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.

Renal artery stenosis and ipsilateral renal cell carcinoma: description of an in situ partial nephrectomy and splenorenal arterial bypass.

A case of a renal artery stenosis and ipsilateral renal cell carcinoma with long term results is reported. A 65-year-old man with renovascular hypertension, renal insufficiency, and nephrotic range proteinuria presented with an incidental renal cell carcinoma. Concomitant in situ left partial nephrectomy and splenorenal arterial bypass was achieved. The patient is doing well without evidence of malignancy, stable renal function, markedly improved proteinuria and stable blood pressure more than three years later. The techniques of this procedure are detailed and underscore the possibility of successful removal of a renal cell carcinoma with preservation of renal function despite renal artery stenosis.

Flow cytometry analysis of proliferative lesions at the gastrocystoplasty anastomosis.

PURPOSE: Proliferative epithelial metaplasia that develops in the anastomotic line after gastrocystoplasty has unknown malignant potential. Flow cytometry analysis of cell cycle profiles is used to predict the neoplastic progression of metaplastic lesions in other proliferative epithelium. We used this technique to evaluate transitional cell metaplasia in rat gastrocystoplasty specimens. MATERIALS AND METHODS: A total of 50 prepubescent female Long-Evans rats were randomly assigned to an experimental group (gastrocystoplasty) or a control group (sham operation). At 21 to 27 months (mean 24.9) after operation 12 rats per group survived to sacrifice. Metaplastic lesions were microdissected to yield a minimum of 10(4) cells for DNA flow cytometry and cell cycle analysis. Transitional cell epithelium from sham specimens and gastric epithelium from experimental animals served as controls. RESULTS: Transitional cell hyperplasia and metaplasia with cyst formation were found in the anastomotic line in all 12 augmented bladders (100%). No proliferative lesions developed in control animals. No nuclear pleomorphism or mitotic changes were identified on routine histological examination. The epithelial cell turnover rate was 10 times higher in the gastrocystoplasty junctional zone than in control bladders (mean 2.2% versus 0.1% S phase) but lower than in native stomach epithelium (mean 3.3% S phase). Of 12 experimental specimens 1 showed near diploid DNA aneuploidy. No DNA abnormalities were detected in control bladder or stomach specimens. CONCLUSIONS: In this animal model histologically benign appearing proliferative lesions that develop in the anastomotic zone after long-term gastrocystoplasty harbor cell cycle and DNA ploidy abnormalities.