https://thepedsurologist.com/en/ A pediatric urology archive by Sang Woon Kim, MD: condition guides for parents, Clinical Pearls for clinicians, and notes on guidelines and papers. en Wed, 21 Oct 2026 12:00:00 +0900 https://thepedsurologist.com/en/clinical/cryptorchidism-pearls-3.html https://thepedsurologist.com/en/clinical/cryptorchidism-pearls-3.html Wed, 21 Oct 2026 00:00:00 +0900 For the impalpable, intra-abdominal testis treated by two-stage Fowler–Stephens orchiopexy: how the gubernaculum and its vessels are preserved at the second stage. Arterial and venous anatomy of the testis, the collaterals that remain after ligation, the technique, and the results and limits of the comparative studies and randomised trials on testicular atrophy. By pediatric urologist Sang Woon Kim, MD. For Clinicians https://thepedsurologist.com/en/clinical/hypospadias-7.html https://thepedsurologist.com/en/clinical/hypospadias-7.html Tue, 20 Oct 2026 00:00:00 +0900 When and in what order to correct penile curvature in hypospadias: where the 30° threshold is actually used, artificial erection and measurement, the flow from degloving and chordectomy through plate-preserving correction (dorsal plication, urethral mobilization with ventral lengthening), plate transection and corporotomy or corporoplasty, recurrence after dorsal shortening versus ventral lengthening, and the change of the last decade toward transecting the plate at 30° or more in proximal hypospadias. By pediatric urologist Sang Woon Kim, MD. For Clinicians https://thepedsurologist.com/en/parents/hypospadias-surgery-care.html https://thepedsurologist.com/en/parents/hypospadias-surgery-care.html Tue, 20 Oct 2026 00:00:00 +0900 A parents’ guide to the timing of hypospadias surgery and anaesthesia in babies, caring for the catheter (stent), dressing and nappies at home, what to watch for, and fistula, stricture and redo surgery. By pediatric urologist Sang Woon Kim, MD. For Parents https://thepedsurologist.com/en/parents/vesicoureteral-reflux-test.html https://thepedsurologist.com/en/parents/vesicoureteral-reflux-test.html Mon, 19 Oct 2026 00:00:00 +0900 A parents’ guide to whether a reflux test (VCUG) is needed after a urinary tract infection with fever: the renal ultrasound and DMSA scan, when a reflux test is recommended, what the test involves, and what to do if you do not test. By pediatric urologist Sang Woon Kim, MD. For Parents https://thepedsurologist.com/en/evidence/vesicoureteral-reflux-guidelines-1.html https://thepedsurologist.com/en/evidence/vesicoureteral-reflux-guidelines-1.html Mon, 19 Oct 2026 00:00:00 +0900 Who needs a reflux test (VCUG), renal ultrasound or DMSA after a first febrile UTI? EAU/ESPU, NICE and AAP 2026 compared, with atypical infection, top-down imaging, and screening of siblings and infants with prenatal hydronephrosis. By pediatric urologist Sang Woon Kim, MD. Evidence & Papers https://thepedsurologist.com/en/evidence/vesicoureteral-reflux-guidelines-2.html https://thepedsurologist.com/en/evidence/vesicoureteral-reflux-guidelines-2.html Mon, 19 Oct 2026 00:00:00 +0900 Assessment, risk stratification and follow-up of children with confirmed reflux in the AUA and EAU/ESPU guidelines: the EAU/ESPU risk table, AUA and AAP risk definitions, and why reflux and kidney follow-up end at different times. By pediatric urologist Sang Woon Kim, MD. Evidence & Papers https://thepedsurologist.com/en/evidence/vesicoureteral-reflux-guidelines-3.html https://thepedsurologist.com/en/evidence/vesicoureteral-reflux-guidelines-3.html Mon, 19 Oct 2026 00:00:00 +0900 RIVUR, Swedish, PRIVENT and PREDICT read by population and outcome, and how AUA, EAU/ESPU, AAP and NICE decide who gets antibiotic prophylaxis and when to stop. Recurrent infection and renal scarring are different outcomes. By pediatric urologist Sang Woon Kim, MD. Evidence & Papers https://thepedsurologist.com/en/evidence/vesicoureteral-reflux-guidelines-4.html https://thepedsurologist.com/en/evidence/vesicoureteral-reflux-guidelines-4.html Mon, 19 Oct 2026 00:00:00 +0900 AUA and EAU/ESPU on when to move to surgery, endoscopic injection versus ureteral reimplantation, open, laparoscopic or robotic approaches, postoperative imaging and what counts as success, with the 10-year International Reflux Study. By pediatric urologist Sang Woon Kim, MD. Evidence & Papers https://thepedsurologist.com/en/clinical/hypospadias-6.html https://thepedsurologist.com/en/clinical/hypospadias-6.html Sun, 18 Oct 2026 00:00:00 +0900 Reading penile curvature in hypospadias as structure rather than angle. What the names chordee and corporal disproportion suggest, the four contributing components from skin and fascia through the urethral plate to the tunica and corpora, how the explanations ran in parallel rather than replacing one another, and deep chordee — the dysplastic ventral tissue that does not divide into layers. By pediatric urologist Sang Woon Kim, MD. For Clinicians https://thepedsurologist.com/en/clinical/vesicoureteral-reflux-3.html https://thepedsurologist.com/en/clinical/vesicoureteral-reflux-3.html Sun, 18 Oct 2026 00:00:00 +0900 Following the path from infection reaching the kidney to a scar. How papillary shape alters intrarenal reflux, the balance between the response that clears bacteria and the one that injures tissue, why scars mature after microbiological cure, when to assess the kidney with DMSA, and how a second febrile UTI and bladder-bowel dysfunction change the risk. By pediatric urologist Sang Woon Kim, MD. For Clinicians https://thepedsurologist.com/en/clinical/vesicoureteral-reflux-4.html https://thepedsurologist.com/en/clinical/vesicoureteral-reflux-4.html Sun, 18 Oct 2026 00:00:00 +0900 How a kidney that starts from congenital hypodysplasia or post-infectious scarring fares through growth and time: compensation and hyperfiltration in the remaining nephrons, split function versus total GFR, trends in proteinuria, blood pressure and puberty, and the follow-up still needed once reflux has resolved. By pediatric urologist Sang Woon Kim, MD. For Clinicians https://thepedsurologist.com/en/parents/vesicoureteral-reflux-kidney.html https://thepedsurologist.com/en/parents/vesicoureteral-reflux-kidney.html Sun, 18 Oct 2026 00:00:00 +0900 A parents’ guide to kidney changes in children with vesicoureteral reflux: kidneys formed differently from the start versus scars left after urinary tract infection, how to read a scan taken just after an infection, the kidney after reflux resolves, and the blood pressure, urine protein and kidney function checks that follow. By pediatric urologist Sang Woon Kim, MD. For Parents https://thepedsurologist.com/en/parents/vesicoureteral-reflux.html https://thepedsurologist.com/en/parents/vesicoureteral-reflux.html Sun, 18 Oct 2026 00:00:00 +0900 A parents’ guide to why vesicoureteral reflux happens and how it relates to urinary tract infection (pyelonephritis): the anti-reflux path the ureter takes through the bladder wall, a connection that forms differently before birth, paraureteral (Hutch) diverticulum, siblings, secondary reflux and bladder-bowel function, and the chance of improving with growth. By pediatric urologist Sang Woon Kim, MD. For Parents https://thepedsurologist.com/en/journal/criteria-for-choosing-a-doctor.html https://thepedsurologist.com/en/journal/criteria-for-choosing-a-doctor.html Sun, 18 Oct 2026 00:00:00 +0900 Choosing a surgeon for my father’s prostate cancer operation, I found that even as a urology professor at the same hospital I could not reach the outcome data I wanted. What I finally chose on was trust — and then the question came back to me. From the Clinic by Sang Woon Kim. From the Clinic https://thepedsurologist.com/en/journal/before-i-say-lets-wait.html https://thepedsurologist.com/en/journal/before-i-say-lets-wait.html Wed, 14 Oct 2026 00:00:00 +0900 Surgeons like to operate, a senior colleague said, and holding that back is part of the craft. What goes through my mind before recommending observation for vesicoureteral reflux — and a night in the emergency room when that judgement looked wrong. From the Clinic by Sang Woon Kim. From the Clinic https://thepedsurologist.com/en/clinical/vesicoureteral-reflux-1.html https://thepedsurologist.com/en/clinical/vesicoureteral-reflux-1.html Tue, 13 Oct 2026 00:00:00 +0900 Following reflux from the mesonephric duct rather than the bladder. Where the ureteric bud arises sets the position of the orifice, the length of the submucosal tunnel and the quality of the kidney: the Mackie-Stephens hypothesis, why Paquin's 5:1 is not a law, the paraureteral diverticulum as a second route to a failed junction, and the two routes by which the kidney suffers — congenital dysplasia, and acquired scarring that requires infection. By pediatric urologist Sang Woon Kim, MD. For Clinicians https://thepedsurologist.com/en/clinical/vesicoureteral-reflux-2.html https://thepedsurologist.com/en/clinical/vesicoureteral-reflux-2.html Tue, 13 Oct 2026 00:00:00 +0900 The natural history of vesicoureteral reflux split into two questions — will it resolve, and is it safe to observe meanwhile. Resolution rates by grade, the interobserver variability in grading shown by the RIVUR data, the ureteral diameter ratio that complements grade, age and filling volume and the VUR Index, and what makes observation a plan. By pediatric urologist Sang Woon Kim, MD. For Clinicians https://thepedsurologist.com/en/evidence/hypospadias-surgical-technique.html https://thepedsurologist.com/en/evidence/hypospadias-surgical-technique.html Tue, 13 Oct 2026 00:00:00 +0900 Reading the technical text of the current EAU/ESPU hypospadias chapter down to its level of evidence: the four operative objectives, TIP where the plate is preserved and the proximal debate, measuring and correcting curvature (5% vs 25% recurrence), one-stage 42% versus staged 21% proximally, and the sentence that says no definitive guidance can be given for redo repair. By pediatric urologist Sang Woon Kim, MD. Evidence & Papers https://thepedsurologist.com/en/parents/hypospadias-cause.html https://thepedsurologist.com/en/parents/hypospadias-cause.html Thu, 08 Oct 2026 00:00:00 +0900 Hypospadias explained for parents: how the urinary channel forms in early pregnancy, why a single cause usually cannot be identified, what is known about endocrine disruptors and heredity, and what it means for a next child. By pediatric urologist Sang Woon Kim, MD. For Parents https://thepedsurologist.com/en/evidence/hypospadias-guidelines.html https://thepedsurologist.com/en/evidence/hypospadias-guidelines.html Thu, 08 Oct 2026 00:00:00 +0900 Reading the current EAU/ESPU hypospadias chapter down to recommendation strength. There are only five recommendations, and the one rated Weak is the 30-degree curvature threshold. Timing, preoperative testosterone, stents and antibiotics get no recommendation at all. By pediatric urologist Sang Woon Kim, MD. Evidence & Papers https://thepedsurologist.com/en/evidence/urethral-development-landmark-papers.html https://thepedsurologist.com/en/evidence/urethral-development-landmark-papers.html Thu, 08 Oct 2026 00:00:00 +0900 Five papers that changed how human urethral development is understood: Glenister (1954) and ectodermal ingrowth, Kurzrock (1999), Hadidi (2014), Li (2015) and the double zipper, and the direct canalization of the glans described in 2018 — what each changed, and what each could not show. By pediatric urologist Sang Woon Kim, MD. Evidence & Papers https://thepedsurologist.com/en/journal/what-we-mean-by-a-good-result.html https://thepedsurologist.com/en/journal/what-we-mean-by-a-good-result.html Thu, 08 Oct 2026 00:00:00 +0900 "So the operation went well, didn't it?" A question at a clinic visit three months after an orchiopexy, and why I could not simply say yes. On marking the line between what has been confirmed and what cannot be confirmed yet. By pediatric urologist Sang Woon Kim, MD. From the Clinic https://thepedsurologist.com/en/clinical/hypospadias-4.html https://thepedsurologist.com/en/clinical/hypospadias-4.html Wed, 07 Oct 2026 00:00:00 +0900 The embryology of hypospadias. The double zipper — canalization of the urethral plate and androgen-dependent fusion of the urethral folds — why the glans forms by a different mechanism, and why a dorsal hood accompanies 95% of cases. By pediatric urologist Sang Woon Kim, MD. For Clinicians https://thepedsurologist.com/en/clinical/hypospadias-5.html https://thepedsurologist.com/en/clinical/hypospadias-5.html Wed, 07 Oct 2026 00:00:00 +0900 Prevalence and aetiology of hypospadias. A nineteen-fold spread between registries and what drives it, and the weight of evidence behind placental insufficiency, endocrine disruptors, assisted reproduction and genetics. By pediatric urologist Sang Woon Kim, MD. For Clinicians https://thepedsurologist.com/en/clinical/hypospadias-1.html https://thepedsurologist.com/en/clinical/hypospadias-1.html Tue, 29 Sep 2026 00:00:00 +0900 Of the three requirements a hypospadias repair must satisfy, the one that persists into adulthood is curvature. Yet counselling and reporting concentrate on urethroplasty and fistula. On deciding at the first operation something that will not declare itself for a decade. By pediatric urologist Sang Woon Kim, MD. For Clinicians https://thepedsurologist.com/en/clinical/hypospadias-2.html https://thepedsurologist.com/en/clinical/hypospadias-2.html Tue, 29 Sep 2026 00:00:00 +0900 Complication rate is not outcome. HOSE, HOPE and PPPS; why patient, surgeon and parent scores diverge; the absence of a functional measure; and what the GMS score revealed. By pediatric urologist Sang Woon Kim, MD. For Clinicians https://thepedsurologist.com/en/clinical/hypospadias-3.html https://thepedsurologist.com/en/clinical/hypospadias-3.html Tue, 29 Sep 2026 00:00:00 +0900 What decides whether a hypospadias is mild, moderate or severe. Why meatal position does not determine severity, the GMS score and its validation, the finding that only curvature survived multivariate analysis, and why outcome reporting leans toward optimism. By pediatric urologist Sang Woon Kim, MD. For Clinicians https://thepedsurologist.com/en/parents/hypospadias-severity.html https://thepedsurologist.com/en/parents/hypospadias-severity.html Tue, 29 Sep 2026 00:00:00 +0900 Whether hypospadias is mild or severe is not decided by where the opening lies. What is actually assessed, why the accurate judgement happens during surgery, and what to ask in the consulting room. By pediatric urologist Sang Woon Kim, MD. For Parents https://thepedsurologist.com/en/parents/hypospadias.html https://thepedsurologist.com/en/parents/hypospadias.html Tue, 29 Sep 2026 00:00:00 +0900 Hypospadias repair is not only about the position of the opening. Why the bend in the penis matters most, why the repair may take two stages, and what to ask before surgery. By pediatric urologist Sang Woon Kim, MD. For Parents https://thepedsurologist.com/en/clinical/concealed-penis-1.html https://thepedsurologist.com/en/clinical/concealed-penis-1.html Wed, 16 Sep 2026 00:00:00 +0900 Why the terminology and classification of concealed (buried) penis never converged, why published observations of its aetiology contradict each other, and the under-recognised gray zone of penile size. By Sang Woon Kim, MD. For Clinicians https://thepedsurologist.com/en/clinical/concealed-penis-2.html https://thepedsurologist.com/en/clinical/concealed-penis-2.html Wed, 16 Sep 2026 00:00:00 +0900 With no international guideline defining the indication or timing of surgery for concealed penis, what is the basis for deciding? The common principles of surgical technique and their limits, and how the author came to change his technique. By pediatric urologist Sang Woon Kim, MD. For Clinicians https://thepedsurologist.com/en/parents/concealed-penis.html https://thepedsurologist.com/en/parents/concealed-penis.html Wed, 16 Sep 2026 00:00:00 +0900 When a boy's penis looks very small and sits buried in the surrounding skin — the causes of concealed (buried) penis explained along two axes, penile size and anatomy, and when to wait versus when to operate. By pediatric urologist Sang Woon Kim, MD. For Parents https://thepedsurologist.com/en/evidence/concealed-penis-guidelines.html https://thepedsurologist.com/en/evidence/concealed-penis-guidelines.html Wed, 16 Sep 2026 00:00:00 +0900 What the EAU/ESPU and AUA guidelines actually recommend on concealed (buried) penis, where they are silent, and what that silence produces in clinical practice. A guideline note by Sang Woon Kim, MD. Evidence & Papers https://thepedsurologist.com/en/clinical/cryptorchidism-pearls-1.html https://thepedsurologist.com/en/clinical/cryptorchidism-pearls-1.html Mon, 07 Sep 2026 00:00:00 +0900 How the theory of cryptorchidism pathogenesis shifted from hormonal to structural, Hadziselimovic's 'bilateral disease' argument, and what large-cohort paternity data actually show — Clinical Pearls Part 1 by Sang Woon Kim, MD. For Clinicians https://thepedsurologist.com/en/clinical/cryptorchidism-pearls-2.html https://thepedsurologist.com/en/clinical/cryptorchidism-pearls-2.html Mon, 07 Sep 2026 00:00:00 +0900 Scrotal vs. inguinal approach trade-offs, laparoscopy indications, atrophy rates across the open-to-laparoscopic era, single- vs. two-stage Fowler-Stephens, diagnostic laparoscopy, and the Shehata technique — Clinical Pearls Part 2 by Sang Woon Kim, MD. For Clinicians https://thepedsurologist.com/en/evidence/cryptorchidism-guidelines.html https://thepedsurologist.com/en/evidence/cryptorchidism-guidelines.html Mon, 07 Sep 2026 00:00:00 +0900 A side-by-side comparison of the AUA and EAU/ESPU guidelines on undescended testis, the pathophysiology behind the 6-18 month surgical window, and the gap between guidelines and real-world practice. By pediatric urologist Sang Woon Kim, MD. Evidence & Papers https://thepedsurologist.com/en/journal/what-do-doctors-do-now.html https://thepedsurologist.com/en/journal/what-do-doctors-do-now.html Mon, 07 Sep 2026 00:00:00 +0900 How parents get their information has changed — from patient forums to AI. What is now within reach, what still is not, and why information, knowledge and judgement are three different things. By pediatric urologist Sang Woon Kim, MD. From the Clinic https://thepedsurologist.com/en/journal/who-will-carry-this-on.html https://thepedsurologist.com/en/journal/who-will-carry-this-on.html Mon, 07 Sep 2026 00:00:00 +0900 Why fewer young doctors choose to operate on children — not a failure of vocation, but the conditions they face. From a small moment in the operating room to the question of who will carry this work on. From the Clinic, by Sang Woon Kim. From the Clinic https://thepedsurologist.com/en/journal/why-i-started-this-log.html https://thepedsurologist.com/en/journal/why-i-started-this-log.html Thu, 03 Sep 2026 00:00:00 +0900 Pediatric urologist Dr. Sang Woon Kim's first entry, written in Toronto — memories from residency, a philosophy of what makes a good doctor, and why this archive exists. From the Clinic https://thepedsurologist.com/en/parents/undescended-testis.html https://thepedsurologist.com/en/parents/undescended-testis.html Wed, 02 Sep 2026 00:00:00 +0900 When you can't feel your child's testicle — causes of undescended testis, the chance of natural descent, and the timing of evaluation and surgery, explained by pediatric urologist Dr. Sang Woon Kim, MD. For Parents