Our 10-year experience of variable Müllerian anomalies and its management.

PURPOSE: Though the Müllerian duct anomalies are rare in incidence, their variable age, and mode of presentation makes their management difficult. METHODS: In the last 10 years authors managed 14 patients with different types of Müllerian anomalies. There were eight patients with complete Müllerian agenesis: three of partial Müllerian agenesis, one patient had uterine didelphys with vertical and transverse vaginal septum on left side, one patient had uterine didelphys with cervical agenesis on the right side, one patient had MRKH with anorectal malformation. RESULTS: Patients with complete Müllerian agenesis underwent bowel vaginoplasty, and patients with partial Müllerian agenesis with hydrocolpos underwent pull-through vaginoplasty. Patient of uterine didelphys one with septum underwent septum excision and in another with cervical agenesis, cervix opened and drain kept. In MRKH with vestibular fistula, fistulous opening was kept as vaginal opening and rectum brought down as a neoanus. CONCLUSION: Müllerian duct anomalies can present in any age group and with variable symptoms. Sigmoid colon vaginoplasty is an excellent procedure for complete or partial Müllerian agenesis. Correct evaluation of these patients and proper management is a challenge.

Mesentric cyst- an unusual presentation as inguinal hernia.

Mesenteric cyst is one of the uncommon childhood tumors. Mostly they are asymptomatic. Some of them present with non specific abdominal symptom like chronic abdominal pain very rarely they present as acute abdomen like torsion or intestinal obstruction. We are reporting a very rare presentation of Mesenteric cyst as an irreducible inguinal hernia.

Hypospadias with dorsal chordee: Case report of a novel approach for correction.

We report a novel surgical technique for correction of dorsal chordee with coronal hypospadias. The bulbar elongation and anastomotic meatoplasty procedure gave an excellent cosmetic and functional outcome.

Urethral duplication in children: our experience of eight cases.

OBJECTIVE: Duplication of urethra has varied presentations and multiple techniques have been described for its correction. We present our experience in the management of this anomaly. MATERIAL AND METHOD: We retrospectively reviewed the records of eight patients treated for urethral duplication in 1998-2008. We managed four cases of Y-duplication, three of whom underwent buccal mucosal tube urethroplasty and one urethrourethrostomy. Two patients presented with double stream (type II A2); in one urethrourethrostomy was done and the other child underwent vesicostomy as initial treatment. Two cases were of type II B duplication (two urethra opening as single meatus); one required only dilatation of urethra and the other excision of accessory tract. RESULT: Mean age at presentation was 56.9 months. Associated anomaly was present in only two patients. Single-stage procedure was done in four patients and multi-staged procedure in three patients. Overall mean number of procedures required was 2.8; more were required in the case of Y-duplication compared to the other types. On follow-up all patients were passing urine in single stream. CONCLUSION: Thorough work up to detect any associated anomaly and type of duplication is required for the management of urethral duplication. Single-stage repair with buccal mucosa as tube urethroplasty in cases of Y-duplication is feasible with good outcome.