John P. Gearhart – författare

The undertaking of the treatment of an infant born with bladder exstrophy is one of the most weighty responsibilities that can fall upon the shoulders of the reconstructive sur­ geon. The modern treatment of a child born with bladder exstrophy began in the mid- 1970's with the widespread application of staged reconstruction. This approach has consistently yielded very good results in several series. However, as in all serious congeni­ tal birth defects, there is certainly room for advancement. Issues such as the routine use of osteotomy, timing and type of epispadias repair, combining bladder closure with epispadias repair, the approach to the small bladder, and the management of a failed exstrophy still remain. This National Institute of Health/Na­ tional Kidney Foundation/Johns Hopkins-sponsored seminar was an attempt to bring ex­ perts in the field of pediatric orthopedic surgery, pediatric urology, pediatric surgery, adult urology, and basic science together to share their experiences in an attempt to foster new clinical and basic science research communications between the participants. If these col­ laborations result, then this first international meeting will have been successful. The editors would like to thank all of the contributors for their timely and complete submissions. John P. Gearhart, M.D. Ranjiv Mathews, M.D. vii CONTENTS 1. The Embryology and Epidemiology of Bladder Exstrophy ................. .

Effective problem-solving approach using cases actually encountered in clinical practice!Pediatric Urology has established itself as a separate subspeciality and is an essential component of the Intercollegiate exams both in Pediatric Surgery (FRCS Paeds) and Adult Urology (FRCS Urol) and the Board exams in the USA. Exposure to Pediatric Urology training is often limited to only one year in most Pediatric surgical training programmes; and is practically non-existent in Adult urology training programmes.There are several Pediatric Urology textbooks providing factual information and literature reviews; however, problem based learning has be shown to be much more useful than the search and scan approach.This book covers all the major topics in Pediatric Urology in a "problem solving" format and using numerous illustrations. Most of the information is evidence-based and all problems are representative of those actually encountered in clinical practice.The contributing authors have key affiliations with societies such as the British Association of Paediatric Surgeons, the British Association of Paediatric Urologists and the European Association of Paediatric Urologists.

Pediatric Urology has established itself as a separate subspeciality and is an essential component of the Intercollegiate exams both in Pediatric Surgery (FRCS Paeds) and Adult Urology (FRCS Urol) and the Board exams in the USA. Exposure to Pediatric Urology training is often limited to only one year in most Pediatric surgical training programmes; and is practically non-existent in Adult urology training programmes.

There are several Pediatric Urology textbooks providing factual information and literature reviews; however, problem based learning has be shown to be much more useful than the search and scan approach.

This book covers all the major topics in Pediatric Urology in a "problem solving" format and using numerous illustrations. Most of the information is evidence-based and all problems are representative of those actually encountered in clinical practice.

The contributing authors have key affiliations with societies such as the British Association of Paediatric Surgeons, the British Association of Paediatric Urologists and the European Association of Paediatric Urologists.

The undertaking of the treatment of an infant born with bladder exstrophy is one of the most weighty responsibilities that can fall upon the shoulders of the reconstructive sur­ geon. The modern treatment of a child born with bladder exstrophy began in the mid- 1970's with the widespread application of staged reconstruction. This approach has consistently yielded very good results in several series. However, as in all serious congeni­ tal birth defects, there is certainly room for advancement. Issues such as the routine use of osteotomy, timing and type of epispadias repair, combining bladder closure with epispadias repair, the approach to the small bladder, and the management of a failed exstrophy still remain. This National Institute of Health/Na­ tional Kidney Foundation/Johns Hopkins-sponsored seminar was an attempt to bring ex­ perts in the field of pediatric orthopedic surgery, pediatric urology, pediatric surgery, adult urology, and basic science together to share their experiences in an attempt to foster new clinical and basic science research communications between the participants. If these col­ laborations result, then this first international meeting will have been successful. The editors would like to thank all of the contributors for their timely and complete submissions. John P. Gearhart, M.D. Ranjiv Mathews, M.D. vii CONTENTS 1. The Embryology and Epidemiology of Bladder Exstrophy ................. .

The undertaking of the treatment of an infant born with bladder exstrophy is one of the most weighty responsibilities that can fall upon the shoulders of the reconstructive sur­ geon. The modern treatment of a child born with bladder exstrophy began in the mid- 1970''s with the widespread application of staged reconstruction. This approach has consistently yielded very good results in several series. However, as in all serious congeni­ tal birth defects, there is certainly room for advancement. Issues such as the routine use of osteotomy, timing and type of epispadias repair, combining bladder closure with epispadias repair, the approach to the small bladder, and the management of a failed exstrophy still remain. This National Institute of Health/Na­ tional Kidney Foundation/Johns Hopkins-sponsored seminar was an attempt to bring ex­ perts in the field of pediatric orthopedic surgery, pediatric urology, pediatric surgery, adult urology, and basic science together to share their experiences in an attempt to foster new clinical and basic science research communications between the participants. If these col­ laborations result, then this first international meeting will have been successful. The editors would like to thank all of the contributors for their timely and complete submissions. John P. Gearhart, M.D. Ranjiv Mathews, M.D. vii CONTENTS 1. The Embryology and Epidemiology of Bladder Exstrophy ................. .

A unique practice-oriented survey of how the new surgical, analytical, and biomedical advances are being applied to pediatric urology. Here the practicing urologist will find informative, easy-to-read reviews of the modern evaluation of prenatal hydronephrosis, the standard treatment of reflux vs the newer injectable techniques, and the spectrum of hypospadias treatment along with new developments in bladder exstrophy. Additional updated topics include what's new in undescended testis, the evaluation of difficult duplication anomalies, voiding dysfunction and neurogenic bladders, pediatric stone disease, and the developmental problems associated with genitourinary defects.