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Introduction: Periodic follow-up prior to and after puberty to evaluate for long-term sequalae following hypospadias repair is commonly recommended. Few studies have evaluated this follow-up, especially into adulthood. This study aimed to evaluate adherence to routine postoperative follow-up appointments over 10 years following elective hypospadias repair., Material and Methods: Retrospective review of all patients undergoing hypospadias repair at our institution under the age of 10 from January-December 2012 was performed. Data were extracted including demographics, meatal location, type of hypospadias and chordee repair, use of postoperative stent, adherence to follow-up, re-operations, and postoperative concerns. Primary outcome was adherence to long-term follow-up. Secondary outcomes included re-operative rates and complications., Results: A total of 213 patients underwent hypospadias repair in 2012 with 52 (24 %) having a distal repair without urethral stent, 112 (53 %) distal repair with urethral stent, 29 (14 %) midshaft repair with urethral stent, and 20 (9 %) proximal repair with urethral stent. Almost all patients followed up for stent removal at our clinic (88 %), and the remaining with a local provider. Overall, 64 % of patients presented for their postoperative check within 3 months which was consistent between groups (p = 0.300). Only 12 % (25/213) of patients followed up after toilet training with the proximal group having the highest rate at 40 % (8/20, p = 0.003). In those following up after toilet training, 36 % (9/25) of patients followed up due to clinical symptoms attributed to their hypospadias repair or another unrelated urologic issue; the vast majority (87.5 %) of those with proximal hypospadias did so without any urologic issues. 15 % (31/213) of patients never followed up. Five (2.7 %) patients underwent secondary procedures related to their initial hypospadias surgery., Discussion: We noted poor rates of follow-up at our institution for boys undergoing hypospadias repair. Short-term follow-up was uniformly poor. After toilet training, boys with proximal hypospadias were more likely to follow-up. This study is limited in being a retrospective, single center study and that some urologic follow-up may not have been captured outside of our tertiary referral center., Conclusions: Despite our recommendations, patient adherence to follow-up after hypospadias repair is poor. More research and attention are needed to optimize and better understand poor adherence to long-term follow-up. Follow-up is essential to assess true rates of long-term complications, and to help develop specific education regarding consequences of unrecognized surgical complications, especially in more complex cases. Sharing such information may ensure parents understand the need for routine and regular evaluation., Competing Interests: Conflict of interest None., (Copyright © 2024 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.)

Purpose: Patient- and family-centered communication is essential to health care equity. However, less is known about how urologists implement evidence-based communication and dynamics involved in caring for diverse pediatric patients and caregivers. We sought to evaluate the feasibility and acceptability using video-based research to characterize physician-family communication in pediatric urology., Materials and Methods: We assembled a multidisciplinary team to conduct a multiphase learning health systems project and establish the Urology HEIRS (Health Experiences and Interactions in Real-Time Studies) corpus for research and interventions. This paper reports the first phase, evaluating feasibility and acceptability based on consent rate, patient diversity, and qualitative identification of verbal and paraverbal features of physician-family communication. We used applied conversation analysis methodology to identify salient practices across 8 pediatric urologists., Results: We recruited 111 families at 2 clinic sites; of these 82 families (N = 85 patients, ages 0-20 years) participated in the study with a consent rate of 73.9%. The racial/ethnic composition of the sample was 45.9% non-Hispanic White, 30.6% any race of Hispanic origin, 16.5% non-Hispanic Black/African American, 4.7% any ethnicity of Asian/Asian American, and 2.3% some other race/ethnicity; 24.7% of families used interpreters. We identified 11 verbal and paraverbal communication practices that impacted physician-family dynamics, including unique challenges with technology-mediated interpreters., Conclusions: Video-based research is feasible and acceptable with diverse families in pediatric urology settings. The Urology HEIRS corpus will enable future systematic studies of physician-family communication in pediatric urology and provides an empirical basis for specialty-specific training in patient- and family-centered communication.

Introduction: Parents are at risk of decision regret (DR) for decisions affecting their children. The Decision Regret Scale (DRS) measures medical DR but lacks context outside of healthcare., Objective: To compare parental DR 1) between common pediatric urologic surgeries and everyday decisions and 2) with preference to make a different choice., Methods: We conducted a cross-sectional online survey of randomly selected parents >1year (y) after their children underwent: orchiopexy (males ≤10y), open ureteral reimplant (OUR, females 2-6y), open pyeloplasty (OP, ≤2y), or robotic pyeloplasty (RP, 5-17y) (2017-2021). Higher DRS scores indicate increased DR (none: 0, mild: 1-25, moderate: 30-50, strong: 55-75, very strong: 80-100). Parents completed DRS on four decisions: their child's surgery, most recent/current romantic relationship, most recent leased/purchased car, and most recent purchased meal. Parents reported if they would make the same choice (yes/no). Nonparametric statistics were used., Results: We surveyed 191 parents (orchiopexy n = 52, OUR n = 50, OP n = 51, RP n = 38). The median parent age was 36y (mothers: 86%). Some DR was reported for all decisions, but with significant differences in DR severity. The lowest median DRS score was seen with surgery (orchiopexy 0 [IQR 0-10], OUR 0 [IQR 0-5], OP 0 [IQR 0-0], RP 0 [IQR 0-0]), with no difference between surgery groups (p = 0.78). This was followed by relationship (0, IQR 0-20), car (15, IQR 0-25), and meal (20, IQR 0-30, p < 0.001). Most parents did not report any DR regarding surgery (orchiopexy 69%, OUR 74%, OP 76%, RP 76%, with no difference between surgery groups p = 0.85, Summary Figure). Comparatively, 59% of parents did not have any regret about their relationship, 37% their car, and 28% their meal (p < 0.001). All surgical DR was mild or moderate. No parent (0%) would have chosen differently for their child's surgery versus 4-12% for non-surgical decisions (p < 0.001). Overall, increasing DR corresponded to increasing desire to have made a different choice (DRS≤10: 0%, DRS 45-50: 32%, DRS 55-60: 66%, DRS≥75: 100%, p < 0.001)., Conclusion: Parental DR varied between urological surgical and non-surgical decisions. It was lowest after surgery. Some regret was reported after every decision, but the subset of parents with regret was smallest after surgical decisions. Positive DRS scores do not necessarily correspond to parents wishing they made a different choice., (Copyright © 2024 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.)

Schwanniomyces species are largely unrecognized as being pathogenic, and a paucity of published reports exist regarding their role as infectious agents. Here, for the first time, we describe a case of human infection caused by Schwanniomyces etchellsii in a patient with cholecystitis., (Copyright © 2016 Elsevier Inc. All rights reserved.)