Complex case of ureteropelvic junction obstruction with bifid renal pelvis in ectopic kidney: A rare combination.

INTRODUCTION: Renal pelvis bifidity, ectopic pelvic kidney, and ureteropelvic junction obstruction are rare urinary tract anomalies resulting from embryological developmental variations. Their coexistence in one kidney is exceedingly uncommon. CASE PRESENTATION: An 18-year-old male with no prior medical history presented with right-sided lumbar pain. A CT scan revealed bilateral hydronephrosis, with the left kidney being malrotated and ectopically positioned in the pelvis. Dynamic renal scintigraphy confirmed bilateral ureteropelvic junction obstruction. Surgical management involved laparoscopic pyeloplasty for the right UPJ and open surgery for the left ectopic kidney with bifid pelvis. DISCUSSION: The combination of pelvic kidney, renal pelvis bifidity, and bilateral ureteropelvic junction obstruction is exceptionally rare. Diagnosis often occurs incidentally or when symptoms related to these anomalies emerge. Imaging and dynamic renal scintigraphy play crucial roles in diagnosis. Individualized surgical management is essential for positive outcomes. CONCLUSION: This case highlights the need for individualized management in complex urological cases involving rare anatomical variations. Surgeon experience and a comprehensive understanding of such anomalies are crucial for successful outcomes.

[Congenital buried penis in the child: about a case]. / La verge enfouie congénitale chez l'enfant: à propos d'un cas.

Congenital buried penis in the child is a congenital malformation where the penis appears small in size while all the parts of the organ are normal (the urethra, the erectile tissue and the glans penis). Our study aimed to describe our experience in the surgical treatment of this abnormality. We report the case of a 18-months old infant with bilateral hydrocele initially admitted to the Emergency Department and then referred to our Department. Clinical examination showed buried penis with tight foreskin and a dilation of the preputial reservoir due to urine. Surgical procedure included several steps: Z-shaped incision, pulling back of the foreskin of the penis, release of the adhesions surrounding the corpus cavernosum and ventral penile skin coverage using bladder catheter kept for a week to protect the wound healing. Aesthetic and functional result was satisfactory after 1-year follow-up. Congenital buried penis is a very debated subject in the literature. Our technique was simple and easily reproducible. Voiding difficulties and urinary infection are the main indications of this surgical procedure.