Pasquale Casale, MD, Guest Editor

Walid A. Farhat, MD, FRCSC, Guest Editor

Common general pediatric urology pathologies (undescended testicles and hernias with hypospadias) are covered by Kirsch et al, while Dr Pinto from Texas revisits the historical topic of circumcision with more current data and evidence-based recommendations.

The routine use of prenatal ultrasound may have had the most significant impact on pediatric urology practice. Therefore Brock et al from Vanderbilt provides the pediatricians with an insightful run of all the possible diagnoses, approaches, and possible dispositions when urological anomalies are suspected. Since hydronephrosis is one of the most common prenatal ultrasound findings, we dedicated an article by Dr Mesrobian from Wisconsin to providing an update on how to best manage patients with an obstruction, highlighted with the most recent advances on the role of noninvasive diagnostic studies, such as urinary proteomics.

With the newly published AAP guidelines for the management of infants and children with urinary tract infection, it was compulsory to dedicate an article to addressing this topic from a pediatric urologist’s point of view, presented by Drs Koyle from Toronto and Shifrin from Seattle, accompanied with an overarching editorial comment by Tom Newman from San Francisco. The treatment of VUR is better standardized today and the role of surgery is better defined. Subsequently, Nguyen et al from Boston provide an evidence-based approach for the management of VUR, while Dr Keren elaborates further by addressing some of the points that general pediatricians need to know, focusing on this evolving subject.

Frimberger et al from Oklahoma and Chicago present an update on the management of children with neurogenic bladder as well as an update on recent advances in this area. Israel Franco from New York updates us on the pathophysiology of voiding dysfunction, coupled with an interesting commentary by Dr Bagli from Toronto.

Urolithiasis in children is on the rise and Dr Copelovitch from Philadelphia wrote a state-of-the-art article on the medical approach to children with urolithiasis, while Baker et al delineated the surgical approaches to children with stones, hence improving on the pediatrician’s knowledge to counsel and tailor treatment options for those children. Dr Ritchey et al from Phoenix provided a review of common and uncommon pediatric urogenital tumors with the current treatment options, while Dr Lorenzo from Toronto added insights into future surgical options that minimize morbidity while maintaining and even enhancing excellent survival.

Finally, a topic of intense controversy and uncertainty is the intersex topic, which was covered by an endocrinologist and a pediatric urologist from Toronto. Romao et al touched on all the necessary information that pediatricians may need to know to adequately manage a patient with ambiguous genitalia with a thorough literature review of advances in the field, while Dr Sandberg from Michigan shed further light on the behavioral issues that surround patients with intersex.

Although pediatric urologists currently spend more time in the office treating nonsurgical conditions such as enuresis, voiding dysfunction, reflux, and prenatally diagnosed hydronephrosis, there have been major leaps in surgical techniques. The incorporation of new technologies, such laparoscopic approaches and robotic surgery, has changed the landscape of this subspecialty, hence markedly improving morbidity while maintaining the excellent outcomes. Ost et al give an overview of all the surgical innovations and advanced technologies used in the field of pediatric urology such as minimally invasive and robotic surgery.

We sincerely thank all of the contributors for their hard work and hope that this issue will help generate interest in this wonderful subspecialty.