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    Comparison of the inguinal and scrotal approaches for the treatment of communicating hydrocele in children
    (Elsevier Taiwan, 2014) Alp, Bilal Firat; Irkilata, Hasan Cem; Kibar, Yusuf; Zorba, Unal; Sancaktutar, Ahmet Ali; Kaya, Engin; Dayanc, Murat
    The inguinal approach is used for the treatment of hydrocele in the pediatric population. Although studies on scrotal orchiopexy have mentioned hernia or hydrocele repair through the same scrotal incision as a part of an orchiopexy procedure, there are a few studies reporting the treatment of isolated communicating hydrocele through a scrotal incision. We retrospectively evaluated and compared the outcomes of inguinal and scrotal approaches for the treatment of communicating hydrocele in boys. The classical inguinal and scrotal approaches to the treatment of communicating hydrocele were performed on 46 and 30 testicular units (in 43 boys and 27 boys, respectively). The patients' charts were reviewed to assess the operative times as well as the immediate and long-term complications during follow-up periods. The patients' ages ranged from 1 year to 8 years (3.6 +/- 2.0 years) in the inguinal group and from 1 year to 10 years (mean 4.6 +/- 2.8 years) in the scrotal group. Operative time was significantly lower in the scrotal group (p < 0.0001). The early minor complication rate did not differ between the two groups. Furthermore, there were no major complications noted. None of the patients had hydrocele recurrence after a mean follow-up of 6 months. The advantages of the scrotal approach for the treatment of communicating hydrocele are as follows: it is well tolerated, simple, and cosmetically appealing, and it has a short operative time in comparison with the standard inguinal approach. The scrotal incision technique is an effective alternative in communicating hydrocele treatment. Copyright (C) 2013, Kaohsiung Medical University. Published by Elsevier Taiwan LLC. All rights reserved.
  • [ X ]
    Öğe
    Effect of Voided Volume on Voiding Patterns and Reliability of Uroflowmetry-Electromyography Results in Children with Lower Urinary Tract Dysfunction
    (Wiley, 2017) Dayanc, M. Murat; Kibar, Yusuf; Irkilata, H. Cem; Sancaktutar, Ahmet Ali; Ebiloglu, Turgay; Gur, Ahmet; Ergin, Giray
    Objective: To examine whether voided volume (VV) could change the uroflow patterns and result in children with lower urinary tract dysfunction (LUTD). Methods: Between January 2009 and May 2010, the children with LUTD were enrolled in this study. Uroflowmetry (UF) combined with electromyography (EMG) was performed two times and was reviewed independently by two urologists. UF-EMG curves were classified as bell, staccato, intermittent, plateau, and tower. Patients' expected bladder capacity (EBC) and VV were recorded. Patients were divided into four groups according to their VV and EBC. Group 1, VV < 50% of EBC; group 2, VV between 50 and 100% of EBC; group 3, VV between 100 and 125% of EBC; group 4, VV > 125% of EBC. Results: A total of 143 patients underwent UF-EMG at least two times and 382 results were obtained. Groups 1, 2, 3 and 4 consisted of 27, 60, 27 and 29 children, respectively. The percentages of normal, intermittent, plateau voiding patterns were 58.5, 12.8, 7.1% in group 1; 79.8, 5.4, 1.8% in group 2; 59.2, 8.5, 2.8% in group 3; and 37.2, 5.1, 2.6% in group 4, respectively. The percentages of staccato and tower pattern were 1.4, 20% in group 1; 9.1, 3.6% in group 2; 30, 0% in group 3; and 55.1, 0% in group 4, respectively. The rate of tower shape curve decreased as voided volume increased, but the rate of staccato curve increased as voided volume increased. Conclusions: In case of exceeding the EBC, the test should be repeated with normal VV when UF results are being evaluated.
  • Küçük Resim
    Öğe
    İnmemiş testis ve eşzamanlı kasık fıtığı birlikteliği: Derleme
    (Dicle Üniversitesi Tıp Fakültesi, 2012) Bozkurt, Yaşar; Sancaktutar, Ahmet Ali; Kibar, Yusuf
    Skrotumda yer almayan testis için kriptorşidizm terimi kullanılır. Kriptorşid testisler ya yoktur veya inmemiştir. Kriptorşidizm, konjenital hastalıkları olan bebeklerde daha sık görülür ve en sık inmemiş testis şeklinde karşımıza çıkar. Miadında doğan erkek bebeklerin %2 ile %5’inde ve erken doğan bebeklerin ise %30’unda inmemiş testis bulunmaktadır. İnmemiş testislerin yaklaşık olarak %10’u çift taraflı olup en sık bulunduğu bölge eksternal inguinal halkanın hemen ağzıdır. İnmemiş testise en sık eşlik eden bozukluk inguinal herni olup, oluşumunda temel etken prosesus vajinalisin (PV) açık kalmasıdır. Primer inguinal herni, tüm yenidoğanların yaklaşık olarak %1 ile %5’inde görülür ve bu oran prematür doğan bebeklerde %9 ile %11’e kadar yükselir. Fıtığı olan bebeklerde genellikle semptom yoktur ve tedavi gerekiyorsa cerrahi işlem uygulanmalıdır. İnkarsere veya strangüle olan kasık fıtığı için acil ameliyat gerektiğinde, eş zamanlı inmemiş testis de eşlik ediyorsa orşiyopeksi yapılmalıdır. Ayrıca rutin orşiyopeksi yapılıyor ve inguinal herni de mevcutsa eş zamanlı herni tamiri de yapılmalıdır. Tedavi edilmeyen inmemiş testise eşlik eden bilinmeyen inguinal herniler, ilerleyen zamanda sıkışarak veya boğularak semptomatik hale gelebilirler. Kriptorşidik hastalarda görülen herni oranı tartışmalı bir konu olup değişik serilerde değişik yüzdeler bildirilmiştir. Yaptığımız literatür taramasında inmemiş testisli hastalara eşlik eden PV açıklığı ve inguinal herni oranlarının sırasıyla % 50 ve % 20 dolayında olduğunu gördük.