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When performing animal experimentation in Pediatric Urology studies, it is important to be aware of physiological differences between species and to understand when relevant disease models are available. Diseased animal models may be more relevant in many cases, rather than performing studies in healthy and normally developed animals. For example, they may be more appropriate for the study of congenital malformations, to investigate the secondary effects of prenatal urinary obstruction, to study the effect of prenatal exposure to endogenous or exogenous factors which may lead to disease, or in testing bioengineered structures. In this short educational article, we aim to describe some disease models that have been used to simulate human pathologies and how, if properly designed, these studies can lead to important new knowledge for human translation. In addition, we also highlight the importance of formulating a research question(s) before deciding on the animal experimental model and species to choose. Keywords Animal experimentationAnimal EthicsAnimal PhysiologyPediatric Urology, When performing animal experimentation in Pediatric Urology studies, it is important to be aware of physiological differences between species and to understand when relevant disease models are available. Diseased animal models may be more relevant in many cases, rather than performing studies in healthy and normally developed animals. For example, they may be more appropriate for the study of congenital malformations, to investigate the secondary effects of prenatal urinary obstruction, to study the effect of prenatal exposure to endogenous or exogenous factors which may lead to disease, or in testing bioengineered structures. In this short educational article, we aim to describe some disease models that have been used to simulate human pathologies and how, if properly designed, these studies can lead to important new knowledge for human translation. In addition, we also highlight the importance of formulating a research question(s) before deciding on the animal experimental model and species to choose.

Robotic pyeloplasty has become a natural progression from the development of open, then laparoscopic procedures to treat pediatric patients with ureteropelvic junction obstruction (UPJO). Robotic-assisted pyeloplasty (RALP) is now considered a new gold standard in pediatric MIS. A systematic review of the literature retrieved from PubMed and published in the last 10 years (2012–2022) was performed. This review underlines that in all children except the smallest infants, where the open procedure has benefits in terms of duration of general anesthetic and there are limitations in the size of instruments, robotic pyeloplasty is becoming the preferred procedure to perform in patients with UPJO. Results for the robotic approach are extremely promising, with shorter operative times than laparoscopy and equal success rates, length of stay and complications. In case of redo pyeloplasty, RALP is easier to perform than other open or MIS procedures. By 2009, robotic surgery became the most used modality to treat all UPJO and continues to grow in popularity. Robot-assisted laparoscopic pyeloplasty in children is safe and effective with excellent outcomes, even in redo pyeloplasty or challenging anatomical cases. Moreover, robotic approach shortens the learning curve for junior surgeons, who can readily achieve levels of expertise comparable to senior practitioners. However, there are still concerns regarding the cost associated with this procedure. Further high-quality prospective observational studies and clinical trials, as well as new technologies specific for the pediatric population, are advisable for RALP to reach the level of gold standard.

Precision Medicine holds promise for helping us manage specific phenotypes of common diseases. For rare diseases such as hypospadias, DSD, and pediatric solid tumors, it can also reveal underlying risk factors and pathogenesis. Professors Ann Nordgren and Anna Lindstrand share their experiences in the development and ongoing initiatives of the Swedish national project on Precision Medicine and how it could change the care of pediatric urology patients.

Although some centres have successfully integrated remote clinics into their paediatric urological practice, for many, remote clinics have developed due to the COVID-19 pandemic. One UK-based institution has integrated remote clinics in their practice for over two years and has developed guidelines considering which conditions may be suitable for remote consultations. These guidelines have been appraised by the European Association of Urology Young Academic Urologists paediatric working group. Through practical experience and anticipated difficulties, we have discussed considerations that paediatric urology departments should ponder when integrating remote clinics into their practice as we move forward from the pandemic.

COVID-19 began in December 2019 then spread worldwide. Providers, including pediatric urologists, had to adapt their clinical processes, and many non-covid research activities were suspended. COVID-19 impacts how research is financed, performed, and published, and is itself the subject of intense research. We present current research and publications specifically related to the urinary tract and the pediatric population.

Carried out the retrospective analysis 52 children, ill nefrolitiasis of etiology hyperparathyroidism. By purpose showed up to study degree demineralization bony cloth as to forms primary hyperparathyroidism at children. The studies of the activity of alkalized phosphatase and ehoosteometrii will lend possibility to appreciate degree demineralization bony cloth and accordingly diferation PGPT as to forms and the weights of disease. Hyperparathyroidism contributes development demineralization the bony cloth of various intensity which is connected by physical charge on bonus cloth. Indicators characterizing bony changes in stone disease of etiology hyperparathyroidism were more at children in miscellaneous form PGPT and accordingly high indicators are noted at children with the disorder of the function of buds and had direct relationship with quantity and size of formed stone and osteoporosis of bones.

Carried out the retrospective analysis 52 children, ill nefrolitiasis of etiology hyperparathyroidism. By purpose showed up to study degree demineralization bony cloth as to forms primary hyperparathyroidism at children. The studies of the activity of alkalized phosphatase and ehoosteometrii will lend possibility to appreciate degree demineralization bony cloth and accordingly diferation PGPT as to forms and the weights of disease. Hyperparathyroidism contributes development demineralization the bony cloth of various intensity which is connected by physical charge on bonus cloth. Indicators characterizing bony changes in stone disease of etiology hyperparathyroidism were more at children in miscellaneous form PGPT and accordingly high indicators are noted at children with the disorder of the function of buds and had direct relationship with quantity and size of formed stone and osteoporosis of bones.

COVID-19 began in December 2019 then spread worldwide. Providers, including pediatric urologists, had to adapt their clinical processes, and many non-covid research activities were suspended. COVID-19 impacts how research is financed, performed, and published, and is itself the subject of intense research. We present current research and publications specifically related to the urinary tract and the pediatric population.

A four-year-old boy presenting with neuropathic bladder and hydrocephalus developed Fournier’s gangrene of the scrotum and perineum. At first, he was in septic shock and intubated. After debridement and grafting, he was taken to the normal service room from the intensive care unit. He was discharged on the 29th postoperative day. We performed bilateral orchiectomy due to testicular involvement and also repair and flap application to urethra due to its involvement. We think that our case is interesting because Fournier’s gangrene is already rare in children and our case also contains atypical involvement sites such as testes and urethra.

We present a rare case of exstrophy variant - inferior vesical fistula. A two-year-old boy with normal continence presented with a suprapubic pit and mucosal plate on the penile dorsum. Examination and cystoscopy revealed vesical fistula. The fistula was closed and the penis was reconstructed. Recognition of the exstrophy variant is important because the treatment and prognosis are very different.

Congenital urethral polyps are a rare cause of obstructive urinary symptoms in childhood. The diagnosis is usually made by ultrasonography, voiding cystourethrogram, and urethrocystoscopy. We report the case of a 7-year-old boy with multiple congenital polyps of the verumontanum, who had symptoms of abdominal pain, urinary tract infection and nocturnal enuresis, and whose symptoms totally disappeared following electrofulguration of the polyps.

Since the late 1980s, minimally invasive surgery (MIS) has been one of the fastest growing approaches for surgical procedures. However, its development has reached a plateau. One of the reasons is the difficulty to operate on more complex cases, such as neonatal procedures. Some experts report outstanding outcomes for complex operations, but not all surgeons may be able to achieve the same results. Is robotic surgery (RS) a solution? Methods: To answer this question, we reviewed the current indications of RS for the pediatric population and the steps needed to incorporate the robotic surgical system in a children's hospital. We reported our experience and presented our first results and the encountered problems. Results: After a year and a half of experience with RS, several lessons were learned: (1) the current robotic surgical system cannot yet be considered a replacement to conventional MIS, (2) docking is less time consuming than expected, (3) postoperative pain is significantly decreased, (4) the absence of haptic feedback is still a matter of concern, and (5) costs can be afforded by sharing the RS with adult surgeons. Conclusions: Based on our experience, the advantages seem to outweigh the drawbacks as it encourages team building and increases overall comfort for the surgeon. However, the current literature fails to prove that RS gives better results for pediatric patients. New advances in technology will probably help to overcome the encountered difficulties and the high costs., SCOPUS: ar.j, info:eu-repo/semantics/published

In 2009 the Dutch Hypospadias study started with the goal to unravel the factors that influence the chance of complications. Now the time has come to transform this study into an international quality registration.

Objectives: Functional bladder capacity is an important factor in the diagnosis of lower urinary tract symptoms (LUTS) in children. LUTS are highly prevalent in children and this prevalence increases in obese children. However, the effects of obesity on bladder capacity are unknown. This study examines the relationship of obesity on functional bladder capacity and LUTS. This study also examines the differences in expected values based on the Koff formula between obese versus non-obese children. Methods: Demographic data and voiding diary measurements were prospectively collected, after informed consent, for children without LUTS. The same data set was compared to data collected retrospectively for children with LUTS managed at the CHOC Children’s Pediatric Urology Center after ethics approval from the institution. Obesity was defined as children who were above the 95th percentile in gender specific weight by age. Expected bladder capacity was calculated using the Koff formula. Statistical comparison was performed using the Student t-test, where significance was set at p<0.05.Results: We prospectively screened 110 children without LUTS and enrolled 35 and retrospectively identified 35 children with LUTS. Eighteen of the children without LUTS (25.7%) were non-obese while 17 (24.3%) were obese. In the LUTS group, 19 (27.1%) were non-obese and 16 (22.9%) were obese. Among patients with LUTS, AVV, MVV, and MMVV were not significantly different in obese versus non-obese children (p=0.154, p=0.587, p=0.378, respectively). There was no difference in prevalence of LUTS between healthy weight and obese children (p=1.000). Furthermore, bladder capacity expressed as a percentage of expected bladder capacity (as calculated by the Koff formula) was significantly different between non-obese and obese patients without LUTS (p=0.040).Conclusion: Although this study has low statistical power due to a small sample size, trends show a lower functional bladder capacity in obese child

Objectives: Functional bladder capacity is an important factor in the diagnosis of lower urinary tract symptoms (LUTS) in children. LUTS are highly prevalent in children and this prevalence increases in obese children. However, the effects of obesity on bladder capacity are unknown. This study examines the relationship of obesity on functional bladder capacity and LUTS. This study also examines the differences in expected values based on the Koff formula between obese versus non-obese children. Methods: Demographic data and voiding diary measurements were prospectively collected, after informed consent, for children without LUTS. The same data set was compared to data collected retrospectively for children with LUTS managed at the CHOC Children’s Pediatric Urology Center after ethics approval from the institution. Obesity was defined as children who were above the 95th percentile in gender specific weight by age. Expected bladder capacity was calculated using the Koff formula. Statistical comparison was performed using the Student t-test, where significance was set at p<0.05.Results: We prospectively screened 110 children without LUTS and enrolled 35 and retrospectively identified 35 children with LUTS. Eighteen of the children without LUTS (25.7%) were non-obese while 17 (24.3%) were obese. In the LUTS group, 19 (27.1%) were non-obese and 16 (22.9%) were obese. Among patients with LUTS, AVV, MVV, and MMVV were not significantly different in obese versus non-obese children (p=0.154, p=0.587, p=0.378, respectively). There was no difference in prevalence of LUTS between healthy weight and obese children (p=1.000). Furthermore, bladder capacity expressed as a percentage of expected bladder capacity (as calculated by the Koff formula) was significantly different between non-obese and obese patients without LUTS (p=0.040).Conclusion: Although this study has low statistical power due to a small sample size, trends show a lower functional bladder capacity in obese child