A missed diagnosis of retrocaval ureter; case report and review of the literature.

The retrocaval ureter is an uncommon congenital anomaly due to an abnormal development of the inferior vena cava. Our case describes an 8 year-old boy who was referred to our center as a case of ureteropelvic junction obstruction with persistent hydronephrosis after pyeloplasty. Retrograde pyelogram showed features of retrocaval ureter which was managed surgically with constructive repair of the ureter. The low clinical incidence may be due to a number of asymptomatic cases that are not diagnosed in the patient's lifetime.

A duplicated Urethra with epispadias: An uncommon association.

Epispadias is a malformation of the urethra in which the urethral opening ends on the dorsum of the penis. It is considered a rare anomaly, especially when associated with urethral duplication. Urethral duplication is another congenital anomaly that has different clinical manifestations and a separate classification. In this case, we present a 4-year-old boy who underwent epispadias repair and was found to have an accidently duplicated urethra of Effiman's Type ⅡA during the operation. Excision of the accessory urethra was performed, and the patient tolerated the procedure well.

Pediatric urology surgical practice in the time of COVID-19: Results from tertiary Saudi Arabia hospitals.

PURPOSE: Our study aimed to evaluate the effect of COVID-19 on pediatric urology practice in the Kingdom of Saudi Arabia (KSA). METHODS: Data of 10 tertiary hospitals in KSA were retrospectively analyzed. Data of outpatient department (OPD) visits and pediatric urology surgical procedures from January 1, 2019, to April 30, 2019, and from January 1, 2020, to April 30, 2020, were extracted. The primary outcome was to compare OPD visits and pediatric urology workload in the first third of 2020 versus 2019, where there was no curfew. The secondary outcome was to compare the same variables during the full curfew time, i.e., April 2020 versus April 2019. RESULTS: The number of OPD visits was lower in the first third of 2020 (7390 vs. 10,379 in 2019 P < 0.001). OPD visits in April 2020 were 78.6% lower than in April 2019, and teleclinics represented 850 (94.3%). Elective procedures in the first third of 2020 were 688, with a reduction rate of 34.3% compared to the same period of 2019 (P < 0.001). In April 2020, there were 18 elective surgeries, with a 91.4% decrease than in April 2019. Ureteric reimplantation, hypospadias, cryptorchidism, and circumcision stopped, while pyeloplasty (n = 14) and urolithiasis (n = 4) procedures had declined by 50% and 76.5%, respectively. Most of the procedures (71.8%) were day surgery. Emergency procedures were similar in the first third of 2020 (65 vs. 64 in 2019, P = 0.994) and declined in April 2020 by 6.7% versus April 2019. During the full curfew, the most common emergency intervention were cases with obstructive uropathy (42.8%), followed by torsion testis (28.6%), posterior urethral valve (14.3%), and urological trauma (14.3%). CONCLUSIONS: In KSA, the number of elective pediatric surgical procedures were reduced by >90%, while the number of emergency pediatric surgical procdures were similar during COVID-19 pandemic compared with non-COVID-19 time. Ureteric reimplantation, hypospadias repair, cryptorchidism, and circumcision procedures were postponed. Pyeloplasty and urolithiasis-related procedures were performed to prevent irreversible disease progression or organ damage. There was an increase in rate of teleclinic and day surgery to reduce the risk of COVID-19 infection.

Urofacial syndrome: Uncommon and unforeseen cause of lower urinary tract dysfunction in children.

Dr. Ochoa proposed a condition known as Urofacial syndrome (UFS) which is characterized by the abnormal facial expression while smiling along with dysfunctional lower urinary tract in 1987. This study investigated 7 years old boy who presented with recurrent urine retention, dysuria, and inversion facial expression. Radiological and genetic work-up diagnosed him with UFS.

Bladder outlet obstruction secondary to posterior urethral cystitis cystica & glandularis in a 12-year-old boy. A rare case scenario.

Urethral cystitis cystica and cystitis glandularis in children are extremely rare condition. Mainly manifested as weak urine flow. Other symptoms may occur, such as terminal hematuria, urgency, frequency, and urinary incontinence. In ultrasound examinations, children usually have high post-void residual urine volume. Transurethral visualization and resection of lesions is a method of diagnosis and treatment. Close follow-up is necessary because recurrence may occur. In addition, systemic corticosteroids may slow down its regrowth. In the current case report, we discussed the clinical presentation and management of urethra cystitis cystica, and cystitis glandularis in a 12-year-old boy.

Complete penile amputation during ritual neonatal circumcision and successful replantation using postoperative leech therapy.

Circumcision is the most common surgical procedure in males in the United States, and minor complications are not uncommon. Major complications like partial penile amputations have been reported with successful replantation. Complete penile amputations in adult males have been described, and successful replantation has been reported with increasing success. We report a case of complete penile amputation at the penopubic junction using a Mogen clamp in a 7-day-old neonate with replantation using postoperative leech therapy. To our knowledge this is the first time leech therapy has been used postoperatively for neonatal penile amputation.