High-strength Neodymium Magnetic Beads: A Rare Foreign Body in the Bladder of an Adolescent.

This article reports the case of an adolescent who repeatedly inserted high-strength magnetic beads into his urethra for erotic reasons. The beads migrated into his bladder requiring a cystostomy to remove them. The available literature is reviewed.

Bladder Hamartoma in a Fetus: Case Report.

We present the case of the youngest reported patient with a bladder hamartoma detected prenatally by ultrasonography. Bladder tumors in newborns are rare, but a hamartoma should not be discarded among the diagnostic possibilities when evaluating a fetus or a newborn with a polypoid bladder lesion.

Late complications of newborn circumcision: a common and avoidable problem.

PURPOSE: The purpose of this paper is to study the types of operative and post-operative late complications resulting from newborn circumcisions and to make recommendations to prevent them. METHODS: After obtaining IRB approval, a retrospective review of the late complications resulting from newborn circumcisions treated at the MassGeneral Hospital for Children from January 2003 to December 2007 was undertaken. The source used was the consultation notes and operative reports of affected patients. Additionally, cases seen in the outpatient Pediatric Urology Clinic from April 2007 to April 2008 were reviewed. RESULTS: A total of 8,967 children were operated during the study period, of which 424 (4.7%) were for complications resulting from previous neonatal circumcision. Penile adhesions, skin bridges, meatal stenosis, redundant foreskin (incomplete circumcision with uncircumcised appearance), recurrent phimosis, buried penis and penile rotation were the most frequent complications. At the outpatient clinic of the Section of Pediatric Urology, 127 boys with concerns following newborn circumcision were evaluated, representing 7.4% of the total volume of cases seen in this clinic. CONCLUSIONS: Our results indicate the need to undertake a collaborative study to define the incidence of complications following newborn circumcisions, which should be performed by practitioners with adequate training in the technique of their choice and its post-operative care.

Symphysiotomy: a valuable approach in children with prostate rhabdomyosarcoma.

Surgery for large prostate rhabdoyasarcoma in children is a challenging procedure. We discussed the value of pubic symphysiotomy in affected patients. The symphysiotomy approach was used in two children with a large rhabdomyosarcoma of the prostate. In each case, the initial exposure was obtained through a lower midline incision, but, due to technical difficulties, resulting from the size of the tumor, surgery was completed via a symphysiotomy approach. In each case, the bladder was preserved and a radical prostatectomy was facilitated by the excellent exposure provided by the symphysiotomy. The patients have been followed for 6 years and 26 months, respectively. Both are tumor free. Neither has developed orthopedic complications. In conclusion, the symphysiotomy approach, for large prostate rhabdomyosarcoma in children, results in an excellent surgical exposure, thus, facilitating the performance of a radical prostatectomy with bladder preservation. Orthopedic complications have not developed throughout the follow up period.

Renal abscess in previously healthy girl.

We describe the case of a previously healthy 11-year-old girl with a Staphylococcal aureus renal abscess. The diagnosis was confirmed by renal ultrasonography and abdominal computed tomography. We emphasize the need to obtain an abdominal ultrasound scan and computed tomography scan in patients with abdominal or flank pain, and laboratory evidences of infection to avoid diagnostic and therapeutic delays.

Circumcised hypospadias.

PURPOSE: Patients with circumcised hypospadias have been of significant concern over many decades due to the belief that prior circumcision might negatively affect the results of hypospadias' repair. We evaluated outcomes in consecutive males with anterior, distal penile, and the megameatus with intact prepuce variant of hypospadias (MIP). METHODS: After IRB approval a retrospective of 48 consecutive males with circumcised hypospadias was reviewed. In all cases the urethroplasty was accomplished with either urethral plate tubularization or a MAGPI procedure. No skin flaps were used. RESULTS: A total of 48 patients with circumcised hypospadias (anterior, MIP variant, and distal penile) underwent operative reconstruction by one of us (RVP). All patients were followed for at least 8 months. CONCLUSIONS: Prior circumcision did not negatively affect the results of subsequent urethroplasty in patients with anterior, distal penile, and the MIP variant of hypospadias. The use of the tubularized incised plate urethroplasty (TIP) has virtually eliminated the need for skin flaps in anterior hypospadias repair.

Megacalycosis: a rare condition.

Megacalycosis is an extremely rare condition. We report our experience with two cases and discuss its pathogenesis, diagnosis and management in children. Our two patients had presented a prior diagnosis of congenital hydronephrosis. An increased number of calyces with a significant disproportion between the degree of calyceal dilatation and a mildly dilated renal pelvis were found in each case. Megacalycosis must be considered in the differential diagnosis of congenital hydronephrosis, polycalycosis, and infundibular stenosis. The diagnosis is suggested by ultrasound and confirmed by diuretic renography, intravenous pyelography or magnetic resonance urography. Voiding cystourethrography should be performed to rule out vesicoureteral reflux. A high index of suspicion is needed for the diagnosis of this condition.

Un caso de hamartoma fibroso de la infancia / A case of fibrous hamartoma of infancy

Se presenta un caso de Hamartoma Fibroso de la Infancia, ubicado en su loacalización más frecuente: la axila y región escapular. Se describen los hallazgos histológicos típicos de esta enfermedad. Enfatizamos la necesidad de efectuar un diagnóstico histológico apropiado, y el empleo de un tratamiento quirúrgico conservador, ya que todos estos tumores siguen un curso clínico enteramente benigno. Nuestro paciente es el tecer caso de este tumor, reportado en un niño de raza negra. Además, es el segundo reportado en Venezuela con este diagnóstico

Apendicitis aguda y plastrón apendicular simulando artritis sépticas de la Cadera Derecha en un Niño / Acute appendicitis and appendicular plastron simulating septic arthritis in the right hip in a child

Se reporta un caso de plastrón apendicular simulando artritis séptica de la cadera derecha en un niño. La apendicitis aguda debe ser incluida en la lista de diagnósticos diferenciales cuando se examina un niño con dolor en la cadera derecha y fiebre. El tacto rectal no debe ser omitido en el examen físico de estos casos