[Cryptorchidism: anomalies of the secretory ducts and azoospermia]. / II criptorchidismo: anomalie dei dotti escretori ed azoospermia.

A range of epididymal and vasal anomalies (EVA), varying from ductal patency aberrations to abnormal attachments of the epidydimis to the testis or even complete absence, exists in boys with cryptorchidism, but there are few studies of normal controls for comparison. In the present study anatomy of testicular-epididymal relationships were recorded in 517 cryptorchid patients (423 unilateral and 94 bilateral) and in 192 boys who underwent inguinal exploration for inguinal hernia or hydrocele. The postmortem anatomic relationship of the testis and epididymis in 50 adults was also examined. The operative findings were divided into two groups: simple variants of normal and forms of complete anatomic disconnection of the spermatic ducts (EVA). We were unable to find EVA in the control groups. In contrast EVA was present in the 20% of cryptorchid patients. The incidence was 16.5% in unilateral cryptorchidism and 26% in bilateral cases, in 17% of whom the EVA was bilateral. According to the literature and our previous study azoospermia is present in about 18-20% of adults operated upon in childhood for bilateral cryptorchidism. Our present study may suggest that azoospermia in adults operated on for bilateral cryptorchidism could be partially related to some forms of bilateral occlusion or interruption of the spermatic ducts.

[Renin-dependent arterial hypertension in polycystic kidney operated on at a late period]. / Ipertensione arteriosa renino-dipendente in rene multicistico operato tardivamente.

A case of a 17 year-old male patient developing renin dependent hypertension 3 years after nephrectomy for multicystic dysplastic kidney is reported. The risks of arterial hypertension in adolescence and adulthood as well as malignancy strongly suggest, at least in our opinion, precocious prophylactic nephrectomy.

[Medullary sponge kidney with severe renal function impairment: a case report]. / Rene a spugna midollare con grave compromissione della funzionalità renale: descrizione di un caso.

The term medullary sponge kidney refers as a renal parenchymal malformation characterized by cystic dilatation of the collecting ducts. Although medullary sponge kidney is a congenital disease, it is rarely identified in childhood and is usually discovered in adulthood. We report a child with bilateral medullary sponge kidney who, in addition to typical urographic findings, presented an unfavorable evolution that ended in renal chronic insufficiency. This outlook is uncommon and is described in only 10% of affected subjects.

[Cryptorchidism: anomalies of excretory ducts and azoospermia]. / Il criptorchidismo: anomalie dei dotti escretori ed azoospermia.

A range of epididymal and vasal anomalies (EVA), varying from ductal patency aberrations to abnormal attachments of the epididymis to the testis or even complete absence, exists in boys with cryptorchidism, but there are few studies of normal controls for comparison. In the present study anatomy of testicular-epididymal relationships were recorded in 517 cryptorchid patients (423 unilateral and 94 bilateral) and in 192 boys who underwent inguinal exploration for inguinal hernia or hydrocele. The postmortem anatomic relationship of the testis and epididymis in 50 adults was also examined. The operative findings were divided into two groups: simple variants of normal and forms of complete anatomic disconnection of the spermatic ducts (EVA). We were unable to find EVA in the control groups. In contrast EVA was present in the 20% of cryptorchid patients. The incidence was 16.5% in unilateral cryptorchidism and 26% in bilateral cases, in 17% of whom the EVA was bilateral. According to the literature and our previous study azoospermia is present in about 18-20% of adults operated upon in childhood for bilateral cryptorchidism. Our present study may suggest that azoospermia in adults operated on for bilateral cryptorchidism could be partially related to some forms of bilateral occlusion or interruption of the spermatic ducts.

[Mesenteric lymphangioma: report of a case]. / Linfangioma mesenterico: descrizione di un caso.

Lymphangiomas are benign tumours that appears to arise from congenital malformation of the lymphatics. They are most commonly reported in the head and neck regions. The clinical presentation, diagnosis and treatment of a rare case of mesenteric lymphangiomas are reviewed. Ultrasound and computed tomography are most useful in the intraabdominal cystic lesions for confirming the diagnosis. Intestinal and mesenteric resection, as soon as diagnosis is established, is the procedure of choice and results in an excellent outcome.

[True hermaphroditism in crossed testicular ectopy: report of a case]. / Ermafroditismo vero in ectopia testicolare crociata: descrizione di un caso.

Crossed testicular ectopia is a congenital anomaly characterized by the presence of both testes in the same hemiscrotum and may be associated in 20% of the cases with genitourinary developmental abnormalities. This review underscores the complexities of assessment and surgical management of an uncommon case in which crossed testicular ectopia and true hermaphroditism are simultaneously described.

[Spontaneous and traumatic rupture of the renal parenchyma in primary obstructive megaureter: a report of 2 cases]. / Rottura spontanea e traumatica del parenchima renale nel megauretere ostruttivo primitivo: descrizione di due casi.

Urinary extravasation in infants may occur secondary to a variety of congenital obstructive uropathic conditions. This condition has been reported most often in infants with posterior urethral valves and pelviureteral junction obstruction. We present two cases of perirenal urinary extravasation from the kidney due to primary obstructive megaureter. Clinical presentation, evaluation and treatment of this rare entity are discussed.

[The urological complications of renal ectopia in childhood]. / Le complicanze urologiche delle ectopie renali in età pediatrica.

Fifty-four cases of anomalies of position in 52 children were reviewed. Of the 52 children 24 (46%) had anomalies involving organs outside the urinary tract and contralateral renal units. Twenty-five ectopic kidneys showed major urological complications (46%). Four were treated conservatively and 21 with surgery. The postoperative results have been excellent in all the cases. Renal anomalies of position often are associated with congenital renal and extrarenal malformations. Nearly 50% of ectopic kidneys are involved by pathological process that often require surgery. Surgical treatment of urological complications of renal ectopia is discussed.

[Chondroid hamartoma of the thoracic wall: apropos of a case treated by extensive surgical exeresis]. / L'amartoma condroide della parete toracica: a proposito di un caso trattato con ampia exeresi chirurgica.

The Authors describe a case of chest wall hamartoma, very rare in infants and usually present at birth. This lesion, histologically, is benign. Surgical ablation is mandatory and curative, but the ablation of the tumor and the reconstruction of the large residual parietal defect are sometimes very difficult. In this case the surgical treatment was successful and the reconstruction of the thoracic cage was obtained with a particular surgical technique.

[Paraesophageal inflammatory pseudotumor in an 11-year-old girl]. / Pseudotumore infiammatorio paraesofageo in una ragazza di 11 anni.

Paraesophageal inflammatory pseudotumor is the cause of anaemia and intermittent fever. The surgical treatment determines a rapid and complete clinical resolution.

[Nephroblastoma with prevalent rhabdomyosarcomatous component. Description of a case with early cerebral metastasis]. / Nefroblastoma a prevalente componente rabdomiosarcomatosa. Descrizione di un caso con metastasi cerebrale precoce.

The malignant rhabdoid tumor of the kidney determines clinical and prognostic evaluations due to the poor therapeutic answer and to the uncertain prognosis. The Authors describe a case of nephroblastoma with anaplasia of the blastemal elements associated to rhabdomyosarcoma areas.

[Neonatal perirenal urine extravasation and urinary ascites associated with obstructive uropathy]. / Versamento urinoso perirenale ed ascite urinosa in epoca neonatale associati ad uropatia ostruttiva.

We report two cases of perirenal urinary extravasation one of which associated with urinary ascites. An underlying congenital obstructive uropathic condition was discovered in both patients. A localised parenchymal perforation was found in both cases. Prompt treatment with correction of metabolic acidosis and decompression of the tense abdomen and the urinary tract is recommended. The patients survive in good health.

[Hydronephrosis in childhood. Long and mid-term morphologic and functional results]. / L'idronefrosi in età pediatrica. Risultati morfologici e funzionali a medio-lungo termine.

Hydronephrosis in infancy and childhood is a frequent urinary malformation and is almost always congenital. In over 80% of the cases it is due to ureteropelvic junction obstruction; in about 17%, anomalous renal vessels at the ureteropelvic junction are present. The authors analyze their experience in the surgical treatment of hydronephrosis. 360 hydronephrosis out of 335 patients were operated on from November 1971 to November 1988. 108 patients were less than 1 year old (32.2%). Primary nephrectomy was carried out only in 11 of the 360 hydronephrosis operated on (about 3%). An anterior approach and a simple dismembering pyeloplasty were performed in the majority of the cases. From the radiological point of view there was an impressive amelioration or normalization in about 92% of the cases operated on. From the functional point of view the radionuclide scan showed a normal or slightly reduced renal function in almost 90% of the cases operated on. The preoperative and postoperative radionuclide study showed a moderate increase of the renal function in the majority of the cases controlled. The authors stress the importance of prenatal ultrasound diagnosis to improve long term results of an early surgical treatment.

[Retrotendinous ureter. An exceptional cause of obstruction in the upper urinary tract]. / Uretere retrotendineo. Una causa eccezionale di ostruzione del tratto urinario superiore.

Retrotendineus ureter is an exceptional anomaly presenting, in our experience, without clinical signs of urinary infection and obstruction. The radiological diagnosis was retrocaval ureter. The Authors report a case of a 9 years old boy who was successfully treated by ureteral section, excision of the obstructed ureteral segment and uretero-ureteral anastomosis. It seems that the case is the first reported in the medical literature of this anomaly.

[A rare cause of occult neuropathic bladder in children: the tethered cord syndrome]. / Una causa rara di vescica neuropatica occulta in età pediatrica: "the tethered cord syndrome".

The tethered cord syndrome is a form of spinal dysraphism in which a short, thickened filum terminale prevents the ascent of the conus medullaris and intraspinal lipoma causes compression upon the caudal part of the spinal cord. In pediatric age the first symptoms are urological: urinary incontinence and infection. Diagnosis is performed with urodynamic studies followed by nuclear magnetic resonance. Tethered cord syndrome is no obvious cause of a neurogenic bladder. When this pathological conditions is recognized properly and an operation is performed early the likelihood of improvement is rather high. The authors report a case of tethered cord syndrome in a girl seven years old.

[Inflammatory pseudotumor as a cause of obstructive jaundice. Report of a case in a child]. / Pseudotumore infiammatorio come causa di ittero ostruttivo. Segnalazione di un caso in età pediatrica.

Inflammatory pseudotumor involving the common bile duct, is a very rare event. The Authors were able to observe such a case in a 10 year old boy and report here the peculiar clinical findings.