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Three children with Skene duct cyst were presented in this article. By reviewing literature, in pediatric population, Skene duct cycts mostly occur in newborns and conservative therapy is the first choice in this group.In contrast, it is extremely rare between the ages of 1 and 12, and surgical excised is the preferred therapy because of having a similar pathogenesis to adults.
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Objective:To explore the clinical features and treatment strategy of congenital anterior urethrocutaneous fistula.Methods:A total of 7 cases with congenital anterior urethrocutaneous fistula were repaired by surgery between January 2006 and February 2019 in Affiliated Children’s Hospital of Xi’an Jiaotong University. The median age was 30 (18-92) months. All of cases had a intact prepucs and a normal external urethal meatus located at the tip of glans. Fistula located at subcoronal culus in 2 cases, midshaft in 3 cases, penioscrotal region in 1 case, scrotum in 1 case, respectively.Defect longitudinal diameter was 0.5-1.5cm. Associated anomalies including division of scrotum in 3 cases, penile chordee in 2 cases, urethral meatus stenosis in 1 case, right hydrocele in 1 case. Six cases had underwent one-stage fistula repair incluing Duplay procedure in 4 cases(case 1, 2, 4 and 6), Onlay preputial flap in 1 case(case 3), TIP repair with dorsal plication for straightening and urethrotomy in 1 case(case 5). Case 7 had underwent a two-stage repair, which received Duckett flap repair with urethrostomy simultaneously at the base of the penis, and the defect was closed in second procedure. All of neourethras were reinforced by soft tissues from different places.Results:Of 6 cases with one-stage repair, the catheter was removed 10-14 days after surgery in 5 cases. Removal of the catheter was delayed until 3 weeks in case 3 because of poor wound healing. Case 7 received Duckett flap repair with urethrostomy in the initial surgery, who recovered uneventfully and was resolved during the second operation. No recurrence, urethral stricture or chordee occurence were noted in all after a 1-8 years followup period.Conclusions:Congenital anterior urethrocutaneous fistula have a high overall success rate.Duplay could be applied to cases without penile curvature, and well-developed urethral plate. Onlay or TIP is more suitable for cases with narrow urethral plate. The principle of hypospadias repair should be followed for those cases with severe penile curvature.
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Ⅳ?were cured by anti-reflux ureteral reimplantation after 1 year;in the other 9 cases, VUR disappeared within 4 years. In the 18 cases ac ;ompanied with hydronephrosis/partial hydronephrosis, hydrops disappeared in 3 years in 15 cases,and it cisappeared after 10 years in 3 cases. All the ureteroceles in 88 children disappeared 1 year after the procedue. Conclusions Transurethral electroscission fenestration of ureterocele through cystoscope is a simple,effective and minimal invasive procedure for children with ureterocele.
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Objective To summarize the experience in diagnosis and treatment of ectopic ureter in children. Methods A total of 22 cases (21 females and 1 male;mean age of 4 years,range from 1 month to 12 years) of ectopic ureter were analyzed retrospectively.Of them,17 cases had unilateral ectopic ureters and 5,bilateral.Normal,divided urination accompanied by abnormal leakage of urine occurred in 18 cases;completely continous leakage of urine in 3;and obstruction of upper urinary tract with infection of urinary system in 1.Fourteen cases had opening of ectopic ureters in vaginas,4 in urethras,3 in vestibula and 1 in bladder necks. Results Of the 22 cases 20 underwent surgical procedures.Of the 20 cases,11 had total nephrectomy and 7,partial nephrectomy.After the operation,leakage of urine disappeared,but 3 cases had syndrome of ureteral stump remnant.One case who underwent bilateral ureter-bladder reimplantation had mild urinary incontinence after the operation.One case who had vesica replaced with rectum was followed up for 5 years,the post-operative result was excellent. Conclusions It is of critical importance to establish definite diagnosis and to select appropriate mode of operation for the successful treatment of ectopic ureter in children.