BACKGROUND:Isolated male epispadias (IME) is a rare congenital malformation. Surgical repair aims to improve urinary function, correct penile curvature, reconstruct the urethra and glans, and preserve future sexual function. Because available series are small, the influence of anatomical subtype and operative technique on outcome remains incompletely defined. OBJECTIVE:To report single-center outcomes of Thiersch-Duplay and modified Cantwell-Ransley repairs for IME, with attention to anatomical subtype, complications, and age-appropriate continence outcomes. METHODS:We retrospectively reviewed boys with IME who underwent primary urethral reconstruction in my hospital, Capital Medical University, from May 2005 to June 2024. Data were locked on 30 June 2024. Primary outcomes were postoperative complications graded by the Clavien-Dindo system and urinary continence at last follow-up in patients aged 5 years or older. Secondary outcomes included improvement of preoperative incontinence, ICIQ score, subsequent bladder neck reconstruction, penile appearance/residual curvature when documented, and patient/parent-reported sexual function. RESULTS:Sixty-seven patients were included: 35 underwent modified Cantwell-Ransley repair and 32 underwent Thiersch-Duplay repair. The cohort included 26 glanular (38.8%), 23 penile (34.3%), and 18 penopubic (26.9%) cases. Median age at surgery was 28 months in both groups. Median age at last follow-up was 92.8 months (IQR 63.9-108.4) after modified Cantwell-Ransley repair and 137.9 months (IQR 77.9-172.6) after Thiersch-Duplay repair (P = 0.011). Procedure distribution differed by meatal location (P = 0.036), although penopubic cases were treated with both procedures. Total complications occurred in 5/35 and 5/32 patients, respectively. Formal continence analysis included 26 modified Cantwell-Ransley patients and 27 Thiersch-Duplay patients aged 5 years or older. Postoperative urinary incontinence persisted in 14/26 (53.8%) and 12/27 (44.4%), respectively. Among age-eligible patients with preoperative incontinence, any improvement was documented in 13/20 (65.0%) and 14/17 (82.4%), and complete remission occurred in 6/20 (30.0%) and 5/17 (29.4%), respectively. Three patients, all with penopubic epispadias treated with Thiersch-Duplay repair, subsequently underwent bladder neck reconstruction for persistent incontinence. Erectile function data were available in 37/67 patients (55.2%). CONCLUSIONS:In this large single-center retrospective cohort, Thiersch-Duplay and modified Cantwell-Ransley repairs had comparable overall complication rates. Continence and reoperation patterns were strongly influenced by anatomical subtype, with penopubic epispadias representing the highest-risk group. These findings support individualized, anatomy-conscious operative planning and prospective evaluation of standardized selection criteria, rather than a single prescriptive algorithm. CLINICAL/TRANSLATIONAL IMPLICATION:This series supports standardized reporting of anatomical subtype, age-appropriate continence outcomes, and graded complications when counseling families and comparing outcomes across centers. LEVEL OF EVIDENCE:Level III.

Background:The optimal timing of urethroplasty for pediatric pelvic fracture-associated urethral injury (PFUI) in boys remains controversial, with limited long-term data. This study aimed to compare the complications and surgical success rates between early (≤10 days) and delayed (≥3 months) urethroplasty in a long-term pediatric cohort. Methods:This retrospective study included boys who underwent PFUI urethroplasty at a single center (2001-2023). Exclusion criteria included loss to follow-up, death, and prior realignment or urethral surgery elsewhere. Early repair was defined as ≤10 days post-injury, and delayed repair as ≥3 months. Outcomes included stricture (clinical or cystoscopic), incontinence (any leakage), erectile dysfunction (ED, by parental or self-report), and reoperation. Statistical comparisons used Mann-Whitney U and Fisher's exact tests. Results:Among 100 screened patients, 48 were analyzed (median follow-up 112 months): 15 in the early group and 33 in the delayed group. Surgical timing was determined by referral time rather than clinical severity; however, the two groups differed in post-injury management patterns, which may introduce selection bias. The overall complication rate was 54.2% (26/48): stricture 41.7% (20/48), incontinence 22.0% (9/41), ED 29.3% (12/41), and reoperation 37.5% (18/48). No significant differences were observed between early and delayed groups for stricture (5/15 vs. 15/33), reoperation (4/15 vs. 14/33), or overall complications (6/15 vs. 20/33; all P>0.05). Wide 95% confidence intervals (CIs) (e.g., reoperation rate difference: -15.7%, 95% CI: -41.3% to 12.4%) reflect small sample size (especially n=15 in early group) and insufficient power. Conclusions:This single-center study does not provide conclusive evidence for superiority of either early or delayed urethroplasty in boys with PFUI. Potential clinically important differences cannot be ruled out. Larger multicenter studies are needed.

Androgen insensitivity syndrome (AIS) is a condition that emerges from mutations in the androgen receptor ( AR ) gene, leading to functional defects and subsequent abnormal development of the urogenital sinus. The aim of this study was to investigate the relationship between genotype and phenotype, surgical treatments, and complications of AIS patients. We retrospectively evaluated the medical records of patients who were diagnosed with AIS after genetic testing and underwent initial surgery at Beijing Children's Hospital, Capital Medical University (Beijing, China), from August 2007 to August 2023. A total of 46 patients were included in this study. Four novel variants, p.Y572S, p.L57dup, p.L882del, and p.V888A, were identified. AR variants are concentrated in the ligand-binding domain (LBD) region (60.9%) and are predominantly missense mutations (78.3%). There was no significant difference in the phenotypes between the LBD group and the non-LBD group ( P > 0.05). Nonsense or frameshift mutations may accompany more severe phenotypes or complete androgen insensitivity syndrome (CAIS; P = 0.011). For CAIS patients with inguinal hernias, we recommend that hernia ligation surgery should be performed during childhood and that gonadectomy should be considered during adolescence or postadolescence. Preoperative hormone stimulation (PHS) had a positive effect on penile growth ( P = 0.0014). Compared with patients with severe hypospadias, those patients with partial androgen insensitivity syndrome (PAIS) experience fewer complications from urethroplasty. If the conditions for a one-stage operation are not adequately met, it is advisable to perform staged surgery.

OBJECTIVE:To develop a clinical prediction model using general clinical and renal ultrasound parameters to noninvasively monitor baseline renal function in children with unilateral ureteropelvic junction obstruction (UPJO), thereby reducing the need for invasive procedures. MATERIALS AND METHODS:This prospective study included 379 children with unilateral UPJO treated between March 2019 and December 2022. Patients were randomly divided into training and validation sets (7:3 ratio). Binary logistic regression identified independent predictors of impaired differential renal function (DRF), which were incorporated into a predictive nomogram. Model performance was evaluated using ROC analysis, calibration curves, and decision curve analysis (DCA). RESULTS:A total of 379 children with UPJO were included in this study. Renal parenchymal thickness (PT) min, Hydronephrosis volume/Renal volume (HV/RV), and corrected contralateral renal volume (RV) were independent predictors of impaired baseline DRF. A nomogram based on these predictors was developed to estimate the risk of baseline DRF impairment in children with UPJO. The area under the receiver operating characteristics curve (ROC) was 0.778 (95% CI: 0.715-0.842) and 0.925 (95% CI: 0.866-0.985) in the training and validation sets, respectively, showing good differentiation ability, and the calibration curve and clinical decision analysis curve validated the better calibration ability and clinical net benefit of the model. CONCLUSIONS:A nomogram incorporating PTmin, HV/RV, and corrected contralateral renal volume effectively predicts baseline DRF impairment in children with UPJO, showing robust performance in internal validation. External validation is warranted to confirm its clinical applicability.

BACKGROUND:Pediatric lymphoma rarely arises from or initially presents as a solitary urogenital mass. Because imaging features often resemble those of primary genitourinary malignancies, misdiagnosis may lead to unnecessary radical organ resection. OBJECTIVE:To describe the clinical features, diagnostic challenges, and treatment outcomes of children with lymphoma initially presenting as a genitourinary lesion, emphasizing the importance of early recognition and a systematic, stepwise diagnostic approach-one that optimizes evaluation to avoid missed diagnoses while minimizing unnecessary radiation exposure in children-with the ultimate goal of preventing unnecessary radical organ resection. STUDY DESIGN:This retrospective study included five boys (6-13 years old) who presented between January 2016 and April 2025 with a solitary urogenital mass later diagnosed as lymphoma. Clinical presentation, imaging, pathology, treatment, and outcomes were analyzed to identify key diagnostic and therapeutic patterns. RESULTS:Initial sites of presentation were the kidney (n = 1), retroperitoneum (n = 1), ureter (n = 1), penis (n = 1), and abdominal mass involving the bladder (n = 1). Imaging typically showed homogeneous soft-tissue masses with mild enhancement, without necrosis or calcification. PET-CT indicated systemic involvement in all patients. Histologic subtypes included aggressive mature B-cell (n = 2), Burkitt (n = 1), B-lymphoblastic (n = 1), and ALK-positive anaplastic large-cell lymphoma (n = 1). Four patients were diagnosed by percutaneous biopsy, and one after local excision. All received systemic chemotherapy, achieving complete remission in four and partial remission in one case complicated by vesical fistula. No deaths occurred during a median follow-up of 2.8 years. DISCUSSION:Lymphoma should be considered when evaluating pediatric genitourinary lesions in children, as the presentation may mimic primary malignancy and delay diagnosis. A complete imaging workup, including cross-sectional imaging with a low threshold for PET-CT, is essential to assess for systemic involvement. When diagnostic doubt persists after imaging, image-guided core-needle biopsy with multidisciplinary input can prevent unnecessary radical surgery. Study limitations include the small sample size and single-institution experience; however, the findings align with published evidence supporting high chemosensitivity and excellent outcomes with systemic therapy. CONCLUSION:Pediatric lymphomas presenting as genitourinary lesions are rare but highly treatable. Heightened diagnostic awareness, followed by a structured approach-comprehensive imaging and, when indicated image-guided biopsy enables accurate diagnosis, organ preservation, and favorable prognosis, meeting the study's aim of improving diagnostic awareness and management.

Wilms tumor (WT) is the most common primary malignant renal tumor in children. Currently, there is no unified consensus regarding surgical management of WT. This is particularly so in complex cases where tumors are large, where there is invasion of adjacent organs, for nephron-sparing procedures, and for lymph node biopsy. Non-standardized surgical procedures can lead to tumor recurrence and progression; this is of increasing clinical concern. Standardizing the surgical approach and protocols for WT is therefore of great importance to improving treatment outcomes and patient prognosis. To better guide clinical practice, the Oncology Surgery Group and Urology Surgery Group of Pediatric Surgery Branch of the Chinese Medical Associationhave formulated this expert consensus. Based on previous clinical research findings and existing guidelines, the consensus provides specific recommendations for surgical approach and for decision-making.

Background: Pediatric non-rhabdomyosarcoma bladder tumors (NRBTs) encompass a diverse spectrum of tumors with low incidence rates. This study aims to improve understanding and contribute to the management of pediatric NRBTs. Methods: We retrospectively enrolled patients with primary pediatric NRBTs diagnosed and treated at our center between 2003 and 2023. Clinicodemographic and clinicopathological data were collected. NRBTs were classified into four categories: urothelial tumors (UTs), mesenchymal tumors (MTs), neuroendocrine tumors (NTs), and rare types of bladder tumors (rBTs). Intergroup comparative analyses were conducted. Results: We identified 51 cases of NRBTs. Four categories encompassed: UTs (n=25, 49.0%), MTs (n=17, 33.3%) and NTs (n=5, 9.8%), and rBTs (n=4, 7.8%). No cases of UTs were identified below the age of 3 years. Comparative analyses demonstrated significant intergroup differences in preoperative anemia prevalence (P=0.02) and tumor size (P<0.001). Total 45 patients (88.2%) completed follow-up, with a median duration of 64 months [interquartile range (IQR), 28-113 months]. Local recurrences were identified in 5 cases (11.1%), among whom 1 case (2.0%) succumbed to local recurrence and disease progression. Conclusions: Pediatric NRBTs demonstrate generally favorable clinical outcomes. Age under 3 years, preoperative anemia or a maximum tumor diameter exceeding 3 cm should raise a strong suspicion for non-UTs bladder tumors. Postoperative surveillance protocols can incorporate urinary ultrasonography (US) as a non-invasive monitoring tool.

This multicenter study aimed to identify risk factors for postoperative complications following tubularized incised plate urethroplasty (TIP) in hypospadias patients and develop a clinical prediction model. Retrospective data from 17 tertiary centers (2018–2021) were analyzed. Inclusion criteria: primary TIP surgery with complete anatomical and follow-up data. Exclusion criteria: prior urethral surgery, genetic disorders, or incomplete records. Multivariate logistic regression identified independent predictors. A nomogram model was constructed and internally validated using bootstrapping (1000 resamples). Discrimination (AUC) and calibration (Hosmer–Lemeshow test) were assessed. Among 493 patients (median follow-up: 42 months), the complication rate was 23.7

To analyze the clinical characteristics, complications and patients satisfaction of MIP hypospadias variant. A retrospective analysis was performed for 31 patients with MIP admitted to our hospital from January 2008 to February 2023. All enrolled patients underwent telephone follow-up and a survey was conducted on the satisfaction of patients and their families. Outcome analysis was focused on clinical data includes age, position of the meatus, penile curvature, type of repair, complications and satisfaction survey results. Statistical analyses were performed using R software. The average age of 31 MIP patients was 92.1 ± 40.7 months, and the median follow-up time was 49.0 [21.0–82.2] months. Twenty one patients (67.7

Wilms tumor (WT), the most common pediatric renal malignancy, exhibits a relatively low mutational burden compared to adult cancers, which hinders the development of targeted therapies. To elucidate the molecular landscape of WT, we perform integrative proteomic, phosphoproteomic, transcriptomic, and whole-exome sequencing analyses of WT and normal kidney tissue adjacent to tumor. Our multi-omics approach uncovers prognostic genetic alterations, distinct molecular subgroups, immune microenvironment features, and potential biomarkers and therapeutic targets. Proteome- and transcriptome-based stratification identifies three molecular subgroups with unique signatures, correlating with different histopathological subtypes and putative cellular origins at different stages of embryonic kidney development. Notably, we identify EHMT2 as a promising prognostic biomarker and therapeutic target associated with epigenetic regulation and Wnt/β-catenin pathway. In this work, we provide a comprehensive molecular characterization of WT, offering valuable insights into its pathogenesis and a foundational resource for future therapeutic development.

This study aims to evaluate the feasibility, safety and efficacy of robotic assisted laparoscopic pyeloplasty (RALP) with the novel SHURUI single-port (SR-SP) robotic surgical platform in children. Between November 2023 and April 2024, 20 pediatric patients diagnosed with ureteropelvic junction obstruction (UPJO) underwent transperitoneal RALP with the SR-SP surgical platform. Baseline characteristics, perioperative parameters and follow-up data were collected and analyzed. All surgical procedures were successfully performed without conversion to open or laparoscopic surgery. The median docking time, console time, and operative time were 3.5 min (range 3.5–6.0), 144.5 min (range 88.0–290.0), and 221.5 min (range 136.0–450.0), respectively. The median estimated blood loss was 5 ml (range 2–20) and the median length of hospital stays was 6 days (range 4–24). Through trans-umbilical incision, RALP was feasible in patients with a height of no less than 114 cm. The minimum incision length was 2 cm. No intraoperative complication was identified. Two cases were identified with the Clavien–Dindo Grade II postoperative complications and one with the Clavien–Dindo Grade III complications. The surgical success rate was 95

BACKGROUND:Varicocele (VC) is a leading cause of male infertility. Insufficient growth and development of the cremaster muscle may contribute to VC, but the underlying mechanism remains unclear. Cremaster muscle dysfunction may impair venous valve support, contributing to VC. The cremaster relies on satellite cells (SCs) for postnatal growth and damage repair. This study aimed to explore the mechanism of the cremaster muscle in the process of VC. METHODS:Ten male Sprague-Dawley (SD) rats were divided into two groups: the VC model group (5 rats) and the sham-control group (5 rats). After four weeks of observation, the cremaster muscles were collected. The diameters of the left and right spermatic veins were measured, and the left testis was isolated for morphological examination via H&E staining. SCs isolated from the left cremaster muscle were analyzed using multiple methods, including qPCR and Western blot. Data were analyzed using SPSS v.22.0. RESULTS:Compared to the control group, the model group showed decreased TFRC mRNA stability, decreased mitochondrial membrane potential, and decreased GSH and GSSG contents, as well as increased m6A modification levels and increased ROS, MDA, and Fe2+ contents. In addition, the model group also showed downregulation of transferrin receptor (TFRC, a key iron uptake protein involved in ferroptosis) expression and upregulated m6A methyltransferase and recognition proteins. Multiple biochemical test results indicated increased ferroptosis, characterized by changes such as decreased mitochondrial membrane potential and GSH and increased ROS, MDA, and Fe2+. CONCLUSION:This study suggests that SCs in the cremaster muscle is associated with impaired cremaster muscle repair and VC pathogenesis through m6A modification of TFRC mRNA. Our findings offer fresh insights into the role of cremaster SCs in VC and provide a foundation for future research on the potential therapeutic target of VC. STRENGTHS AND LIMITATIONS OF THIS STUDY:This study is the first to investigate the pathogenesis of varicocele from the perspective of the cremaster muscle, and some clues have been discovered from it. The causal relationship between m6A-TFRC axis and ferroptosis requires further validation using functional rescue experiments (e.g., METTL3 knockdown or ferroptosis inhibitors). The small sample size may limit statistical power; future studies with larger cohorts are warranted.

Background:Wilms tumor (WT) is the most common pediatric malignant renal tumor in children. Overall, the prognosis for recurrent WT remains poor, with an overall survival (OS) rate of approximately 50%. This study aimed to characterize the clinical features and outcomes of patients with relapsed unilateral WT. Methods:We conducted a retrospective study of patients diagnosed with and treated for relapsed unilateral WT at Beijing Children's Hospital between January 2010 and December 2022. Results:A total of 46 patients with recurrent WT were included in the study. The 5-year event-free survival (EFS) and OS rates from the time of first relapse were 44.5% [95% confidence interval (CI): 28.4-59.4%] and 54.7% (95% CI: 37.4-69.0%), respectively. Multivariable Cox proportional hazards regression analysis revealed that early relapse and nonoperative management after relapse were independent risk factors for a second recurrence. Patients who relapsed within six months had a significantly higher risk of second recurrence than those who relapsed after six months [hazard ratio (HR) 3.0; 95% CI: 1.1-8.8; P=0.03]. Patients who did not undergo surgery after relapse had a significantly higher risk of second recurrence than those who did (HR 3.9; 95% CI: 1.4-11.4; P=0.01). In addition, the only factor significantly associated with OS in this cohort was the histology of the initial tumor. Focal or diffuse anaplasia in the initial tumor was associated with a markedly higher risk of death (HR 10.3; 95% CI: 2.1-50.9; P=0.007). Conclusions:We emphasize the importance of identifying adverse risk factors for recurrent WT. Early relapse (within six months) and nonoperative management after relapse are independent predictors of a second recurrence. Furthermore, unfavorable histology of the initial tumor independently predicts mortality in recurrent WT.

To investigate the long-term natural history of fetal hydronephrosis (FH) in a Chinese population, identify key prognostic factors, and optimize evidence-based postnatal management strategies using the Urinary Tract Dilation (UTD) classification system. A hybrid retrospective-prospective cohort study was conducted among 49,097 pregnant women who received prenatal screening at Beijing Children’s Hospital Shunyi Women’s and Children’s Hospital between January 2010 and March 2020. A total of 2,263 fetuses were diagnosed with hydronephrosis and followed for 5 years. Prenatal ultrasound parameters (anteroposterior renal pelvic diameter [APD], renal parenchymal thickness, and A/R ratio) and postnatal outcomes (surgery, urinary tract infections, hypertension) were analyzed. Cases were stratified into UTD A1 (low-risk) and A2 3 (high-risk) groups. Statistical analyses included generalized linear mixed-effects models (GLMM), cumulative link mixed models (CLMM), and generalized linear models (GLM). The incidence of fetal hydronephrosis was 4.61

Background:Many factors influence the risk of breakthrough urinary tract infection (BTUTI) in children with primary vesicoureteral reflux (VUR). Distal ureteral diameter ratio (UDR) and VUR index (VURx) have been shown in studies as predictors of BTUTI. We aimed to establish a predictive model through selecting voiding cystourethrography (VCUG)-related parameters in combination with clinical parameters for BTUTI in children with primary VUR. Methods:A retrospective cohort analysis was conducted on the clinical characteristics and VCUG-related parameters of patients with primary VUR. Univariable and multivariable analyses were performed to identify independent predictors and develop a model for predicting the probability of BTUTI. We compared our model against two other metrics for predicting BTUTI: the distal UDR and the VURx. The area under the receiver operating characteristic (ROC) curve (AUC), calibration curve, and decision curve analysis (DCA) were used to evaluate the predictive performance of the model. Results:A total of 193 patients were included in this study. Based on the results of univariable and multivariable analyses, three variables of sex (female) [odds ratio (OR): 3.39; 95% confidence interval (CI): 1.57-7.33], high-grade VUR (OR: 2.27; 95% CI: 0.98-5.25), and ureterovesical junction diameter of ureter (UVJ diameter) (OR: 5.85; 95% CI: 1.81-18.92) were used to create a prediction model and a nomogram. The AUCs for our model, the UDR, and the VURx in predicting the occurrence of BTUTI were 0.736, 0.680, and 0.546, respectively. The DCA revealed the clinical usefulness of the model. Conclusions:This study identified three independent variables, namely, female sex, high-grade VUR, and UVJ diameter, for predicting the probability of BTUTI in primary VUR. The model and nomogram established in this study can greatly assist urologists in individualizing the management of primary VUR patients.

Techniques: Robotic laparoendoscopic single-site (R-LESS) surgery system can achieve comparable perioperative outcome, reduced pain level, shorter length of hospitalization and better cosmetic outcome when compared to conventional multiport robotic surgery system. The SHURUI single-port robotic surgical platform (SR-SP), a novel R-LESS surgery system, accommodates four bendable snake-shaped robotic arms constructed with dozens of super elastic nitinol alloy rods, providing enough driven force and ensuring reliability. This surgical system has been applied in adult urologic surgery, gynecological surgery and general surgery. In this study, we present our technique of transperitoneal robotic assisted laparoscopic pyeloplasty (RALP) with SR-SP in a child. Results: This ten-year old boy, diagnosed with left side ureteropelvic junction obstruction, accepted RALP by using SR-SP. A step-by-step surgical procedure walkthrough was illustrated in the video. The surgery was completed without conversion. The total operative time and console time were 159 min and 102 min, respectively. The estimated blood loss was 5 ml. The patient was discharged 6 days after surgery. The JJ stent was removed 4 weeks after surgery. No intraoperative or postoperative complication was reported. APRPD reduced to 4 cm and left side DRF increased to 35 %. The cosmetic outcome was satisfactory. Conclusions: SR-SP for RALP is applicable in elder children. Further follow-up of the patient's long-term prognosis and more experiences are demanded to explore the preliminary safety and efficacy of this surgical platform.

To summarize our treatment experience of acute urethral trauma in pre-pubertal girls. We retrospectively analyzed six pre-pubertal girls with acute severe urethral trauma who were admitted to our hospital from April 2003 to April 2023 and followed up. All six patients had pelvic fractures and vaginal injuries, and one had a rectal injury. Five showed a large amount of fresh blood flowing from the perineum and an inability to urinate. However, the remaining patient had a more insidious onset, causing the emergency doctors to miss the diagnosis. Four had severe perineal tearing and had lost their normal urethral and vaginal openings, making urinary catheter insertion impossible. The diagnosis was very clear. The other two were diagnosed with urethrovaginal injury during cystourethroscopy. Five underwent urethral and vaginal repair surgery within 7 days after the injury, and two of them developed complications requiring endoscopy or reoperation. Postoperative questionnaire scoring showed that four patients had normal urinary function and two had mild dysfunction. The diagnosis of acute urethral injury in girls needs doctors’ attention. If the patient’s vital signs are stable, urgency urethrovaginal repair surgery can be performed. Although this is difficult and requires experienced pediatric urologists, it facilitates discovery of concurrent injuries.

ABSTRACT:Isolated male epispadias typically presents with preputial defects and dorsal urethral dehiscence. A less common subtype, known as concealed epispadias, is distinguished by an intact prepuce. Despite its clinical relevance, there is limited literature on this variant. In this study, we retrospectively analyzed the clinical data of 86 pediatric patients with isolated male epispadias treated in Beijing Children's Hospital (Beijing, China) from May 2004 to July 2023, including 19 cases of concealed epispadias and 67 of nonconcealed epispadias. We compared clinical characteristics, preoperative diagnostics, surgical techniques, postoperative outcomes, and sexual function during follow-up between the concealed and nonconcealed groups. No significant differences were observed between the two groups regarding surgical methods, postoperative complications, or rates of urinary incontinence. However, notable distinctions were found in the age at initial diagnosis, timing of surgery, frequency of incontinence, location of the urethral meatus, and postoperative urinary incontinence scores (all P < 0.05). Given the absence of penopubic epispadias in concealed cases, we categorized glans and penile epispadias within nonconcealed epispadias as distal epispadias ( n = 40) and subsequently compared them with concealed epispadias cases. The postoperative urinary incontinence scores did not differ significantly between the concealed and distal epispadias groups. These findings suggest that concealed epispadias represents a relatively milder form of the condition, characterized by the absence of penopubic involvement, lower rates of urinary incontinence, and favorable surgical outcomes. However, the intact prepuce in concealed cases underscores the need for careful identification and early diagnosis.

OBJECTIVE:This study outlines the diagnosis, treatment, and follow-up protocols for pediatric bladder urothelial tumors, sharing insights from clinical experience to assist pediatric surgeons. METHOD:A retrospective analysis was conducted on medical records from January 2006 to January 2024, involving 17 pediatric cases treated at our hospital. The patients were categorized into two groups: Group 1 included children diagnosed with the pathological type "urothelial papilloma" (UP), while Group 2 consisted of those with the pathological type "papillary urothelial neoplasm of low malignant potential" (PUNLMP). The primary outcomes of the study were the presence or absence of recurrence. RESULTS:The average age of the patients was 10.5 years, with all patients being male. Gross hematuria was the predominant symptom, observed in 88.2% of cases. All patients underwent a urinary ultrasound examination. Open resection of bladder tumors was performed in 82.3% of patients, while the remainder underwent transurethral resection of bladder tumors (TURBT) surgery. Pathologic findings revealed UP in 11 cases and PUNLMP in 6 cases. The median follow-up duration was 46 months. Two out of the six PUNLMP patients received postoperative chemotherapy with bladder instillation, while the remaining 4 patients did not receive this treatment. Among those not treated, one patient experienced a recurrence 25 months after the initia surgery. Subsequently, the patient underwent a second bladder tumor resection and received intravesical chemotherapy. No recurrences were noted following bladder instillation chemotherapy. CONCLUSION:Children presenting with gross hematuria should be evaluated for bladder urothelial tumors. Timely ultrasonography aids in diagnosis. The prognosis for children with this condition is favorable, although recurrence is possible. Ultrasound monitoring is crucial during follow-up, and prophylactic bladder instillation chemotherapy may be considered for children with PUNLMP to reduce recurrence risk, though further evidence is required to validate this approach. LEVELS OF EVIDENCE:Level III.