Seventeen cases of a solitary polyp of posterior urethra in children (ages ranged between 4 months and 12 years) are presented. All patients were treated endoscopically using a 10 Fr. pediatric cystoscope, equipped with a straight ahead lens, and a Bugbee 3 Fr. electrode to fulgurate the stalk of the polyp through the urethra, without meatotomy. No complications or relapses are recorded, which proves the safety and the efficiency of the transurethral endoscopic resection in all pediatric ages. With the exception of one case, the smallest polyp of the series, lost because entirely burnt during the electrocution, all polyps were recuperated and examined histologically. The dimensions of the polyps ranged from 4 mm to 27 mm length. Their shape varied from a long "cordon-like" peduncle to a short stalk, "balloon-like" appendix. The histologic features were similar, the main component was an axis of connective tissue and vessels, surrounded by transitional epithelium, usually described as a fibroepithelial polyp.

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Cystic dilatation of Cowper's gland ducts (Cowper's syringocele) is uncommon in children and is frequently asymptomatic, but it may cause urinary infection, haematuria, dysuria, and obstructive voiding symptoms. Fifteen consecutive children with syringocele aged 15 days to 15 years old are reported here. Only four patients with obstructive syringocele were successfully treated surgically; all the others were successfully treated conservatively. The true clinical significance of Cowper's syringocele lies in its potential to cause urethral obstruction. Careful clinical, radiological, endoscopic, and urodynamic evaluation is necessary in order to avoid unnecessary surgery. (Arch Dis Child 1996;75:71-73)

Closure of the skin defect in myelomeningocele repair is an essential step that determines the quality of the surgical result. In large myelomeningoceles, however, adequate skin coverage may not be accomplished by direct closure or skin undermining. In such cases, the skin defect is best repaired using flaps. To evaluate whether the Limberg skin flap is effective for the repair of large round or oval lumbosacral myelomeningoceles, we studied the records of 25 children. Surgical repair was carried out within 24-36 hours of birth in all 25 patients, with the defect size ranging from 36-72 cm(2). Durable, stable soft tissue coverage of the defect was obtained in 23 of 25 patients, with a postoperative follow-up of at least 2 years. Reoperation became necessary in the remaining two patients, but flap necrosis occurred in only one. We suggest that Limberg flap repair may have some advantages in patients with large round or oval lumbosacral myelomeningoceles, including minimal invasivity, short hospitalization, and improved cosmetic results.

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