In the United States, circumcision is a commonly performed procedure. It is a relatively safe procedure with a low overall complication rate. Most complications are minor and can be managed easily. Though uncommon, complications of circumcision do represent a significant percentage of cases seen by pediatric urologists. Often they require surgical correction that results in a significant cost to the health care system. Severe complications are quite rare, but death has been reported as a result in some cases. A thorough and complete preoperative evaluation, focusing on bleeding history and birth history, is imperative. Proper selection of patients based on age and anatomic considerations as well as proper sterile surgical technique are critical to prevent future circumcision-related adverse events.

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OBJECTIVE To present our initial experience in children undergoing single‐port laparoscopic varicocelectomy (SPLV) using a new approach in which the entire procedure is performed through a multichannel single laparoscopic port inserted in the umbilicus rather than the traditional LV performed through three abdominal ports. PATIENTS AND METHODS We reviewed our experience with all paediatric patients who had undergone transumbilical SPLV [Uni‐XTM Single Port Access Laparoscopic System, Pnavel Systems, NJ, USA]. This novel 20‐mm laparoscopic port has three working channels and gas insufflation access. The system also includes a variety of curved laparoscopic instruments that can be introduced through the SP. A Hassan technique through an incision within the inferior aspect of the umbilicus is used to obtain laparoscopic port access to the abdominal cavity. The SP is then fixed into position with pre‐placed rectus facial sutures. Using a curved laparoscopic grasper and scissors, an incision is made within the posterior peritoneum on the medial and lateral aspects of the left testicular artery and veins, proximal to the vas deferens. The vessels, both artery and veins, are transected leaving clips both proximally and distally. RESULTS Transumbilical SPLV was completed in three consecutive adolescents (aged 13, 15 and 16 years) without placing any additional ports or conversion to open surgery. All procedures were performed for left‐sided grade III varicoceles. The operative duration was <1 h for each procedure. All patients were discharged on the same day as their surgery and none required re‐hospitalization. At a mean (range) follow‐up of 8.7 (6–10) weeks there was a good cosmetic result, with no varicocele recurrence, or intraoperative or postoperative complications including wound infection, hydrocele, or incision site herniation. CONCLUSION We report the first use of a multicannula single laparoscopic port in children and for SPLV. This new laparoscopic approach, similar to any new technique, requires further experience to fully evaluate its benefits and limitations.

Goal: We propose a speech modeling and signal-processing framework to detect and track COVID-19 through asymptomatic and symptomatic stages. Methods: The approach is based on complexity of neuromotor coordination across speech subsystems involved in respiration, phonation and articulation, motivated by the distinct nature of COVID-19 involving lower (i.e., bronchial tubes, diaphragm, lower trachea) versus upper (i.e., laryngeal, pharyngeal, oral and nasal) respiratory tract inflammation [1], as well as by the growing evidence of the virus' neurological manifestations [2]-[5]. Preliminary results: An exploratory study with audio interviews of five subjects provides Cohen's d effect sizes between pre-COVID-19 (pre-exposure) from post-COVID-19 (after positive diagnosis but asymptomatic) using: coordination of respiration (as measured through acoustic waveform amplitude) and laryngeal motion (fundamental frequency and cepstral peak prominence), and coordination of laryngeal and articulatory (formant center frequencies) motion. Conclusions: While there is a strong subject-dependence, the group-level morphology of effect sizes indicates a reduced complexity of subsystem coordination. Validation is needed with larger more controlled datasets and to address confounding influences such as different recording conditions, unbalanced data quantities, and changes in underlying vocal status from pre-topost time recordings.

The aim of the study herein reported was to review mobile health (mHealth) technologies and explore their use to monitor and mitigate the effects of the COVID-19 pandemic. Methods: A Task Force was assembled by recruiting individuals with expertise in electronic Patient-Reported Outcomes (ePRO), wearable sensors, and digital contact tracing technologies. Its members collected and discussed available information and summarized it in a series of reports. Results: The Task Force identified technologies that could be deployed in response to the COVID-19 pandemic and would likely be suitable for future pandemics. Criteria for their evaluation were agreed upon and applied to these systems. Conclusions: mHealth technologies are viable options to monitor COVID-19 patients and be used to predict symptom escalation for earlier intervention. These technologies could also be utilized to monitor individuals who are presumed noninfected and enable prediction of exposure to SARS-CoV-2, thus facilitating the prioritization of diagnostic testing.

Our study shows that passive dilation of the ureteral orifice in preparation for ureteroscopy is a straightforward, successful and beneficial technique in children, with no associated complications.

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Although it is rare in children, any solid scrotal mass in prepubertal males warrants evaluation for possible testicular or paratesticular neoplasm.