There has been no consensus regarding the best surgical strategy for patients with cryptorchidism involving high-level intra-abdominal testes. This systematic review and meta-analysis compared the outcomes of Fowler-Stephens orchiopexy (FSO) conducted as 1-stage or 2-stage, open or laparoscopic. The databases PubMed, Cochrane Library, Web of Science Database, Russian Science Citation Index, SciELO Citation Index, China National Knowledge Infrastructure, WanFang Data, and China Biology Medical disc were systematically searched for relevant articles. Sixty studies involving 1991 operated testes were included in the final analysis. The overall success rates for 1- and 2-stage FSOs were 85% and 87%, respectively; overall atrophy rates for both were 10%. The success rates of 1-stage FSOs, open and laparoscopic, were 83% and 87%; with atrophy rates of 12% and 8%. The corresponding success rates of 2-stage FSOs were 81% and 89%; with atrophy rates of 17% and 8%. The odds ratios indicated that 2-stage FSO was significantly superior to 1-stage, and laparoscopic superior to open. Evaluating laparoscopic FSO over time, the success rates prior to year 2000, 2000 through 2010, and after 2010 were 85%, 89%, and 88%, and atrophy rates were 15%, 9%, and 6%, with no heterogeneity in the reports, and the funnel plot showed no publication bias. Each surgical technique for correcting high-level intra-abdominal testes (IATs) had an acceptable success rate, from 81% to 89%. However, in terms of highest success rate and lowest atrophy rate, 2-stage laparoscopic FSO is the first choice for treating high intra-abdominal cryptorchidism.

To describe 19 years of clinical experience managing pediatric patients with testicular yolk sac tumors at the Chongqing Medical University Affiliated Children’s Hospital. This study involved a retrospective review of the records of 61 pediatric patients who presented with testicular yolk sac tumor at our institution between 1995 and 2014. All patients presented with a painless scrotal mass. Serum alpha-fetoprotein (AFP) levels were elevated (n = 15). Ultrasonography identified the yolk sac tumors as solid masses. Color Doppler flow imaging showed rich blood flow inside and around the masses in 84.8% cases. X-ray of the scrotum showed no intrascrotal calcification (n = 38). Inguinal orchiectomy was performed in 60 patients, one case was treated with testis-sparing surgery. In 11 cases, radical dissection of the inguinal lymph nodes was performed. Histological analysis showed pathologies typical of yolk sac tumor including microcapsule and reticular structures, gland tube-gland bubble structures, an embryo sinus structure, and papillary structures. All patients received postoperative chemotherapy. Serum AFP levels returned to normal 1 to 2 months after surgery. No patients treated with surgery in our hospital relapsed. Testicular yolk sac tumor presents as a painless scrotal mass, increased serum AFP levels, and a solid mass on ultrasound. Chest radiography and abdominal ultrasound should be used to accurately stage the tumor. We advocate for inguinal orchiectomy for Stage I disease and postoperative chemotherapy to prevent recurrence in the ipsilateral or contralateral testis.

Background: Urinary tract infection (UTI) is a common occurrence in children. UTI and urological malformations are intimately linked. However, whether urinary tract malformations affect the clinical features of pediatric UTI remains unclear. The purpose of this study was to characterize the clinical features and microbial etiology of UTI in children.Methods: We retrospectively reviewed the records of 741 patients with UTI treated at the Chongqing Medical University Affiliated Children's Hospital between 2015 and 2020. Patients with and without urological malformations were compared using propensity score matching (PSM).Results: Escherichia coli was the most common causative microorganism of UTI, accounting for 40.5% of infections. One hundred twenty-two patients (16.5%) had urological malformations. PSM identified 122 matched pairs of patients with or without urological malformations. The proportion of patients with UTI caused by atypical microorganisms was significantly higher in patients with urological malformations (P = 0.048). Children with urological malformations showed longer duration of intravenous antibiotic treatment (P = 0.010), higher cost of treatment (P < 0.001), and higher prevalence of recurrence (23.8 vs. 10.7%, P < 0.001), compared with the normal group.Conclusion: Children with urological malformations are more likely to develop UTI with atypical microorganisms. Appropriate imaging examination and urine culture are strongly recommended for the diagnosis and management of pediatric UTI.

Background: The aim of this study was to quantify the impact of coronavirus disease 2019 (COVID-19) on pediatric operations, and establish preoperative, intraoperative, and postoperative protocols to improve the pediatric operations. Methods: We here compare the number of patients who underwent surgery in Chongqing Medical University Affiliated Children’s Hospital during the pandemic (January 23–March 11), after the pandemic (March 12–April 30), after our measures were put in place (May 1–May 21), and the equivalent period in 2019. Result: During the COVID-19 pandemic, 62.68% fewer patients underwent surgery than during the homologous period of time 1 year earlier (P < 0.01). After the COVID-19 pandemic, the number of orchidopexy cases increased significantly from 175.14 to 504.57 per week (P < 0.01). The large number of patients that accrued in our hospital may have increased the risk of COVID-19 transmission. In response, hospitals and clinics have made protocols and reorganized healthcare facilities (e.g., performing nucleic acid tests (NAT), adding adequate personal protective equipment (PPE)) from May 1, 2020. After the measures were implemented, the number of operations performed remained stable and comparable to the pre-pandemic period. COVID-19 RNA detection was performed in 5104 cases and there were no new confirmed cases in our hospital. Conclusion: This outbreak of COVID-19 has affected not only individuals with COVID-19 but also patients seeking surgical operations. Understanding the present situation helps clinicians provide a high level of treatment to all children.