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Cryptorchidism (undescended testis) is one of the most common diagnoses in the pediatric urologist office. Even in the modern era, there still are a lot of debates regarding the optimal time for surgery related to the expected results in relation with the testicular function, including fertility. The review below intends to clarify issues regarding the impact of cryptorchidism on testicular histology and function, semen analysis, the relation between hormonal and surgical treatment, future fertility, and paternity rate.

We describe an unfavourable outcome for the conservative management applied to a case of placenta percreta in a 32 year-old woman who referred to our obstetrics department with irregular vaginal bleeding. Her medical history pointed out she had undergone a corporeal caesarean one month before. Ultrasonography revealed a hyperechoic mass in the uterine cavity. After careful investigation by serial values of beta HCG, ultrasound, magnetic resonance imaging (MRI) and exploratory cystoscopy for assessing the degree of placental accretisation we decided to perform an inter-adnexal total hysterectomy with bilateral hypogastric artery ligation. To prevent immediate complications an early diagnosis and a prompt evaluation of the bleeding are important, while a careful follow up is also necessary for predicting any subsequent serious consequences.

This article reviews the latest information about preserving reproductive potential that can offer enhanced prospects for future conception in the pediatric male population with cancer, whose fertility is threatened because of the gonadotoxic effects of chemotherapy and radiation. An estimated 400,000 children and adolescents aged 0–19 years will be diagnosed with cancer each year. Fertility is compromised in one-third of adult male survivors of childhood cancer. We present the latest approaches and techniques for fertility preservation, starting with fertility preservation counselling, a clinical practice guideline used around the world and finishing with recent advances in basic science and translational research. Improving strategies for the maturation of germ cells in vitro combined with new molecular techniques for gene editing could be the next scientific keystone to eradicate genetic diseases such as cancer related mutations in the offspring of cancer survivors.

Acute acalculous cholecystitis associated with Epstein Barr virus (EBV) infection is a known entity, as opposed to the extremely rare cases of cystic duct stenosis secondary to EBV- related inflammation. The authors present the case of a 10-year-old male patient admitted with altered general state, anorexia, painful and distended abdomen. The patient had a history of EBV acute hepatitis two years prior to the current presentation, diagnosed based on clinical examination (fever, vomiting, and severe pain of right upper abdominal quadrant), and abdominal ultrasound revealing acute acalculous cholecystitis with gallbladder hydrops; still no indication for surgical treatment was made. The clinical outcome was favorable, but during those two years he suffered two episodes of chronic acalculous cholecystitis exacerbation, which required a MRI examination, indicating gallbladder hydrops and narrowing of terminal segment of the cystic duct (secondary inflammatory processes). The biological investigations revealed cholestasis, hepatocytolysis and inflammatory syndrome and the abdominal-ultrasound indicates an acalculous gallbladder and gallbladder hydrops. After cholecystectomy, the histopathological examination revealed chronic inflammation of the gallbladder wall, setting the diagnosis of exacerbation of chronic acalculous cholecystitis. Particularly for the case is the development of cystic duct stenosis, after the EBV acute infection. The clinical and laboratory outcome (monitored after 1, 3, 6, and 12 months) was favorable.

Introduction: The main goal of surgery and multidisciplinary behavioral therapy in anorectal malformations (ARMs) is to achieve good anatomical and functional outcomes and a better quality of life. Material and Methods: A retrospective analysis of 146 patients with ARMs was conducted over a 20 years period in our pediatric surgery department. The clinical and demographical data, operative protocols, short and long term outcomes were subject to assessment. Results: The patient series included 85 boys and 61 girls aged between one day and two years, of which 82.19% were diagnosed in the first few days of life by means of clinical examination and current imaging tests. In 26.02% of cases we found associated congenital abnormalities. A total of 142 (97.25%) cases of all our series underwent surgical treatment; four patients died before surgery. For 131 children the definitive treatment involved posterior sagittal anorectoplasty (PSARP) respectively 11 posterior sagittal anorectovaginourethroplasty (PSARVUP). Long-term followup in 115 patients showed good clinical continence in 82 cases (71.30%) but more than half of the teenagers had body dissatisfaction and social difficulties. Conclusions: Through this review of 20 years of experience our findings are consistent with other reports regarding male predominance, low birth weight, clinical and imaging diagnosis. We found however a lower incidence of associated abnormalities. The most frequent surgical intervention was posterior sagittal anorectoplasty (PSARP) or posterior sagittal anorectovaginourethroplasty (PSARVUP), both followed by satisfactory functional outcome reporting nevertheless moderate social insertion. Our experience in ARMs proved the effectiveness of the consecrated surgical strategy; long-term assistance for patients and their families should be improved.