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954 results on '"Routh, Jonathan C."'

53. Variation in Definitions of Kidney Abnormality in Patients with Spina Bifida: A Systematic Scoping Review

Author

Rague, James T., primary, Lai, Jeremy D., additional, Murphy, Peggy, additional, Fawcett, Andrea, additional, Walton, Ryan, additional, Rosoklija, Ilina, additional, Bowen, Diana K., additional, Yerkes, Elizabeth B., additional, Cheng, Earl Y., additional, Hodgkins, Kavita S., additional, Routh, Jonathan C., additional, Isakova, Tamara, additional, and Chu, David I., additional

Published
2022
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67. Robot-assisted laparoscopic anterior urethral diverticulectomy.

Author

O'Shea, Michele, Routh, Jonathan C., and Siddiqui, Nazema Y.

Subjects
*URETHRA, *SURGICAL robots, *URINATION disorders, *DIVERTICULUM, *MAGNETIC resonance imaging, *LAPAROSCOPIC surgery, *BRAIN abscess, TUMOR surgery
Abstract

Introduction and hypothesis: A 31-year-old patient with a history of fetal sacrococcygeal teratoma requiring tumor resection and pelvic reconstruction in infancy presented with a 3-year history of recurrent vulvar abscesses and voiding dysfunction. Magnetic resonance imaging demonstrated a fluid collection posterior to the pubic bone and inferior to the bladder. The objective was to demonstrate the key steps in the resection and repair of an anterior urethral diverticulum via robot-assisted laparoscopic approach. Methods: Cystoscopy followed by robot-assisted laparoscopic retropubic dissection was used for resection of an anterior urethral diverticulum followed by urethral reconstruction. Results: Cystoscopy revealed a large anterior cavity at the midpoint of the urethra consistent with an anterior urethral diverticulum. This likely tracked inferiorly toward her vulva during repeated episodes of infection expressing through her recurrent abscesses. Retropubic space exploration revealed dense fibrotic tissue adherent to the underside of the pubic tubercule contiguous with the anterior urethral diverticulum, which was successfully resected. Conclusions: Female anterior urethral diverticulum is a rare entity. A robot-assisted laparoscopic approach can be safely utilized to identify and resect an anterior urethral diverticulum. Key points include optimization of port placement, use of a council-tip catheter to facilitate bladder drainage in the setting of distorted pelvic anatomy, and multi-layered tension-free urethral closure with flap placement. [ABSTRACT FROM AUTHOR]

Published
2023
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75. Additional file 1 of Combining adult with pediatric patient data to develop a clinical decision support tool intended for children: leveraging machine learning to model heterogeneity

Author

Sabharwal, Paul, Hurst, Jillian H., Tejwani, Rohit, Hobbs, Kevin T., Routh, Jonathan C., and Goldstein, Benjamin A.

Abstract

Additional file 1: Supplemental Table 1. Predictor Variables used in each model. Supplemental Table 2. CPT Code Ranges Used (286, including None and Other). Supplemental Table 3. Performance of models on pediatric patients (n = 1428) during the COVID period (March 2020 – January 2022). Supplemental Figure 1. ROC plots for ICU and Ventilator models based on training population and model type.

Published
2022
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86. The Importance of Early Diagnosis and Management of Pediatric Neurogenic Bladder Dysfunction

Author

Hobbs,K Tyler, Krischak,Madison, Tejwani,Rohit, Purves,J Todd, Wiener,John S, and Routh,Jonathan C

Subjects
Research and Reports in Urology
Abstract

K Tyler Hobbs,1 Madison Krischak,2 Rohit Tejwani,1 J Todd Purves,1 John S Wiener,1 Jonathan C Routh1 1Division of Urologic Surgery, Duke University Medical Center, Durham, NC, USA; 2Duke University School of Medicine, Durham, NC, USACorrespondence: Jonathan C RouthDivision of Urologic Surgery, Duke University Medical Center, DUMC 3831, Durham, NC, 27710, USATel +1 (919) 684-6994Fax +1 (919) 681-5507Email jonathan.routh@duke.eduAbstract: Neurogenic bladder dysfunction is a major source of urologic morbidity in children, especially in those with spina bifida (SB). Complications from progression of bladder dysfunction can include urinary tract infections (UTIs), urinary incontinence, upper tract deterioration, and renal dysfunction or failure. In these children, there has been a recent trend toward proactive rather than expectant management of neurogenic bladder. However, there is a lack of consensus on how to best achieve the three main goals of neurogenic bladder management: 1) preserving kidney function, 2) achieving continence (if desired by the family/individual), and 3) achieving social and functional urologic independence (if appropriate). Hence, our objective was to perform a narrative literature review to evaluate the approaches to diagnosis and management of pediatric neurogenic bladder dysfunction, with special focus on children with SB. The approach strategies vary across a spectrum, with a proactive strategy on one end of the spectrum and an expectant strategy at the other end. The proactive management strategy is characterized by early and frequent labs, imaging, and urodynamic (UDS) evaluation, with early initiation of clean intermittent catheterization (CIC) and proceeding with pharmacotherapy, or surgery if indicated. The expectant management strategy prioritizes surveillance labs and imaging prior to proceeding with invasive assessments and interventions such as UDS or pharmacotherapy. Both treatment strategies are currently utilized and data have historically been inconclusive in demonstrating efficacy of one regimen over the other. We performed a narrative literature evaluating proactive and expectant treatment strategies as they relate to diagnostics and management of Spina Bifida. From the available literature and our practice, a proactive strategy favors greater benefit in preventative management and may decrease risk of renal dysfunction compared with expectant management.Keywords: bladder dysfunction, management, pediatric, neurogenic bladder, spina bifida, diagnosis

Published
2021

94. Urodynamic characteristics of neurogenic bladder in newborns with myelomeningocele and refinement of the definition of bladder hostility: Findings from the UMPIRE multi-center study

Author

Tanaka, Stacy T., primary, Yerkes, Elizabeth B., additional, Routh, Jonathan C., additional, Tu, Duong D., additional, Austin, J. Christopher, additional, Wiener, John S., additional, Vasquez, Evalynn, additional, Joseph, David B., additional, Ahn, Jennifer J., additional, Wallis, M. Chad, additional, Williams, Tonya, additional, Rose, Charles, additional, Baum, Michelle A., additional, and Cheng, Earl Y., additional

Published
2021
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