2023
Spontaneous vesicoureteral reflux resolution curves based on ureteral diameter ratio
Arlen A, Leong T, Kirsch A, Cooper C. Spontaneous vesicoureteral reflux resolution curves based on ureteral diameter ratio. Journal Of Pediatric Urology 2023, 19: 468.e1-468.e6. PMID: 37188603, DOI: 10.1016/j.jpurol.2023.04.028.Peer-Reviewed Original ResearchConceptsUreteral diameter ratioUrinary tract infectionPrimary vesicoureteral refluxVesicoureteral refluxSpontaneous resolutionRisk groupsBreakthrough febrile urinary tract infectionDistal ureteral diameter ratioFebrile urinary tract infectionLargest ureteral diameterObjective prognostic informationGrade of refluxHigh-risk patientsLow-risk patientsHigh-risk groupLow-risk groupLow-risk childrenVUR resolutionPrimary refluxProphylactic antibioticsVUR gradeConservative managementPersistent refluxRisk patientsTract infections
2018
Impact of continuous low-dose antibiotic prophylaxis on growth in children with vesicoureteral reflux
Guidos P, Arlen A, Leong T, Bonnett M, Cooper C. Impact of continuous low-dose antibiotic prophylaxis on growth in children with vesicoureteral reflux. Journal Of Pediatric Urology 2018, 14: 325.e1-325.e7. PMID: 30181099, DOI: 10.1016/j.jpurol.2018.07.007.Peer-Reviewed Original ResearchConceptsContinuous antibiotic prophylaxisBody mass indexPrior treatment coursesPrior antibiotic useAntibiotic prophylaxisVesicoureteral refluxBMI percentileYears of ageTreatment courseMass indexAntibiotic useHeight percentilesContinuous low-dose antibiotic prophylaxisUse of CAPLow-dose antibiotic prophylaxisPrior antibiotic usageSignificant BMI increaseMainstay of treatmentUrinary tract infectionPrimary vesicoureteral refluxSignificant increaseUse of antibioticsBreakthrough infectionsEffects of antibioticsTract infections
2017
The Iowa Voiding Improvement Partnership experience: Early observations with a collaborative pediatric uro-psychologic clinic
Bonnett K, Fuller L, Cooper C, Arlen A, Storm D. The Iowa Voiding Improvement Partnership experience: Early observations with a collaborative pediatric uro-psychologic clinic. Journal Of Pediatric Urology 2017, 13: 391.e1-391.e6. PMID: 28729177, DOI: 10.1016/j.jpurol.2017.05.024.Peer-Reviewed Original ResearchConceptsBBD symptomsClinic visitsQuestionnaire scoresPsychiatric issuesBowel Dysfunction QuestionnaireFurther psychological evaluationRecent clinic visitInstitutional review boardPsychologic diagnosesUrology referralBladder dysfunctionBowel dysfunctionPatient demographicsTreat patientsClinical outcomesClinic patientsMean agePediatric bladderPsychologic conditionsVIP treatmentSpecialized clinicsTreatment decisionsUrological conditionsPatientsClinicRole of body mass index in school-aged children with lower urinary tract dysfunction: Does weight classification predict treatment outcome?
Arlen AM, Cooper CS, Leong T. Role of body mass index in school-aged children with lower urinary tract dysfunction: Does weight classification predict treatment outcome? Journal Of Pediatric Urology 2017, 13: 454.e1-454.e5. PMID: 28483466, DOI: 10.1016/j.jpurol.2017.03.033.Peer-Reviewed Original ResearchConceptsBody mass indexBladder-bowel dysfunctionLower urinary tract dysfunctionUrinary tract dysfunctionUrinary tract infectionSchool-aged childrenTreatment outcomesTreatment responseLUT dysfunctionTract dysfunctionTract infectionsTreatment failureMass indexElevated body mass indexLower urinary tract symptomsDetrusor-sphincter dyssynergiaUrinary tract symptomsAdditional treatment modalitiesComplete treatment responseMajor health concernBowel programPsychologic comorbiditiesSphincter dyssynergiaUrology referralTract symptomsValidation of the ureteral diameter ratio for predicting early spontaneous resolution of primary vesicoureteral reflux
Arlen AM, Kirsch AJ, Leong T, Cooper CS. Validation of the ureteral diameter ratio for predicting early spontaneous resolution of primary vesicoureteral reflux. Journal Of Pediatric Urology 2017, 13: 383.e1-383.e6. PMID: 28256423, DOI: 10.1016/j.jpurol.2017.01.012.Peer-Reviewed Original ResearchConceptsPrimary vesicoureteral refluxUreteral diameter ratioVesicoureteral refluxReflux gradeSpontaneous resolutionVUR gradeMultivariable modelUreteral diameterDistal ureteral diameter ratioGrade of VURLargest ureteral diameterPersistent vesicoureteral refluxVesicoureteral reflux gradeGrade of refluxImportant prognostic factorSpontaneous resolution rateValuable prognostic informationL3 vertebral bodyUnit increaseExternal validation studyHighest likelihood ratioVUR timingPersistent diseasePrimary outcomePrognostic factors
2016
Vesicoureteral Reflux Index: Predicting Primary Vesicoureteral Reflux Resolution in Children Diagnosed after Age 24 Months
Garcia-Roig M, Ridley DE, McCracken C, Arlen AM, Cooper CS, Kirsch AJ. Vesicoureteral Reflux Index: Predicting Primary Vesicoureteral Reflux Resolution in Children Diagnosed after Age 24 Months. Journal Of Urology 2016, 197: 1150-1157. PMID: 27939835, DOI: 10.1016/j.juro.2016.12.008.Peer-Reviewed Original ResearchConceptsResolution/improvementAge 24 monthsReflux indexIndex scoreReflux gradeUreteral abnormalitiesImprovement/resolutionVesicoureteral reflux gradeGrade of improvementHigh grade refluxPrimary vesicoureteral refluxMedian resolution timesProportional subdistribution hazards modelSubdistribution hazard modelVesicoureteral reflux resolutionGrade refluxDifferent time pointsSD ageLatest followupVesicoureteral refluxReflux resolutionVoiding cystourethrogramFemale genderInclusion criteriaDiagnosis increasesInter-rater reliability of distal ureteral diameter ratio compared to grade of VUR
Swanton A, Arlen A, Alexander S, Kieran K, Storm D, Cooper C. Inter-rater reliability of distal ureteral diameter ratio compared to grade of VUR. Journal Of Pediatric Urology 2016, 13: 207.e1-207.e5. PMID: 28089295, DOI: 10.1016/j.jpurol.2016.10.021.Peer-Reviewed Original ResearchConceptsUreteral diameter ratioDistal ureteral diameter ratioVesicoureteral refluxVUR gradeInter-rater reliabilityReflux gradePediatric urologistsGrade of VURGrading of VURLargest ureteral diameterHigh grade refluxImportant prognostic factorPrimary vesicoureteral refluxConfidence intervalsSignificant inter-rater variabilityGood inter-rater reliabilityPrognostic factorsClinical courseClinical outcomesPredictive factorsRenal unitsUreteral diameterInter-rater agreementSpontaneous resolutionBlinded fashionDelayed upper tract drainage on voiding cystourethrogram may not be associated with increased risk of urinary tract infection in children with vesicoureteral reflux
Garcia-Roig M, Arlen AM, Huang JH, Filimon E, Leong T, Kirsch AJ. Delayed upper tract drainage on voiding cystourethrogram may not be associated with increased risk of urinary tract infection in children with vesicoureteral reflux. Journal Of Pediatric Urology 2016, 12: 312.e1-312.e6. PMID: 27492248, DOI: 10.1016/j.jpurol.2016.04.056.Peer-Reviewed Original ResearchConceptsUpper tract drainageCulture-proven UTIsVesicoureteral refluxUTI ratesVUR gradeUTI riskRisk factorsHigh inter-observer correlationSetting of obstructionUTI risk factorsUrinary tract infectionPrimary vesicoureteral refluxPredictors of infectionAvailable prognostic informationSignificant predictorsYears of ageEndoscopic VUR treatmentHydrodistention gradeInter-observer agreementRecurrent UTIUTI incidenceVUR timingEndoscopic findingsInter-observer correlationTract infectionsComputer model predicting breakthrough febrile urinary tract infection in children with primary vesicoureteral reflux
Arlen AM, Alexander SE, Wald M, Cooper CS. Computer model predicting breakthrough febrile urinary tract infection in children with primary vesicoureteral reflux. Journal Of Pediatric Urology 2016, 12: 288.e1-288.e5. PMID: 27072485, DOI: 10.1016/j.jpurol.2016.03.005.Peer-Reviewed Original ResearchConceptsBreakthrough febrile urinary tract infectionFebrile urinary tract infectionPrimary vesicoureteral refluxBladder-bowel dysfunctionOnset of VURUrinary tract infectionVesicoureteral refluxLow bladder volumesBladder volumeUTI historyTract infectionsPrognostic calculatorSpontaneous resolutionRecurrent febrile urinary tract infectionsCorrect vesicoureteral refluxRecurrent febrile infectionsRenal parenchymal scarringIndividual child's riskCharacteristic curve areaParenchymal scarringVCUG findingsRenal scarringPatient demographicsVUR gradeFebrile infections
2015
Detailed evaluation of the upper urinary tract in patients with prune belly syndrome using magnetic resonance urography
Garcia-Roig M, Grattan-Smith J, Arlen A, Smith E, Kirsch A. Detailed evaluation of the upper urinary tract in patients with prune belly syndrome using magnetic resonance urography. Journal Of Pediatric Urology 2015, 12: 122.e1-122.e7. PMID: 26826943, DOI: 10.1016/j.jpurol.2015.11.008.Peer-Reviewed Original ResearchConceptsMagnetic resonance urographyCalyceal diverticulumRenal dysplasiaRenal transit timeUrinary tractPrune belly syndrome patientsSmall retrospective case seriesMean serum creatinineRetrospective case seriesUrinary tract anatomyUpper urinary tractIndividual clinical needsRenal biopsy studiesDiuretic renal scintigraphyPrune belly syndromeLarger patient populationUreteropelvic junction obstructionSolitary kidneyRenal functionRenal scarringSerum creatinineMedian ageCase seriesSevere hydronephrosisPatient population
2014
Bladder Volume at Onset of Vesicoureteral Reflux is an Independent Risk Factor for Breakthrough Febrile Urinary Tract Infection
Alexander S, Arlen A, Storm D, Kieran K, Cooper C. Bladder Volume at Onset of Vesicoureteral Reflux is an Independent Risk Factor for Breakthrough Febrile Urinary Tract Infection. Journal Of Urology 2014, 193: 1342-1346. PMID: 25305355, DOI: 10.1016/j.juro.2014.10.002.Peer-Reviewed Original ResearchConceptsBreakthrough febrile urinary tract infectionFebrile urinary tract infectionUrinary tract infectionOnset of refluxBladder-bowel dysfunctionRisk of pyelonephritisTract infectionsVesicoureteral refluxBladder volumeReflux gradeRecurrent febrile urinary tract infectionsMedian bladder volumeIndependent risk factorAdditional prognostic informationIdentification of childrenDuration of exposureReflux onsetBladder capacityMedian followupSD agePrognostic informationRisk factorsMultivariate analysisClinical decisionInfection