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Congenital vaginal atresia is a rare anomaly of the female genital tract. Many vaginoplasty procedures have been described, but the postoperative risk of vaginal stenosis remains a challenge. We report a case of isolated distal vaginal agenesis in a patient with neurological impairment where the use of an "alternative" dilator was needed. An 11-year-old girl with Down syndrome was admitted to the Emergency Department complaining of pelvic pain. The clinical evaluation showed a hard and painful pelvic mass associated with an imperforate hymen. Abdominal ultrasound and pelvic MRI were suggestive for hematometrocolpos and absence of the lower third segment of the vagina. Vaginoscopy confirmed the diagnosis of congenital vaginal agenesis. The patient then underwent a laparoscopic-assisted vaginoplasty. Considering the difficult management of the postoperative period, an epistaxis catheter was used as a vaginal stent and dilator. The use of an epistaxis catheter to provide adequate vaginal patency after vaginoplasty can be an alternative solution especially in those cases where calibrations with dilators are difficult or not tolerated. [ABSTRACT FROM AUTHOR]

Duplex collecting system is a common congenital urinary system anomaly and is usually asymptomatic. Vascular variations associated with a duplex system are common but haven't been reported as obstructive. 14-month-old female had a right sided incomplete ureteral duplication complicated by lower pole hydroureteronephrosis due to distal ureteral obstruction by an aberrant vessel crossing the bifid ureters at ureteric junction of these bifid ureters. Prenatal imaging detected right hydronephrosis. Magnetic resonance suggested a diagnosis of duplicated ureters. At surgery, an aberrant artery compressed the lower moiety ureter at the bifid ureteric junction. The stenotic section was resected and ureter segments were anastomosed. The occluding small artery was not resected to preserve vascularization. An anatomical vascular variation can cause proximal ureteral dilatation and segmental hydronephrosis in a bifid system. [ABSTRACT FROM AUTHOR]

The term exstrophy-epispadias complex refers to a group of midline defects ranging from epispadias to cloacal exstrophy. Bladder exstrophy is the most frequent malformation of this spectrum and it can present as a classical or a variant form. We report a case of a hybrid bladder exstrophy variant having some characteristics of both a duplicate bladder exstrophy and a superior vesical fistula. [ABSTRACT FROM AUTHOR]

We suggest extending testing to all patients undergoing gastrointestinal surgery who have had recently demonstrated SARS-CoV-2 infection (even if they tested negative on admission on nasal swab). We detected SARS-CoV-2 in peritoneal fluid from two children with prior nasopharyngeal detection of SARS-CoV-2 who developed complicated appendicitis. Similarly, patients with a recently demonstrated SARS-CoV-2 infection (although tested negative on admission on nasal swab) should be considered SARS-CoV-2 positive, as per the use of PPE and for the setting of the operating room. [Extracted from the article]

Laboratory investigations included renal function tests, hormonal examinations, urinalysis, and complete blood count which were all normal. A 3-day-old female newborn was consulted for paediatric urology because of an interlabial mass (Fig. A lower abdomen ultrasonography was also performed and it showed a normal uterus and both ovaries. [Extracted from the article]