The reference values for uterus and ovaries were determined in healthy girls. There is a progressive increase in size of internal female genitalia in relation to age, height, weight, and puberty. Uterine volume and body length presented the best correlation with age and stage of puberty.

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PurposeThe Pediatric Lower Urinary Tract Scoring System (PLUTSS) is a standardized questionnaire used for screening and evaluation of the response of children with lower urinary tract symptoms (LUTS) to therapy. We presumed that adding the Child Behavior Check List (CBCL) and bladder volume wall index (BVWI) to the PLUTSS would increase its validity in the detection of children with LUTS.Materials and MethodsOne hundred twenty-two children aged 5 to 15 years with LUTS were enrolled in the study. Seventy-two healthy, age-matched children without urinary complaints were considered as controls. The PLUTSS and CBCL were filled out for all children. Sonography was performed to measure BVWI. Chi-square test and likelihood ratio were used to compare frequencies, receiver operating curve (ROC) analysis was used to evaluate the correlation, and Cohen's kappa was used to measure the agreement between variables. p-values <0.05 were considered significant.ResultsBehavior problems were significantly more common in children with LUTS than in healthy children (p<0.05). The frequency of thick, thin, and normal BVWIs did not differ significantly in the two groups (p>0.05). ROC analysis showed that there was no correlation between PLUTSS, CBCL, and BVWI in either the LUTS subgroup or in the controls (p>0.05). The PLUTSS had the highest sensitivity and specificity, and adding the two other tests decreased its validity for the diagnosis of children with LUTS.ConclusionsThe PLUTSS by itself was the best predictor of LUTS. The CBCL and BVWI were not helpful in making a diagnosis; however, the CBCL was useful in the detection of behavior problems in children with non-monosymptomatic enuresis.

Although a few cases of vaginal clear cell adenocarcinoma (CCAC) have been reported in the ages under 14, they have presented in a much more aggressive form than the CCAC cases in higher ages and parenchymal pulmonary metastasis are known to occur following the primary tumor. This is a case report of a primary vaginal CCAC in an 8.6-year-old girl with no history of DES exposure who presented with vaginal bleeding and abdominal pain and the imaging signs of pulmonary metastasis at the presentation. Diagnostic imaging modalities should be considered for any child complaining of vaginal bleeding, due to limitation of vaginal examination. Chest X-ray is recommended at the time of diagnosis of CCAC and at follow-up sessions for early diagnosis of pulmonary metastasis.

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