Defects of the urachus obliteration may lead to urachal abnormalities such an urachal cyst, which tend to rest asymptomatic. We report a case of a four-old-year boy who referred a three-week history of abdominal pain, dysuria and fever. A hypogastric mass was observed at the exploration. The ultrasonography and the computed tomography were compatible with an infected urachal cyst. Intravenous antibiotic therapy was started, with an optimal response. Four months later, a chirurgical complete excision of the urachal cyst was performed. Among different congenital disorders of the urachus, urachal cysts and patent urachi are the most frequent. Urachal cysts may become infected, causing suprapubic pain, dysuria, fever and abdominal mass, as well as signs of peritonism. The main tool for diagnose these lesions is ultrasonography. They could potentially degenerate into adenocarcinoma in adults, which is rare but associated to bad prognosis. Urachal remnants have been classically managed surgically. However, an active surveillance of these lesions with a conservative treatment could be an alternative, since spontaneous resolution is more common than previously thought.

Paraphimosis is a disease when the foreskin of an uncircumcised penis is left retracted behind the glans penis for a time period. An uncircumcised boy with paraphimosis was treated with dorsal slit following subsequent circumcision. If normal anatomy is not corrected, serious consequences can occur, including necrosis or partial amputation of the glans penis; therefore, an urgent approach is necessary. This case is presented and discussed with reference to etiology and current treatment options in paraphimosis which is a rare but real urological emergency problem.

Urinary incontinence in a child secondary to a severe congenital anatomical disorder or due to complication of a previous surgery can be difficult to manage. Decisions can be especially hard when a redo procedure is being considered. We present one such case where a 6 year old girl previously operated for cloaca was brought with incontinence and after much consideration of options available, underwent a modified ureterosigmoidostomy to aid in her continence. The modification used was detubularized isolated ureterosigmoidostomy, described by Atta et al in 1996.

Urethral duplication is a rare congenital condition. This case series intends to strengthen the concept of Y-type urethral duplication (new anatomic variation of an accessory limb of duplicated urethra). We have conducted a retrospective analysis collecting information from four cases of type IIA-2Y variety of urethral duplication (Effmann classification), which is one of rarely found subtype with its embryogenesis, diagnosis and single stage repair with outcome. Four babies around 1- 6 months of age range (mean- 3.2 months), complaining of passing urine from a site other than penis which includes anal canal, perineal area. All babies were investigated for other associated anomaly and were planned for surgery. Three out of four cases had undergone excision of accessory urethra and urethral stent in ventral urethra in postoperative period for 8-10 days with good results. In one case, posterior sagittal anorectoplasty (PSARP) approach was used to delineate accessory urethra and end to end urethral anastomosis was done with better outcome. All babies are on regular follow up till now ranging 6months to three years. It is important to delineate the functional urethra before planning for intervention so as to address the problem.

Patients with nutcracker syndrome (NCS) associated left varicocele are at high risk of varicocele recurrence when treated only with routine surgical approach for varicocele. An eleven year-old boy who had mild symptoms for NCS and left grade 3 varicocele referred to our clinic. To cure varicocele and to decrease left renal vein pressure, an end to end anastomosis was performed between left spermatic vein and inferior epigastric vein after inguinal microscopic varicocelectomy. His six months follow-up was uneventful. In this case report, we present that this method in children with NCS is a safe and effective method.