Complete Urethral Duplication in Children: A Case Report.

INTRODUCTION: Urethral duplication (UD) is a rare congenital anomaly with multiple anatomical variants. CASE PRESENTATION: In this article we present a four year-old child with complete UD. The patient was admitted for hypospadias repair, in evaluation we found type IIA1 UD according to Effmann classification. Patient underwent hypospadias repair saving complete UD. CONCLUSIONS: After one year follow-up he has normal and continent urination.

Gastric Duplication Cyst in Association with Duodenal Atresia in a Neonate.

Concurrence of duodenal atresia and gastric duplication cyst is extremely rare entity. We report a 6-day-old female neonate who presented with neonatal intestinal obstruction. X-ray abdomen showed double bubble sign. At laparotomy, a huge cystic structure attached to greater curvature of the stomach along with duodenal atresia of second part of duodenum was found. The cystic structure was excised and duodeno-duodenostomy performed. Histopathology report confirmed it gastric duplication cyst.

Gil-Vernet antireflux surgery in children's primary vesicoureteral reflux.

PURPOSE: The assessment of the results of Gil-Vernet antireflux surgery in children with primary vesicoureteral reflux. MATERIALS AND METHODS: In a descriptive retrospective study, 72 patients with vesicoureteral reflux (VUR) and 104 refluxing units underwent Gil-Vernet antireflux surgery in Mofid children's hospital from Dec 2000 to Nov 2005. The study group was selected from among the patients with VUR who had been operated in our center. Data were collected from the medical records of the patients in the archive of the hospital and analyzed for gender, age, method of diagnosis, side of involvement, grading types, usage of catheter and stent, operating time, hospital stay, reflux down grading, operative success rate, recurrence and operative complication. RESULTS: Among 72 patients, 47 (65%) were females and 25 (35%) were males with a mean age of 4.35 ± 2.96 years (range 1-13 years). 32 patients had bilateral and 40 had unilateral reflux, and 76% were in grades III and IV. Mean operative time was 55 ± 13 min, median hospital stay was 2 ± 0.9 days and mean follow-up period was 48 ± 9 months. Reflux was improved completely in 100 (96.15%) refluxing units, and down-graded in 4 (3.84%) units. Treatment was performed medically in 2 and surgically in 2 refluxing units, and all were improved successfully. There were no complications post-operatively. CONCLUSION: Gil-Vernet antireflux technique is a useful method, and it has many advantages such as simplicity, shorter operative time, lower complication rate and high success rate.

Diphallus with imperforate anus and complete duplication of recto-sigmoid colon and lower urinary tract.

BACKGROUND: Diphallus is a rare anomaly and accompanying anomalies vary from bifid scrotum, bladder exstrophy, imperforate anus and colo-rectal anomaly such as duplication, and other associated anomalies. CASE PRESENTATION: A 2-day old infant is reported with imperforate anus and complete duplication of recto-sigmoid colon, rectal pouch, doubling of the genitalia with completely formed penis (diphallus), double bladder, urethra and hypospadias. No family history of abnormalities was noted. The patient underwent several operations: laparatory and colostomy at 3rd day of life, and after clinical and paraclinical investigations, cystoplasty, ureteral reimplantation and resection of left phallus were carried out when 4 months old. At the age of 1 year, after colostogram and total colon evaluation, laparatomy, resection of duplicated recto-sigmoid colon, and pull-through was carried out; 3 months later colostomy closure was performed and the patient discharged without complications. CONCLUSION: The patients with diphallus have to be examined carefully because of the high incidence of other systemic anomalies. Treatment of diphallus usually includes excision of the duplicated penile structure, its urethra, and repair of associated anomalies.