Emin Balkan

The effectiveness of early primary realignment in children with posterior urethral injury

Abstract Aim:  The aim of this retrospective study was to compare the results of delayed repair and early primary realignments in patients with posterior urethral injury.

Severe Hypospadias Associated with Robertsonian Translocation

In this study, we report a 3-year-old boy with severe scrotal hypospadias with Robertsonian translocation [45,XY,t(13q;14q)]. The patient was born at term with a low birth weight and hypospadias. There was no endocrinological abnormality. His father also has a balanced 13–14 Robertsonian translocation. Two-stage hypospadias repair was carried out. The presence of this chromosomal anomaly and hypospadias are unique to our patient, compared to others with the 45,XY,t(13q;14q) translocation. Although no such association has been reported so far, we thought that severe hypospadias in this case might be associated with this translocation.

Transitional cell carcinoma of the bladder presenting after blunt abdominal trauma: A very rare occurrence in childhood

Abstract  Tumors of the urinary bladder are rare in children and nearly all of them are of mesodermal in origin. Herein we report a case of transitional cell carcinoma of the urinary bladder in a 13‐year‐old boy who presented after blunt abdominal trauma. It should be remembered that hematuria could develop after blunt abdominal trauma in children, for reasons other than the trauma itself (e.g. tumors of the urinary tract).

Surgical correction of muscular torticollis in older children with Peter G. Jones technique

In the Department of Pediatric Surgery, Uludağ University Medical Faculty in Bursa, during the last 11 years, the Peter G. Jones technique for the surgical correction of muscular torticollis in older children has been introduced. Twenty children between 4 and 13 years of age were treated for muscular torticollis. They were followed up from 3 months to 10 years after surgery. All patients had a middle-third open transection of the sternocleidomastoid muscle. Preoperative and postoperative assessment by a rigid scoring system showed that all patients improved in terms of function as well as cosmesis. Children younger than 10 years showed the most improvement, with 90% excellent and good results. Late middle-third open transection of the sternomastoid in muscular torticollis may give acceptable results.

Indirect computed tomography sign of renal artery injury: retrograde filling of the renal vein.

Abstract  Computed tomography is a very useful diagnostic tool in childrens trauma. In the present case report, retrograde filling of the renal vein during computerized tomographic examination of a patient with renal trauma is presented. This is an indirect sign of traumatic renal artery injury. This finding might assist in the early diagnosis of severe renovascular trauma.

Late effects in patients with sacrococcygeal teratoma: A single center series

Abstract Introduction: The aim of this study is to evaluate late side effects that affect quality of life in children with sacrococcygeal teratoma (SCT). Patients and methods: The patients with SCT were evaluated retrospectively. The data were expressed by percentage and the subgroups were compared statistically. Results: A total of 40 children with SCT were identified with median age 12 days (range: 1 day-14.6 years), 27 of whom were analyzed in this study with urodynamic data available for 24 and anal manometric evaluations for 20. Chronic constipation with need for laxative was reported in (7/27) 25.9%, fecal incontinence was present in (1/27) 3.7%, and urodynamic abnormalities were reported in (16/24) 66%. Among those with urodynamic abnormalities, low bladder capacity, dyssyergia and neurogenic bladder were observed in (21/24) 87.5% and anticholinergic treatment was applied. Urinary incontinence was present in (2/27) 7%, with clean intermittent catheterization utilized in (7/27) 25.9%. While defecation was observed more in the patients with Altman types II, III, and IV, micturation problems were observed more in the patients with Altman types II and IV. It was found that urodynamic dysfunctions were more frequent in the patients with increased number of operations. Discussion: Although the rate of symptomatic patients was low, abnormalities determined by radiological and urodynamic evaluations were high.

Urothelial Carcinoma of the Bladder in Pediatric Patient: Four Case Series and Review of the Literature

Background: Urothelial carcinoma of the bladder is a rare condition in children, and most cases in this age group are noninvasive and low-grade. However, no follow-up protocol has been defined for this patient group. The objective of this study was to draw attention to bladder tumors in children and focus on the current recommendations for postoperative follow-up along with a case study of four patients. Case Report: Four patients aged <18 years with urothelial carcinoma who were treated in our clinics between 2001 and 2015 were retrospectively evaluated. The results were compared with those of published pediatric case series in the literature. No abnormalities were found in the patients’ physical examinations and laboratory analyses, except hematuria (microscopic or macroscopic). Ultrasonography was used in all the patients to detect lesions in the bladder. Surgical resections were performed endoscopically, except in one patient. Histopathological evaluations revealed low-grade superficial urothelial carcinoma. No recurrence or complication was observed for all patients. Conclusion: Although rarely encountered during childhood, urothelial carcinoma should be considered as a differential diagnosis in pediatric patients with hematuria.

The Association of Congenital Urethral Duplication and Double Megalourethra

Background: Urethral duplication and megalourethra are rare urethral anomalies. However, the concomitance of urethral duplication and double megalourethra has not been reported previously. Case Report: A newborn was presented with penile swelling during voiding. Physical examination revealed a retractable foreskin and two external meatus of a double urethra. Retrograde urethrography demonstrated two complete megalourethras. Urethro-urethrostomy and urethroplasty were performed when the patient was 10 months old. The patient was followed up for one year without any urinary problems and has good cosmetics and urinary continence. Conclusion: The concomitance of these two rare anomalies and more importantly its surgical treatment makes this case report unique and valuable.

Çocuklarda enürezis noktürna: Tedavide güncel yaklaşımlar

Nizamettin Kilic1, Osman Donmez2, Emin Balkan1 JThe Medical Faculty Of Uludag University, Department Of Pediatric Surgery, Division Of Pediatric Urology, Gorukle, 16059, Bursa 2The Medical Faculty Of Uludag University, Department Of Pediatrics, Division Of Pediatric Nephrology, Gorukle, 16059, Bursa

Çocuklarda Özofagus Yabancı Cisimleri

Foreign bodies of the esophagus are common problems in children and there are various methods to manage esophageal foreign bodies We retrospectively reviewed our cases in respect to the time of admittance after ingestion the presenting symptoms the site and type of the foreign body and the management undertaken From 1991 to 1998 134 esophageal foreign bodies were managed in our institution There were 77 boys and 57 girls 56 7 n:76 of the children were less than 3 years old 91 8 n:123 of foreign bodies were opaque and 8 2 n:1 1 were nonopaque 98 of opaque foreign bodies were coins 106 of foreign bodies were located at the proximal third 14 at the middle third and 14 at the distal third of the esophagus Duration of ingestion was less than 12 hours in 64 9 n: 87 of the patients and the longest duration was three months Complications were observed in two patients 84 8 n:127 of foreign bodies were managed with McGill pliers extraction n: 85 with foley balloon extraction n: 16 with endoscopic extraction n:25 with fogarty cathater extraction n:1 under general anesteshesia and with magnetic exraction n:3 Four of the foreign bodies were pushed into the stomach We believe that removal of the esophageal foreign bodies in children must be performed in the operation theatre McGill pliers and foley balloon catheter are suitable for removal of proximal third esophageal foreign bodies and endoscopy for removal of middle or distal third esophageai foreign bodies If the removal of the foreign bodies is impossible advancement into the stomach is suitable Key words: Esophagus Foreign Bodies Children