Abdominoscrotal hydrocele in an infant boy.

Abdominoscrotal hydrocele (ASH) is the rarest type of hydrocele. This condition is characterised by a large abdominal and scrotal component connected by an isthmus within the inguinal canal. The incidence among the paediatric population is reported to be less than 3%, although it might be underdiagnosed. Several theories have been proposed in the literature but the aetiology of ASH remains unknown. Diagnosis can be made clinically and confirmed by ultrasound. Spontaneous resolution is rare and long-standing ASH may lead to complications, thus early surgical intervention is recommended. Different techniques have been described, but dissection remains challenging due to the tunica vaginalis adherence to the testis and the distal cord. We present a male infant with ASH who underwent inguinal repair. The procedure was facilitated by needle decompression of the mass. Identification and preservation of the vessels and vas deferens was done successfully without compromising the testis.

Paraurethral cysts in newborn girls.

The Skene's glands are located in the distal urethral floor, and they are the largest paraurethral glands. Skene's gland cysts are unusual at any age, but specially newborns. However, due to lack of systematic reporting, true incidence is probably higher than the one described in the literature. We present a newborn girl found to have a paraurethral cyst at birth. Characteristic displacement of the urethral opening was revealed on catheterisation. Review of literature, and comparison to a similar case of interlabial mass previously evaluated, were carried out. We suggest a prenatal development possibly due to maternal oestrogen exposure, although further studies are necessary to determine the exact aetiology. Treatment options include observation, needle aspiration and incisional drainage, partial excision, unroofing and marsupialisation. Expectant management is preferred in asymptomatic cases, particularly in newborns, since spontaneous resolution can occur without long-term sequalae or recurrence. Cases with acute obstruction require immediate surgical management.