Background: Recurrent urinary tract Infection (UTI) is a common problem in pediatric age group. Vesicoureteral reflux (VUR) is a common cause for recurrent UTI. Objectives: This study was conducted to determine the prevalence of VUR in children who presented with recurrent UTIs and to assess the effect of endoscopic treatment in patients with grade III-V VUR. Methods: This was a prospective study recruiting 1232 patients who presented with recurrent UTI during April 2008 and January 2012. We used voiding cystourethrogram to diagnose VUR, and treated grades III-V VUR by bulking agent. One to 2 sessions were performed and the participants were followed-up postoperatively at first, second, third, and 12th months postoperatively. Results: VUR was found in 437 (35.5%) of the patients. Amongst those, 197 (16%) patients were diagnosed with VUR grade I and II. Additionally, 240 (19.5%) cases were diagnosed with VUR III-V. Two sessions were required to correct the reflux in all patients with grade III. The success rate of correction of grade IV was 79% after the second session. The success rate was 71% in grade V. New contralateral reflux with low grade (I and II) de novo VUR was found in 28/240 (11.7%) cases. After successful correction of VUR, UTI occurred in 12/203 (5.9%) of the patients. Conclusions: VUR was common in children with recurrent UTI with a good prognosis after endoscopic correction. Further study is needed to follow-up the participants who did not respond to treatment.

Background: The tubularized incised plate urethroplasty has well been depicted for the hypospadias management, however, few studies have measured its complication on hypospadias. The current study aimed to compare the tubularized incised plate urethroplasty procedure in circumcised and uncircumcised patients on different locations of distal hypospadias. Subject and Methods: Between 9-July-2012 and 9-March-2014, 81 male patients aged 6 to 108 months (mean age 42.10 ± 25.72), including33 circumcised and 48 uncircumcised boys with distal hypospadias were recruited into the study and underwent tubularized incised plate for the first time. The complications included fistula, meatal stenosis, surgery failure or success, penile skin necrosis, and final outcome were obtained after six month follow-up of the patients. Results:The study revealed that mean surgery duration was60.00±8.18 minutes. The study did not show that surgery in different locations (p=0.872), overall outcome (p=0.153) and specific outcomes including fistula (p=0.261), meatal stenosis (p=0.337), and penile skin necrosis (p=0.299), and successful rate of operation (p=1.000) have a significant difference in circumcised and uncircumcised patients. Conclusion: The procedure is an effective, safe, and proper clinical technique to treat hypospadias in circumcised and uncircumcised patents. The study showed that the technique can be done in both group of patients successfully. Duhok Med J 2017; 11 (1): 61-68.

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