Perineal groove in female infants: A case series and literature review.

BACKGROUND: Perineal groove is a rare congenital malformation that is unknown to many clinicians and is often misdiagnosed. Although it may be self-resolving during childhood, this nonepithelized mucous membrane can pose the risk of local irritation and infection, particularly urinary tract infection. METHODS: A retrospective study of female infants diagnosed with a perineal groove was performed, demographic characteristics and clinical features were analyzed, and a photographic review was conducted. RESULTS: Five patients with perineal groove were observed in our clinic in 2015-16. The mean age was 14 months. None had symptoms, and no treatment was required. During follow-up of 1 year, all remained asymptomatic. CONCLUSIONS: Our retrospective review suggests that perineal groove may be an underdiagnosed condition. Most cases resolve spontaneously, but confusion in diagnosis may lead to misdiagnosis or misinterpretation of sexual abuse and unnecessary treatments.

Reactive hydrocele after laparoscopic Palomo varicocele ligation in pediatrics.

OBJECTIVES: To evaluate the incidence of hydrocele following laparoscopic Palomo varicocele ligation in pediatric and adolescents in our institution. METHODS: Between 1997 and 2009, 180 boys diagnosed as having varicocele who underwent Palomo laparoscopic ligation were evaluated retrospectively. Outcome variables recorded for analysis were age at presentation, symptoms, varicocele grade (Dubin-Amelar classification), testicular atrophy, length of hospital stay, perioperative complications, recurrence and hydrocele formation after surgery. Mean follow up was 5.8 years (6 months- 9 years). RESULTS: Age at diagnosis ranged between 9 and 19 years. Mean age at operation was 14.1 ± 1.8 years. There were 177 left-side varicoceles (98%) and four cases were bilateral. Testicular atrophy was noted in 45. Mean operative time was 38 min. The last 63 surgeries were performed on a two-trocar basis with Ligasure vascular sealing device and operative time decreased significantly to 22 min. Median hospital stay was 31h. Twenty-three patients developed hydrocele (13%); 11 of these underwent Winkelman-Lord's hydrocelectomy at least 1 year after Palomo (9% of total). Of the remaining 12, two resolved spontaneously and 10 were stable at mean 4-year follow up. CONCLUSIONS: Laparoscopic Palomo procedure is a safe successful method to correct varicoceles in pediatric and adolescent males. Reactive hydrocele formation following laparoscopic varicocelectomy is a worrisome problem particularly in cases with longer follow-up.

A simple dressing for hypospadias surgery in children.

One of the most controversial aspects of hypospadias surgery is the election of an appropriate wound dressing. In fact, there may be as many different types of dressing as there are types of surgical repair. Here, we describe a new, simple method for hypospadias dressing in children that minimizes painful removal.

Congenital absence of preputial foreskin: an extremely uncommon anomaly.

The part of the penile skin that covers the glans penis is named prepuce or foreskin. The embryologic development of the prepuce and urethra is related. Several congenital anomalies of the prepuce have been previously reported, but the absence of the prepuce with a normal development of the urethra is a very rare association. We report a sporadic case with absence of the prepuce and normal urethral development.

Prolapsed cecoureterocele presented as a prenatal genital mass: A urological challenge.

Prolapse of a cecoureterocele through the urethra presenting as a prenatal vulval mass is an extremely uncommon entity. We present a case of a newborn girl with a cecoureterocele extending through the urethra (diagnosed at 29 weeks' gestation) and we present its postnatal findings and outcomes.

Giant presacral tailgut cyst mimicking rectal duplication in a girl: report of a pediatric case.

Tailgut cyst, or retrorectal cystic hamartoma, is a rare congenital lesion found in the presacral space. The lession has been infrequently reported in medical literature. It is most common in middle-aged women and is rare in children. We report a case of a tailgut cyst mimicking a rectal duplication in an 8-year-old child. Excision and histological examination of the mass confirmed the tailgut cyst.

Incomplete unilateral polyorchidism (bilobed testicle) mimicking testicular tumour.

Incomplete polyorchidism (also called bilobed testicle) is an extremely uncommon congenital anomaly. Only 3 cases of bilobed testicle were previously reported in the available literature. We describe a case of a 4-year-old boy who presented with a 6-month history of an asymptomatic scrotal mass located in the upper pole of the left testicle mimicking testicular tumour. After partial orchiectomy, macroscopic and pathological examination of the lesion confirmed the diagnosis of normal testicular tissue.

Bipolar electrothermal vessel sealing system and 5-mm 2 expandable trocar approach in pediatric laparoscopic varicocelectomy: a successful time-effective technical refinement.

BACKGROUND: To present our initial experience with electrothermal bipolar vessel device and only 2 expandable ports for laparoscopic Palomo varicocele procedure in pediatric and adolescent population. METHODS: In a 3-year period between 2006 and 2009, sixty-three boys and adolescents diagnosed in our institution as having varicocele underwent Palomo laparoscopic surgery with a two 5-mm expandable-trocar laparoscopic approach using the LigaSure technology (Valleylab Inc., Covidien, Boulder, CO) for spermatic vessels sealing. The outcome variables recorded for analysis were age at presentation, symptoms, varicocele grade based on Dubin and Amelar Classification, testicular atrophy, operative time, complications, recurrence, and reactive hydrocele formation. Mean follow-up was 1.8 years (range, 6 mo to 3 y). RESULTS: Children's age at diagnosis ranged between 9 and 19 years. Mean age at operation was 14.8 ± 1.2 years. All cases were left side varicoceles and 70% had grade III varicocele. Testicular atrophy was noticed in 39.8% of cases. All boys underwent Palomo laparoscopic sealing of the spermatic vessels using bipolar vascular electrothermal device Ligasure with a 2-trocar approach. Mean operative surgery time was 21 minutes. Median hospital stay was 21 ± 8 hours. No conversion cases were registered. Nine patients developed hydrocele after laparoscopic procedure (14.2%). Three patients of these cases underwent Winkelman-Lord's hydrocelectomy (4.7% of total). CONCLUSIONS: Laparoscopic Palomo varicocele surgery for pediatric patients using Ligasure as spermatic vessels sealant and only 2 radially expandable 5-mm trocars is a safe, feasible, and time-effective technical improvement.

Laparoscopic Palomo varicocele surgery: lessons learned after 10 years' follow up of 156 consecutive pediatric patients.

OBJECTIVES: To evaluate our experience using laparoscopic Palomo varicocele ligation in a population under 18years, and confirm the factors involved in postoperative hydrocele formation. PATIENTS AND METHODS: Between 1997 and 2007, 156 boys diagnosed as having varicocele were evaluated retrospectively. Outcome variables recorded for analysis were age at presentation, symptoms, varicocele grade (Dubin-Amelar classification), testicular atrophy, length of hospital stay, perioperative complications, recurrence and hydrocele formation after surgery. Mean follow up was 5.6 years (6 months- 9 years). RESULTS: Age at diagnosis ranged between 9 and 18 years. Mean age at operation was 14.1+/-1.8 years. There were 153 left-side varicoceles (98%) and three cases were bilateral. All patients had grade II or III varicocele (38%/62%) and testicular atrophy was noted in 43.8%; 8.1% mentioned testicular pain at diagnosis. All boys underwent Palomo laparoscopic ligation of the spermatic vessels. Mean operative time was 38 min (25-82 min). The last 51 surgeries were performed on a two-trocar basis with Ligasure vascular sealing device and operative time decreased significantly to 22 min (16-32 min) (P<0.05). Median hospital stay was 31+/-8 h. Conversion rate was 1.28%. Twenty-one patients developed hydrocele (13.5%); 11 of these underwent Winkelman-Lord's hydrocelectomy at least 1 year after Palomo (9% of total). Of the remaining 10, two resolved spontaneously and eight were stable at mean 4-year follow up. CONCLUSIONS: Laparoscopic Palomo varicocele surgery for pediatric patients is a safe and effective procedure. Recurrence and complication rates are similar to those reported with open surgery.

Giant omental lipoblastoma in a 10-month-old infant composing 20% of total body weight.

Lipoblastoma of the greater omentum is an extremely rare benign tumor with less than 10 cases reported in the available literature. We report an unusual case of a 10-month-old girl with a giant omental lipoblastoma that composed 20% of her total body weight (1480 g, 17 x 12 x 16 cm). Complete excision of the tumor was performed. Histology confirmed the diagnosis of omental lipoblastoma.