Objective: Hypospadias is a common genitourinary system (GUS) anomaly in boys occurring in 1 of 200 to 300 live births. Undescended testes is frequently detected among accompanying anomalies in cases with hypospadias. Especially in proximal hypospadias and bilateral cases, this association may indicate sexual differentiation disorders. The aim of the study was to evaluate the togetherness of additional anomalies in hypospadiac children with undescended testes. Material and Methods: Between 2007 and 2016, data of 392 children who underwent surgery for hypospadias were evaluated retrospectively. Urethral meatus was present at scrotal and penoscrotal in 65 cases (16.6%) and glanular, coronal, subcoronal and midpenile in 327 cases (83.4%). The cases were divided into two groups as those with both testes in the scrotum and those with undescended testes, and the anomalies were recorded. Results: The mean age of the children with proximal hypospadias was 21 months (6-240 months). Of the children with proximal hypospadias, 26 (40%) had undescended testes and 39 (60%) had testes in the scrotum. Undescended testes were detected bilaterally in 17 patients (65.4%) and unilaterally in nine patients (34.6%) in the undescended testes group. In the undescended testes group, 24 patients (92.3%) had suspected external genitalia (bifid scrotum, penoscrotal transposition, togetherness of micropenis and penoscrotal hypospadias, scrotalized labium majus) on physical examination. In the undescended testes group, three patients (11.5%) had additional urinary pathology and ten patients (38.5%) had other system anomalies. Ten patients (25.5%) had suspicious external genitalia on physical examination in the proximal hypospadias group who had both testes in scrotum. Additional urinary pathology was detected in one patient (2.5%) while other system anomalies were detected in five (12.8%) patients. The mean age of children with distal hypospadias was 33 months (6-156 months). Nine of 327 children with distal hypospadias (2.8%) had undescended testes. Of these, five were bilateral (55.6%) and 4 had unilateral undescended testes (44.4%). None of the patients with distal hypospadias had any suspicious genitalia on physical examination. In the undescended testes group, one patient (11.1%) had additional urinary pathology and one patient had other system anomaly. Seven patients (2.2%) who had both testes in scrotum had additional urinary pathology and 32 patients (9.8%) had other system anomalies. Conclusion: According to our results, further tests such as genitourinary ultrasonography, pelvic MRI if necessary, endocrine and genetic evaluation should be considered in cases where the proximal hypospadias is accompanied by an undescended testicle, and detailed anamnesis and physical examination covering all systems is necessary in all hypospadiac children in terms of additional anomalies.

Amaç: Akut apandisit, çocuk cerrahisi pratiğinde en önemli ve yaygın olarak uygulanan acil cerrahilerden biridir. Çocuklarda apandisit tanısı yetişkinlere göre daha zordur. Olgunlaşmamış granülosit yüzdesi (%IG) son zamanlarda erişkin popülasyonda inflamasyon şiddetinin saptanması için laboratuvar parametresi olarak araştırılmaktadır. Çalışmanın amacı, pediatrik akut apandisit erken tanısında IG sayısı ve yüzde rolünün belirlenmesidir. Gereç ve Yöntemler: Ocak 2021-Aralık 2022 tarihleri ​​arasında karın ağrısı şikayeti ile Acil Servise başvuran ve preoperatif akut apandisit tanısı ile opere edilen hastaların verileri hastane kayıtlarından geriye dönük olarak incelendi. 18 yaş altı, akut apandisit ön tanısı ile ameliyat edilen ve hemogramı olan hastalar çalışmaya dahil edildi. Bulgular: Çalışmaya 108 hasta dahil edildi. Akut apandisit grubunda 48 hasta, perfore apandisit grubunda 9 hasta ve kontrol grubunda 53 hasta vardı. Apandisit ve kontrol grubundaki hastalarda ortalama IG %'si sırasıyla 0,31±0,37 ve 0,96±5,1 idi. Apandisit hastaları ile kontrol grubu arasında IG sayısı ve yüzdesi açısından anlamlı fark bulunmadı. Akut ve perfore apandisit arasında IG sayısı ve IG % açısından istatistiksel olarak anlamlı fark bulunmadı. Sonuç: IG sayısı ve IG%, herhangi bir ek fayda sağlamadı ve klinisyen için akut apandisit belirlemede kesin bir biyobelirteç değil. Akut apandisit tanısı için anamnez, fizik muayene ve laboratuvar testinin bir kombinasyonu altın standart olmaya devam etmektedir.

Emphysematous pyelonephritis (EPN) is severe necrotising inflammation of renal parenchyma. Because of the devastating consequences of the pathology aggressive treatment can prevent permanent renal damage. Fifteen-year-old-girl patient without medical follow-up applied to emergency room with fever and vomiting. Computed Tomography (CT) revealed EPN. After diagnostic procedure minimal invasive procedures like double J catheter and nephrostomy tube insertion failed. While taking into account family’s treatment and medical follow-up compliance, also severe dilatation in both ureters made bilateral ureterocutaneostomy (UC) to be considered as a feasible option. UC creation can be thought as a safe and effective alternative surgical procedure. Pediatric neurogenic bladder (NB) population incompatible to treatment and follow-up are candidates for EPN development. We also believe that UC can be beneficial in terms of acute and long-term management of EPN in NB patients who the clinician thinks will not be compatible with complex surgical intervention, follow-up and treatment.

Objective: Aim of the study is to determine the hemostatic techniques among pediatric urologists in Turkey. Material and methods: Questionnaire forms were sent to 459 pediatric urologist by e-mail. Results: Ninety eight of 459 participants answered the questionnaire forms. Eighty-one (84.4%) of the participants were using tourniquet. The participants who didn't use tourniquet stated their justifications as follows: lack of need (n=10: 66.7%), development of edema, ischemia, delay of wound-graft healing and fistula risk (n=5: 33.3%). The indications of tourniquet use were stated as follows: penile (91.4%: n=74), distal (72.8%: n=59), penoscrotal (55.6%: n=45) hypospadias; fistula repair (33.3%: n=27), cripple hypospadias (33.3%: n=27), repair with flaps (30.9%: n=25), repair with grafts (27.2%: n=22), and isolated penile curvature (21%: n=17). Most commonly used tourniquet material (49.9%) was latex glove. Erection test was applied by 43.8% of participants. Scalp vein set was the most commonly (54.8%) used injector during erection test. Only 9.4% of participants were using adrenaline. Adrenaline dosages used at 1/100.000 dilution by 55.6%, lidocaine with 1/100.000 adrenaline by 44.4% of participants. Conclusion: Beside a few experimental ones there is a paucity of studies that can serve as a guideline for using these techniques in the literature. There is a necessity of realizing prospective, randomized studies with long-term follow up to evidence that postoperative complications could develop secondary to hemostatic techniques and also to facilitate safe use of these techniques.

Aim Neuropathic bladder dysfunction (NBD) or neurogenic lower urinary tract dysfunction occurs as a result of a lesion at any level of central nervous system. The most common aetiology of NBD in children is abnormal development of spinal column. These defects cause neurogenic detrusor overactivity which contributes to detrusor‐sphincter dysfunction and results in lower urinary tract symptoms such as incontinence. One of the more progressive and insidious, at the same time preventable result of neuropathic bladder is upper urinary tract deterioration. It is vital to aim reduction in bladder pressures and the minimisation of urine stasis in order to prevent or at least attenuate renal disease. Despite world‐wide strategies for prevention of neural tube defects currently, we will still be involved in the care of spina bifida patients born every year with a neuropathic bladder and at risk of long‐term renal damage. This study was planned for evaluation of results and detection of possible risk factors for upper urinary tract deterioration during routine visits of neuropathic bladder population. Methods The electronic medical records of the patients who were followed up for at least 1 year with the diagnosis of neuropathic bladder in Pediatric Urology and Nephrology units of Adana City Training and Research Hospital were reviewed retrospectively. A total of 117 patients, whose blood, urine, imaging and urodynamic study required for the evaluation of nephrological and urological status were completed and included in the study. Patients under the age of one were excluded from the study. Demographic characteristics, medical history, laboratory and imaging results were recorded. All statistical analyses were analysed by SPSS version 21 software package and analysed by descriptive statistical. Results Of the 117 patients who participated in the study, 73 (62.4%) were female and 44 (37.6%) were male. Mean age of the patients was 6.7 ± 4.9 years. The leading cause of neuropathic bladder was neuro‐spinal dysraphism with 103 (88.1%) patients. Urinary tract ultrasound imaging revealed hydronephrosis in 44 patients (35.9%), parenchymal thinning in 20 patients (17.1%), increased parenchymal echo in 20 patients (17.1%) and trabeculation or increase in wall thickness of the bladder in 51 patients (43.6%). Voiding cystogram revealed the presence of vesicoureteral reflux in a total of 37 patients (31.6%), with 28 patients being unilateral and 9 patients bilateral. More than half of the patients had abnormal bladder findings (52.1%). In the Tc 99 m DMSA scan of the patients, 24 patients (20.5%) had unilateral renal scars and 15 (12.8%) had bilateral. Loss of renal function was detected in 27 (23.1%) of the patients. Urodynamic study revealed decreased bladder capacity in 65 patients (55.6%) and increased detrusor leakage pressure was found in 60 patients (51.3%). The mean leak point pressure of the patients was 36 ± 26 cm H2O, and the mean leakage volume was determined as 157 ± 118 mL. Conclusion Findings obtained from imaging and uro...