Direct inguinal hernia surprise
All hernias that I have seen in the last few years have been indirect: the defect is lateral to the epigastrics. Indirect hernias are caused by a failure of the … Read more
4 Robotic Mistakes
The video demonstrates 4 minor technical mishaps during robotic pediatric urologic surgery. These caused no harm to the patient but did prolong the time it took to complete the operation. … Read more
Bowel-Prep Before Robotic Surgery
Recently I started recommending a saline enema the night before and the day of robotic surgery. I have not done that for the past several years and I don’t consider … Read more
Biostatistics for Busy Doctors: The Basics
Clinicians need a basic understanding of biostatistical variables and the tests used to compare them. Following are the 20% of statistical terms mentioned in 80% of the journal articles. … Read more
The Acute Scrotum
The “acute scrotum” is a condition characterized by the recent onset of scrotal pain with or without redness or swelling. A good history and physical examination are all that is needed to make … Read more
Laxatives the day before robotic surgery
Recently I performed a robotic ureteroureterostomy on a 7-month-old girl with a left ectopic ureter. Her left colon was very dilated with mostly gas and some hard stool proximally. The … Read more
Difficult urethral catheterization algorithm
As a urology intern, I witnessed other residents approach difficult urethral catheterizations (DUC) in a random and disorganized way. They would bring to the bedside the “urology-cart” and open drawers … Read more
Ultrasound is Not Useful To Diagnose Undescended Testis
Scrotal ultrasounds are not clinically useful in the management of the undescended testis. This is not just my rogue opinion but the consensus of the American Medical Association and the … Read more
Journal of Pediatric Urology, December 2018 Digest
For these posts, I go through every article from the issue; I comment on the ones that taught me something new or will change the way I practice. Higher prevalence … Read more
Non-palpable, unilateral, undescended testis: laparoscopy or scrotal exploration first?
Exploratory laparoscopy is the standard of care for approaching a non-palpable, unilateral, undescended testis. However, exploring the scrotum first makes more sense if you analyse the literature (reference, reference, reference): … Read more