Given their complexity, these tumours should be addressed by experts and all treatment options must be contemplated. They continue to present a challenge, above all in malignant tumours where the tumour cannot be controlled at a locoregional level.

The reasons for failure of orchiopexy were investigated by reviewing the records of 350 boys with undescended testis. There were 36 boys (10 per cent) who had experienced failure of an initial surgical procedure. We found that the standard surgical techniques of local inguinal dissection, high ligation of a patent processus vaginalis, extensive retroperitoneal mobilization of the spermatic vessels and vas deferens, and/or creation of a dartos pouch were sufficient to correct these failures. Retroperitoneal dissections were required to correct the undescended testes in 58 per cent of the boys. Only 37 per cent of the boys could be treated satisfactorily by localized inguinal dissection. It appears that standard surgical techniques, especially aggressive retroperitoneal dissection, are adequate to correct even troublesome cases of undescended testis.

A unique necropsy specimen of a cecoureterocele, together with the bladder and urethra in a female newborn, was studied to determine the structure of the ureterocele and the accompanying vesicourethral sphincter. The ureterocele within the bladder base and the entire urethra were examined macroscopically and microscopically in serial sections. The ureterocele and its cecal extension were amuscular. The bladder neck, and the involuntary and voluntary sphincters were attenuated or devoid of muscle in the quadrant beneath the ureterocele and its cecal extension. These findings were correlated with the clinical features of 2 living patients with comparable ureteroceles who had urinary incontinence following surgical excision of the ureteroceles.