Pediatric Urology Case Reports

69-72

Authors: Sudhir Singh, Jiledar Rawat

Hair tourniquet syndrome is characterized by circumferential strangulation of an appendages or genitalia by human hairs or fibres. Here we are reporting a rare case and its successful management of coronal urethrocutaneous fistula developed due to penile hair tourniquet syndrome (PHTS) in a 5 years old child

77-79

Authors: Omer Faruk Yagli, Ali Gokkaya

Testicular torsion is one of the most common causes of acute scrotum in children and adolescents. The bell-clapper deformity, which detected in 12% of males, is the most important reason that leads to testicular torsion. In our case, a 14 years old male admitted to our clinic due to testicular torsion developed after ejaculation with manual sexual stimulation of the penis. The most important criteria in determining the loss of testis is the degree and duration of torsion. Here, we discussed the rare cause of testicular torsion along with diagnostic and therapeutic characteristics.

84-88

Authors: Julian O. Galvis-Angulo, Sandra Milena Rueda-Quijano, Natalie Estefania Pinto-Briceño, Angie Lucía Méndez-Zaraza, Bernardo Santamaría-Fuerte, Armando J. Lorenzo, Victor H. Figueroa

Uretero-appendicular fistulas represents a rare entity, closely related to appendicitis and are usually encountered intraoperatively. A literature review showed six published cases –only one of them involving a pediatric patient. We describe the case of a ten year-old girl with history of recurrent urinary tract infections (UTIs) since the age of three. Following a six-year asymptomatic period, she was referred for evaluation after a new diagnosis of UTI complicated by a right distal ureteral stone. The patient underwent ureteroscopy and laser stone fragmentation. During the endoscopic procedure a mature, well-epithelialized ureteral tract to the peritoneal cavity was encountered. The procedure was converted to open exploration through a right Gibson incision, where an appendicular phlegmon associated with an uretero-appendicular fistula with passing of faecoliths to the ureteral lumen was found. An appendectomy was performed along with primary fistula closure. Uretero-appendicular fistulas represent a rare entity. Our case highlights the relation between this type of fistula with appendicitis, its unexpected intraoperative diagnosis and the unusual presentation, as the patient did not present clinical findings compatible with acute abdomen.

94-98

Authors: Gursev Sandlas, Bhushanrao Bhagawan Jadhav

Bladder exstrophy is a rare developmental anomaly. Four principle variants of bladder exstrophy have been described and they themselves are rarer than the bladder exstrophy. Authors describe the management of a case of pseudoexstrophy type of variant in a 9 month old male child with penile duplication with torsion and coronal hypospadias. The rectal fascial defect was repaired without osteotomy as the distance between two pubic bones was <4 cm (3.1 cm). Genital reconstruction with excision of duplicate atrophic penile shaft and repair of coronal hypospadias with detorsion of the functional penile shaft could be accomplished. The patient had good outcome in terms of cosmesis and urinary stream. Total of 18 cases of the pseudoexstrophy have been described till date. Pseudoexstrophy of bladder is a very rare condition and can simultaneously present with other defects like omphalocele, anorectal malformations, pouch colon, multiple or solitary urogenital anomalies. The principles of correction though remain same with correction of abdominal wall defect with or without osteotomy depending upon severity of pubic diastasis. Other anomalies can undergo treatment as per standard protocol.