Pediatric Urology Case Reports

116-120

Authors: Paarth Kapadia, Shreeya Popat, Angela G. Mittal

Hydrocolpos is a rare congenital genitourinary anomaly that can cause clinically significant urinary tract obstruction with oligohydramnios and hydronephrosis antenatally and renal failure postnatally. Here, we discuss the management of a neonate with hydrocolpos and renal failure. Vaginostomy tube and bladder catheterization have been described previously. However, in this population, external tubes can be difficult to manage and have a high propensity of failure. Therefore, the patient was managed via creation of a vaginostomy, which allowed for continuous passive drainage of fluid into a diaper and maintained a decompressed urinary tract until further reconstruction could be pursued.

126-130

Authors: William J. Scott, Aaron J. Shaw, Kenice D. Ferguson-Paul

Perinephric abscess is an uncommon infection in children, but it is usually caused by Escherichia coli, Staphylococcus aureus, Proteus mirabilis and Pseudomonas aeruginosa. Group B Streptococcus (GBS) is an uncommon cause of perinephric abscess or serious bacterial infections beyond the neonatal period. Comorbid conditions such as diabetes mellitus and immunosuppression can increase the risk of GBS invasive disease. We describe a 10-year-old female who presented with 1-month of right-sided flank pain and swelling with ultrasound showing large (>3 cm) right perinephric and subcutaneous abscesses. She was additionally diagnosed with new onset type 2 diabetes mellitus (DM) during admission. Abscess cultures obtained after placement of two percutaneous drains and the initiation of broad-spectrum intravenous antibiotics grew beta-hemolytic GBS. Here, we present to our knowledge, the first known documented case of GBS perinephric abscess in a school-aged child with DM. Much of the knowledge of perinephric abscess management is extrapolated from adults, therefore making optimal treatment in the pediatric population challenging. We propose that GBS be considered in the etiology of perinephric abscess in children with DM and other immunosuppressing conditions. In addition, percutaneous drainage of larger abscesses (>3 cm) in conjunction with antibiotic therapy is a reasonable management strategy.

136-139

Authors: Sevinc Akdeniz, Ulas Alabalik, Mehmet Hanifi Okur

We report the case of a 16-year-old female with a huge mass (40 × 30 × 40 cm) on the left ovary, causing mild bilateral hydronephrosis. Ultrasonography and computed tomography allowed us to diagnose this condition and showed an associated uretero-hydronephrosis. A unilateral salpingooophorectomy was performed on the left ovary, and final pathology revealed a mature cystic teratoma. The patient did not experience any problems in the follow-up six months later, and her hydronephrotic appearance disappeared.