SOCIETY FOR PEDIATRIC UROLOGY
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OPERATIVE CASE LOG
PLEASE NOTE: The case log is now required to be in this format. Please do not upload another format or file type to your application.
Name__________________________________________________________________
Total number of cases (Adult & Pediatric)______________________________________
Time Period (from) _______/_______ (to)_______/_______
Number of Pediatric Cases__________________________________________________
SUMMARY OF PEDIATRIC CASES
Cystoscopy (includes retrogrades, urethral dilation, etc)______
Ureteroscopy __________________
Endoscopic calculus extraction __________________
ESWL __________________
Transurethral incision of ureterocele __________________
Transurethral ablation of posterior urethral valves___________
Circumcision, minor penile procedures __________________
Meatotomy, meatoplasty __________________
Orchiopexy __________________
Hydrocele/hernia repair __________________
Minor scrotal procedures
(torsion, scrotal orchiopexy, orchiectomy) ___________
Varicocelectomy __________________
Pyeloplasty __________________
Nephrectomy __________________
Partial nephrectomy __________________
Pyelolithotomy/Nephrolithotomy __________________
Renal biopsy __________________
Renal transplant __________________
Ureteral reimplantation __________________
Ureteroureterostomy, ureteropyelostomy, TUU _____________
Ureteral tapering __________________
Cutaneous ureterostomy, cutaneous pyelostomy _______
Closure of bladder exstrophy __________________
Partial/Simple cystectomy __________________
Radical cystectomy __________________
Augmentation cystoplasty __________________
Cutaneous vesicostomy (bowel or ureter) __________________
Open cystostomy, cystolithotomy, repair bladder trauma _______
Bladder neck reconstruction (Young Dees, Kropp, etc) _________
Bladder neck suspension (MMK, Raz, sling) _______________
Conduit (ileal, colon) __________________
Continent urinary diversion __________________
Correction of chordee without hypospadias ______________
Correction of hidden penis, webbed penis, penile torsion______
Distal hypospadias repair (MAGPI) __________________
Proximal hypospadias repair
(subcoronal, midpenile, penoscrotal) __________________
Staged hypospadias repair __________________
Free graft (buccal/bladder mucosal) hypospadias repair______
Repair of urethrocutaneous fistula __________________
Repair of urethral stricture __________________
Epispadias repair __________________
Laparoscopy, diagnostic __________________
Laparoscopy, therapeutic (list) __________________
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