Pramod Reddy

112 statements · 3 topics

Featured statements

▶ Ep 3 · 6:53
The shunts have not really provided the improvement in renal function, they have provided us with pulmonary survivors.
quote · Fetal Surgery
▶ Ep 3 · 57:14
If their creatinine at age one is less than one, most likely that they will not need renal replacement therapy.
quote · Fetal Surgery
▶ Ep 2 · 4:49
If the pressure in a bladder exceeds 40 centimeters of water, that does injure the kidneys.
quote · Lower Urinary Tract Obstruction
▶ Ep 2 · 44:27
We struggle with this.
quote · Lower Urinary Tract Obstruction
▶ Ep 2 · 2:04
Not all fetuses with urinary tract obstruction are candidates for intervention; those too healthy (normal AFI, non-obstructive dilation, unilateral UPJ) or too sick (cystic dysplasia, abnormal karyotype, multiple anomalies) should not be offered fetal surgery.
guideline · Posterior Urethral Valves
▶ Ep 2 · 38:44
Current algorithms reserve the most invasive interventions (open vesicostomy) for the worst-prognosis fetuses, which may be flawed because these patients are least likely to benefit and most likely to suffer maternal and fetal harm.
opinion · Posterior Urethral Valves

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Pramod's statements about Fetal Surgery 56 statements

Open the Fetal Surgery collection →

Urologic Fetal Intervention: Cincinnati Fetal Center

▶ Ep 3 · 2:04
guideline Not all fetuses with urinary tract obstruction are candidates for intervention; those too healthy (normal AFI, non-obstructive dilation, unilateral UPJ) or too sick (cystic dysplasia, abnormal karyotype, multiple anomalies) should not be offered fetal surgery. ↗
▶ Ep 3 · 2:04
quote Not all fetuses with urinary tract obstructions are candidates for interventions. ↗
▶ Ep 3 · 2:04
guideline Not all fetuses with urinary tract obstruction are candidates for intervention; those too healthy (normal AFI, non-obstructive dilation, unilateral UPJ) or too sick (cystic dysplasia, abnormal karyotype, multiple anomalies) should not be offered fetal surgery. ↗
▶ Ep 3 · 2:04
quote Not all fetuses with urinary tract obstructions are candidates for interventions. ↗
▶ Ep 3 · 2:33
quote All of the risk is accountable to the mother. ↗
▶ Ep 3 · 2:33
quote All of the risk is accountable to the mother. ↗
▶ Ep 3 · 4:00
clinical Vesicoamniotic shunts have not improved renal outcomes because the long, thin tubes do not adequately reduce bladder pressure; they provide pulmonary survivors but not renal protection. ↗
▶ Ep 3 · 4:00
clinical Vesicoamniotic shunts have not improved renal outcomes because the long, thin tubes do not adequately reduce bladder pressure; they provide pulmonary survivors but not renal protection. ↗
▶ Ep 3 · 4:49
clinical In adult studies, bladder pressure exceeding 40 cm H₂O (29 mmHg) causes renal injury and abolishes net glomerular filtration. ↗
▶ Ep 3 · 4:49
clinical In adult studies, bladder pressure exceeding 40 cm H₂O (29 mmHg) causes renal injury and abolishes net glomerular filtration. ↗
▶ Ep 3 · 4:49
quote If the pressure in a bladder exceeds 40 centimeters of water, that does injure the kidneys. ↗
▶ Ep 3 · 4:49
quote If the pressure in a bladder exceeds 40 centimeters of water, that does injure the kidneys. ↗
▶ Ep 3 · 5:13
quote What are the pressures that are safe in a bladder for a fetus and the fetal kidneys to continue to develop, we don't know. ↗
▶ Ep 3 · 5:13
clinical Safe bladder pressures for fetal kidneys are unknown; adult thresholds are used by extrapolation. ↗
▶ Ep 3 · 5:13
quote What are the pressures that are safe in a bladder for a fetus and the fetal kidneys to continue to develop, we don't know. ↗
▶ Ep 3 · 5:13
clinical Safe bladder pressures for fetal kidneys are unknown; adult thresholds are used by extrapolation. ↗
▶ Ep 3 · 6:53
quote The shunts have not really provided the improvement in renal function, they have provided us with pulmonary survivors. ↗
▶ Ep 3 · 6:53
quote The shunts have not really provided the improvement in renal function, they have provided us with pulmonary survivors. ↗
▶ Ep 3 · 16:39
clinical Bladder cycling enabled by fetoscopic valve ablation is physiologically important for bladder health, not for upper-tract protection. ↗
▶ Ep 3 · 16:39
clinical Bladder cycling enabled by fetoscopic valve ablation is physiologically important for bladder health, not for upper-tract protection. ↗
▶ Ep 3 · 17:57
opinion A urethral fistula from fetoscopic laser ablation can be repaired surgically with minimal morbidity, whereas renal dysplasia cannot be reversed. ↗
▶ Ep 3 · 17:57
opinion A urethral fistula from fetoscopic laser ablation can be repaired surgically with minimal morbidity, whereas renal dysplasia cannot be reversed. ↗
▶ Ep 3 · 17:59
quote I would rather have to deal with a fistula that I can repair surgically than renal dysplasia. ↗
▶ Ep 3 · 17:59
quote I would rather have to deal with a fistula that I can repair surgically than renal dysplasia. ↗
▶ Ep 3 · 18:30
clinical Posterior urethral valves can sometimes be ablated by blunt mechanical disruption (guidewire and catheter) rather than laser, because the valves are flimsy. ↗
▶ Ep 3 · 18:30
clinical Posterior urethral valves can sometimes be ablated by blunt mechanical disruption (guidewire and catheter) rather than laser, because the valves are flimsy. ↗
▶ Ep 3 · 18:46
quote If hydrodistention all by itself could do it, then the amount of pressure developing in the urinary tract should blow open those valves. ↗
▶ Ep 3 · 18:46
quote If hydrodistention all by itself could do it, then the amount of pressure developing in the urinary tract should blow open those valves. ↗
▶ Ep 3 · 30:18
clinical A flexible 4.9 Fr ureteroscope can be introduced through a 10 Fr sheath to improve maneuverability when accessing the fetal bladder neck and posterior urethra. ↗
▶ Ep 3 · 30:18
clinical A flexible 4.9 Fr ureteroscope can be introduced through a 10 Fr sheath to improve maneuverability when accessing the fetal bladder neck and posterior urethra. ↗
▶ Ep 3 · 38:44
opinion Current algorithms reserve the most invasive interventions (open vesicostomy) for the worst-prognosis fetuses, which may be flawed because these patients are least likely to benefit and most likely to suffer maternal and fetal harm. ↗
▶ Ep 3 · 38:44
opinion Current algorithms reserve the most invasive interventions (open vesicostomy) for the worst-prognosis fetuses, which may be flawed because these patients are least likely to benefit and most likely to suffer maternal and fetal harm. ↗
▶ Ep 3 · 41:06
clinical Open fetal vesicostomy predisposes the mother to shortened gestation (~10 additional weeks) and very high risk of preterm labor. ↗
▶ Ep 3 · 41:06
clinical Open fetal vesicostomy predisposes the mother to shortened gestation (~10 additional weeks) and very high risk of preterm labor. ↗
▶ Ep 3 · 41:33
epidemiological Cincinnati performed open fetal vesicostomy in six anhydramniotic fetuses; four died from preterm delivery, one has normal renal function at age 5, and one required transplant. ↗
▶ Ep 3 · 41:33
epidemiological Cincinnati performed open fetal vesicostomy in six anhydramniotic fetuses; four died from preterm delivery, one has normal renal function at age 5, and one required transplant. ↗
▶ Ep 3 · 44:27
quote We struggle with this. ↗
▶ Ep 3 · 44:27
quote We struggle with this. ↗
▶ Ep 3 · 44:46
quote In the one instance where we've got this incredibly successful outcome, I think that that was the right choice for them. ↗
▶ Ep 3 · 44:46
quote In the one instance where we've got this incredibly successful outcome, I think that that was the right choice for them. ↗
▶ Ep 3 · 47:57
opinion Better biomarkers of fetal renal function are urgently needed to guide intervention selection and predict outcomes. ↗
▶ Ep 3 · 47:57
opinion Better biomarkers of fetal renal function are urgently needed to guide intervention selection and predict outcomes. ↗
▶ Ep 3 · 47:57
quote We really need to identify a better marker of renal function, fetal renal function. ↗
▶ Ep 3 · 47:57
quote We really need to identify a better marker of renal function, fetal renal function. ↗
▶ Ep 3 · 56:35
quote The creatinine at the time of discharge from the hospital is very misleading. ↗
▶ Ep 3 · 56:35
quote The creatinine at the time of discharge from the hospital is very misleading. ↗
▶ Ep 3 · 56:52
clinical Creatinine at hospital discharge is misleading; creatinine at age 1 year is a better predictor of long-term renal function. A creatinine <1.0 mg/dL at age 1 suggests the child will not require renal replacement therapy. ↗
▶ Ep 3 · 56:52
clinical Infants with LUTO triple their birth weight in the first year, revealing the true extent of renal reserve; discharge creatinine does not account for this growth. ↗
▶ Ep 3 · 56:52
clinical Creatinine at hospital discharge is misleading; creatinine at age 1 year is a better predictor of long-term renal function. A creatinine <1.0 mg/dL at age 1 suggests the child will not require renal replacement therapy. ↗
▶ Ep 3 · 56:52
clinical Infants with LUTO triple their birth weight in the first year, revealing the true extent of renal reserve; discharge creatinine does not account for this growth. ↗
▶ Ep 3 · 57:14
quote If their creatinine at age one is less than one, most likely that they will not need renal replacement therapy. ↗
▶ Ep 3 · 57:14
quote If their creatinine at age one is less than one, most likely that they will not need renal replacement therapy. ↗
▶ Ep 3 · 57:31
quote The bladder is often underestimated in terms of its importance. ↗
▶ Ep 3 · 57:31
clinical Polyuria from fetal concentrating defects causes high bladder storage pressures, which damage the upper tracts in a vicious cycle; aggressive postnatal bladder management is required to break this cycle. ↗
▶ Ep 3 · 57:31
clinical Polyuria from fetal concentrating defects causes high bladder storage pressures, which damage the upper tracts in a vicious cycle; aggressive postnatal bladder management is required to break this cycle. ↗
▶ Ep 3 · 57:31
quote The bladder is often underestimated in terms of its importance. ↗
Pramod's statements about Lower Urinary Tract Obstruction 28 statements

Open the Lower Urinary Tract Obstruction collection →

Urologic Fetal Intervention: Cincinnati Fetal Center

▶ Ep 2 · 2:04
guideline Not all fetuses with urinary tract obstruction are candidates for intervention; those too healthy (normal AFI, non-obstructive dilation, unilateral UPJ) or too sick (cystic dysplasia, abnormal karyotype, multiple anomalies) should not be offered fetal surgery. ↗
▶ Ep 2 · 2:04
quote Not all fetuses with urinary tract obstructions are candidates for interventions. ↗
▶ Ep 2 · 2:33
quote All of the risk is accountable to the mother. ↗
▶ Ep 2 · 4:00
clinical Vesicoamniotic shunts have not improved renal outcomes because the long, thin tubes do not adequately reduce bladder pressure; they provide pulmonary survivors but not renal protection. ↗
▶ Ep 2 · 4:49
clinical In adult studies, bladder pressure exceeding 40 cm H₂O (29 mmHg) causes renal injury and abolishes net glomerular filtration. ↗
▶ Ep 2 · 4:49
quote If the pressure in a bladder exceeds 40 centimeters of water, that does injure the kidneys. ↗
▶ Ep 2 · 5:13
clinical Safe bladder pressures for fetal kidneys are unknown; adult thresholds are used by extrapolation. ↗
▶ Ep 2 · 5:13
quote What are the pressures that are safe in a bladder for a fetus and the fetal kidneys to continue to develop, we don't know. ↗
▶ Ep 2 · 6:53
quote The shunts have not really provided the improvement in renal function, they have provided us with pulmonary survivors. ↗
▶ Ep 2 · 16:39
clinical Bladder cycling enabled by fetoscopic valve ablation is physiologically important for bladder health, not for upper-tract protection. ↗
▶ Ep 2 · 17:57
opinion A urethral fistula from fetoscopic laser ablation can be repaired surgically with minimal morbidity, whereas renal dysplasia cannot be reversed. ↗
▶ Ep 2 · 17:59
quote I would rather have to deal with a fistula that I can repair surgically than renal dysplasia. ↗
▶ Ep 2 · 18:30
clinical Posterior urethral valves can sometimes be ablated by blunt mechanical disruption (guidewire and catheter) rather than laser, because the valves are flimsy. ↗
▶ Ep 2 · 18:46
quote If hydrodistention all by itself could do it, then the amount of pressure developing in the urinary tract should blow open those valves. ↗
▶ Ep 2 · 30:18
clinical A flexible 4.9 Fr ureteroscope can be introduced through a 10 Fr sheath to improve maneuverability when accessing the fetal bladder neck and posterior urethra. ↗
▶ Ep 2 · 38:44
opinion Current algorithms reserve the most invasive interventions (open vesicostomy) for the worst-prognosis fetuses, which may be flawed because these patients are least likely to benefit and most likely to suffer maternal and fetal harm. ↗
▶ Ep 2 · 41:06
clinical Open fetal vesicostomy predisposes the mother to shortened gestation (~10 additional weeks) and very high risk of preterm labor. ↗
▶ Ep 2 · 41:33
epidemiological Cincinnati performed open fetal vesicostomy in six anhydramniotic fetuses; four died from preterm delivery, one has normal renal function at age 5, and one required transplant. ↗
▶ Ep 2 · 44:27
quote We struggle with this. ↗
▶ Ep 2 · 44:46
quote In the one instance where we've got this incredibly successful outcome, I think that that was the right choice for them. ↗
▶ Ep 2 · 47:57
quote We really need to identify a better marker of renal function, fetal renal function. ↗
▶ Ep 2 · 47:57
opinion Better biomarkers of fetal renal function are urgently needed to guide intervention selection and predict outcomes. ↗
▶ Ep 2 · 56:35
quote The creatinine at the time of discharge from the hospital is very misleading. ↗
▶ Ep 2 · 56:52
clinical Creatinine at hospital discharge is misleading; creatinine at age 1 year is a better predictor of long-term renal function. A creatinine <1.0 mg/dL at age 1 suggests the child will not require renal replacement therapy. ↗
▶ Ep 2 · 56:52
clinical Infants with LUTO triple their birth weight in the first year, revealing the true extent of renal reserve; discharge creatinine does not account for this growth. ↗
▶ Ep 2 · 57:14
quote If their creatinine at age one is less than one, most likely that they will not need renal replacement therapy. ↗
▶ Ep 2 · 57:31
quote The bladder is often underestimated in terms of its importance. ↗
▶ Ep 2 · 57:31
clinical Polyuria from fetal concentrating defects causes high bladder storage pressures, which damage the upper tracts in a vicious cycle; aggressive postnatal bladder management is required to break this cycle. ↗
Pramod's statements about Posterior Urethral Valves 28 statements

Open the Posterior Urethral Valves collection →

Urologic Fetal Intervention: Cincinnati Fetal Center

▶ Ep 2 · 2:04
quote Not all fetuses with urinary tract obstructions are candidates for interventions. ↗
▶ Ep 2 · 2:04
guideline Not all fetuses with urinary tract obstruction are candidates for intervention; those too healthy (normal AFI, non-obstructive dilation, unilateral UPJ) or too sick (cystic dysplasia, abnormal karyotype, multiple anomalies) should not be offered fetal surgery. ↗
▶ Ep 2 · 2:33
quote All of the risk is accountable to the mother. ↗
▶ Ep 2 · 4:00
clinical Vesicoamniotic shunts have not improved renal outcomes because the long, thin tubes do not adequately reduce bladder pressure; they provide pulmonary survivors but not renal protection. ↗
▶ Ep 2 · 4:49
quote If the pressure in a bladder exceeds 40 centimeters of water, that does injure the kidneys. ↗
▶ Ep 2 · 4:49
clinical In adult studies, bladder pressure exceeding 40 cm H₂O (29 mmHg) causes renal injury and abolishes net glomerular filtration. ↗
▶ Ep 2 · 5:13
clinical Safe bladder pressures for fetal kidneys are unknown; adult thresholds are used by extrapolation. ↗
▶ Ep 2 · 5:13
quote What are the pressures that are safe in a bladder for a fetus and the fetal kidneys to continue to develop, we don't know. ↗
▶ Ep 2 · 6:53
quote The shunts have not really provided the improvement in renal function, they have provided us with pulmonary survivors. ↗
▶ Ep 2 · 16:39
clinical Bladder cycling enabled by fetoscopic valve ablation is physiologically important for bladder health, not for upper-tract protection. ↗
▶ Ep 2 · 17:57
opinion A urethral fistula from fetoscopic laser ablation can be repaired surgically with minimal morbidity, whereas renal dysplasia cannot be reversed. ↗
▶ Ep 2 · 17:59
quote I would rather have to deal with a fistula that I can repair surgically than renal dysplasia. ↗
▶ Ep 2 · 18:30
clinical Posterior urethral valves can sometimes be ablated by blunt mechanical disruption (guidewire and catheter) rather than laser, because the valves are flimsy. ↗
▶ Ep 2 · 18:46
quote If hydrodistention all by itself could do it, then the amount of pressure developing in the urinary tract should blow open those valves. ↗
▶ Ep 2 · 30:18
clinical A flexible 4.9 Fr ureteroscope can be introduced through a 10 Fr sheath to improve maneuverability when accessing the fetal bladder neck and posterior urethra. ↗
▶ Ep 2 · 38:44
opinion Current algorithms reserve the most invasive interventions (open vesicostomy) for the worst-prognosis fetuses, which may be flawed because these patients are least likely to benefit and most likely to suffer maternal and fetal harm. ↗
▶ Ep 2 · 41:06
clinical Open fetal vesicostomy predisposes the mother to shortened gestation (~10 additional weeks) and very high risk of preterm labor. ↗
▶ Ep 2 · 41:33
epidemiological Cincinnati performed open fetal vesicostomy in six anhydramniotic fetuses; four died from preterm delivery, one has normal renal function at age 5, and one required transplant. ↗
▶ Ep 2 · 44:27
quote We struggle with this. ↗
▶ Ep 2 · 44:46
quote In the one instance where we've got this incredibly successful outcome, I think that that was the right choice for them. ↗
▶ Ep 2 · 47:57
quote We really need to identify a better marker of renal function, fetal renal function. ↗
▶ Ep 2 · 47:57
opinion Better biomarkers of fetal renal function are urgently needed to guide intervention selection and predict outcomes. ↗
▶ Ep 2 · 56:35
quote The creatinine at the time of discharge from the hospital is very misleading. ↗
▶ Ep 2 · 56:52
clinical Infants with LUTO triple their birth weight in the first year, revealing the true extent of renal reserve; discharge creatinine does not account for this growth. ↗
▶ Ep 2 · 56:52
clinical Creatinine at hospital discharge is misleading; creatinine at age 1 year is a better predictor of long-term renal function. A creatinine <1.0 mg/dL at age 1 suggests the child will not require renal replacement therapy. ↗
▶ Ep 2 · 57:14
quote If their creatinine at age one is less than one, most likely that they will not need renal replacement therapy. ↗
▶ Ep 2 · 57:31
quote The bladder is often underestimated in terms of its importance. ↗
▶ Ep 2 · 57:31
clinical Polyuria from fetal concentrating defects causes high bladder storage pressures, which damage the upper tracts in a vicious cycle; aggressive postnatal bladder management is required to break this cycle. ↗