Introduction The treatment of children with pelviureteric junction obstruction (PUJO) has naturally progressed from open, to minimally invasive approaches, including laparoscopic pyeloplasty and robot-assisted laparoscopic pyeloplasty (RALP). The RALP is now considered to be the gold standard for paediatric patients with PUJO, except for smaller infants due to size limitations. Our systematic review aims to synthesise all the available evidence regarding key postoperative outcomes for the three surgical approaches to pyeloplasties in children. Our outcomes of interest include, but are not limited to, the reoperation rate, length of hospital stay and postoperative complications as classified by the Clavien-Dindo grading system. A comprehensive assessment of all three methods in paediatric patients has yet to be conducted in the literature to date. Methods and analysis A systematic search of the MEDLINE, PubMed, EMBASE and Cochrane databases will be conducted. Screening, data extraction, statistical analysis and reporting will be performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Included papers will be full-text manuscripts written between 1947 and March 2024, comparing the outcomes and complications of open, laparoscopic and RALP. Quality and study bias will be assessed using the Newcastle-Ottawa score and, if relevant, the Cochrane risk of bias tool for randomised trials. This present protocol is written in accordance with the PRISMA Protocol 2015 checklist, ensuring that the highest methodological standards are adhered to. Ethics and dissemination No ethical approval shall be required, as this is a review of already published literature. Findings will be disseminated through publications in peer-reviewed journals and presentations at international and national conferences. PROSPERO registration number CRD42023456779.

Polyorchidism, or supernumerary testes (SNTs), is a rare congenital condition, management of which remains debated, particularly in paediatric cases with other concomitant features. We report a case of intrascrotal polyorchidism in a 14‐year‐old boy managed surgically due to parental preference and the need for histological confirmation. The patient presented with a 2‐week history of painless heaviness in the scrotum. Physical examination and Doppler ultrasonography revealed a 1.8 cm mass fused to the inferior pole of the left testicle with associated Grade 1 varicocele, hydrocele and testicular appendix. Although MRI of the scrotum was initially offered, the family declined in favour of timely histological confirmation. Surgical exploration confirmed a fused supernumerary testicle and a biopsy showed normal spermatogenesis; this was consistent with Type A3 triorchidism. The patient had no complications or recurrence of symptoms at 12‐month follow‐up. This case highlights the use of surgical exploration in selected intrascrotal polyorchidism cases where imaging can be inconclusive or histological confirmation is required. Parental concerns and long‐term reassurance may also reasonably influence management decisions.

To the Editor,Pelvi-ureteric junction obstruction (PUJO) is a well-recognised clinical entity characterised by functionally significant impairment of drainage of urine at the level of the pelvi-ureteric junction due to extrinsic or intrinsic obstruction and is encountered both by adult and paediatric urologists alike. Management of PUJO has been surgical historically, and the gold standard has been an open Anderson-Hynes dismembered pyeloplasty

Purpose Poisoning remains a major health problem worldwide. Most non-intentional acute exposures are non- or minimally toxic, but occasionally highly toxic substances need specific medical interventions. The COVID-19 pandemic with the lockdown that followed had a negative impact on the poisoning incidence.Methods This was a retrospective study including data from 103 children that were examined during the period 2019–2021 at the Penteli Children’s General Hospital.Results The most common poisons were drugs (N = 39, 37.9%) and cigarettes (N = 33, 32.0%). Detergents and insecticides followed with 5.9% (N = 6) and 4.9% (N = 5), respectively. The number of poisoned children was lower in 2019 (N = 25) compared to 2020 (N = 46). The majority were observed in 2020 (44.7%), during the Covid19 lockdown.Conclusion Pediatric poisoning constitutes a global emergency. Despite the overall decrease in the pediatric visits, an increase in the poisonings was noted during the lockdown. Prevention should focus on adult supervision and proper storage of chemicals.