[Neonatal bilateral ovarian cystadenoma: Conservative or surgical treatment?] / Cistoadenoma ovárico bilateral neonatal, ¿tratamiento conservador o quirúrgico?

INTRODUCTION: Bilateral complex ovarian cysts in newborns are rare and their reporting becomes imperative to in crease knowledge about the best therapeutic management. OBJECTIVE: To describe the clinical case of a newborn with a diagnosis of bilateral complex ovarian cysts and to discuss the conditions for conservative or surgical management according to the ultrasound characteristics of the cyst. CLINICAL CASE: At 35 weeks of gestational age, prenatal ultrasound identified the presence of cystic masses in both adnexa, so it was decided to interrupt the pregnancy by cesarean section at 37 weeks. After birth, bilateral ovarian cysts of 3.5 x 4.4 x 2.7 and 3.4 x 2.4 x 3.3 cm, right and left, respectively, were corro borated. The right cyst had a septum of 1.4 mm thick and thickened wall of 3 mm which was com patible with complex cysts. On the 4th day of extrauterine life, laparoscopic vacuum aspiration and deroofing with electrocautery of the upper wall of both cysts was performed, without complications. The diagnosis of ovarian serous cystadenoma was made by pathological anatomy. CONCLUSIONS: We describe a case with adequate prenatal diagnosis and laparoscopic surgical intervention of a bilateral ovarian cyst > 4 cm. Prenatal diagnosis is essential for choosing the best therapy management (con servative or surgical) depending on the echography characteristics of the cyst. Neonatal surgery is recommended for simple ovarian cysts >4 cm, complex cysts regardless of their size, and those that become complex cysts during conservative management.

[Four years experience in the follow up of nursing children with urolithiasis]. / Litiasis urinaria en lactantes. Seguimiento a cuatro años.

OBJECTIVE: to describe clinical data, metabolic profile, treatment and evolution of a nursing children cohort with urolithiasis. METHODS: using a descriptive, prospective and longitudinal design, were registered all patients with urolithiasis, of Pediatric Division at the Hospital General "Agustín O'Horán," in Yucatan, Mexico. We included all patients who were 36 months old and younger. We did not include children with malformations or associated disease which causes urolithiasis. Clinical and metabolic profiles, evaluation of the applied treatment as well as an evolution by four years period were done. RESULTS: 63 patients were recruited with ages ranging from 2 to 36 months; 39 (61.9 %) were male. The most common clinical signs were crying upon urination (49.2 %), urinary retention (31.7 %), hematuria (30.2 %), and pollakiuria (28.6 %). Calculus were most frequently located in the kidney (58.7 %). The most common complications were acute urinary tract infection (61.9 %), malnutrition (47.6 %) and acute renal failure (12.7 %). Documented metabolic alterations included hyperuricosuria (57.1 %), hypomagnesiuria (11.1 %) and hypercalciuria (9.5 %). CONCLUSIONS: urolithiasis should be suspected in children with crying upon urination and urinary symptoms; it should be considered among the different causes of renal failure; hyperuricosuria was the most frequent metabolic alteration.