A Case of Congenital Urethrovaginal Fistula in a Female Child with Suspected Imperforate Hymen: A Case Report

Urethrovaginal fistula is an abnormal communication between the urethra and vagina. Urethrovaginal fistula results in urinary incontinence with urine continually leaking from the vagina. In children congenital anomaly may also be the cause. Congenital Urethrovaginal fistula is an extremely rare genitourinary anomaly. The reported five cases in the literature are all associated with urogenital abnormalities like vaginal septum, vaginal agenesis and imperforate hymen. We present a case of a 7-year-old female that was referred from a peripheral hospital for micturating cystourethrography (MCUG) on account of urinary incontinence and passage of urine from vaginal orifice. Following MCUG the urethra, proximal fistula between the urethra and vagina, distended urinary bladder, contrast opacified uterus and a fallopian tube were all demonstrated. We report this case because of its rarity in the literature.

Polyorchidism: a rare case report

Polyorchidism is a very rare genitourinary anomaly defined with the presence of more than two testicles. Polyorchidism is associated up to 40% with undescended testicles. The present report is about an incidentally detected triorchidism case with left side, one atrophic and second Normal testis. A 4 years old child, diagnosed with left side undescended testis revealed during orchiopexy polyorchidism with distinct epididymis and vas deferens. Whereas one of the testis was in regular size, the other was atrophic. Orchidectomy was conducted on the atrophic testicle and sent for histopathological examination (HPE), orchiopexy to the normal size testicle. The atrophic testicle excised was referred histopathological analysis and was diagnosed as left side undescended atrophic testis. The patient discharged on 2nd postoperative day, was considering as normal during postoperative evaluation made on 5th postoperative day. Polyorchidism is a rare genitourinary abnormality, and its management is still controversial. Yet, we believe that orchidectomy is to be conducted in atrophic testicle cases.

A case of diabetic fetopathy: caudal regression syndrome and associated anomalies

Uncontrolled periconceptional diabetes in mother can give rise to severe malformation in the offspring. Author describe a case of diabetic fetopathy presenting as a case of Caudal regression syndrome along with cardiovascular, gastrointestinal and genitourinary anomaly. Though most cases of Caudal regression syndrome are sporadic, it is the most specific lesion of diabetic fetopathy. Clinical presentation varies depending on the severity of the neurological lesion along with the presence of other anomalies, most commonly genitourinary malformation. The index case described here had a type IV lumbosacral agenesis with severe bilateral motor and sensory deficits along with D-Transposition of great arteries and Pyloric atresia. Such cases arise due to inadequate prenatal care of diabetic mother, which is not uncommon in developing country like India.

Scrotal Ultrasound Is Not Routinely Indicated in the Management of Cryptorchidism, Retractile Testes, and Hydrocele in Children

Cryptorchidism, or undescended testes, is the most common congenital genitourinary anomaly. A failure or delay of treatment may result in reduced fertility or an increased risk of testicular cancer. The American Urological Association (AUA) recommends that a scrotal ultrasound (SUS) not be performed in the preoperative management of cryptorchidism. This study investigated how likely pediatricians were to perform SUS despite the AUA guidelines. We retrospectively studied 243 patients referred to a single pediatric urology practice for clinically diagnosed testis pathology including undescended testis, hydrocele, and retractile testis over a 4-year period (January 1, 2015, to December 30, 2018). A total of 72 patients (29.6%) underwent a SUS ordered by their pediatrician prior to the pediatric urology visit. Pediatricians should be aware that SUS performed prior to pediatric urological evaluation does not alter management and is associated with a significant financial cost in patients with cryptorchidism or hydrocele.

Case 12.2

32-year-old man with infertility and azospermia Axial fat-suppressed FSE T2-weighted images (Figure 12.2.1) reveal 2 ovoid hyperintense structures in the anterior right pelvis and lateral left pelvis. Bilateral undescended testicles Cryptorchidism is the most common genitourinary anomaly in male infants, occurring in 1% to 3% of term infants and in up to 30% of premature infants. Boys with cryptorchidism are at increased risk for infertility and testicular cancer, with the incidence of both complications increasing the longer the testicle remains undescended; therefore, orchiopexy is generally recommended at 12 months of age....

Congenital anatomical malformation at birth in Western Regional Hospital, Pokhara, Nepal

BACKGROUND: Congenital anomalies are any abnormality present at birth, either structural or functional, which may have been inherited genetically, acquired during gestation, or inflicted during parturition. There has not been much studies related to the congenital anomalies in Nepal. METHODOLOGY: One year hospital based review study was conducted to find out the incidence, magnitude of congenital malformation and to know the specific involvement of anatomical structures among babies born at Western Regional Hospital, Pokhara, Nepal. RESULTS: Of 10013 deliveries during the period of 1 year, total number of live birth was 98.82% (9895). Out of 9895 of total live births with any form of conginital anomolies was found amongst 0.42% (42) children, congenital anomalies were ranging from minor to major, single to multiple systems. Musculoskeletal anomalies accounted for the maximum of 57.1% followed by genitourinary anomaly 14.3%. Nervous system anomaly was seen in 11.9% and few cases of gastrointestinal system anomaly and anomalies of the sense organs. CONCLUSION: Incidence of congenital anatomical malformations at birth at Western Regional Hospital, Pokhara was found to be 0.42%. DOI: http://dx.doi.org/10.3126/jucms.v1i4.9572 Journal of Universal College of Medical Sciences (2013) Vol.1 No.04: 37-40