Introduction: There is a limited data on the incidence of pediatric urolithiasis in the Philippines as well as studies on how it is managed. With the advent of endourology, there is already an evident shift from open stone surgery to minimally invasive surgery as first line in the treatment of pediatric urolithiasis. A tertiary referral center in the country caters to most pediatric urolithiasis cases in the country and offers the different minimally invasive modalities outlined in the latest guidelines. This study aimed to review the different minimally invasive therapeutic modalities for pediatric urolithiasis and its outcomes in the past ten years in a tertiary referral center in the Philippines. Methods: This retrospective study was conducted through charts review of all pediatric patients (0-18 years) who underwent stone surgery from January 2012 to December 2022. Demographic and clinical data, stone characteristics, types of stone surgery, and outcomes were obtained. Results: A total of 87 pediatric patients (54 boys, 33 girls) with 105 urolithiases were analyzed. The patients had a mean age of 13 years, with an interquartile range (IQR) spanning from 6 to 18 years. Among them, 62.07% were male, while 37.93% were female. The most prevalent symptom reported was flank pain, affecting 41.38% of the patients, followed by urinary tract infections (UTI) (11.49%) and gross hematuria (8.05%). For the management, 82.86% of the patients underwent minimally invasive stone procedures with extracorporeal shockwave lithotripsy (ESWL) as the most common procedure (44.76%) and ureterolithiases as the most common stone (43.81%). On the other hand, 17.14% of the subjects underwent open stone surgery done mostly on cystolithiases and large ureterolithiases (38.89% each). All patients recovered and were discharged post operatively. Conclusion The institution practices minimally invasive approaches in the majority of pediatric patients with urolithiasis. Open stone surgery is reserved for patient with large complex stones and those with anatomic abnormalities.
Child ; Lithotripsy ; Ureteroscopy

Renal cell carcinoma is the most common renal malignancy in adults and extremely rare in children.It may present with hematuria, flank pain and palpable mass. Treatment protocols for renal cellcarcinoma in children have not yet been well-defined due to the rarity of the desease, however surgeryremains the mainstay treatment for tumors that are resectable. Presented here is a case of a 1 year oldfemale presenting with left hemiabdominal mass, who underwent transabdominal left radicalnephrectomy. Histopathology showed a papillary renal cell carcinoma type 1, with positiveimmunohistochemical stains for Vimentin, CK7 and AMACR.
Vimentin

OBJECTIVE: Endoscopic correction of vesicoureteral reflux has evolved as a viable alternative to open surgery. This study was conducted to review the experience of a single institution with the endoscopic Deflux procedure and assess its effectiveness in the treatment of vesicoureteral reflux.

MATERIALS AND METHODS: A retrospective review of patients who underwent endoscopic Deflux treatment for primary vesicoureteral reflux (VUR) between January 2005 and December 2010 was performed. Data collected included: age, gender, unilateral or bilateral treatment, pre-operative grade of VUR on voiding cystourethrogram (VCUG), and the number of Deflux injections per patient.

RESULTS: Sixteen patients [7 (43.75%) males and 9 (56.25%) females] were included in this study. The ages ranged from 6 months to 8 years old with a mean age of 3.15 years. Four (25%) patients had bilateral VUR while 12 (75%) had unilateral VUR, with a total of 21 refluxing ureters. Three had Grade II reflux (14.3%), 13 had Grade III reflux (62%), 5 had Grade IV reflux (24%), and 1 had Grade V reflux (4.7%). Nineteen ureters required one injection while one ureter required two injections. There were no intraoperative nor postoperative complications noted.

CONCLUSION: At the National Kidney and Transplant Institute, endoscopic treatment of VUR with Deflux for primary VUR demonstrated a cure rate of 90%, with no associated perioperative morbidity.

Human ; Male ; Female ; Child ; Child Preschool ; Infant ; deflux ; Endoscopy ; Vesico-Ureteral Reflux-treatment, therapy, management, drug therapy ; Urinary Bladder Diseases ; dextranomer ; dextranomer-hyaluronic acid copolymer

The objectives of this study were to conduct a prevalence survey of trichomoniasis in pregnant women and to evaluate the utility of different methods for its diagnosis. A total of 597 vaginal exudates from pregnant women who were examined at the Hospital de Clinicas in Buenos Aires, Argentina from 1 August 2005 to 31 January 2007, were prospectively and consecutively evaluated. The investigation of Trichomonas vaginalis was made by different microscopic examinations, and culture on liquid medium. The sensitivity and specificity of the microscopic examinations were assessed considering culture on liquid medium as the "gold standard". The prevalence of T. vaginalis obtained by culture on liquid medium was 4.0% (24/597). The prevalence of T. vaginalis obtained by direct wet smear, prolonged May-Grunwald Giemsa staining, and sodium acetate-formalin (SAF)/methylene blue staining-fixing technique was 1.8%, 2.3% and 2.5%, respectively. The sensitivity of the direct wet smear was 45.8%, that of the prolonged May-Grunwald Giemsa staining was 58.3%, and that of the SAF/methylene blue method was 62.5%. Considering the 3 microscopic examinations altogether, the sensitivity rose to 66.7% and the specificity was 100% for all of them. This is the first time that the prevalence data of T. vaginalis by culture in pregnant women are published in Argentina. Due to the low sensitivity obtained by microscopy in asymptomatic pregnant women, the use of the liquid medium is recommended during pregnancy, in order to provide an early diagnosis and treatment.
Argentina/epidemiology ; Cell Culture Techniques ; Female ; Humans ; Microscopy/*methods ; Parasitology/*methods ; Pregnancy ; Pregnancy Complications, Infectious/*diagnosis/*epidemiology/parasitology ; Pregnant Women ; Prevalence ; Prospective Studies ; Sensitivity and Specificity ; Trichomonas Infections/*diagnosis/*epidemiology/parasitology ; Trichomonas vaginalis/growth & development/*isolation & purification

A 17 year old female with diabetes mellitus type 1, with chronic kidney disease. Moreover, hypoplastic left kidney and a renal mass on the functional kidney. The possibility all these medical problems occurring at the same time is close to impossible. The management is likewise very difficult and challenging. Partial nephrectomy as initial choice to treatment but initial ureteroscopic findings and change to radical nephrectomy was prudent. In lieu of chronic dialysis, the decision of early transplantation was done. We present the management choices we had to make in a very difficult case.

Diabetes Mellitus Type1 ; Hypoplastic Kidney ; Solitary Kidney ; Renal Cell Cancer