RESUMO
This report outlines the case of a 3-year-old boy whose initial presentation was that of asymptomatic hypertension (lowest recording 148/90), found at preoperative check prior to stage 2-correction surgery for distal hypospadias. Upon diagnosis of true hypertension, an ultrasound of the child's renal tract showed evidence of marked hydronephrosis and calyceal dilatation. On the background of deteriorating renal function (Urea 25.5 and Creatinine 188), a Micturating Cystourethrogram was performed, demonstrating posterior urethral dilatation. With difficulties controlling blood pressure, the child was transferred to Urology care, where resection of a posterior urethral valve (PUV) was undertaken. Despite this, renal function deteriorated further and re-cystoscopy identified an anterior urethral valve (AUV), which was also resected. Renal function, although improved, remains poor and blood pressure is controlled with two anti-hypertensives. To the publisher's knowledge, the association between hypospadias, PUVs and AUVs is as yet undocumented.
RESUMO
INTRODUCTION: Terminal myelocystocele is a rare form of spinal dysraphism characterised by cystic dilatation of the central canal of a low-lying terminal cord. Typical presentation is a skin-covered dorsal mass; early surgical repair has been recommended. CASE REPORT: We present the case of a 4-year-old girl with a terminal myelocystocele and syrinx, which were both observed to spontaneously regress on subsequent magnetic resonance imaging. CONCLUSION: Terminal myelocystocele and its associated syrinx may resolve spontaneously. Early surgical repair may not always be necessary.
