Abstract
Paediatric urology is a relatively young subspecialty that represents a unique intersection; both adult urologists and paediatric surgeons contribute their expertise, skills and perspectives to address the urological problems faced by children. This special edition highlights distinct areas of advancement, particularly where this intersection has provided fruitful new developments.
Congenital problems that occur during childhood may have far-reaching consequences that require ongoing expertise by an adult urologist, even if that be reassurance. Gaeda et al. 1 have comprehensively reviewed the long-term implications of common paediatric urological conditions – such as hypospadias, posterior urethral valves, undescended testis, varicocele and testicular torsion – on sexual function and fertility. The team from Colorado have contributed a succinct review emphasizing key facets of urological care for patients with anorectal malformations, spanning through birth adulthood. 2
As we enter a new wave of minimally invasive surgery with the growth of robotic paediatric surgery, the use of simulation takes on new prominence. This new technical challenge exists against a backdrop of limited case numbers, restricted training time and a steep learning curve. 3 Ritchie et al. 4 provide a timely review on the current state-of-the-art with regards to surgical simulation. They highlight the recent advancement in emerging simulation modalities, particularly operable 3D-printed models, robotic surgery simulation and online simulation. Implementation into robotic credentialing pathways and training programs will be an important development to watch.
Functional bladder disorders are common in childhood. Clearly defining bladder behaviour – both in neurogenic and functional conditions – is essential for guiding management. This special edition includes a review of various traditional bladder diagnostics (including the test performance where this is available), and also expands to new and less-invasive technologies the digital age (e.g., ambulatory and telemetric modalities). 5 Substantial progress has been made in the last decade, but further innovative is required to advance urodynamic studies. Achieving this will require integrating advances from adult urology, with paediatric urologists actively participating in technological development and standard-setting as the paradigm shifts.
A further study reviews controversies around terminology and diagnoses in the spectrum of paediatric functional bladder disorders. 6 This represents a common clinical problem, and the article provides a timely review with novel insights into treatment options, specifically: mechanism of action, efficacy, indications, and an overview of current pharmacological understanding.
‘A child is not a small adult’. Paediatric stone disease therefore, presents certain unique situations, challenges and controversies relating to investigation, treatment and follow-up that are reviewed by the EAU YAU Urolithiasis group. 7
This collection will provide clinically impactful evidence to inform the care of children with urological conditions. We give thanks to all contributors for their collaboration.
