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INTRODUCTION: Pediatric testicular torsion (TT) is a urologic emergency that may result in testicular loss if left untreated. Testicular salvage is dependent on prompt intervention, and thus delays in diagnosis and management may threaten testicular viability. Knowledge of real-world Canadian practice patterns for pediatric TT will allow optimization of practices based on resource availability and geographic limitations to improve care. METHODS: An electronic survey on pediatric TT management was distributed to Canadian urologists. Descriptive statistics were performed on respondent demographic factors, hospital policies and barriers to care, surgical approaches, and transfer practices. Respondent practice patterns were analyzed based on geographic location and training. RESULTS: Thirty-four urologists responded, with most respondents operating a community practice. Ultrasonography (US) was frequently used to support TT diagnosis. Despite this, poor US access was often cited as a barrier to care, with particular impact on rural urologists. Neonatal patients and <10 years old were commonly transferred to a pediatric hospital for definitive management due to surgeon discomfort and hospital policies. Reported transport methods commonly included use of the patient's own vehicle or ambulance based on availability and timing. CONCLUSIONS: Neonatal patients and patients under 10 years old are most commonly reported to be transferred to pediatric hospitals for TT management. Patients located in rural locations and at centers with limited US access may be at risk for delayed diagnosis and treatment. Pathways for prompt management of suspected TT may better serve these younger pediatric patients. [ABSTRACT FROM AUTHOR]

The article presents a clinical practice guideline (CPG) on pediatric neurogenic lower urinary tract dysfunction (NLUTD) developed by the Canadian Urological Association (CUA) and the Pediatric Urologists of Canada (PUC). It focuses on pediatric patients with neurological conditions causing urinary dysfunction. It further emphasizes the importance of diagnosis, conservative management, surgical interventions, and long-term follow-up.

The article provides guidelines for the diagnosis, management, and treatment of pediatric patients with neurogenic lower urinary tract dysfunction (NLUTD), primarily focusing on those with congenital spinal dysraphism, such as spina bifida. It aims to improve care and outcomes in this patient population by emphasizing early detection and prenatal intervention, involving multidisciplinary healthcare teams, and providing recommendations for various aspects of patient care.