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Objective: To evaluate preoperative predictive factors for postoperative complications of augmentation cystoplasty in children by using the modified Clavien classification system (MCCS)., Patients and Methods: A retrospective review of medical records between 1994 and 2014 identified 117 children (64 males and 53 females) who underwent augmentation cystoplasty. Complications were evaluated according to the MCCS. Univariate and multivariate analyses were used to determine predictive factors affecting complication rates., Results: The mean (SD) age was 9.3 (1.9) years and the mean (SD) hospitalization time was 9.7 (3.6) days. Patients with an adverse or unexpected event within 30 days of surgery were identified. Complications occurred in 29 (24.7%) children; 13 (11.1%) were MCCS grade I, 8 (5.1%) were grade II, 5 (4.2%) were grade III, and 3 (2.5%) were grade IV. Antireflux surgery, outlet resistance increasing procedures, Society of Fetal Urology (SFU) grades 3-4 hydronephrosis, posterior urethral valves, scoliosis, and serum creatinine greater than 1.0 mg/dL were statistically significant predictors of complications on univariate analysis. In the multivariate analysis, SFU grades 3-4 hydronephrosis, bladder neck reconstruction, and serum creatinine greater than 1.0 mg/dL were statistically significant independent predictors of complications., Conclusion: Augmentation cystoplasty remains a valid method of treating severe bladder dysfunction in children. SFU grades 3-4 hydronephrosis, outlet resistance increasing procedures, and serum creatinine greater than 1.0 mg/dL were the main predictive factors for postoperative complications. Use of a standardized complication grading system, such as the MCCS, should be encouraged to allow the valid comparison of complication rates between series., (Copyright © 2016 Elsevier Inc. All rights reserved.)

Horseshoe kidney is a relatively common congenital anomaly. In 95% of the cases, lower poles are connected to each other. In a small subset, an isthmus connects both upper poles (reverse horseshoe kidney). Almost always, the fusion of kidney poles occurs anterior to the aorta and vena cava. The fusion of renal poles posterior to both aorta and vena cava is extremely rare. Herein, we present a case with multiple rare congenital anomalies-retroaortic variant of reverse horseshoe kidney, retroaortic left renal vein, and butterfly vertebrae., (Copyright © 2016 Elsevier Inc. All rights reserved.)

Objective: To identify the incidence and associated factors of the postoperative hydronephrosis in pediatric patients who underwent ureterorenoscopy (URS) for renal or ureteral stones., Patients and Methods: We evaluated the results of 116 patients who underwent semirigid or flexible URS retrospectively. Primary end points of the study were to determine the incidence of postoperative hydronephrosis and factors associated with the development of postoperative hydronephrosis. Logistic regression analysis was used to define factors associated with the presence of hydronephrosis., Results: Mean age of the population was 9.5 years and mean stone size was 9.4 mm. Hydronephrosis was detected in 32 (27.6%) patients. Stone-free status was achieved in 101 (87%) patients. Univariate analysis revealed history of ipsilateral URS, duration of operation, presence of impacted stone, development of ureteral injury during operation, and presentation with a renal colic episode as the parameter associated with increased risk of hydronephrosis. History of ipsilateral URS (odds ratio: 1.664, P = .027), presence of impacted stones (odds ratio: 1.788, P = .014), and development of ureteral injury during operation (odds ratio: 1.106, P = .039) were found to be the independent markers of developing postoperative hydronephrosis in a multivariate analysis., Conclusion: Ipsilateral hydronephrosis following URS develops in a significant portion of patients. In patients with history of ipsilateral procedure and those with an impacted stone and had ureteral injury, the risk of postoperative hydronephrosis is higher; therefore, physicians should keep these parameters in mind in the decision-making process of selective imaging postoperatively., (Copyright © 2016 Elsevier Inc. All rights reserved.)

Renal angiomyolipoma (AML) is the most common benign renal mesenchymal tumors. AMLs are usually asymptomatic and frequently affect women. Only epithelioid variant has malignant potential. Although life-threatening complications related to retroperitoneal bleeding and massive hematuria are possible, it is often detected incidentally. Pulmonary embolism as the first symptom is extremely rare. Herein, we present a case of renal AML who admitted with pulmonary embolism symptoms., (Copyright © 2015 Elsevier Inc. All rights reserved.)

Urethral calculi are extremely rare in pediatric population and are usually presented with dysuria, hematuria, lower urinary tract obstruction, and rarely as a scrotal mass. We here report a giant primary urethral stone presenting as a scrotal mass that developed in the penile urethra resulting from a postsurgical complication of exstrophy-epispadias repair. A 7-year-old boy was admitted with the complaint of scrotal mass and dysuria. Computerized tomography confirmed giant urethral stone impacted to diverticulum of urethra. Cystoscopy revealed a nonobstructed stone in the urethra related to a posterior diverticulum. After scrotal incision, stone was removed with open diverticulectomy., (Copyright © 2015 Elsevier Inc. All rights reserved.)

Objective: To investigate the efficacy of near infrared spectroscopy (NIRS) and an algorithm on the diagnosis of bladder outlet obstruction in men with lower urinary tract symptoms (LUTS)., Methods: Male patients with LUTS were recruited and underwent uroflowmetry and urodynamic pressure flow study (PFS) with simultaneous transcutaneous NIRS monitoring. Next, the postvoid residual urine volume was measured using ultrasonography. Data analysis first classified each subject as obstructed or unobstructed using the standard pressure flow data and nomogram and compared these results with the NIRS algorithm, which analyzed the pattern of change of the NIRS data plus the measurements of the postvoid residual urine volume and peak flow rate on uroflowmetry., Results: A total of 65 patients were enrolled in the present study. Of these patients, 10 with equivocal PFS findings and 2 with concurrent urinary tract infection were excluded. Of the 53 patients, 29 and 24 were classified as obstructed and unobstructed according to the PFS outcomes, respectively. The International Prostate Symptom Score and uroflowmetry peak flow rate demonstrated significant differences between the obstructed and unobstructed patients. The NIRS algorithm correctly identified 25 patients diagnosed as obstructed (86.2%) and 21 diagnosed as unobstructed (87.5%) according to the PFS findings., Conclusion: The NIRS algorithm could be a noninvasive option for the diagnosis of bladder outlet obstruction in men with LUTS, with 86.2% and 87.5% sensitivity and specificity, respectively., (Copyright © 2012 Elsevier Inc. All rights reserved.)