Unilateral newborn hydronephrosis appears to be relatively benign and in most instances dilatation and renal function improve with time. However, close followup is necessary to identify the subgroup of less than 25% of infants with obstruction because prompt pyeloplasty will prevent permanent loss of renal function. Standard tests for assessing obstruction in older patients appear to be invalid in infants because prolonged half-time and/or high grade hydronephrosis is neither an indicator of obstruction or surgery. Nonoperative treatment with close followup especially during the first 2 years is safe and recommended for these children.

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Ninety-seven children with distal hypospadias were treated surgically using perimeatal-based flap urethroplasty (Mathieu procedure) in a two and a half years period. A review of the medical records revealed two distinct groups of patients according to the suturing type and suture material. In the first group of 36 patients (group I), neourethra was constructed using 6/0 polyglactine (Vicryl) in a single layer, full-thickness, uninterrupted fashion. Skin flaps were approximated using interrupted simple 5/0 polyglactine (Vicryl) sutures. In the second group of 61 patients (group II), 7/0 polydioxanone (PDS) was used in the urethral anastomosis performed in a subcuticular, uninterrupted fashion. The skin flaps were closed using interrupted simple 5/0 rapidly absorbable polyglactine (Rapid Vicryl) sutures. Patients were followed-up from 6 to 12 months. Urethral or meatal stenosis was not observed in any patient. There was no infectious complication. Urethrocutaneous fistula rate was significantly higher in group I (16.6%) compared to group II (4.9%) (p < 0.01). Complication rate following hypospadias repair can be reduced by the use of a subcutaneous suture technique utilizing polydioxanone suture material in urethroplasties.

The Rapunzel syndrome, found characteristically in girls with varying gastrointestinal symptoms, is a rare form of gastric trichobezoar extending throughout the bowel. The previously reported cases have different clinical and pathological features affecting the mortality. We describe a new case preoperatively diagnosed with none of the complications previously reported.

Background/Aims: Prevention of renal scarring is the main therapeutic goal in children with spina bifida. We aimed to determine factors affecting renal scar development in these patients. Materials and Methods: Records of 312 children admitted between 1994 and 2005 with spina bifida were reviewed. Age on admission, gender, presence of previous febrile urinary tract infections (UTIs), vesicoureteral reflux (VUR), and initial urodynamic findings were noted. Patients were grouped regarding presence/absence of renal scars on DMSA scans. χ² and Student’s t tests were used for statistical evaluation. Results: Seventy-two patients had renal scars on admission. Mean age was 4.62 ± 4.59 years for patients without renal scars and 6.35 ± 4.9 years for patients with scars. Male/female ratio was 1:1 in the scarless group and 1:2 in the group with scars. Previous febrile UTI was present in 11 of 240 scarless patients in contrast to 7 out of 72 patients in the scar group (p > 0.05). VUR was present in only 16.3% of cases without scars, whereas 36.1% of patients in the scar group had VUR. Detrusor overactivity and detrusor sphincter dyssynergia were observed in 67.1% of scarred patients, whereas this figure was 42.4% in the scarless group. The comparison of age on admission, gender, detrusor overactivity, and detrusor sphincter dyssynergia revealed significant differences between patients with and without renal scars. Conclusions: Late referral, female gender, overactive detrusor, and detrusor sphincter dyssynergia have detrimental effects on renal parenchymal function in spina bifida patients. Patient selection for aggressive treatment using these features may prevent renal parenchymal deterioration.

Vesicoureteral reflux is associated with daytime incontinence, urinary tract infection, younger age and renal cortical abnormalities among patients with idiopathic lower urinary tract dysfunction. Increased intravesical pressures seem to be the primary factor for inducing reflux in idiopathic lower urinary tract dysfunction. Initial bladder capacity predicts the resolution of reflux.

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Five hundred and nineteen NaOH ingestion cases were admitted to our department between 1975 and 1994, and examined via esophagoscopy in the first 48 hours. Two hundred and forty-six patients in this series were diagnosed as severe burns endoscopically. This group of 246 patients were evaluated in a retrospective study to determine whether systemic steroid treatment had any place in preventing stricture formation following severe esophageal burns. Seventy-nine patients in this group were divided into three subgroups and they received methyl prednisolone parenterally in three different regimens. The control group consisted of 167 patients admitted between the years 1986 and 1994 who did not receive any form of steroid treatment. There were no statistically significant differences between the healing rates of the subgroups and the control group (p > 0.01). The authors concluded that systemic steroid treatment has no beneficial effect on esophageal wound healing following caustic esophageal burns.