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Öğe A case report of spleen tuberculosis treated by splenectomy(2004) Önen A.; Yaramiş A.; Şenyi?it A.; Deveci E.A 4-years-old boy who had weakness, anorexia, coughing, fever, night sweats, and weight loss that had persisted for 20 months admitted to our institution. Although he had received three antituberculous agents due to pulmonary tuberculosis for almost a year, there has been no significant improvement in his overall condition. Micronodular infiltration in chest x-ray, multiple nodules and/or small abscesses in the spleen in abdominal ultrasound and computerized tomography were found. Because of the failure of antituberculous therapy, splenectomy has been performed. Intraoperatively, the spleen was completely calcified and covered with multiple nodules and micro abscesses. Following the splenectomy, the patient's symptoms resolved and he began to gain weight. He received antituberculous therapy for two years concomitant with surgery. After 4 year-follow up, he still had no symptom and continued to do well with normal growth. The incidence of spleen tuberculosis has increased recently. The suspicion of tuberculous spleen abscess especially in endemic area and early diagnosis with early nonoperative management is important. The cases associated with severe drug resistant multiple tuberculous spleen abscesses that delayed in tuberculous treatment may benefit from splenectomy.Öğe A comparison of early primary realignment and delayed urethroplasty in the management of posterior urethral injuries in children(2000) Otçu S.; Kaya M.; Dokucu A.I.; Önen A.; Öztürk H.; Azal Ö.F.; Aydin G.Early or late treatment modialities may be instituted in urethral injuries related to trauma. Forty-six boys with urethral injuries that were treated were retrospectively analysed to review our results with early primary realignment and delayed urethroplasty. Thirty-six children were treated with early primary realignment while 10 had a delayed urethroplasty. Urethral strictures developed in 14 cases (39 %) of the realignment group and in 2 cases (12 %) of the urethroplasty patients. The primary realignment patients had a more unfavorable outcome when compared to the delayed repair group. We believe that delayed urethroplasty should be favored to early primary alignment in childhood posterior urethral injuries.Öğe Cystoscopic subureteral injection in children with vesicoureteral Reflux(Logos Medical Publishing, 2018) Önen A.Vesicoureteral reflux is one of the major cause of end-stage renal disease in children in our country. Febrile UTI with should be treated immediately to prevent renal damage. Due to recent developments in endoscopic techniques, there has been a remarkable change in the treatment protocols of VUR in children, and minimally invasive interventions have gained popularity. Therefore, cystoscopic subureteral injection has become to replace medical treatment as well as ureteroneocystostomy. So in most of the children, VUR now can be easily, and successfully treated on an outpatient basis, and thus avoiding need for proscribing prophylactic antibiotics for years and serial invasive follow-up exams. Many different materials have been used for cystoscopic injections. All have increased short-term success rates. Cystoscopic subureteral injections have marked benefits in selected cases including young babies with high grade VURs. Long-lasting stable materials that do not disappear with time should be selected. Its main disadvantages include lower success rates when compared with ureteroneocystostomy, and the requirement of confirmation of resolution of VUR based on postoperative VCUG. Though rarely obstructions may develop due to prolonged retention of subureteral injection material. Contralateral reflux may be observed after injection. In addition, sufficient evidence-based data related to its long-term effects are not still available. 2017 © Logos Medical Publishing. All Rights Reserved.Öğe Effect of admission time on morbidity and mortality in children with intussusception: Analysis of 123 cases(2001) Öztürk H.; Ihsan Dokucu A.; Otçu S.; Önen A.; Gedik Ş.Background/Aim: Intussusception is one of the most frequent reasons of intestinal obstruction in newborn and infants. Delay in diagnosis results in severe morbidity and mortality. We aimed to investigate the effects of admission time on morbidity and mortality in children with intussusception. Methods: A total of 123 intussusception cases were diagnosed and treated at our department between June 1983 and March 2000. We reviewed the charts of these cases retrospectively and evaluated the age, sex, the time of hospitalization, symptoms and signs, the type of intussusception, leading point, recurrence, the mode of treatment, postoperative complications, and mortality. According to time of the admission, we grouped the patients into three; G1: admitted before 12 hours after the first sign, G2: admitted between 12 to 24 hours, G3: admitted after 24 hours. The differences between the groups were investigated for postoperative complications and mortality. Results: Seventy six percent of the cases were under the age of 12 months: The most frequent symptom of the cases in admission were vomiting. Eighty per cent of the cases occurred between the months of April and September when epidemic gastroenteritis is very frequent. The most frequently encountered type of intussusception was ileocaeco-colic (77 %). The leading point of the disease were seen only in 7 % of the cases in. Colon enema with barium for hydrostatic reduction was performed in 25 patients and reduction could be successful in 5 (20 %) of them. Sixty-three percent of cases was treated by manual reduction, 30 % by resection and anastomosis, 3 % resection and ostomy. Postoperative complications were observed in 27 % of the patients. The mortality rate of our patients was 6.5 %. The postoperative complication and mortality rate in the group 3 (>24h) was found significantly different in comparison with G1 and G2 (p<0.0001, p<0.0001). Conclusion: The method of non-invasive treatments may be more frequently used in children diagnosed in early period of disease, while the delay in diagnose determine the mode of the treatment as surgery which cause high morbidity and mortality.Öğe The effect of lidocain infiltration applied pre or postoperatively on postoperative pain after inguinal hernia repair(2003) Önen A.; Kararmaz A.; Tosyali A.N.; Otiçu S.; Öztürk H.; Dokucu A.I.; Kaya M.Aim: To compare the effect of lidocain infiltration applied pre or postoperatively on postoperative pain after inguinal hernia repair. Method: Eighty-one children between 2 to 9 years of age who underwent inguinal hernia repair were reviewed prospectively. The patients were divided into three groups. Control group patients (n=20) underwent herniectomy alone. Five mg/kg lidocain 1% was infiltrated into the incision area 5 minutes before incision in preincisional group (n=35) and at the end of operation in postincisional (n=26) group. The severity of postoperative pain was evaluated by 4 staged pain scale. Results: Sixty-nine were boys and 12 were girls. Thirty-six had right-sided, 31 had left-sided, and 14 had bilateral inguinal hernia. The mean age was 3.6±1.9 years in control, 4.3±2.01 years in preincisional, and 3.3±1.6 years in postincisional group. The mean postoperative pain score was 0.65±0.75 in pre-incisional group, 0.80±0.87 in post-incisional group, and 1.7±0.78 in control group. While there was no significant difference between study groups, the postoperative pain score was significantly higher in control group compared to lidocain groups (p<0.001). The first analgesic demand time was 128.4±46.08 minutes in pre-incisional, 83.6±29.88 in post-incisional, and 27.2±14.9 in control group. The first analgesic demand time was significantly higher in pre-incisional group compared to others (p<0.001). Conclusion: Perioperative local infiltration of lidocain, which does not need additional equipment and experience, seems to be easy to perform, safe, and effective in decreasing postoperative pain after hernioplosty. In addition, the pre-incisional infiltration of lidocain allows more long postoperative painless period.Öğe The effect of tamoxifen on the neonatal development of rat glans penis(1997) Deveci E.; Önen A.; Tacar O.; Yildirim A.From the first day of birth to the fifth day, daily subcutaneous 100 ?g tamoxifen (Tx) was injected into new-born male rats. The penises that were taken totally were fixated in 10% formaline, and then they were put in paraffin inclusion. The paraffin sections were stained with Hematoxylen-Eosin. Verhoeff and Triple on days 7, 14, 21, 28, 35 and 60. The alterations in the development of glans penis construction were examined. We found that in the glans penis of animals which were given Tx, from the 21st day, the epidermal projections were erased slowly and on the 60th day the epidermal projections and keratinisation completely ceased altogether. As a result, the development of epidermal projections in rats which were given tamoxifen in the neonatal period were hindered.Öğe The epidemiology and control of nosocomial infections in pediatric surgery(2002) Önen A.; Çi?dem M.K.; Geyik M.F.; Otçu S.; Öztürk H.; Dokucu A.I.Purpose: To investigale the epidemiology and control methods of nosocomial infection (NCI) in pediatric surgery. Method: We retrospectively reviewed 2844 hospitalized children in the pediatric surgical clinic between January 1997 and December 2000. The diagnosis of NCI was made based on criteria proposed by "Centers for Disease Control and Prevention (CDC)". The incidence of NCIs, type of microorganisms and infections, age, sex and risk factors were determined. The mortality rate and hospitalization period of patients with NCI were compared with 78 control patients whose age, sex and primary disease were identical and free of NCI. Results: There were 78 children with NCI; the overall incidence was 2.74% (4.99% in 1997, 3.89% in 1998, 1.33% in 1999, 1.44% in 2000). The meanage was 28 months the most frequent infections were surgical wound and urinary tract infection, in the NCI and 26 months in the control group. The most frequent risk factors were urethral catheter (10.26%), trauma (9.25%), and parenteral nutrition (8.70%). The mean hospitalization period was 16 days (range 4-28 days) in patients with NCI, while it was 9 days (range 2-22 days) in control group. There was a significant difference in mortality rate and hospitalization period (p<0.05, p<0.001, respectively) between the patients with NCI and those of controls. Conclusion: Surgical wound infection was the most common NCI in Pediatric Surgery. Urethral catheterization, trauma and parenteral nutrition were the most frequent risk factors. NCIs caused high mortality, prolonged hospitalization period and increased cost. Close relationship between the pediatric surgical team and the infection disease team; the education of medical staff; handwashing and disinfetion; limited antibiotics; close follow-up for risk factors; minimized invasive interventions and catheterizations; isolation; and early enteral nutrition resulted in significant decrease in the incidence of NCIs in our clinic in the last two years.Öğe The factors affecting mortality in omphalocele patients(2007) Çiğdem M.K.; Önen A.; Duran H.; Otçu S.Aim: The incidence of omphalocele has been reported to be 1 in 5000 live births. Despite improvements in recent years, mortality rate is still high in these patients. In the present study, we evaluated the possible factors affecting mortality in omphalocele patients who were operated in our clinic. Material and Method: In this study, we evaluated 61 omphalocele cases who were operated in our clinic between 1983 and 2006. Sex, birth weight, gestational age, size of abdominal wall defect, type of surgery, associated anomalies and mortality rate were recorded. Results: The mean birthweight was 3060 gram (1300-4200 gram). In the 24 % of patients, gestational age was under 38 weeks. Primary closure was done in 49 (80 %), silo in 5 (8.1 %), patch in 4 (6.5 %), and skin closure alone in 3 (5 %) patients. Overall, 50 % had associated anomalies. The most common associated anomaly was malrotation (30 %). Mortality rate was 24.5 %; 53.3 % of these patients died in the first postoperative day. While the highest mortality rate was observed in the patients who underwent silo procedure, none of the patients undergoing skin closure alone died. Conclusion: Because of high rate of severe associated anomaly that needs to be treated, all omphalocele cases should be evaluated carefully for such anomalies. Particularly those patients who are treated with silo technique should be followed-up for sepsis, it should be kept in mind that primary closure may increase mortality by causing high intraabdominal pressure in patients with underdeveloped abdominal cavity. Secondary fascial repair should be prefered suspicious cases.Öğe Fetal thoracic aorta doppler in cases with intrauterine growth restriction(2001) Önen A.; Önen A.; Cemal Ark H.Purpose: Considering the accompanying hemodynamic changes Doppler studies have recently been performed for early diagnosis of intrauterine growth restriction (IUGR) cases with high morbidity and mortality. In the present study, Doppler study of the fetal thoracic aorta was conducted and the sensitivity and specificity of the study was assessed in the diagnosis and follow-up of IUGR, as well as prediction of pregnancy outcome. Methods: This study included 44 IUGR cases and 52 healthy pregnant women (as a control group); Doppler waveforms of the fetal aortas were used to predict fetal outcome in pregnancies complicated with IUGR. Due to the short interval between the diagnosis of IUGR and delivery, the Doppler measurement could be redone for only 11 pregnant women in the control group; Doppler measurement could be done twice. Results: There was no significant difference between the study group and the control group in terms of maternal age. There were significant differences in terms of gestational age, birth weight, pulsatility index, blood pressure and first minute apgar score. Of the 44 IUGR cases, there were additional pathologies such as hypertension, DM and oligohydroamniosis, while there was no significant malfunction in the control group. Conclusion: We observed a decrease in the aortic blood flow and a high pulsatility index, which was an independent variable in the IUGR group. A high PI was strongly correlated with bad pregnancy outcome, fetal distress and a high cesarean section rate.Öğe Follow-up and therapeutic approach in children with sacrococcygeal teratoma(2007) Çiğdem M.K.; Önen A.; Otçu S.; Okur H.; Akay H.Sacrococcygeal teratoma (SCT) is the most common solid tumor in neonates. In this study, we retrospectively reviewed 32 SCT patients who were treated and followed in our clinic between 1983 and 2006. Of all the patients, 13 were bigger than 12 months of age. Only 11 patients were present during the neonatal period. The presenting symptoms were sacral mass in 27 patients, difficulty voiding in 3, and difficult defecation in 2 patients. Pathological examination revealed mature teratoma in 17 patients, yolk sac tumor in 9, and immature teratoma in 6 patients. Of the patients who were diagnosed after 1 month of age, 43 % were found to have malignant tumor. Recurrence was observed in five patients during follow-up period; 4 were yolk sac and one was immature teratoma. Postoperative recurrence time was between 6 and 36 months. Two patients died intraoperatively due to massive bleeding, while the other four died due to metastases after chemotherapy. Early (antenatal) diagnosis, early and complete surgical resection of tumor with coccyx is important in reducing morbidity and mortality. Postoperative follow-up might include sacral examination and blood AFP level for at least 3 years in terms of tumor recurrence.Öğe Gastric perforation in neonates: Analysis of five cases(2003) Öztürk H.; Önen A.; Otçu S.; Dokucu A.I.; Gedik Ş.The aetiology of neonatal gastric perforation (NGP) remains unknown and the mortality rate is still very high. We have treated five cases of gastric perforation over the past 17 years, and analysed them retrospectively to present our experience. Clinical data included age, sex, weight, maternal complication, fetal complication, gestational age, type of delivery, admission time, associated pathologies, localization of perforation, perforation age, operative procedures and outcome. There were four boys and one girl. Three of the infants were full-term, while two were premature. All of the infants were septic prior to rupture. Two infants had acute respiratory distress syndrome (ARDS); one due to prematurity and low gestational weight, and one due to meconium aspiration. Perforation was located at major curvature and anterior wall of the stomach in four patients, while it was located in minor curvature and anterior wall in one. The rupture was closed in two layers. Histopathology revealed local chronic inflammation and ischemia. Mortality rate was 60%. In conclusions, gastric perforation is a life-threatening complication in neonates. In our limited series, sepsis, prematurity and corticosteroid treatment were likely to be predictive for development of NGP. Early diagnosis and prompt management before clinical deterioration of the metabolic status may improve the outcome of such infants with NGP.Öğe Hirschsprung's disease: An 18-years experience(2002) Öztürk H.; Otçu S.; Önen A.; Dokucu A.I.; Gedik Ş.; Yücesan S.Aim: In this study, we aimed to analyse the diagnostic and therapeutic features, morbidity, mortality and long-term functional results of patients with Hirschsprung's disease, whom the majority were treated hy Duhamel-Martin procedure. Method: A total of 64 Hirschsprung's disease cases were diagnosed and treated in the department between June 1983 and February 2001. We reviewed the charts of these retrospectively and evaluated the age, sex, symptoms and signs, associated anomalies, the length of bowel involved, type of pull-through performed, functional results of treatment, morbidity and mortality of these patients. Results: There were 52 boys and 12 girls. Thirty seven percent of the cases were diagnosed below the age of one month. The most frequent presenting symptom was abdominal distention (34%). Thirteen of the cases had associated anomalies (20%). The most frequent site of aganglionosis was at the rectosigmoid (82%). A decompressing enterestomy was performed in 56 patients. Soave-Boley's and Duhamel-Martin's technique with protective colostomy were performed in 7 and 41 patients respectively. Postoperative complications were seen in 25 % of the patients. In 4 cases a Duhamed-Martin's procedure was performed without a colostomy. In the postoperative period 16 cases (25%) developed a complication. The most frequent complication was intestinal obstruction due to adhesions (33%). Preoperative and postoperative enterocolotis was found in three (2%) and 5 (9%) patients respectively. Eight children (12%) died, one related to associated anomalies and six due to sepsis one patient died from enterocolitis after the definitive procedure. In the 10 to 15 year age and the greater than 15 year age groups, functional scores were significantly increased when compared to the 5 to 10 year age group (p<0.05). A significant correlation was not found between the functional score and age of the patients. Conclusion. As a conclusion, we have used Duhamel-Martin procedure in majority of patients with Hirschsprung's disease. Long-term fonctional evaluations have shown an improvement in functional score in children older than 10 year in comparison with younger ones.Öğe Histopathological changes in the uterus of rats treated neonatally with clomiphene citrate(1997) Deveci E.; Önen A.; Erdinç M.Clomiphene citrate has estrogenic and teratogenic effects on the developing rat and human fetal genital tract. Clomiphene citrate was given subcutaneously to newly born rats by daily injections of 100 ?g/kg and changes caused by clomiphene in female rats were investigated at 28 and 35 days. Depending upon the effect of clomiphene citrate, histopathological changes such as the observation of polygonal shaped nodular cells in the uterus epithelium and presence of erythrocytes in free nature in the stroma were considered as important findings.Öğe Histopathological changes in the vagina of rats treated neonatally with clomiphene citrate(1997) Önen A.; Deveci E.; Erdinç M.Clomiphene citrate is a nonsteroid antiestrogen which is widely used in the therapy of receptor-positive estrogen for the induction of ovulation. Clomiphene citrate was given subcutaneously to newly born rats with daily injections of 100 mg/kg for 5 days. Changes caused by the clomiphene citrate in vaginas of female rats were investigated at 28 and 35 days. Depending upon the effect of the clomiphene citrate, histopathological changes such as papillary development at keratinization, increase in vaginal epithelium, and observation of polygonal shaped nodular cells in stroma were considered as important findings. It should be emphasised that clomiphene citrate used for induction of ovulation caused these abnormalities in the vagina of rats.Öğe Idiopathic perforation of the colon in the newborn and infant(2004) Öztürk H.; Dokucu A.I.; Otçu S.; Önen A.; Gedik S.; Öztürk H.Aim: The aetiology of idiopathic colon perforation in neonates remains unclear. We present, 8 cases with idiopathic colon perforation occurring in the neonatal period and infancy. The aim of presenting these cases is the rarity of disease without definitive etiology and the features of diagnosis and therapy. Method: We reviewed eight patients with idiopathic colon. perforation from January 1996 to October 2002. Clinical data included age, sex, weight, associated problems, day of perforation, location of colon perforation, repair of perforation, fetal complication, morbidity, mortality and survival. Results: All patients were boys. The median age was 39.2 days. Seven of the newborn infants were full-term, while one was premature. The aetiology was established in none of the patients. The site of the perforation was transverse colon in three patients, left colonic flexure in two, and sigmoid colon in three patients. After resection of the perforation area, proximal colostomy was performed in four patients and sigmoid colostomy in four. Two patients died. Postoperative wound infection developed in five patients who survived. Ganglion cells were present in all colonic specimens. Conclucion: The main reason of colonic perforations in newborn is Hirschsprung disease while there is no etiologic reason found in some cases. We found no ganglionic abnormality in any of eight presenting cases. We think the prematurely and sepsis are the important risk factors leading to mortality for this disease.Öğe The natural history, follow-up and therapeutic approach of hydronephrosis after birth(2006) Önen A.Aim: To determine the natural history, follow-up and therapeutic approach of antenatally diagnosed UPJ-type hydronephrosis after birth. Material and Methods: A total of 108 patients (159 kidneys) associated with antenatally diagnosed UPJ-type hydronephrosis were prospectively followed and treated by the same surgeon between January 2001 and December 2003 for a period of 29 (8-44) months. Ultrasonography and diuretic renogram were used for the diagnosis and follow-up of these patients. SFU grading system and renal pelvic anterior-posterior (AP) diameters were used to determine the severity of hydronephrosis. Results: Seventy-five were boy and 33 were girl. On the first postnatal ultrasound, renal pelvic AP diameter was <15mm in 126 kidneys (surgery, 0.8%), 16-30 mm in 18 (surgery, 22.2%), and >30mm in 15 kidneys (surgery, 80 %). On the first postnatal ultrasound, the severity of hydronephrosis was SFU ? 2 in 125 kidneys (surgery, 0%), SFU-3 in 13 (surgery, 15.4%), and SFU-4 in 21 kidneys (surgery, 71.4%). A total of 142 kidneys (89%) were treated conservatively, while 17 required surgery. Conclusions: Serial ultrasonographic evaluation is very beneficial in determining the natural history of UPJ-type hydronephrosis. The vast majority of mild hydronephrosis is benign and resolve spontaneously without significant renal deterioration. Therefore, close follow-up and invasive tests are not necessary in such cases. About 1/5th of moderate hydronephrosis may require surgery. Therefore, close follow-up is necessary in these patients. About 3/4th of severe hydronephrosis require surgery. Rapid evaluation, close follow-up and timely prompt management are necessary in such cases.Öğe Protective effects of L-Arginine and pentoxifylline on mucosal barrier in ischemia-reperfusion induced gastric injury in rats(2003) Önen A.; Kanay Z.; Kurt D.Aim: To determine the effects L-Arginine (L-Arg) and pentoxifylline (Ptx) on mucosal barrier in ischemia-reperfusion (IR) induced gastric injury in rats. Method: Twenty-eight males, adult Wistar Albino rats (200-250 g) were used in the study. The rats were anesthetized by ketamine hydrokloride. Laparotomy only was applied in control group (n=7). In other three groups, coeliac artery was occluded for a period of 30 minutes followed by a reperfusion period of 60 minutes. No drug was given in IR group (n=7). In Ptx+IR group (n=7), 50 mg/kg Ptx was administered intraperitoneally before reperfusion. In L-Arg+IR group (n=7), 3 mg/kg/minute L-Arginine was increased immediately before refursion. The amounts of mucus and phospholipid were determined by Corne and Baur's methods. Ulcer index was measured via counting macroscopical petechial hemorrhage. Results: Mucus and phospholipid levels in gastric mucosa were significantly lower in IR group compared to control group (p<0.01). The amount of phospholipid was significantly higher in both Ptx+IR and L-Arg+IR groups when compared to those of IR group (p<0.01), while there were no significant differences between Ptx+IR and L-Arg+IR and IR group in terms of mucus amount (p>0.05). Phospholipid level was significantly higher in L-Arg+IR group when compared to Ptx+IR group (p<0.01), while there was no significant difference between these two groups from the point of mucus amount (p>0.05). Ulcer index was significantly higher in IR group than Ptx+IR and L-Arg+IR groups (p<0.05, p<0.01). Conclusion: Gastric IR breaks mucosal barrier through significantly decreased mucus and phospholipid levels and results in gastric mucosal damage via increased ulcer index. Ptx and L-Arg diminish barrier breakage and mucosal damage induced by IR. L-Arg seems to protect the gastric mucosal barrier better than Ptx does.Öğe The role of prenatal steroid and TRH treatment in rats with nitrofen induced diaphragmatic hernia(2000) Çi?dem M.K.; Dokucu A.I.; Önen A.; Otçu S.; Öztürk H.; Deveci E.; Yücesan S.The mortality of congenital diaphragmatic hernia (CDH) is high due to associated pulmonary hypoplasia and pulmonary hypertension. Thus studies aiming to prevent pulmonary hypoplasia in the prenatal period are gaining importance. In this study the role of glucocorticoids and "Thyroid releasing hormone" (TRH) on lung maturation in rats with nitrofen induced CDH is investigated. Ten pregnant Wistar-Albino female rats received nitrofen (100 mg) in two groups on their 9.5 day of pregnancy, while the control group had olive oil administered. In one nitrofen group additionally starting on day 16, glucocorticoids (0, 25 mg/kg betametazon) and TRH (25 ?g/kg) was administered for 5 days. Fetuses were delivered by ceaserean section on the 21st day of gestation and the fetal lungs were histopathologically investigated and DNA analysis and maturation were obtained. Nine fetuses in the control, 14 in the nitrofen and 7 in the treatment group could be investigated. No significant difference was identified in the morphologic evaluation and DNA analysis of the nitrofen and treatment groups. Histopathology revealed hypoplasia that was more prominent in the left lung in both groups. In conclusion the prenatal administration of TRH and glucocorticoids in prevention of nitrofen induced CDH has not been found effective. We believe this may be related to the initiation of treatment on day 16 of gestation.Öğe Which treatment in retrocaval ureter in children?(2007) Çiğdem M.K.; Önen A.; Okur H.; Akay H.Retrocaval ureter is a rare condition in pediatric population. In this study, we present the diagnosis, therapeutic approach and follow-up of our two cases with retrocaval ureter. One of these underwent surgical correction due to persistent severe hydronephrosis and significant symptoms. We treated the second patient conservatively because, of moderate hydronephrosis and normal renal function with no symptoms. The treatment approach in patients associated with retrocaval ureter might be similar to these patients with UPJ-type hydronephrosis.
