Dermatolojik Açıdan Labial Füzyon: Prospektif Çalışma

Aim:Labial fusion is a common condition in prepubertal girls and has several complications. Some dermatological conditions were reported as etiologic factor for this disease. The aim of this study is to evaluate the etiological factors of labial fusion in children through a dermatologic view and to compare the socio-demographic, and environmental data of patients with healthy children.Materials and Methods:In this cross sectional prospective study,23 patients with labial fusion and 49 age-sex matched healthy subjects were questioned and examined from dermatological aspect and assessed by aquestionnaireResults:In the control group; 35 % of mothers graduated from university. In children with labial fusion 35% and 26% of mothers graduated from primary school and university, respectively. The atopic family history and history of atopic diseases of patients were higher in labial fusion group when compared with healthy controls. (p<0.001, p <0.001) There were complaints of pre-erythematous lesions with a mean of 1.26±1.32 (median: 1.00) weeks before labial fusion in 60.9% (n:14) of patients with labial fusion. The alcohol based baby wipes usage was higher in group with labial fusion (p = 0.035).Conclusion:Labial fusion can be diagnosed in children of mothers with lower grade education, with family and personal atopic history and diseases, and frequent usage of alcohol based baby wipes. Also erythema in genital area could need follow-up in first month of visit for prevention or early diagnosis of labial fusion.Amaç:Labial füzyon, prepubertal kızlarda sık görülen bir durumdur ve çeşitli komplikasyonları vardır. Bazı dermatolojik durumlar bu hastalık için etiyolojik faktör olarak bildirilmiştir. Bu çalışmanın amacı çocuklarda labial füzyonun etiyolojik faktörlerini dermatolojik olarak değerlendirmek; sosyodemografik ve çevresel verilerini sağlıklı çocuklarınkilerle karşılaştırmaktır. Materyal ve Metot:Bu kesitsel prospektif çalışmada, 23 tane labial füzyon olgusu ve 49 tane yaş cinsiyetine uygun sağlıklı denekler dermatolojik açıdan değerlendirildi ve tümüne bir anket uygulandı. Bulgular:Kontrol grubunda; annelerin %35’I üniversite mezunudur. Labial füzyonlu çocuklarda annelerin %35’'i ilkokuldan ve %26’sı üniversiteden mezun bulunmuştur. Atopik aile öyküsü ve hastaların atopic hastalık öyküsü, labial füzyon grubunda sağlıklı kontrollere gore daha yüksekti (p <0.001, p <0.001). Labial füzyon grubundaki olguların %60.9’unda (n:14) ortalama1.26 ± 1.32 (ortanca: 1.00) hafta öncesinde pre-eritematöz lezyon şikayeti mevcuttu. Alkol bazlı bebek mendillerinin kullanımı labial füzyonlu grupta daha yüksekti (p = 0.035). Sonuç:Annelerin eğitim düzeyi düşük olan; aile ve kişisel atopic öyküleri ve hastalıkları bulunan; alkol bazlı bebek mendilleri sık kullanılan çocuklarda labial füzyon saptanmaktadır. Ayrıca, genital bölgede eritemi olan çocuklar labial füzyonun erken tanısı ve önlenebilmesi için muayeneden sonraki ilk bir ay boyunca takip edilmelidir

Self Examination of Testes for Protection of Fertility: Case Report

Çocukluk çağında testis sorunları ile yaygın olarak karşılaşılmaktadır. Bu sorunlar doğumsal olabileceği gibi sonradan da oluşabilmektedir. Bu sorunlardan birisi de varikoseldir. Varikosel erken dönemde tanılanabilirse, infertilite açısından riskler azaltılmış olacaktır. Bu yazıda testisinde kendi fark ettiği sertlik nedeniyle hastaneye getirilen, varikosel tanısı alan on yaşında bir erkek çocuk sunulmuş; ebeveynlerde çocukluk çağında testiste oluşabilecek değişimler ve kendi kendine testis muayenesinin önemi konusunda farkındalık oluşturulması amaçlanmıştır.The testicular pathologies are detected commonly during childhood. These can be either congenital or acquired. One of them is varicocele. If varicocele is diagnosed earlier, the risk of infertility should be decreased. Herein, a ten year old boy who was diagnosed to have varicocele after his admittance to hospital due to his feeling of hardness in the testicle. The aim of the article is to create an awareness of childhood testicular pathologies in parents and also to state the importance of self testicular examination

Self Examination of Testes for Protection of Fertility: Case Report

The testicular pathologies are detected commonly during childhood. These can be either congenital or acquired. One of them is varicocele. If varicocele is diagnosed earlier, the risk of infertility should be decreased. Herein, a ten year old boy who was diagnosed to have varicocele after his admittance to hospital due to his feeling of hardness in the testicle. The aim of the article is to create an awareness of childhood testicular pathologies in parents and also to state the importance of self testicular examination.

Dermatological Aspect of Labial Fusion: A Prospective Study

Aim:Labial fusion is a common condition in prepubertal girls and has several complications. Some dermatological conditions were reported as etiologic factor for this disease. The aim of this study is to evaluate the etiological factors of labial fusion in children through a dermatologic view and to compare the socio-demographic, and environmental data of patients with healthy children.Materials and Methods:In this cross sectional prospective study, 23 patients with labial fusion and 49 age-sex matched healthy subjects were questioned and examined from dermatological aspect and assessed by a questionnaire.Results:In the control group; 35 % of mothers graduated from university. In children with labial fusion 35% and 26% of mothers graduated from primary school and university, respectively. The atopic family history and history of atopic diseases of patients were higher in labial fusion group when compared with healthy controls. (p<0.001, p <0.001) There were complaints of pre-erythematous lesions with a mean of 1.26±1.32 (median: 1.00) weeks before labial fusion in 60.9% (n:14) of patients with labial fusion. The alcohol based baby wipes usage was higher in group with labial fusion (p = 0.035).Conclusion:Labial fusion can be diagnosed in children of mothers with lower grade education, with family and personal atopic history and diseases, and frequent usage of alcohol based baby wipes. Also erythema in genital area could need follow-up in first month of visit for prevention or early diagnosis of labial fusion

It is not Just Circumcision

Objective: Circumcision is one of the most commonly performed operations during childhood. The procedure is often underestimated in areas where it is frequently executed due to social and religion-based indications. In fact it might be an opportunity to detect and to correct any existing penile anomaly. The aim of the study was to retrospectively evaluate the boys who were admitted to a hospital for circumcision and the outcome of the procedure. Methods: The boys who were brought to outpatient clinics for circumcision between 2009-2015, were retrospectively evaluated. The indications for hospital admission and the presence of associated penile anomalies were searched. All the boys were examined and operated by a single surgeon of the institution. Results: Nine hundred forty four boys were brought to pediatric surgery outpatient clinics in order to be circumcised. The operation was performed in 318 of them. The physical examination revealed penile anomalies in 29 of the 318 cases. The detected anomalies were webbed penis, penile torsion, hypospadias, chordee without hypospadias and meatal stenosis. Conclusions: The proper examination of the boys by a physician prior to circumcision provides the detection of penile anomalies which can be corrected at the same session. The arrangements for performing circumcision in hospitals by the medical staff should be favored. The misleading perception of underestimation of the procedure where it is ritually performed, should be corrected

EFFECT OF TADALAFIL ON PREVENTION OF URETHRAL STRICTURE AFTER URETHRAL INJURY. AN EXPERIMENTAL STUDY

Objective: To evaluate the preventive effect of PDE-5 inhibitor (Tadalafil) on the formation of urethral stricture after urethral injury. Material and Method: A total of 28, four-month-old male New Zealand rabbits were included and divided into three groups. Group 1 was a sham group with 8 rabbits that underwent only urethroscopy. Group 2 was a non-treatment group with 10 rabbits that underwent urethral electro-coagulation without any treatment. Group 3 was the treatment group with 10 rabbits that underwent urethral electro-coagulation with systemic tadalafil treatment. After 30 days of follow-up, urethroscopy and retrograde urethrography was performed to evaluate the morphological changes in the urethra. The urethra tissues were examined with standard light microscopy by a histologist and apoptosis was evaluated by the terminal dUTP nick end-labeling (TUNEL) assay. Results: Urethral diameters in group 1, group 2 and group 3 were 9.14 ± 0.73 mm, 3.52 ± 1.2 mm, and 7.68 ± 1.14 mm, respectively. The differences in urethral diameters were statistically significant between groups.(p<0.01) Collagen deposition in submucosal connective tissue was significantly less in the tadalafil group versus the non-treatment group. The numbers of apoptotic cells in submucosal connective tissuewere also quantitatively higher in urethral stricture groups compared to the sham group. Conclusion: Tadalafil treatment had a protective effect against the formation of urethral stricture in rabbit model. This treatment can be a promising opportunity for urethral stricture and must be supported by clinical studies.Amaç: Üretra yaralanmasına bağlı üretra darlığı oluşmasını PDE-5 inhibitorünün(Tadalafil) önleyici etkisini araştırmayı amaçladık. Materyal, Metod: Toplam 28 tane 4 aylık erkek New Zealand tavşan 3 gruba bölündü. Sham olan grup1’deki 8 tavşana sadece üretroskopi yapıldı. Tedavisiz grup olan grup2’deki 10 tavşanın üretrasına elektrokoterizasyon yapıldı ve herhangi bir tedavi verilmedi.Tedavi grubu olan grup 3’deki 10 tavşanın üretrasına elektrokoterizasyon yapıldı ve sistemik tadafil tedavisi verildi. 30 gün takip sonra, üretradaki morfolojik değişiklikleri değerlendirmek için üretroskopi ve retrograde üretrografi yapıldı. Üretra dokusu tekbir histolok tarafından standart ışık mikroskopuyla değerlendirildi. Ayrıca apoptosis terminal dUTP nick end-labeling (TUNEL) ile değerlendirildi. Sonuçlar: Grup 1, grup2 ve grup3’ün üretra çapı sırasıyla 9.14 ± 0.73 mm, 3.52 ± 1.2 mm ve 7.68 ± 1.14 mm bulundu. Gruplar arasında üretra çapı istatistiksel olarak farklıydı(p<0.01). Submukozal konnektif dokuda kollejen depolanması tadalafil grubunda tedavisiz gruba göre belirgin azdı. Submukozal konnektif dokudaki apoptotic hücre sayısı üretral darlığı gruplarında, sham grupbundan daha yüksektir. Sonuç:Tadalafil tedavisi, tavşan modelinde üretra darlığı oluşmasına karşı koruyucu etkiye sahiptir. Bu tedavi üretra darlığına karşı umut veren bir seçenek olabilir ve klinik çalışmalarla desteklenmelidir

Determination of the normal anal location in neonates: A prospective cross-sectional study

Aim: Anterior displacement of the anus might be a form of anorectal malformations. The study aims to measure the anal position index (API) in neonates with a modified method. Methods: The study was conducted between March 1, and December 31, 2019, in the neonatal unit at Tekirdag Namık Kemal University Hospital. The neonates between 35 and 42 gestational weeks and those without congenital malformation were included in the study. Four hundred five neonates were evaluated prospectively. API was determined by using distances between posterior fourchette-anus and posterior fourchette-coccyx in girls; scrotum-anus, and scrotum-coccyx in boys. Results: Of 405 participants, there were 230 males. API was found 0.52±0.05 and 0.39±0.04 in boys and girls, respectively. For the diagnosis of the anterior location of the anus, the lower limit was 0.33 cm in girls and 0.43 cm in boys. According to these results, nine boys (3.9%) and seven girls (4%) had an anteriorly located anus. Conclusion: API could be measured more accurately by the modified method and this resulted in a lower incidence of anterior location when compared with the previously defined techniques. © 2021 by The Medical Bulletin of İstanbul Haseki Training and Research Hospital The Medical Bulletin of Haseki published by Galenos Yayınevi

How did the surgeons treat neonates with imperforate anus in the eighteenth century?

Anorectal malformations (ARMS) are one of those challenging topics of pediatric surgery. The developments in assessing and approaching patients with these anomalies have been made in the last decades and the methods described in older textbooks functioned as a guide in planning these attempts (Kiely and Pea in Pediatric surgery, Mosby, Missouri, pp 1425-1449, 1998; Grosfeld in Anorectal malformations in children, Springer-Verlag, Berlin, pp 3-15, 2006). The aim of this study is to present the attitude of a surgeon of eighteenth century to the treatment of anorectal malformations, and the evolution in the history of the anomaly. The part about imperforate anus in a textbook of surgery, found in a second-hand bookstore, was translated. The description and the classification of the anomaly, the methods of approaching these cases together with some case reports were presented and compared with today's practice. The historical background of the anomaly was evaluated not only with regard to the book of Heister specifically but also to the other data obtained in the literature. The anomaly was reported to be not rarely observed. The obstetricians were warned to examine a newborn baby completely for early diagnosis. The classification of the anomaly was made according to the properties of the membrane covering the anus but prompt treatment, initiating with its simple excision, was suggested in all types. Better results in cases whose anus was covered with a thin, delicate membrane were reported. The results show that routine neonatal examination for all babies was recommended in this Textbook of Surgery which had been published 260 years ago. The physical deterioration due to delay was well described. A broad classification of imperforate anus was made and successful outcome in low-type anomalies of today was reported with some case samples. It is clear that all the efforts starting from Soranus until today improved the understanding of the anomaly. Combining previous information with today's practice in the meetings focused totally on anorectal malformations, where the leading surgeons shared their experiences and re-evaluated the problems encountered, enlightened the future status of this interesting topic of pediatric surgery