Background: Paediatric stone disease is very common in certain regions of India. Traditionally, the endourology for the stones even in paediatric age group is managed by adult urologist and paediatric surgeons tend to do open surgeries. The nonavailability of paediatric size equipments and lack of training at the teaching and tertiary care paediatric surgical centers in India are factors due to which there is continued apathy of paediatric surgeons to endourology. The aim of this study was to discuss the feasibility of paediatric ureterolithotripsy for successful procedure. We introduced the paediatric ureterolithotripsy as per the predecided indications of stone size up to 15 mm in paediatric ureterolithiasis at a tertiary care center in rural set up. Subjects and Methods: Patients up to 18 years of age presenting with ureterolithiasis and not responding to conservative treatment or who needed endourological intervention were included in the study. Results: Thirty-one patients underwent uretero lithotripsy (URSL) for ureteric calculus with more than 95% clearance rate. Conclusions: Single-stage paediatric ureterolithotripsy is quite feasible and effective in achieving the stone clearance in paediatric ureterolithiasis.

Background: The Plastibell is the most popular circumcision method among mothers in our city. Haemorrhage is its major problem. At our centre, we have recorded many circumcision problems resulting from prolonged retention of the Plastibell ring and this study, therefore, sought to explore the ways of reducing complications resulting from prolonged retention of the ring. Patients and Methods: This was a prospective study, in which a total of sixty consecutive male neonates were recruited with all undergoing circumcision using the Plastibell device. Thirty patients were assigned to the subject group, in whom the Plastibell ring was removed by the investigator at 24 h while the other thirty constituted the control group whose Plastibell rings were allowed to fall off on their own. The patients selected were aged between 7 and 28 days. Results: Overall, 4 (6.6%) of the sixty neonatal circumcisions in this study were complicated by haemorrhage. There was minor bleeding in 3 (10%) of the thirty subjects and 1 (3.3%) of the thirty controls. There was no statistically significant difference between the groups (P = 0.3006). One patient each from the subject and control groups bled following slipped ligature a few hours after Plastibell circumcision. The other two patients in the subject group bled following the removal of the Plastibell ring at 24 h. All the bleeding episodes were effectively controlled within 5 min by firm digital pressure only administered through a piece of dry, sterile gauze. Conclusion: Post-circumcision haemorrhage was not significantly different between circumcised babies whose Plastibell rings were removed at 24 h and those in whom it was left to fall off on its own.

Background: The purpose of this study is to evaluate the aetiology of posterior urethral stricture in children and analysis of results after delayed primary repair with extensive distal urethral mobilisation. Materials and Methods: This was a retrospective study carried out in a tertiary care centre from January 2009 to December 2013. Results: Eight children with median age 7.5 years (range 4–11 years), underwent delayed anastomotic urethroplasty: Six through perineal and two through combined perineal and transpubic approach. All the eight children had long-segment >2 cm stricture: Three posterior and five anterior urethral stricture. On a mean follow-up period of 33 months (range 24–48 m), all were passing urine with good flow and stream. Conclusion: End-to-end anastomosis in post-traumatic long segment posterior urethral stricture between prostatic and penile urethra in children is possible by perineal or combined perineal and transpubic approach with good results without any urethral replacement.

Gastric volvulus is an uncommon entity found in the paediatric population. We are reporting a case of chronic gastric volvulus presented to us with the complaints of recurrent vomiting after each feed. The vomiting was projectile, nonbilious, and the content was milk. The patient was evaluated by clinical and radiological means in the form of the X-ray abdomen, ultrasound abdomen, upper gastrointestinal (GI) contrast study, and computed tomography scan of the abdomen. The upper GI contrast study was suggestive of gastric volvulus. The patient was operated and gastropexy was done. There was lax gastrocolic ligament with increased distance between stomach and transverse colon without any obvious gastric volvulus. Postsurgery, the patient was symptom-free.

Perineovaginorectal defect usually requires surgical repair; however, direct closure often leads to dehiscence. We present two patients with a congenital perineal skin defect who were successfully treated using a gluteal-fold bilobed perforator flap. This flap facilitates esthetic restoration and a more natural perineovaginorectal appearance, using only a one-stage procedure. This technique may be a favorable option for perineal and genital repair.