Daisuke Matsuno

Kanagawa Children's Medical Center, Yokohama, Kanagawa, Japan

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Publications (8)27.15 Total impact

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    ABSTRACT: The aim of this study was to evaluate the efficacy of the retrograde colonic enema relative to the Malone antegrade continence enema. We retrospectively investigated 25 children with spina bifida and fecal incontinence. Thirteen children had started retrograde colonic enema and twelve had started Malone antegrade continence enema. Fecal continence, water volume, time to washout, procedure frequency, pain during procedure, performance independence and demographical data were compared between the two groups. Fecal continence was achieved for 10 of 13 (76.9%) in the retrograde group and 9 of 12 (75.0%) in the antegrade group. In the antegrade group 8 of 12 (66.7%) performed procedure independently, while 3 of 13 (23.1%) did so in the retrograde group. Achievement of fecal continence did not differ between the groups, but procedure independence was significantly better in the antegrade group. Our results suggest that retrograde colonic enema was not inferior to Malone antegrade continence enema on fecal continence. We recommend considering retrograde colonic enema prior to introduction of Malone antegrade continence enema in children with spina bifida.
    No preview · Article · Mar 2010 · Pediatric Surgery International
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    ABSTRACT: To determine whether a scrotal nubbin is present in children with unilateral non-palpable testis when diagnostic laparoscopy demonstrates blind-ending vessels and a normal vas deferens entering a closed internal ring. Eighty consecutive patients with a unilateral nonpalpable testis were retrospectively reviewed. Patients underwent initial diagnostic laparoscopy, and, if needed, subsequent inguinal exploration was performed. On inguinal exploration, any testicular remnant or nubbin-like tissue was removed and evaluated histologically. Patients with a patent processus vaginalis were excluded from this analysis. Overall, 60 of the 80 patients had neither an abdominal testis nor a patent processus vaginalis. Of these 60, 34 patients had both a vas deferens and spermatic vessels entering a closed internal ring, and all of these underwent inguinal exploration. A total of 17 patients had both a blind-ending vas deferens and blind-ending spermatic vessels; no inguinal exploration was attempted. In nine patients, laparoscopy revealed blind-ending vessels with a normal vas deferens entering the closed internal ring. Of these nine, six underwent inguinal exploration, and a scrotal nubbins was found in three. At histological examination, hemosiderin deposit and calcification were seen in the nubbin tissue. No viable germ cell was detected in these specimens. A laparoscopic finding of blind-ending vessels above the closed internal ring does not mean intra-abdominal vanished testis, regardless of the appearance of the vas deferens.
    Full-text · Article · Nov 2009 · International Journal of Urology
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    ABSTRACT: We identified independent factors predicting recurrent urinary tract infection within 1 year after the first urinary tract infection in pretoilet trained children with vesicoureteral reflux. We retrospectively reviewed the records of infants younger than 2 years with primary vesicoureteral reflux and a history of febrile urinary tract infection. Patients were divided into 2 groups based on the presence or absence of recurrent febrile urinary tract infection. Analysis included age, gender, reflux laterality and grade, abnormalities on dimercapto-succinic acid renal scan and prophylactic antibiotic type. Univariate and multivariate analyses were performed to identify risk factors for recurrent febrile urinary tract infection. From 2004 to 2007, 78 children met study inclusion criteria. Mean age at the first urinary tract infection was 4 months (range 1 week to 16 months). None of the males were circumcised. Of 78 children 25 (32%) had a recurrent febrile urinary tract infection during 1 year of followup. Univariate analysis showed that bilateral reflux, high grade reflux (IV-V) and abnormal dimercapto-succinic acid scan were statistically significant predictors of early recurrent urinary tract infection (p <0.05). However, on multivariate analysis only an abnormal dimercapto-succinic acid scan showed a significant association with early recurrent urinary tract infection (OR 8.01, 95% CI 2.10-30.51, p = 0.002). Abnormal dimercapto-succinic acid renal scan is an important predictor of early recurrent urinary tract infection in pretoilet trained children with vesicoureteral reflux. Whether the explanation lies in congenital or infection related damage, in this patient subgroup careful clinical followup or early surgical management for reflux should be considered.
    No preview · Article · Aug 2009 · The Journal of urology

  • No preview · Article · Apr 2009 · The Journal of Urology
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    ABSTRACT: (99m)Technetium dimercapto-succinic acid renal scans are ideal for demonstrating renal scarring in children with spina bifida. However, doubt persists about the need for routine application. We assessed the associations among abnormal (99m)technetium dimercapto-succinic acid renal scans, vesicoureteral reflux and urodynamic findings in patients with spina bifida during long-term followup. We retrospectively reviewed the records of 64 patients with spina bifida followed at our center. All patients were older than 10 years (mean 15.8, range 10 to 23). Dimercapto-succinic acid renal scans were considered abnormal with differential function of less than 40% or focal defects. Patient age, gender, previous febrile urinary tract infections, positive vesicoureteral reflux history, timing of clean intermittent catheterization initiation and the latest urodynamic findings were noted. Patients were grouped based on normal/abnormal scan results. Statistical analysis included univariate and multivariate regression analyses and chi-square tests. A total of 16 patients (25%) had abnormal scans. Mean patient age, male-to-female ratio, leak point pressure, bladder compliance and timing of clean intermittent catheterization initiation did not differ between groups. Rates of previous febrile urinary tract infections differed significantly (11 of 16 in the abnormal group vs 9 of 48 in the normal group, p <0.01), as did positive reflux history (100% vs 31%, p <0.01). No patient with a negative reflux history had an abnormal dimercapto-succinic acid renal scan. Multivariate analysis identified previous febrile urinary tract infections as a significant risk factor for an abnormal scan. A positive vesicoureteral reflux history and febrile urinary tract infections were associated with abnormal dimercapto-succinic acid renal scan in followup of patients older than 10 years with spina bifida. Thus, these factors are indicators of proactive evaluation of renal function using dimercapto-succinic acid renal scanning.
    No preview · Article · Mar 2009 · The Journal of urology
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    ABSTRACT: We report a case of asymmetric development of tumor-like cysts in a child with autosomal dominant polycystic kidney disease (ADPKD). The preliminary considerations were renal cell carcinoma and Wilms' tumor. After open biopsy, the patient was diagnosed with ADPKD with atypical renal cyst development. The development pattern of renal cysts in children with ADPKD is varied, and open biopsy is sometimes needed.
    No preview · Article · Dec 2008 · Journal of Pediatric Surgery

  • No preview · Article · Apr 2008 · The Journal of Urology

  • No preview · Article · Apr 2008 · The Journal of Urology