genetic basis of these conditions has improved understanding of disease pathophysiology. We summarise recommendations for genomic testing in pediatric stone formers, of whom around 20 % have a monogenic cause, and show how this can facilitate access to targeted therapies (e.g. primary hyperoxaluria type 1). Finally, we review how genotype-phenotype correlations can be used to guide risk stratification, surveillance protocols and screening of other organ systems in children at risk of Wilms tumour.

Evaluating a Collaborative Care Model for Inguinal Surgery in Pediatric Urology.

Pediatric nephrolithiasis continues to pose a substantial clinical challenge in pediatric urology because of its elevated recurrence rate and elevated morbidity with risk of end-stage renal failure. The management of pediatric nephrolithiasis involves dietary modification, pharmacological therapy, and urological intervention, with the choice of treatment guided by stone size, location, and composition. To evaluate the efficacy and safety of mini-percutaneous nephrolithotomy (mini-PCNL) and extracorporeal shock wave lithotripsy (SWL) for the management of renal stones measuring 1-2 cm in pediatrics. This prospective, randomized comparative research was conducted at the Department of Urology, Al-Azhar University Hospital, Assiut, Egypt, between December 2022 and November 2024. Sixty children with single renal stones were enrolled, with 30 undergoing SWL and 30 receiving mini-PCNL. Mini-PCNL achieved a significantly elevated stone-free rate (SFR, 93.33%) in contrast with SWL (33.33%) (p < 0.001). The SWL group also showed a higher rate of auxiliary approaches and retreatment. Overall complication rates were comparable. Mini-PCNL is more effective than SWL for managing renal stones measuring 10-20 mm in children aged 6 months to 6 years. It provides an elevated SFR and lowers the likelihood of retreatment and hospital readmission, with a comparable safety profile.

Pre-pubertal testicular torsion: A critical analysis of outcomes from a tertiary care center.

Ectopic ureterocele in duplex systems is commonly treated with open reconstruction, despite advances in minimally invasive pediatric urology. We developed a fully intravesical transvesicoscopic technique that reproduces key elements of open repair, including mucosa-preserving marsupialization, ureteral tapering, and common-sheath reimplantation. This study evaluated the feasibility and safety of this approach compared with open surgery. Between 2006 and 2023, eight children underwent definitive reconstruction (four open, four transvesicoscopic). All had prior ureterocele decompression and subsequent vesicoureteral reflux. The transvesicoscopic group had longer operative times but shorter hospitalization and did not require routine ureteral stenting. Vesicoureteral reflux resolved in all upper-pole systems, and hydronephrosis improved in all cases. No major complications or reoperations occurred, and renal function remained stable. In selected pediatric patients, transvesicoscopic reconstruction is a feasible and minimally invasive alternative that can replicate essential elements of open surgery with comparable early outcomes.

"Why children with anorectal malformations need urological evaluation: Insights from a retrospective study".