Pediatrics

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Montreal--The anti-estrogen agent clomiphene citrate (Clomid, Milophene, Serophene) may provide an easier, less expensive treatment for infertility among some men with hypogonadotropic hypo-gonadism [HH], according to a small retrospective study. The agent may be worth trying before the more expensive and difficult-to-administer gonadotropins are employed.

Washington--For children with ambiguous genitalia at birth, surgical techniques have improved vastly, but deciding when and whether to do surgery hasn't gotten easier. That was apparent from the lively and sometimes contentious panel and audience discussion here at the American Academy of Pediatrics Section on Urology annual meeting.

Washington--Long-term experience with bladder augmentation in children is now giving pediatric urologists and parents a true picture of the risks and benefits of different bowel segments. No single segment was the obvious winner in two experimental studies presented here at the American Academy of Pediatrics Section on Urology annual meeting, but the maintenance and surveillance required has become clearer. Other than technical considerations, metabolic, rather than urodynamic considerations, may prove more important in deciding which segment to use.

Washington--The most common anomaly detected on prenatal ultrasound is hydronephrosis. Up to 38% of those patients will have vesicoureteral reflux in early life. What to do about it, however, isn't always clear.

As the only nonprofit organization dedicated to teaching urology in developing countries, International Volunteers in Urology (IVU) provides a number of opportunities for residents and practicing urologists alike. Volunteers offer their teaching and clinical skills and learn about resourcefulness and compassion in return, IVU President Catherine deVries, MD, says in this exclusive interview. She was interviewed by UT Editorial Consultant Richard D. Williams, MD, professor and chairman of the department of urology at the University of Iowa, Iowa City. Dr. Williams also leads a volunteer surgical team that travels to Haiti each year.

Across a spectrum of indications, minimally invasive procedures are having a major impact on the practice of pediatric urology, said Howard Snyder, MD, professor of surgery in urology, University of Pennsylvania School of Medicine and Children's Hospital of Philadelphia. This observation was evident in a number of papers presented at the AUA annual meeting.

San Antonio--Although it may be routine at any number of tertiary care institutions and centers of excellence, the practice of automatically reviewing pathology slides that accompany referred bladder cancer patients nets little gain for either physicians or patients. In an overwhelming majority of instances, the practice does little more than add unnecessary dollars to the cost of treatment, according to a study presented at the 2005 AUA annual meeting here.

The most important factor in predicting a successful prostatectomy appears to be the overall experience of the surgeon, not the frequency of using a specific approach.

Nearly every practice is increasing the use of technology to improve office efficiency, enhance reimbursement, and increase patient satisfaction. Nearly every practice has or is considering implementing an electronic medical record, creating a robust interactive web site, networking their computers, and using electronic claims submission and a claims scrubber to ensure that claims are processed more quickly to increase your practice's cash flow.

Atlanta--Children treated with endoscopic intervention for vesicoureteral reflux continue to demonstrate cures that approach those of open surgery and have a high resolution rate after initial failure. In addition, incidence of febrile and non-febrile urinary tract infection after treatment is lower than after surgery, according to data presented here at the State-of-the-Art Symposium on Pediatric UTI, Reflux, Antibiotic Resistance, and Endoscopy.

Although routine, the practice of automatically reviewing pathology slides that accompany referred bladder cancer patients nets little gain for physicians or patients. In an overwhelming majority of instances, the practice does little more than add unnecessarily to the cost of treatment, according to a study presented here yesterday.

Clinical research in the field of trauma and reconstructive urologic surgery shows a recent focus on challenging cases, and study results are providing useful insight about their management, said Allen F. Morey, MD.

When Howard M. Snyder, MD, was asked to moderate a session on the latest developments in pediatric urology at the American College of Surgeons clinical congress last fall, he didn't have to think twice about the topics he wanted to cover.

Istanbul, Turkey--Swiss data add to growing evidence that injecting botulinum toxin A (Botox) into the detrusor muscle is a safe and efficient treatment option in patients suffering from overactive bladder, particularly in cases that prove refractory to other more conventional treatment modalities, like anticholinergic agents and physiotherapy.

San Francisco--Environmental factors have emerged as potential contributors to genetic anomalies affecting male genitalia, according to studies reported at the American Academy of Pediatrics Section on Urology annual meeting.