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Introduction Fibroepithelial polyps (FEP) of the lower urinary tract are relatively common in adults but rare in children, with fewer than 250 cases reported in the literature to date. Objective The aim of this study was to address the experience of FEP management in children. Study design A retrospective multicenter review was undertaken in children with defined FEP of the lower urinary tract managed between 2008 and 2018. The data at 18 pediatric surgery centers were collected. Their demographic, radiological, surgical, and pathological information were reviewed. Results A total of 33 children (26 boys; 7 girls) were treated for FEP of the lower urinary tract at 13 centers. The most common presentation was urinary outflow as hematuria (41%), acute urinary retention (25%), dysuria (19%), or urinary infections (28%). A prenatal diagnosis was made for three patients with hydronephrosis. Almost all of the children (94%) underwent ultrasound imaging of the urinary tract as the first diagnostic examination, 23 (70%) of them also either had an MRI (15%), cystourethrography (25%), computerized tomography (6%), or cystoscopy (45%). Two of these children (6%) had a biopsy prior to the surgery. The median preoperative delay was 7.52 (range: 1–48) months. Most of the patients were treated endoscopically, although four (12.1%) had open surgery and two (6.1%) had an additional incision for specimen extraction. The median hospital stay was 1.5 (range: 1–10) days. There were no recurrences and no complications after a median follow-up of 13 (range: 1–34) months. Discussion The main limitation of our study is the retrospective design, although it is the largest one for this pathology. Conclusion This series supports sonography as the most suitable diagnosis tool before endoscopy to confirm the diagnosis and to perform the resection for most FEP in children. This report confirms the recognized benign nature in the absence of recurrences. Level of Evidence Level V.

Here we investigated the role of murine mast cell protease 4 (MCPT4), the functional counterpart of human mast cell chymase, in an experimental model of renal ischemia reperfusion injury, a major cause of acute kidney injury. MCPT4-deficient mice had worsened kidney function compared to wildtype mice. MCPT4 absence exacerbated pathologic neutrophil infiltration in the kidney and increased kidney myeloperoxidase expression, cell death and necrosis. In kidneys with ischemia reperfusion injury, when compared to wildtype mice, MCPT4-deficient mice showed increased surface expression of adhesion molecules necessary for leukocyte extravasation including neutrophil CD162 and endothelial cell CD54. In vitro, human chymase mediated the cleavage of neutrophil expressed CD162 and also CD54, P- and E-Selectin expressed on human glomerular endothelial cells. MCPT4 also dampened systemic neutrophil activation after renal ischemia reperfusion injury as neutrophils expressed more CD11b integrin and produced more reactive oxygen species in MCPT4-deficient mice. Accordingly, after renal injury, neutrophil migration to an inflammatory site distal from the kidney was increased in MCPT4-deficient versus wildtype mice. Thus, contrary to the described overall aggravating role of mast cells, one granule-released mediator, the MCPT4 chymase, exhibits a potent anti-inflammatory function in renal ischemia reperfusion injury by controlling neutrophil extravasation and activation thereby limiting associated damage.

A small proportion of patients with EB develop genitourinary disorders, which can nevertheless have a major impact on their morbidity. We present the case of a 7-year-old boy with junctional EB who presented with dysuria and lower back pain caused by bladder lithiasis complicating posterior urethral stenosis, surgical management, and postoperative outcomes.

Large and rapidly growing abdominal tumors endanger vital prognosis in neonates. Sometimes, quickly worsening patients’ clinical conditions demand surgical decision-making that cannot wait for precise histological diagnosis. There is neither consensus nor rules to manage these situations. We presented our experience with five patients and we looked in the literature for the best possible management of such rare disease. Laparostomy should be considered only as a safe-life procedure and if the liver is affected by the tumor and a coagulopathy is present, the prognosis is often compromised.

Prematurity affects 6.6 % of births in France [1,2]. It is the first cause of neonatal mortality [3]. It induces a high rate of neonatal morbidity correlated with gestational age...

Objectifs : Faire le recensement des internes et chefs de clinique des universites-assistants des hopitaux (CCA) en formation en chirurgie pediatrique et analyser les resultats en fonction des besoins de la specialite. Materiel et methodes : Les donnees concernant la demographie des chirurgiens pediatres en formation ont ete recueillies par un questionnaire adresse aux internes, CCA et coordonnateurs interregionaux de la specialite, de septembre 2009 a mars 2010. Les informations suivantes ont ete recueillies : nom et prenom, sexe, annee de validation du concours de l’internat ou des epreuves classantes nationales, orientation choisie en chirurgie pediatrique, le centre hospitalier universitaire (CHU) de formation durant l’internat, lieu d’exercice. Resultats : Cinquante-trois internes sont inscrits en diplome d’etudes specialisees complementaires (DESC) de chirurgie infantile avec une orientation urologique, viscerale, thoracique ou plastique et vingt-et-un en orthopedie pediatrique. Par ailleurs treize internes en DESC d’orthopedie adulte vont s’orienter vers l’orthopedie pediatrique. La repartition des internes sur le territoire montre des differences importantes entre les inter-regions. Il existe 55 postes de CCA en chirurgie pediatrique. Conclusion : Cette etude devra servir de socle aux reflexions engagees par la Commission nationale de l’internat et du post-internat. Le nombre important d’internes formes chaque annee montre l’attractivite de la chirurgie pediatrique pour les chirurgiens en formation. Il nous alerte sur la necessite d’adapter la formation des chirurgiens pediatres aux capacites de formation de notre systeme de sante et aux besoins de sante de la population francaise.