We present a rare case of exstrophy variant - inferior vesical fistula. A two-year-old boy with normal continence presented with a suprapubic pit and mucosal plate on the penile dorsum. Examination and cystoscopy revealed vesical fistula. The fistula was closed and the penis was reconstructed. Recognition of the exstrophy variant is important because the treatment and prognosis are very different.

Isolated bladder neck horizontal transection without bladder or prostatic involvement is very rare in pediatric age group. To our knowledge, this is the first case of such trauma reported in Malaysia. In this article, we present a case of primary suprapubic catheter insertion with delayed vesicoprostatic urethral anastomosis in the treatment of complete bladder neck horizontal transection.

Hair tourniquet syndrome (HTS) is a rare condition and may pose diagnostic dilemma. The purpose of this study is to report our experience in 3 female cases with HTS involving genitalia. All the patients in this series presented with swollen and edematous genitalia and clitoris accompanied by strangulation in clitoris or labia minora with a hair thread. Strangulating hair was excised and removed under local anesthesia. The pain was cleared away and edematous discoloration disappeared immediately. Local application of antibiotic ointment was added to the treatment in these cases for a period of 6-7 days. The anatomy of the genitalia was found to be normal in these children during the follow up exam. A brief literature review on this subject is also given in this review.

The acute scrotum is usually due to testicular pathology, but, less often, it could be related to abdominal or retroperitoneal conditions, such as adrenal hemorrhage. The adrenal hemorrhage in the newborn is a rare condition with prevalence of 0.2%. We present a case report of an adrenal hemorrhage in a full-term neonate. The conservative management was performed, with periodic clinical and radiological follow-up. There was a favorable outcome with complete resolution of hematoma at 12 weeks. Within this unusual case, the authors want to emphasize the fact that in presence of acute scrotum it is imperative to exclude testicular torsion. The Doppler ultrasonography is a valuable resource but it should be allied with minicious physical examination. The conservative management is recommended in the majority of the cases of adrenal hemorrhage, avoiding unnecessary exploration.

A 13-year-old prepubertal girl had with primary amenorrhea and severe lower abdominal pain. Pelvic ultrasound showed double uterine cavity and a fluid collection in left uterine cavity with diffuse low level internal echoes, which appeared contiguous with the endocervix. Hymen could not be evaluated because the patient could not be taken to the gynecological table the patient was initially diagnosed as imperforate hymen, gynecologic examination was performed with sedation, and hymen has a normal patency. Magnetic resonance imaging (MRI) revealed two uterus and two cervix, normal right endometrial cavity and 17 mm fluid in the left endometrial cavity and compatible with hematometra. Hematocolpos was observed in the left half of the vagina. There was no left kidney and the right kidney was normal. Based on these findings, the patient was diagnosed as Herlyn-WernerWunderlich syndrome and vaginal septum resection was performed as treatment. Evaluation of the genital tract by means of MRI scanning or ultrasonography should be recommended in all girls with known renal abnormalities before the onset of menstruation.