Pediatric urology looks to advances in minimally invasive surgery

This article is part of the State of Urology 2014

Dr. SnyderResearch in stone disease and minimally invasive surgery will also make its mark at the Society for Pediatric Urology (SPU) annual meeting, which runs concurrently with the first 3 days of the AUA meeting.

“There are a lot of papers on stones and the minimally invasive revolution in medicine, including ways to treat stones, [use of] robotics, and reflux,” said Howard M. Snyder, III, MD, professor of surgery in urology at the University of Pennsylvania School of Medicine, Philadelphia. “I would point out the rising epidemic of stones and the ability to deal with this problem.”

A group of five abstracts examines varicocele, which Dr. Snyder said continues to be controversial in terms of its management and effect.

“How much varicocele contributes [to an abnormal sperm count] continues to be very questionable. Many more varicoceles are treated in general than is justified by any evidence,” he said.

Also highly controversial are guidelines from the British National Institute for Health and Clinical Excellence (NICE) and the American Academy of Pediatrics (AAP) discussing the workup of febrile urinary tract infections in children. That will be the topic of the SPU’s John Duckett Memorial Lecture, which will be given by H. Gil Rushton Jr., MD.

“Many of us [in pediatric urology] disagree with the guidelines pretty vehemently, with good reason. The statement that’s coming out of AAP and the NICE committee is that you should wait until the second infection with fever before getting a VCUG. As the yield is so high, most pediatric urologists pretty vehemently disagree with this recommendation. No parent wants their child to be at risk for having a ‘make-me-sick’ infection,” Dr. Snyder said.

Among the can't-miss SPU/AUA 2014 abstracts selected by Dr. Snyder are the following:

5: A single centre experience comparing miniperc and Shock wave lithotripsy(SWL) for treatment of radioopaque 1-2 cm renal calculi in children :A prospective randomized study
Anup Kumar

MP22: Upper Tract Calculi and Associated Surgical Complications in Spina Bifida patients
HsinHsiao Wang

MP26-16: Hypercalciuric renal stones linked to atherosclerosis: Proteomics-based evidence
Larisa Kovacevic

MP26-17: Characteristics of Pediatric Stone Formers with Positive Family History- Single Center Experience
Necole M. Streeper

Continue to next page for more abstracts.

MP26-19: Tamsulosin increases spontaneous passage of ureteral stones in children
Janelle Fox

MP26-12: Radiation exposure in pediatric patients undergoing evaluation and management of nephrolithiasis
Benjamin Ristau

MP26-13: Predictors of CT Utilization in the Emergency Department for Children with Nephrolithiasis
Justin Ziemba

MP23: Proximal hypospadias: a continuous challenge. Outcome analysis of 3 surgical techniques over a 10-year period
Salwa Sayed

34: Minimally invasive versus open pyeloplasty in children: the differential effect of procedure volume on operative outcomes
Briony Varda

MP38: Multi-Institutional Review of Outcomes of Robotic Assisted Extravesical Ureteral Re-Implantation
Gwen Grimsby

MP33: Utilization of Minimally Invasive Partial Nephrectomy by Age and Tumor Pathology in Pediatric Patients, 2009-2010
Daniel Pucheril

MP44-14: Evaluation of the intravesical ureters after failed endoscopic treatment of vesicoureteral reflux with dextranomer/hyaluronic acid in children: Light and transmission electron microscopic analysis
Volkan Izol

Continue to next page for more abstracts.

MP26-07: Dilemma of adolescent varicocele: Long-term outcome in patients managed surgically and in patients managed expectantly.
Essam ElDin Moursy

MP26-08: 1.    Childhood varicoceles do not lead to progressive testicular atrophy/hypotropy
Siddharth Khasnavis

MP26-09: Effect of Treatment of Youth Varicocele on Semen Analysis: A Meta-Analysis
Justin Nork

MP26-10: Combined Correlation of Total Testis Volume and Volume Differential with Total Motile Sperm Counts in Adolescent Varicocele
Michael P. Kurtz

MP26-11: Long-term Outcomes of Adolescent Varicoceles Treated with Selective Gonadal Vein Embolization: 23 Years’ Experience
Kai-wen Chuang

MP44-03: Early Effect of American Academy of Pediatrics UTI Guidelines on Emergency Admissions, Radiographic Imaging and Diagnosis of Vesicoureteral Reflux
Laura S. Merriman

MP44-08: Imaging after UTI in older children and adolescents
Michael P. Kurtz

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