Condyloma acuminatum is an anogenital lesion caused by human papillomavirus (HPV) infection, a common sexually transmitted disease. It usually affects the external genitalia while urethral and/or bladder involvement is rare. HPV types are classified into three categories depending on their oncogenic potential: low risk (type 6, 11, 42, 43, 44, 59, 66, 68, 70), intermediate risk (type 30, 31, 33, 34, 35, 39, 40, 49, 51, 52, 53, 57, 58, 63, 64) and high risk (type 16, 18, 45, 56). High-risk and intermediate-risk HPV-DNA types, together with other co-factors still to be defined, are responsible for over 90% of the cases of anogenital pre-malignant and malignant tumours. We report a unique case of a urinary bladder condyloma acuminatum positive for HPV 16/18 DNA, presented as the primary and only site of the disease in an immunocompetent patient. We review the treatment and follow-up strategies of this rare lesion.

Paediatric nephrolithiasis is quite challenging in terms of management because of the smaller size of the urinary tract and the bigger risk for stone recurrence. Children bear a higher risk of metabolic and infectious causes of stone disease and a longer lifetime risk for recurrence, especially in cases of residual fragments. Complete stone clearance should become the absolute objective and clinically insignificant residual fragments should be avoided. Nowadays, percutaneous nephrolithotomy (PCNL) arises as a logical first-line treatment option for considerable paediatric nephrolithiasis as miniaturization of endoscopes and advances in energy sources for stone fragmentation have facilitated stone-free rates. In this review we present the evolution of PCNL in children and we demonstrate its safety and efficacy. As appropriate instruments are available and relevant surgical experience is accumulating, age should no longer exist as a limiting factor for performing PCNL.

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In pediatric oncology patients, hemorrhagic cystitis can be a life-threatening complication of bone marrow transplantation, chemotherapy, and radiation therapy. The treatment of this condition is often challenging and includes intravesical irrigation with aluminum, embolization, endoscopic laser coagulation, hydrostatic pressure, use of hyperbaric oxygen, instillation of formalin, prostaglandins, and oral sodium pentosan polysulfate. Although the efficacy of aluminum irrigation is well documented for the management of hemorrhagic cystitis in adults, there are limited reports describing its use in children. The potential multisystem toxic effects of aluminum are well described and the range and progression of aluminum toxicity can be devastating. We report a case of a 9-year-old girl suffering from acute lymphocytic leukemia with hemorrhagic cystitis. Although the symptoms resolved after intravesical aluminum treatment, she developed significant aluminum toxicity. We have reviewed the literature relating to aluminum toxicity in the pediatric age group and present our recommendations for the effective and safe use of aluminum in this cohort of patients.

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