Urological Survey Pediatric Urology Re: Using a Serosal Trough for Fashioning a Continent Catheterizable Stoma: Technique and Outcomes N. Baradaran, A. A. Stec, A. Gupta, M. A. Keating and J. P. Gearhart Division of Pediatric Urology, Brady Urological Institute, Johns Hopkins Medical Institutions, Baltimore, Maryland BJU Int 2013; 111: 828e833.

Abstract available at http://jurology.com/ Editorial Comment: A number of centers are moving toward anterior placement of continent catheterizable stomas. The anterior channel results in shorter overall channel length, resulting in an improved ability to control for kinking during catheterization. This elegant and simple approach, namely creation of a U-shaped incision with an intraserosal tunnel, was immediately effective in 24 of 26 patients. The other 2 patients required revision of the stoma at 6 and 21 months after the original surgery. These are good results in a complicated group of patients. This is another reliable technique for the toolbox of any busy reconstructive urologist. Douglas A. Canning, MD

Re: Growth of Spontaneously Descended and Surgically Treated Testes during Early Childhood € ld and E. M. Ritze n C. Kollin, T. Granholm, A. Nordenskjo Department of Women’s and Children’s Health, Center of Molecular Medicine, Karolinska Institutet, Stockholm, Sweden Pediatrics 2013; 131: e1174ee1180.

Abstract available at http://jurology.com/ Editorial Comment: The authors reviewed 91 boys with unilateral cryptorchidism with later spontaneous descent of the initially retained testis from birth up to age 5 years. They compared this group to boys with cryptorchidism randomized to surgery at either age 9 months or age 3 years. Testicular volume, which may be a surrogate measure of testicular health, was determined with ultrasonography. Of those with spontaneous descent 82% demonstrated descent within 2 months of life. The spontaneously descended testis was smaller than the contralateral scrotal testis at all ages. Those operated on early had larger testicular volume than those operated on late. This series may support the practice of most of us, who operate as soon as we diagnose cryptorchidism. Douglas A. Canning, MD

Re: Partial Orchiectomy for Bilateral Synchronous Testicular Masses in a Prepubescent Boy: A Case Report R. Madden-Fuentes, J. S. Wiener, S. S. Ross and J. C. Routh

0022-5347/14/1913-0790/0 THE JOURNAL OF UROLOGY® © 2014 by AMERICAN UROLOGICAL ASSOCIATION EDUCATION

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http://dx.doi.org/10.1016/j.juro.2013.11.040 Vol. 191, 790-791, March 2014 Printed in U.S.A.

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Division of Urology, Duke University Medical Center, Durham, North Carolina Urology 2012; 80: 1144e1146.

Abstract available at http://jurology.com/ Editorial Comment: This case report reminds us that in prepubertal boys testicular masses are generally benign and can be managed even in bilateral cases with simple excision rather than orchiectomy. Douglas A. Canning, MD

Re: Pediatric Urology Fellowship Training: Are We Teaching What They Need to Learn? M. H. Wang, B. Chen, D. Kern and S. Gearhart Urology, Division of Pediatric Urology, Johns Hopkins School of Medicine, Baltimore, Maryland J Pediatr Urol 2013; 9: 318e321.

Abstract available at http://jurology.com/ Editorial Comment: This study surveyed 31 of 44 pediatric urology fellows who graduated from accredited pediatric urology programs across the country between 2007 and 2009. Each took an anonymous survey assessing the most effective methods of teaching during their fellowship. Of those surveyed 74% felt prepared to a large extent and 23% to a moderate degree to manage intraoperative complications. Multidisciplinary conferences, didactic lectures, Web based self-learning and simulation appear much less important than direct faculty supervision and feedback. The top 3 procedures that fellows wished they had learned better were laparoscopic/robotic surgery, hypospadias repair and augmentation/Mitrofanoff. The top 3 nonsurgical topics included urinary tract infection, voiding dysfunction, and billing and coding. Those of us in the business of teaching (which is most of us in pediatric urology) need to keep in mind that direct faculty supervision and feedback remain the most important tools in teaching our fellows and residents. Fellows and residents are adult learners who spend a considerable amount of time in independent reading but there is no substitute for direct teaching at the hands of the attending surgeon. Douglas A. Canning, MD

Re: using a serosal trough for fashioning a continent catheterizable stoma: technique and outcomes.

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