Our Summary

This study looked at whether being overweight or obese affects the outcomes of children and teenagers having surgery to reconstruct their urinary tract. The researchers examined medical records of patients aged up to 20 years who had this surgery between 2010 and 2016. They categorised the patients’ weight using a standard measure called the body mass index. The main outcomes they looked at were how long the patients spent in intensive care and in hospital, and whether they had to be readmitted or suffered complications within 30 days of the operation.

Contrary to what some might expect, the researchers found that being overweight or obese did not affect these outcomes. This was the case even when they looked at different subgroups of patients, or at specific types of complications.

This is surprising as it contradicts previous studies in adults, which have found that obesity increases the risk of infection and wound problems after surgery. The researchers suggest that the fact their patients were already at high risk might have made any effect of obesity less noticeable.

The study had some limitations: it was based on past records from a single hospital, and the way they categorised patients’ weight might not have been completely accurate.

In conclusion, the study found that nearly a third of the young patients having this type of surgery were overweight or obese, but that this did not seem to affect their risk of problems after the operation.

FAQs

  1. Does being overweight or obese affect the outcomes of urinary tract reconstruction surgery in children and teenagers?
  2. How did the researchers determine the weight categories of the patients in the study?
  3. What were the main outcomes the researchers were looking at in this study?

Doctor’s Tip

A helpful tip a doctor might give to a patient about pediatric urologic reconstruction is to focus on following the post-operative care instructions provided by the medical team. This can include proper wound care, monitoring for any signs of infection, staying hydrated, and following a healthy diet to support healing. It’s also important for the patient to attend all follow-up appointments to ensure proper healing and address any concerns that may arise.

Suitable For

Typically, pediatric urologic reconstruction is recommended for patients who have congenital abnormalities of the urinary tract, such as hypospadias, vesicoureteral reflux, or bladder exstrophy. Other conditions that may require pediatric urologic reconstruction include urinary incontinence, neurogenic bladder, and obstructive uropathy. These patients may require surgical intervention to improve urinary function, prevent complications, and improve quality of life.

Timeline

Timeline:

Before pediatric urologic reconstruction:

  • Patient is diagnosed with a urinary tract issue that requires surgical intervention.
  • Patient undergoes pre-operative assessments and tests to determine the best course of treatment.
  • Surgery is scheduled and patient and family are informed about the procedure and potential risks.
  • Patient may need to follow pre-operative instructions such as fasting or medication adjustments.
  • Surgery is performed to reconstruct the urinary tract.

After pediatric urologic reconstruction:

  • Patient is closely monitored in the intensive care unit post-operatively.
  • Patient is transferred to a regular hospital room for further monitoring and recovery.
  • Patient is discharged from the hospital once stable and able to manage at home.
  • Patient follows up with healthcare providers for post-operative care and monitoring.
  • Patient may experience complications or require readmission within 30 days of the operation.
  • Long-term follow-up may be needed to monitor the success of the reconstruction and address any ongoing issues.

What to Ask Your Doctor

Questions a patient should ask their doctor about pediatric urologic reconstruction:

  1. How will my child’s weight affect their surgery and recovery process?
  2. Are there any specific precautions or considerations that need to be taken for overweight or obese patients undergoing this type of surgery?
  3. What steps can be taken to minimize any potential risks associated with being overweight or obese during the surgery?
  4. Will my child’s weight impact the success rate of the surgery or their long-term outcomes?
  5. Are there any lifestyle changes or interventions that can be made to improve the overall health of my child before and after the surgery?
  6. How will the medical team monitor and manage any potential complications that may arise during the recovery period?
  7. Are there any additional resources or support services available for overweight or obese pediatric patients undergoing urologic reconstruction surgery?
  8. How can we work together to ensure the best possible outcome for my child given their weight status?

Reference

Authors: Strine AC, VanderBrink BA, May T, Riazzi AC, Schulte M, Noh PH, DeFoor WR Jr, Minevich E, Sheldon CA, Reddy PP. Journal: J Pediatr Urol. 2019 Oct;15(5):521.e1-521.e7. doi: 10.1016/j.jpurol.2019.06.009. Epub 2019 Jun 20. PMID: 31301974