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We report the case of a neonate who underwent bladder exstrophy repair on the second day of life. Bilateral ureteral stents were placed intra-operatively. Postoperatively azotemia developed secondary to kinking of the proximal ureter bilaterally. Issues in diagnosis and management are discussed.

We hereby describe the technique and our experience of a single-staged repair of bladder exstrophy and epispadias in two newborn males. The combined repair improves dissection and exposure of the bladder neck, posterior urethra and prostate, allowing better exposure for reconstruction and proper positioning in the pelvis. This approach should be avoided in premature babies and in patients with a very small penis. Although the complication rate of this procedure is low, large experience and expertise in exstrophy and epispadias is imperative prior to embarking in this major neonatal reconstruction.

This study is designed to evaluate the relative ability of DMSA and DTPA renal scans to accurately reflect differential renal function (DRF) compared with inulin clearance in the presence of partial unilateral ureteral obstruction. DRF was determined in 29 young rabbits by both renal scans. In the experimental group (n=21), left partial ureteral obstruction was created. Following 8 to 24 weeks, individual renal function in the obstructed animals were assessed by both renal scans and clearance of inulin. Eight animals were used as control. In the control group, DRF measured by DMSA, but not DTPA, correlated well with inulin clearance. Both scans documented a significant change in the DRF of the obstructed group (p<0.001). In the partially obstructed kidneys DRF derived by inulin was significantly lower than that measured by DMSA or DTPA scans (p<0.001 and p<0.0001). DRF measured by DMSA correlates well with inulin clearance in the control group. A similar correlation was not obtained by DMSA in the presence of obstruction. DTPA does not correlate with inulin clearance either in the control or the obstructed group.

Testicular microlithiasis is a rare diagnostic entity of unknown etiology and clinical significance. We hereby describe a case of bilateral testicular microlithiasis in a 10 year-old boy with a past history of mumps. Diagnosis was made by ultrasonography. Serum testicular tumor markers (alpha fetoprotein and beta human chorionic gonadotropin) were negative. Although the clinical significance of testicular microlithiasis remains obscure, in view of its association with testicular tumor and other pathology, we advocate regular self-examination and clinical follow-up with ultrasonography as an adjunct on a regular and long-term basis.