Background: Miniaturization of endoscopic instruments in percutaneous nephrolithotomy (PCNL) allowed less invasive procedures with low complication rates, especially in children. This study was conducted to evaluate the safety and efficacy of ultrasonography-guided (USG) versus fluoroscopy-guided (FG) mini-PCNL in children.Materials and methods: This is a retrospective comparative study conducted from June 2015 to June 2020. The sample included 70 children (35 pateints underwent USG mini-PCNL and 35 pateints underwent FG mini-PCNL). They were compared mainly by the patients’ demographic characteristics, procedural information, and post-treatment outcomes. In the USG mini-PCNL group, puncturing was performed using a 3.5 MHz US probe, whereas fluoroscopy was utilized in the FG mini- PCNL group. Results: Both groups were comparable in terms of gender, previous history of failed ESWL, and hydronephrosis grade. The mean stone burden was 15.94 ± 3.69 mm and 19.20 ± 7.41 mm in USG and FG groups, respectively (p = 0.024). The stonefree rate (SFR) was 97.1% in the USG group and 94.3% in the FG group, which was not statistically significant (p = 0.16). Mean operative time in the USG group and FG group was 69.00 ± 13.33 minutes and 63.48 ± 16.90 minutes, respectively. Four (11.4%) patients in the FG group required blood transfusions to restore the hemodynamic state (p = 0.039). Fever was detected in 4 (11.4%) patients in the USG group and 15 (31.4%) patients in the FG group (p = 0.041). Conclusions: In children, mini PCNL under USG is safe and as effective as fluoroscopy.

Purpose: Circumcision is one of the most prevalently performed surgeries worldwide. It is a common non-therapeutic procedure, which, based on the cultural and social background of people, could be performed by individuals at different levels of skill ranging from trained medical professionals to non-specialists. Therefore, this surgery could cause complications of varying frequencies and types. For example, penile damage during the circumcision procedure is a severe and rare complication leaving patients with morbidity and lifelong consequences. Here, we reported two cases of penile injury during a ritual circumcision. Patients and Methods: This study was approved by the ethics committee of Ibb University of Medical Sciences. Case 1: A 6-month-old child was brought to hospital by parents with complaints of purulent discharge around the penis after ritual circumcision performed 3 days ago with complete skin loss in the whole part of the penis extended to the scrotum and suprapubic area. Case 2: A 2-month-old child was brought to hospital with complaints of penile discharge and gangrene after ritual circumcision performed 10 days ago. Results: Case 1: He was treated with daily debridement and wound irrigation followed by a surgical procedure to bury the penis in the scrotum for future reconstructive surgery. Case 2: A suprapubic cystostomy was inserted into the bladder. Then, daily debridement and wound irrigation was performed for the child. To treat penile gangrene, two options were available. The first option was to bury the penis in the scrotum and do reconstructive surgery later. The second option was to change the child's anatomical sex from male to female. Conclusion: We suggest that every child, before a circumcision procedure, should be evaluated by a medically trained professional. This procedure should also be carried out in aseptic conditions. Additionally, the circumcision procedure needs to be performed by an experienced medical professional.

Circumcision is one of the important public surgeries performed globally. It is a popular non-therapeutic procedure that can be performed by people of various abilities and skills, ranging from trained medical practitioners to non-specialists, depending on their cultural and social backgrounds. Consequently, this surgery may cause varying types and frequencies of complications. Glans amputation and death due to severe bleeding, as a complication of this procedure, are rare, and the patients are left with morbidity and life-long complications. Here, we describe two cases of catastrophic complications due to ritual circumcision (one penile glans amputation and one death).

Hydatid cyst (HD) disease is a parasitic infection produced by cysts containing the larval stage of Echinococcus granulosus. It occurs worldwide, but its prevalence is higher in the rural communities of some developing countries like Yemen, where sheep and cattle raising constitute a crucial component of the agricultural industry. This zoonotic disease spreads due to close contact humans with sheep and dogs. The most involved organs with HC are the liver and lungs. However, other organs may also foster it, such as the spleen, with an incidence rate of between 0.5% and 6%. To the best of our knowledge, primary involvement of the spleen by HC is very rare, and a few cases with isolated spleen HC in children were reported. In this study, a ten-year-old boy with a huge primary splenic HC is reported with chief chief complaint of pain and non-tender bulging in his abdomen’s left upper quadrant. A 20×16×18 cm splenic cystic mass was detected by ultrasonography (US) and confirmed by abdominal computed tomography (CT) scan without macroscopic involvement in other organs. Total splenectomy was carried out for hem. Pathological examinations revealed cystic hydatidosis. We describe this case of an isolated huge spleen HC, which was successfully treated with total splenectomy, focusing on the management and outcome of this disease.

Double j stent is commonly used in urological procedures. Its main purpose is to afford the sufficient drainage from the renal pelvis to the urinary bladder. Following increased usage of double-J stent, several consequences associated to it have been reported. In this work, we report on a case of “forgotten” double j stent for 1 year in a 32-year-old male patient who visited emergency department with bilateral flank pain, fever, and vomiting for a duration of 3 days. A double-J stent was detected in the plain abdominal X-ray. It was also observed that a 20 × 15 mm stone has impacted the left renal pelvis. Therefore, two operations were performed successfully until the full recovery of the patient. Hence; the main aim of this paper is to increase awareness about the potential complications of “forgotten” double J Stent.