We reported a case of donkey bite to the external genitalia of a 10 years old child. We had performed delayed reconstruction of the penis following adequate saline washing and wound debridement; under antibiotic coverage. Previous studies have shown that delayed repair together with strict wound management resulted in satisfactory outcomes in most victims of such animal bites.

Spontaneous resolution of a large renal stone burden in adults is a rare occurrence with few reports in the last 50 years. Improved imaging techniques and understanding of the pharmacology of dissolution therapy have led to a better understanding of which stones have the potential for spontaneous passage or targeted dissolution via medical treatment. Less is known regarding stone outcomes in children, and anecdotes of pediatric patients spontaneously passing large stones has been widely propagated. Here we report a case of spontaneous resolution of a large renal stone burden in a child with a congenital solitary kidney.

Ureteral atresia is a rare congenital anomaly and is usually associated with renal dysplasia. Distal atresia is more common and other associated urinary anomalies are rare. We report a case of an eight year old boy who presented with left flank pain and vomiting. Ultrasound abdomen and pelvis and renal scintigraphy were suggestive of hydroureteronephrosis with obstructed drainage. He was suspected to have ureteric stricture and taken up for surgery. Cystoscopy and retrograde pyelogram revealed an incomplete duplication with lower moiety ureter ending blindly. Exploration of left renal fossa showed a duplex anomaly with normal upper moiety and hydronephrosis of lower moiety with a ureteric stump. Ureteropelvic anastomosis was done between the dilated renal pelvis and the blind ending ureter. Patient was doing well post operatively with good function in both moieties. Review of literature shows only two previously reported cases of proximal ureteric atresia. Preservation of renal function in an older child has also been reported only once. Ureteral atresia is usually diagnosed intra-operatively and various reconstruction options are available in patients with preserved function.

Lymphatic malformations are rare vascular abnormalities that usually occur in the head and neck but can occur elsewhere in the body. Here, we present an unusual case of a 14-year-old male who presents with hematospermia, hematochezia, and hematuria. Following work-up which included urinalysis, ultrasound, and magnetic resonance imaging (MRI), the patient was diagnosed with pelvic lymphatic malformations (LMs), including a perirectal lesion and a lesion involving the right spermatic cord. He was started on sirolimus therapy, which resolved the hematospermia and hematuria, and decreased the frequency of the hematochezia. However, the hematochezia did not resolve completely and the patient wished to discontinue sirolimus. The decision was made to pursue doxycycline sclerotherapy for the perirectal lesion. The hematochezia resolved for two weeks following sclerotherapy, but resumed soon thereafter. Options to further manage the patient’s symptoms include re-starting sirolimus or repeating doxycycline sclerotherapy. To our knowledge, this is the first report of a lymphatic malformation presenting with hematospermia. Pelvic lymphatic malformations should be considered as a possible etiology for otherwise unexplained bleeding episodes in the adolescent genitourinary system.

Absence of any orifice in perineum, presence of smooth perineum, and absence external genitalia are characteristic of cloacal dysgenesis sequence (CDS). Newborn of 40w gestational age, born to mother with oligohydramnios, had very low APGAR scores, and was put on ventilator. Child had dysmorphic facies, short neck, compressed chest, no urinary bladder swelling, absence of any perineal orifice, a raised fold of skin at the site of phallus and bilateral talipes calcaneovalgus. Esophageal atresia (EA) was diagnosed clinically and radiographically. Pulmonary hypoplasia, distal tracheoesophageal fistula (TOF), thin, flat and broad cervical vertebrae with spina bifida, partial sacral agenesis and cardiac anomalies were demonstrated by radiographs and echocardiography respectively. Child progressively more desaturated on ventilator and died at 16h after birth before detailed assessment including sex could be done. CDS results from failure of urorectal septum to fuse with cloacal membrane at 7th week of intrauterine life. It can occur in male and female. CDS is lethal resultant from associated severe pulmonary hypoplasia and renal insufficiency. Very rarely such child is born alive as in our case. Association of CDS with EA+TOF is extremely rare. In view of 5 long-term survival reports of CDS, prenatal diagnosis is warranted and treatment should be initiated.