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    A case of isolated female epispadias and our approach to treatment
    (Elsevier Science Bv, 2016) Arslan, M. S.; Arslan, S.; Zeytun, H.; Basuguy, E.; Ozkir, M.; Aydogdu, B.; Okur, M. H.
    Cases of isolated female epispadias (IFE) without exstrophy of the bladder are quite rare. The clinical symptoms of IFE are abnormal external genitalia with primary urinary incontinence. Our patient was a 7-year-old girl with total urinary incontinence. Physical examination revealed a patulous urethra, bifid labia minora, and a bifid clitoris. The vagina and hymen appeared to be normal. Uroflowmetry demonstrated an overflow-type pathological voiding pattern with low voiding pressure. A voiding cystourethrogram showed no indications of reflux. To treat our IFE patient, we performed a single stage genital approach reconstruction of the urethra, clitoris, and labia minora. Follow up with the patient ensured that she was continent and that her external genitals took on an acceptable appearance. (C) 2016 Pan African Urological Surgeons' Association. Production and hosting by Elsevier B.V. All rights reserved.
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    Gastrointestinal tract duplications in children
    (Verduci Publisher, 2014) Okur, M. H.; Arslan, M. S.; Arslan, S.; Aydogdu, B.; Turkcu, G.; Goya, C.; Uygun, I.
    AIM: Gastrointestinal tract duplications (GTD) are rare congenital abnormalities that can occur anywhere along the gastrointestinal tract. These anomalies may present as a single, multiple, or a vague pathologies. Diagnosing and treating these diseases may be difficult in some patients. We aimed to present 32 patients who were followed and treated in our clinic. PATIENTS AND METHODS: This study included the patients between 2000 and 2013. Evaluations included clinical presentations, diagnostic strategies and algorithms, surgical procedures and associated anomalies, and presence of ectopic tissue, complications, and prognosis. RESULTS: Common clinical presentations included vomiting (n=8; 25%), palpable abdominal mass (n=4; 13%). Twenty-eight patients (2 of them antenatally) were diagnosed preoperatively while four of them were diagnosed at surgery. Ileal duplications constituted the most common type (34%) while the least common ones were located in appendix, thoracoabdomen and rectum. One of our patients was present with a gastric duplication which was closely interconnected to a tubular duplication of esophagus, which had never been encountered in the literature before. CONCLUSIONS: It is crucial to note that duplications are likely to occur in various types and numbers and also may accompany other anomalies. Computed Tomography (CT) remains the method of choice since Magnetic Resonance (MR) is likely to cause the use of sedation and analgesia at very young ages and it may also be relatively costly despite being more sensitive in soft tissues. Mucosal stripping is an ideal method for the patients requiring restricted surgery. The antenatal asymptomatic cases can be operated after their 6th months of age.
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    Management of high-grade renal injury in children
    (Springer Heidelberg, 2017) Okur, M. H.; Arslan, S.; Aydogdu, B.; Arslan, M. S.; Goya, C.; Zeytun, H.; Basuguy, E.
    The management of severe renal trauma is disputable. Herein, we present diagnosis and treatment of patients with high-grade renal injury (grades IV and V). The records of 31 patients with severe renal trauma who were treated between 2009 and 2014 were analyzed retrospectively. All patients' CT results were evaluated by two radiologists and assigned grades of IV or V in accordance with the American Association for the Surgery of Trauma Organ Injury Severity Scale. All hemodynamically stable renal trauma patients were treated conservatively. Patients with renal traumas of grade IV and V were evaluated statistically via the SPSS 15.0 software program. Chi-square and Mann-Whitney U tests were used to evaluate the categorical data. Thirteen (42 %) of 31 patients had grade IV, and 18 (58 %) had grade V renal traumas. Twenty-seven (87 %) of the patients had suffered blunt trauma, and four (13 %) had sustained penetrating injuries. Additional organ injuries were seen in 16 patients (52 %), and 15 (48 %) had no concurrent injuries. Twenty-five patients (89 %) were monitored conservatively, three (10 %) underwent surgery, and three patients with grade V renal trauma and additional organ injuries died. There was no statistically significant difference between the grade IV and grade V groups, except in hemoglobin values and the affected kidney (P = 0.07 and P = 0.02, respectively). Computerized tomography can help to grade renal injury and assess additional organ injuries quickly. Most children with high-grade renal injury can be managed conservatively. However, conservative management of renal traumas relies on a multidisciplinary approach. Additionally, surgical intervention is generally required in the face of hemodynamic instability or other concurrent organ injuries.