Dialogues in Pediatric Urology

1 An official publication of the Society for Pediatric UrologyRichard M. Ehrlich, , Founding Editor / William J. Miller, Founding PublisherDialogues inPediatric UrologyVolume 34, Number 2 February, 2013 FROM THE SFU PRESIDENTS ociety for Pediatric Urology500 Cummings Center, Suite 4550, Beverly, MA 01915(978) 927-8330 / Fax: (978) 524-8890 / EDITION:Society for Fetal Urology :Year in Review(continued on next page)John Kryger, MDEditor: Elizabeth B. Yerkes, MDAssociate Editors: Earl Y. Cheng, MD Martin A. Koyle, MDEditorial Board:Jeffrey Campbell, MDMarc Cendron, MDYutaro Hayashi, MDAntonio Macedo, Jr., MDLane S. Palmer, MDJohn Park, MDSerdar Tekgul, MDManaging Editor: Lorraine M. O GradyThe year of 2012 was a very exciting year for the Society for Fetal Urology (SFU). It washighlighted by two outstanding national meetings, a historic management agreement reachedbetween the SFU and the American Urological Association (AUA), and the execution of criti-cal memorandum of understanding (MOU) between the SFU and the Society for PediatricUrology (SPU) as regards the role of the SFU in the SPU/AUA Annual 48th Bi-Annual Meeting of the SFU was held in conjunction with the AUA AnnualMeeting in Atlanta, GA.

2 The full day program was coordinated by Dr. Armando Lorenzo (TheHospital for Sick Children, Toronto, ON). The meeting was centered on study design, dataanalysis, and reporting in prenatal and perinatal Urology . The meeting was organized with tenmini-symposia by experts in the field including: Randomized Controlled Trials by Dr. EdwinSmith (Georgia Urology , Atlanta, GA), Non-Experimental/Observational Studies by Dr. NicolBush (Children s Medical Center, Dallas, TX), Population-Based Research by Dr. KatherineHerbst (Connecticut Children s Medical Center, Hartford, CT), Systematic Reviews and Meta-analysis by Dr. Luis Braga (McMaster Children s Hospital, Hamilton, ON), Clinical Significance by Dr. Hillary Copp (UCSF Benioff Children s Hospital, San Fran-cisco, CA), Guidelines, Consensus Statements and Recommendations by Dr.

3 Bob Nguyen(Boston Children s Hospital, Boston, MA), Ethical Issues in Research by Kourosh AfsharFROM THE EDITORE lizabeth B. Yerkes, MDSFU EXECUTIVE COMMITTEEJ effrey B. Campbell, MDPresidentElizabeth B. Yerkes, MDPresident ElectArmando J. Lorenzo, MDSecretary/TreasurerJohn V. Kryger, MDPast PresidentHillary L. Copp, MDMember at LargeJohn Gatti, at LargePramod Reddy, at LargeChristopher S. Cooper, MDEmeritus Anthony Herndon, MDEmeritus MemberLuis H. Braga, MDInternational Member at LargePedro Jose Lopez, MDInternational Member at LargeAdministrative OfficePhone: you will read in John Kryger s summary, the Society for Fetal Urology has had a busyyear academically and politically. Dialogues in Pediatric Urology is pleased to continue toshowcase their presentations in this annual Society for Fetal Urology Special those of us who are indeed hung up on the p-value, read on!

4 This Edition of Dialoguesfeatures four contributions from Armando Lorenzo s excellent morning program from the SpringSFU meeting. Since this is a special edition, we were also able to showcase a few of the Springcase presentations. Part II will feature the abstracts from the Fall you to each of the authors for sharing their expertise so thoroughly and clearly thecontributions are truly accessible to the less indoctrinated scholars who want to do honest,worthwhile clinical research. There is an enormous amount to Iearn and practice. I had no ideathat there were so many forms of bias that affect every aspect of our work! It is also very clearhow much work goes into creation and execution of a solid prospective RCT hats off to thosewho take on the that many Pediatric Urology fellowship programs are offering formal additionalcoursework, training or degrees in clinical investigation, our field certainly has a bright futurefor high quality clinical in Pediatric UrologyFebruary, 2013 From the SFU President(continued from page one)(British Columbia Children s Hospital, Vancouver, BC), Publishingin High-Impact Journals by Dr.

5 Anthony Caldamone (HasbroChildren s Hospital, Providence, RI), Manuscript Review by Dr. PaulMerguerian (Seattle Children s Hospital, Seattle, WA). Finally, Herndon (University of Virginia Pediatric Urology ,Charlottesville, VA) outlined the SFU research goals and reviewedthe current and future projects and registries. The meeting finishedwith a 2-hour session of case presentations on topics of fetal 49th Bi-Annual Meeting was held in conjunction with theAmerican Academy of Pediatrics (AAP) National Conference and Ex-hibition in New Orleans, LA. Dr. Eric Jones (Houston Pediatric Urol-ogy, Houston) coordinated the program. It was highlighted by a lec-ture on Ethical Dilemmas in Fetal Urology (Dr. David Diamond,Boston Children s Hospital, Boston, MA), Fetal Urologic Imaging (Dr. Amy Mehollin-Ray, Texas Children s Hospital, Houston, TX), Open Fetal Surgery for Myelomeningocele Closure (Dr.)

6 MichaelBabington, Director of Prenatal Diagnosis and Fetal Imaging, TexasChildren s Fetal Center, Houston, TX), Marks Fetal Surgery for Con-genital Malformations (Dr. Darryl Cass, Director of Texas Children sFetal Center, Houston, TX), Fetal Therapy for Obstructive Uropathy -A 30-year Retrospective (Dr. Andrew Freedman, Cedar Sinai Medi-cal Center, Los Angeles, CA), Importance of Multidisciplinary Teamin Optimizing Fetal Care (Dr. Pramod Reddy, Cincinnati Children sHospital, Cincinnati, OH). These were followed by a 3-hour sessionof case presentations and studies pertaining to fetal were proud to ratify a historic management agreement withthe AUA. This will bring us into a secure relationship with the AUA ina fashion consistent with other AUA-affiliated societies. The agree-ment will include official headquarters in the offices of the AUA alongwith dedicated management staff.

7 It will strengthen the financial ser-vices, meetings management, marketing, industry relations, andmemberhip services to the addition, a great deal of time and effort was dedicated to draft-ing an MOU that would ensure the SFU is able to continue bi-annualmeetings in conjunction with the SPU in the future. This was an espe-cially critical initiative, since Pediatric Urology has withdrawn its an-nual fall meeting from the management of the AAP. Thus, it is a mo-ment of great change and restructuring in the world of Pediatric urol-ogy and an opportunity for improvement. We have worked hard tomaintain dedicated meeting time for the SFU as part of the SPU/AUAA nnual Meeting in the spring and the new Pediatric Urology Fall Con-gress. The agreement protects the autonomy of the SFU as regards meet-ing planning and ensures representation on the planning successes of this year would not have been realized withoutthe tremendous effort of Dr.

8 John Weiner (Duke Children s Hospital,Durham, NC), who was SFU President, and Dr. Jeffrey B Campbell(Children s Hospital Colorado, Denver, CO), who was SFU Secretary/Treasurer. They worked closely with Dr. Gopal Badlani (Wake ForestSchool of Medicine, Winston-Salem, NC), AUA Secretary and DrewShifflet, AUA Director of Committee and Society Affairs to establishthe management agreement with the AUA, and Dr. David Diamond(Boston Children s Hospital, Boston, MA), SPU Past President, Baskin (UCSF Benioff Children s Hospital, San Francisco, CA),SPU President, and Dr. Ross Decter (Penn State Hershey Surgical Spe-cialties, Hershey, PA), SPU Secretary to establish the MOU betweenthe SFU and the SPU. Furthermore, we are indebted to the insight andefforts of Dr. Anthony Herndon and Dr. Chris Cooper (University ofIowa Pediatric Urology , Iowa City, IA) in forging these look forward to ongoing success in 2013.

9 I want to congratulateand thank Dr. John Wiener and Dr. Jeffrey B Campbell who completedtheir terms in office of the SFU. The year of 2012 will be a significantyear in the history of the SFU due to their exceptional efforts. I wel-come Dr. Armando Lorenzo as the new SFU Secretary/Treasurer andDr. Jeffrey B Campbell as the SFU President-Elect to continue ourtrajectory of success along with myself as the current President of theSFU. Plans are underway for the 50th Bi-Annual Meeting, which willbe a half-day session in conjunction with the SPU/AUA Annual Meet-ing in San Diego, CA. I hope our 50th will be momentous!We are grateful to the Dialogues in Pediatric Urology for the op-portunity to feature the proceedings of our society. Additional infor-mation can be found on the SFU website: Controlled Trials: The FrequentlyRecommended but Rarely Achieved Gold StandardClinical Versus Statistical Significance: Let s GetPast the P-ValueSystematic Reviews and Meta-Analysis: Garbage InGarbage Out versus Meaningful Data CrunchingHealth Services Research with Administrative Data andthe Dartmouth Atlas of Health CareConcomitant Ovotesticular DSD and CongenitalAdrenal HyperplasiaA Conservative Approach to the Ectopic UreteroceleCloacal Exstrophy in Polyzygotic Multiples:A Case SeriesEhlers-Danlos Syndrome with Posterior UrethralValves.

10 For Better or WorseAll Posterior Urethral Valves Are Not AlikeFibroepithelial Polyp of the Verumontanum Presentingwith Bladder Outlet ObstructionA Case of Concurrent Prune Belly Syndrome andPosterior Urethral Valves Leading to Persistent RenalFailure Despite Maximal Upper Tract DrainageINSIDE THIS ISSUE:3 Dialogues in Pediatric UrologyFebruary, 2013 Randomized Controlled Trials: The Frequently Recommendedbut Rarely Achieved Gold StandardArun Srinivasan, , Children s Hospital of Philadelphia Edwin Smith, , Children s Hospital of AtlantaWhat makes randomized clinical trials (RCT) the goldstandard in study methodology and how frequently arethey currently employed?For centuries physicians have relied on careful, practical observa-tion to make deductions about the effectiveness of treatments. Histori-cally, the introduction of interventions has been by development of aprocedure by a surgeon or group of surgeons, followed by observationand report of results in a case series or retrospective or prospectivecohort study.