Pediatric Urology: Surgical Complications and Management -- About the companion website -- Contents -- Contributors -- Preface -- PART I Principles of Surgical Audit -- CHAPTER 1 How to set up prospective surgical audit -- Introduction -- Why conduct prospective audit? -- As a result of local clinical interests -- As a result of clinical incident reporting -- To comply with regional or national initiatives -- To inform patients -- To drive continuous quality improvement -- To comply with health care regulation -- To engage patients in decisions about their health care -- To provide public reassurance -- What data can be used for audit? -- Routine hospital data -- Specialty‐specific multi-center data -- Locally‐derived data -- Techniques of data collection -- Good practice in audit -- Arguments against audit -- Conclusion -- References -- CHAPTER 2 Evaluating personal surgical audit and what to do if your results are not "as expected" -- Introduction -- Presentation and analysis of data -- Dealing with outlying performance -- Conclusion -- References -- CHAPTER 3 A critical assessment of surgical outcomes -- Introduction -- Asking focused questions -- Finding the evidence -- Critical appraisal of the evidence -- Study designs -- Bias in pediatric studies -- Common description of outcome results -- Determining causality using observational studies -- Critical appraisal of studies -- Clinical appraisal of diagnostic studies -- Clinical appraisal of systematic reviews -- Evaluating for heterogeneity -- Are the results of the studies applicable to my patients? -- Conclusion -- References -- CHAPTER 4 Implications of a poor surgical outcome -- Introduction -- Disclosure of poor outcome -- An apology -- An explanation -- An obligation to disclose errors that are not immediately obvious to the patient -- From the perspective of the patient.

Local resolution -- The Ombudsman -- NHS redress -- Litigation -- From the perspective of the surgeon -- Local -- National Clinical Assessment Service (NCAS) -- General Medical Council (GMC) -- The media response -- From the perspective of the hospital -- Adverse event reporting and clinical governance -- NHS Act 1977 Practice Direction 2006 -- Conclusion -- References -- PART II General Principles -- CHAPTER 5 Endocrine and metabolic response to surgery and its management -- Introduction -- The endocrine response to surgery -- Sympathetic nervous system -- Hypothalamic-pituitary-adrenal axis -- Adrenocorticotrophic hormone and cortisol -- Growth hormone -- Prolactin and β‐endorphin -- Thyroid hormones -- Gonadotropins -- Antidiuretic hormone -- Insulin and glucagon -- The immune response to surgery -- Thermoregulation -- The metabolic response to surgery -- Carbohydrate metabolism -- Protein metabolism -- Lipid metabolism -- Water and electrolytes metabolism -- Perioperative fluid management in children -- Maintenance of fluid requirements -- Oral fluid management prior to surgery -- Fluid deficit prior to surgery -- Dextrose management during surgery -- Management of fluid losses during surgery -- Postoperative fluid management -- Monitoring of fluid therapy -- Management of hyponatremia -- Management of hypernatremia -- Management of potassium imbalance -- Management of calcium imbalance -- Postobstructive diuresis -- Metabolic consequences after incorporation of bowel into the urinary tract -- Factors affecting the endocrine and metabolic response to surgery -- Minimally invasive surgery -- General anesthesia -- Local anesthesia -- References -- CHAPTER 6 Perioperative anesthetic and analgesic risks and complications -- Introduction -- Gastrointestinal -- Respiratory -- Cardiovascular -- Neurological -- Psychological -- Awareness.

Pharmacological -- Paracetamol -- Non-steroidal anti‐inflammatory drugs (NSAIDs) -- Opioids -- Fluid management -- Transfusion -- Infectious risk of transfusion -- Incompatibility and immune considerations -- Regional anesthesia -- Caudals -- Epidurals -- Peripheral blocks -- The future -- Conclusion -- References -- PART III Open Surgery of the Upper Urinary Tract -- CHAPTER 7 Nephrectomy -- Introduction -- Surgical approaches to the kidney -- Retroperitoneal approaches -- Transabdominal approaches -- Surgical approaches in specific situations -- Conversion from laparoscopic to open nephrectomy -- Approaches to ectopic kidneys -- Complications -- Intraoperative complications -- Early postoperative complications (≤30 days) -- Late postoperative complications (>30 days) -- Conclusion -- References -- CHAPTER 8 Partial nephrectomy -- Indications and evaluation -- Procedure -- Outcomes -- Partial nephrectomy for ureteral duplication with associated ureterocele -- Partial nephrectomy for ectopic ureter -- Partial nephrectomy for lower‐pole vesicoureteral reflux -- Management and outcomes of the retained ureteral stump -- Specific complications of upper‐pole heminephrectomy -- Renal loss -- Renal cysts -- Hemorrhage -- Urine leak -- References -- CHAPTER 9 Ureteropelvic junction obstruction -- Surgical techniques -- Outcomes -- Outcomes by preoperative criteria -- Outcomes by presentation -- Outcomes by age -- Outcomes by delayed repair -- Outcomes by surgical technique -- Complications -- Complications by use of drains -- Managing complications -- Initial management -- Definitive management -- Conclusion -- References -- CHAPTER 10 Complications of antireflux surgery -- Introduction -- Surgical techniques -- Patient selection and timing of surgery -- Assessment of outcomes -- Factors affecting surgical outcomes.

Preventative measures to avoid complications -- Risks and complications -- Early complications -- Late complications -- Suggested follow‐up after surgical correction of VUR -- Conclusion -- References -- CHAPTER 11 Ureteral surgery Ureteroureterostomy and transureteroureterostomy -- Introduction -- Surgical techniques -- Ipsilateral ureteroureterostomy -- Transureteroureterostomy -- Outcomes from operations -- Complications -- Preventing complications -- Managing complications -- Conclusion -- References -- PART IV Surgery of the Bladder -- CHAPTER 12 Complications Epispadias and bladder exstrophy -- Introduction -- No treatment -- Surgical intervention -- Anatomical reconstruction of the epispadias-exstrophy complex -- Early complications -- Fascial dehiscence -- Catheter malfunction -- Bladder dehiscence -- Urethrocutaneous fistula formation -- Orthopedic complications -- Male genital complications -- Intermediate outcomes -- Bladder outlet obstruction -- Vesicoureteral reflux -- Late outcomes -- Renal deterioration -- Incontinence -- Malignancy -- Male sexual and reproductive health -- Female sexual and reproductive health -- Psychological outcomes -- Conclusion -- References -- CHAPTER 13 Umbilical and urachal anomalies -- Introduction -- Prevalence -- Embryology -- Anatomy -- Clinical urachal anomalies -- Diagnosis -- Outcomes and complications of urachal anomalies -- Diagnosis and management of urachal anomalies -- Patent urachus -- Urachal cyst -- Urachal sinus -- Vesicourachal diverticulum -- References -- PART V Endoscopic Surgery of the Urinary Tract -- CHAPTER 14 Cystoscopy and cystoscopic interventions -- Introduction -- Posterior urethral valves -- Surgical techniques and outcomes -- Complications -- Urinary incontinence -- Preventing complications -- Summary -- Anterior urethral valves or syringocele -- Surgical techniques and outcomes.

Complications and management -- Summary -- Urethral strictures -- Surgical techniques and outcomes -- Complications of visual internal urethrotomy -- Summary -- Endoscopic management of ureteroceles -- Surgical techniques and outcomes -- Complications and their management -- Summary -- JJ stenting for primary obstructive megaureter -- Surgical techniques and outcomes -- Complications -- Summary -- Botox ® injections for neurogenic bladder dysfunction -- Surgical techniques and outcomes -- Complications -- Summary -- References -- CHAPTER 15 Interventional procedures of the genitourinary tract -- Introduction -- Clinical problem/case 15.1 -- Clinical problem/case 15.2 -- Clinical problem/case 15.3 -- Clinical problem/case 15.4 -- References -- CHAPTER 16 Minimally invasive interventions for stone disease -- Introduction -- Extracorporeal shock wave lithotripsy -- Hematuria -- Pain/colic -- Infection -- Steinstrasse (stone street) -- Bruising/ecchymosis and haematoma -- Injury to other viscera -- Uretero(reno)scopy -- Hematuria -- Infection -- Failure of access -- Ureteric injury/extravasation -- Stricture -- Vesicoureteral reflux -- Stone retropulsion -- Stone trapped in a basket -- Stent migration -- Forgotten stent -- Percutaneous nephrolithotomy -- Hemorrhage -- Fever -- Infection -- Hypothermia -- TUR syndrome -- Urine leak, urinoma or extravasation of fluid -- Hydrothorax and pleural injury -- Intestinal injury -- Steinstrasse (stone street) -- Tract scarring/calcification -- Pelvicalyceal scarring and stricture -- Minimally invasive cystolithotomy -- Infection -- Hematuria -- Extravasation and leak -- Urethral stricture -- Laparoscopy -- Conversion to open -- Stone migration -- Hemorrhage -- Leak -- Ureteric stricture -- Conclusion -- References -- CHAPTER 17 General laparoscopy -- Introduction -- History -- Procedure -- Complications.

Port sites.