DeFoor WR, Bischoff A, Reddy P, VanderBrink B, Minevich E, Schulte M, Sheldon C, Pena A. Chronic Kidney Disease Stage Progression in Patients Undergoing Repair of Persistent Cloaca. J Urol. 2015 Jul;194(1):190-4.
Children born with persistent cloaca undergo complex pelvic reconstruction early in life. Long-term risks of bladder dysfunction and chronic kidney disease are well described. We report upper urinary tract outcomes and the risk of chronic kidney disease stage progression in this patient population. Early outcomes in patients with stage I to III chronic kidney disease demonstrate that maintained renal function is possible despite a high rate of lower urinary tract dysfunction. Aggressive bladder management may help prevent progressive renal injury in this population.
Greenfield SP, Cheng E, DeFoor W, Kropp B, Rushton HG, Skoog S, Carpenter M. Vesicoureteral Reflux and Antibiotic Prophylaxis: Why Cohorts and Methodologies Matter. J Urol. 2016 Oct;196(4):1238-43.
Published cohorts of children with vesicoureteral reflux placed on antibiotic prophylaxis differ in baseline characteristics and methodology. Researchers combined these data in meta-analyses to derive treatment recommendations. We analyzed these cohorts in an attempt to understand the disparate outcomes reported. Subpopulations and methodologies vary significantly in published series of children with vesicoureteral reflux on antibiotic prophylaxis. It is inappropriate to combine outcomes data from these series in a meta-analysis, which would serve to blur distinctions between these subpopulations. View with caution broad recommendations or guidelines based on meta-analyses.
Barthold JS, Wang Y, Kolon TF, Kollin C, Nordenskjold A, Fisher AO, Figueroa TE, BaniHani AH, Hagerty JA, Gonzalez R, Noh PH. Pathway analysis supports association of nonsyndromic cryptorchidism with genetic loci linked to cytoskeleton-dependent functions. Hum Reprod. 2015 Oct;30(10):2439-51.
A genome-wide association study (GWAS) suggests that susceptibility to cryptorchidism is heterogeneous, with a subset of suggestive signals linked to cytoskeleton-dependent functions and syndromic forms of the disease. As the only GWAS to date of nonsyndromic cryptorchidism, these data will provide a basis for future efforts to understand genetic susceptibility to this common reproductive anomaly and the potential for additive risk from environmental exposures.
DeFoor WR, Asplin JR, Kollar L, Jackson E, Jenkins T, Schulte M, Inge T. Prospective evaluation of urinary metabolic indices in severely obese adolescents after weight loss surgery. Surg Obes Relat Dis. 2016 Feb;12(2):363-7.
Observational studies in obese adults have found abnormal urinary metabolic indices that predispose to nephrolithiasis. There have been few studies performed in severely obese adolescents. Elevated excretion of oxalate in the urine of severely obese adolescents and in those who have undergone RYGB may portend increased risk for kidney stone formation. Researchers will need to conduct larger longitudinal studies to verify these findings, and to determine the clinical risk of developing stone disease in these patient populations.
Mann EA, Alam Z, Hufgard JR, Mogle M, Williams MT, Vorhees CV, Reddy P. Chronic social defeat, but not restraint stress, alters bladder function in mice. Physiol Behav. 2015 Oct 15;150:83-92.
Voiding disorders in humans, particularly in children, associate with increased incidence of behavioral issues as well as past history of childhood abuse. We hypothesized that creating stress in mice, utilizing either a chronic social defeat model (SD) or restraint stress in shallow water model (RSSW) would engender changes in bladder function, morphology, and behavior, thereby enabling us to study the resultant voiding dysfunction. Mice exposed to repeated SD (14 days) respond with altered voiding indicative of urine retention, and exhibit bladder wall changes consistent with hypertrophy while maintaining the urothelial barrier. These changes were not observed with repeated RSSW. SD, in contrast to RSSW, provides a model of psychological stress to further study the interplay of behavior and bladder dysfunction, enabling an improved understanding of voiding dysfunction, and the ability to create innovative and more effective management pathways for children who present with voiding dysfunction.