Advances in the management of enuresis

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The Effect of Inhaler Aromatherapy on Pain and Anxiety in Patients undergoing Shock Wave Lithotripsy

Aim: The aim of this study was to determine the effects of inhaler aromatherapy on pain and anxiety during the shock wave lithotripsy (SWL) protocol. Material and Methods: This placebo-controlled prospective double-blind study included 120 patients who were scheduled to undergo SWL. Patients were randomly assigned a control placebo group 1 (n=40), the lavender group 2 (n=40), and the frankincense group 3 (n=40). The nebulizer (a rate of 2%) was prepared and operated on in the SWL room before the procedure. Data were collected using the visual analog scale (VAS) and the state-trait anxiety inventory (STAI-I). Results: Of the 120 patients included in the study, 67 (55.8%) were male and 53 (44.2%) were female. The mean age of the patients was 37.38±11.35 years. The mean stone size was 11.07±3.09 mm. There were no statistically significant difference between the groups in terms of VAS scores of the patients after the procedure (p=0.557). While there was no statistically significant change in the STAI-I score in group 1 and group 2 after the procedure compared to the pre-procedure, a statistically significant decrease was detected in group 3 (p=0.030). The percentages of patients with changing STAI-I scores were compared, it was observed that the decrease in STAI-I score in group 2 and group 3 at a higher rate compared to group 1 (p=0.018). Conclusion: Frankincense reduced anxiety more significantly than lavender. Both had no significant effect on pain. Inhaler aromatherapy can be used in the SWL process to reduce anxiety and improve treatment compliance

Clinical Course of Pregnant Women with Maternal Hydronephrosis: Retrospective Clinical Study

Aim: The study aims to investigate the clinical course of symptomatic physiological hydronephrosis in pregnant women and the results of treatment in patients required treatment. Material and Methods: A hundred and two consecutive pregnant women who presented with clinical signs and symptoms related to the upper urinary system were included in the study. Renal ultrasonography, urinalysis, serum creatinine levels, white blood cell count, and urine culture were done in all patients at the first visit and repeated at least once a month until 1 month after delivery. In patients with acute pyelonephritis, urinalysis was repeated every 3 days until white blood cell count, erythrocyte sedimentation rate and C-reactive protein levels normalized; urine culture and kidney ultrasonography were performed monthly until 1 month after delivery. Conservative measures (positioning, analgesia, antibiotics) were used in all patients with symptomatic physiological hydronephrosis. If the patient's condition was resistant to medical treatment and the degree of hydronephrosis was increased, drainage was performed by inserting a double J stent into the ureter. Results: Conservative treatments were successful in 98 (96.1%) of 102 patients, but 4 (3.9%) had signs and symptoms of acute pyelonephritis progressing to urosepsis. Antibiotics were continued in patients who developed pyelonephritis, symptoms regressed rapidly, signs of kidney infection returned to normal. Follow-up pregnancies ended with normal vaginal delivery. Conclusion: Symptomatic hydronephrosis in pregnancy can be treated conservatively, should be treated carefully and patients should be followed up. However, ureteral double-J stenting is an effective and safe treatment method in patients with resistant symptoms

Histological and morphological development of the prepuce from birth to prepubertal age

Purpose: To study the histological changes of the preputial tissue from birth to prepubertal age in order to define unnoticed morphological changes. Materials and Methods: Prepuce samples were obtained from 79 healthy boys who underwent routine ritual circumcision. Specimens were divided into six groups according to the boys’ age: newborn, 0–1 year of age, 2–3 years of age, 4–5 years of age, 6–7 years of age, and 8–9 years of age. Histologic analysis of the specimens was performed by H&E, Masson’s trichrome, Verhoeff–Von Gieson, immunohistochemical staining. Results: Microscopic examinations showed that average epithelial thickness increased after the neonatal period (p=0.001). When collagen fiber density was evaluated, no significant differences between groups were found (p=0.083). When the elastic fibers in the dermis were evaluated, it was determined that the number and thickness of elastic fibers increased with age. Immunohistochemical examinations showed that the number of peripheral nerves marked with S100 was lower in the neonatal period than at other ages (p=0.048). When the vessels marked with CD105 antibody were counted, there was no significant difference between the groups (p=0.078). Conclusions: This is the first study to examine the age-related structure of connective tissue elements in the foreskin. Our results showed that the prepuce’s prepubertal maturation process is continuous, and the first 2 years of life are appropriate not only in relation to the physiological effects of age but also the optimum structural changes for wound healing, such as vessel diameter, epithelium thickness, peripheral nerve count

Evaluation of Functional Lower Urinary Tract Dysfunction in Children: Are the Physicians Complying with the Current Guidelines?

Objective. To elucidate whether the diagnostic and treatment approaches of the physicians for functional lower urinary tract dysfunction (LUTD) in children is complying with the current guidelines. Material and Methods. We have conducted an internetbased national survey for the physicians from different departments randomly sampled from the database of Turkish Paediatric Urology Society. Participants were asked to answer two-page questionnaire consisting of 4 main sections: "demography, " "working conditions, " "daily practice, " and "scientific knowledge. " Kruskal Wallis and multiple logistic regression were used for statistical analyses. Results. Of the 117 departments a total of 93 have completed the survey ( : 58 urology; : 35 paediatric nephrology). Routine use of a questionnaire with validated symptom scoring system was found to be 13.9%. Of the participants, only 38.7% were asking all of the patients to fill the bladder diary. During treatment, only 24.7% were applying standard urotherapy for every patient. Almost half of the clinicians (45.1%) believed that they were personally insufficient during the evaluation of those children. Finally, 86% reported that children with LUTD were not adequately approached. Conclusions. Evaluation of LUTD in children is not complying with the current guidelines. General approach for those children needs to be revisited by the clinicians

Evaluation Of Functional Lower Urinary Tract Dysfunction In Children: Are The Physicians Complying With The Current Guidelines?

Objective. To elucidate whether the diagnostic and treatment approaches of the physicians for functional lower urinary tract dysfunction (LUTD) in children is complying with the current guidelines. Material and Methods. We have conducted an internet-based national survey for the physicians from different departments randomly sampled from the database of Turkish Paediatric Urology Society. Participants were asked to answer two-page questionnaire consisting of 4 main sections: “demography,” “working conditions,” “daily practice,” and “scientific knowledge.” Kruskal Wallis and multiple logistic regression were used for statistical analyses. Results. Of the 117 departments a total of 93 have completed the survey (n: 58 urology; n: 35 paediatric nephrology). Routine use of a questionnaire with validated symptom scoring system was found to be 13.9%. Of the participants, only 38.7% were asking all of the patients to fill the bladder diary. During treatment, only 24.7% were applying standard urotherapy for every patient. Almost half of the clinicians (45.1%) believed that they were personally insufficient during the evaluation of those children. Finally, 86% reported that children with LUTD were not adequately approached. Conclusions. Evaluation of LUTD in children is not complying with the current guidelines. General approach for those children needs to be revisited by the clinicians.PubMedWoSScopu