Person: YÜCEL, SELÇUK
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YÜCEL
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SELÇUK
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Publication Open Access Consistency of uroflowmetry analysis in children among observers(2023-01-01) ŞEKERCİ, ÇAĞRI AKIN; TANIDIR, YILÖREN; TARCAN, TUFAN; YÜCEL, SELÇUK; ŞEKERCİ Ç. A., TANIDIR Y., TARCAN T., YÜCEL S.© 2023 Wiley Periodicals LLC.Aim: The aim of the study is to compare the intra- and inter-observer interpretations of the same uroflowmetry study at two different times. Materials and Methods: Two-hundred children with a voided volume of 50% above the expected bladder capacity were included. All traces were asked to be evaluated by 11 observers two times in a time span of 1 month. These observers consist of pediatric urologists (n = 2), pediatric urology fellows (n = 2), urology residents (n = 5), and certified urodynamics nurses (n = 2). Each uroflowmetry was asked to be assessed for three domains: voided volume (VV), detrusor sphincter dyssynergia (DSD), and flow curve pattern (FCP). Results: Of the 200 patients with a median age of 10 (4–18) years, 128 (64%) were girls and 72 (36%) boys. The maximum flow rate and the median voided volume were found to be 20 (4–61) mL/s and 232 (116–781) mL. The Fleiss\" kappa coefficient of VV, DSD, and FCP in the first assessment was 0.510, 0.501, and 0.346. In the second assessment, κ values were 0.530, 0.422, and 0.373. The best-agreed findings were similar at both times. These were found to be low VV (0.602 and 0.626) and intermittent pattern (0.500 and 0.553). Interpreters were found to have a statistically significant difference in agreement with their own interpretation at different times. Conclusion: Both inter- and intra-observer reliability of the agreement point out the problem in the standardization of uroflowmetry. Inter- and intra-observer reliability of uroflowmetry interpretation can be increased by defining precise numbers and numerical algorithms.Publication Metadata only The comparison of anxiety levels in children who underwent invasive or non-invasive urodynamic studies(2022-05-13) ŞEKERCİ, ÇAĞRI AKIN; TARCAN, TUFAN; YÜCEL, SELÇUK; TANIDIR, YILÖREN; Sekerci C. A., Can Ozkan O., Tanidir Y., Tarcan T., Yucel S.INTRODUCTION AND OBJECTIVE: Urodynamic studies play an important role in the evaluation of children with lower urinary tract dysfunction. In this study, we aimed to examine the effects of invasive and non-invasive urodynamic studies on the anxiety levels of children with the help of an anxiety scale. METHODS: Children aged 8-17 years who were scheduled for uroflowmetry (UF) or filling cystometry (FC) and who agreed to fill out an anxiety scale were included in the study. It was the first UF or FC of all children. “The Screen for Child Anxiety Related Disorders (SCARED)” form consisting of 41 questions was used in the evaluation. All children included in the study filled the form themselves. The SCARED results of children who underwent UF and FC were compared. RESULTS: A total of 56 children with a mean age of 10.85þ/- 2.98 years were included in the study. 31 (55.4%) of the children were females and 25 (44.6%) were males. The number of children who had UF was 26 (46.4%; 8.5 (8-14) years), and 30 (53.6%; 11.5 (8-17) years) had FC. The total SCARED scores of the children who underwent UF and FC were 26.5 (5-75) and 27 (2-57), respectively, and there was no statistical difference (p[0.980) (Table 1). A significant difference was found only in "Separation Anxiety Disorder" among sub-score evaluations (p[0.049) (Table 1). In children who underwent filling cystometry, there was no statistical difference in the total SCARED score between those who did and did not do clean intermittent catheterization (28 (3-41); 27 (2-57), respectively) (p[0.860). CONCLUSIONS: The SCARED scores above 25 indicate an anxiety disorder, and interestingly, in this study, both the invasive and noninvasive urodynamic study groups scored over 25. We consider that non-invasive urodynamic tests may cause stress on children as much as invasive ones.Publication Metadata only Predictive factors of full response to desmopressin treatment in children with primary monosymptomatic enuresis nocturna(2023-02-01) ÖZGÜR, GÜNAL; TANIDIR, YILÖREN; TARCAN, TUFAN; YÜCEL, SELÇUK; Ozgur G., Sekerci C. A., TANIDIR Y., Tarcan T., YÜCEL S.Publication Open Access Normal glanular and meatal measurements in boys and men(2023-01-01) ŞEKERCİ, ÇAĞRI AKIN; ÖZKAN, ONUR CAN; GENÇ, YUNUS EMRE; TANIDIR, YILÖREN; TARCAN, TUFAN; YÜCEL, SELÇUK; ŞEKERCİ Ç. A., ÖZKAN O. C., Sahak M. Y., GENÇ Y. E., TANIDIR Y., TARCAN T., YÜCEL S.Objective: To determine the normal vertical urethral meatus length (ML), maximum glanular width (MGW), the glanular seam length (between the lowest edge of urethral meatus and the glans closure line corona) (GSL) and GSL/ML ratio in all age groups. Materials and Methods: Consecutive patients presented to urology and pediatric urology outpatient clinics were included in the study. Penile abnormalities, known endocrinological disorders, history of penile/urethral surgery were excluded. MGW, ML, and GSL were measured with a caliper. Glanular and meatal measurements were compared according to ages. Results: A total of 1398 boys and men (380 (27.18%) prepubertal (1-12), 203 (14.52%) adolescent (13-19), and 815 (58.30%) postpubertal (19-93)) with a median age of 31 years (range: 1-93) were included in the study. In consecutive age groups, ML and GSL gradually increased and became steady between 16-19 & 20-30 age groups and 10-12 & 13-15 age groups, respectively. On the other hand, MGW gradually increased until 20 years of age and became steady at median of 35 mm over 20 years of age. Another interesting finding was a rather stable GSL/ML ratio in all age groups. Pairwise comparison of different age groups seemed to be similar and suggests a fixed ratio of 1.33 (IQR: 0.6). Conclusion: The normal glanular and meatal measurements may guide the surgeons for better cosmetic results during hypospadias repair. The GSL/ML ratio appears to be a stable measure for all ages to achieve better cosmetic results.Publication Open Access A survey study on evaluation and management of nocturnal enuresis in pediatricians and family physicians(2023-09-01) ŞEKERCİ, ÇAĞRI AKIN; KÜTÜKOĞLU, MEHMET UMUT; DÖRÜCÜ, DOĞANCAN; TANIDIR, YILÖREN; ÇAM, HAYDAR KAMİL; TARCAN, TUFAN; YÜCEL, SELÇUK; Şekerci Ç. A., Kütükoğlu M. U., Dörücü D., Ergün R., Tanıdır Y., Çam H. K., Tarcan T., Yücel S.Objective:Nocturnal enuresis (NE) is one of the most common disorders in pediatric urology, and patients often turn to family physicians (FP) and pediatricians (P) initially. The aim of this study was to understand the awareness, self-confidence and suggestions of physicians regarding the management of NE.Materials and Methods:In this study, 360 FP and family medicine residents (FMR), as well as 280 P and pediatrics residents (PR), were contacted through a cellular phone texting system. A simple multiple-choice questionnaire (Surveymonkey®) consisting of 10 questions was used to gather data. The survey included questions about their experience, training, evaluation, and management of NE.Results:A total of 119 FPs and Ps (18.5%) filled the questionnaire. Thirty (25.21%) of the participants were P, 27 (22.69%) PR, 3 (2.52%) FP and 59 (49.58%) FMR. The rate of physicians who encounter at least 5 children with NE per month is 31.33%. The mean self-confidence in the management of NE was 4.5 out of 10. The self-confidence of pediatricians was significantly higher than that of PR and FMR (p<0.001, p<0.001). Most (n=78, 65.55%) of the participants stated that they received training on EN during medical faculty and 62 (52.10%) during residency. Psychological problems (89.92%), sleep disorders (78.15%), and excessive fluid intake (75.63%) were the most frequently considered factors in etiology. While most responders (75.63%) considered dietary regulation and behavioral interventions as the first-line treatment, 25.21% consult a pediatric urologist and only 1.6% recommend medical treatment.Conclusion:Although FP and P admit they had training on NE, they mostly felt incompetent to manage NE and exclusively avoided pharmacological treatment.Keywords:Children, enuresis nocturna, pediatric urology, physicians, surveyPublication Metadata only Pedi̇atri̇k laparoskopi̇k pi̇yeloplasti̇de perkütan üreteral stent yerleşti̇ri̇lmesi̇(2022-03-10) ŞEKERCİ, ÇAĞRI AKIN; TARCAN, TUFAN; YÜCEL, SELÇUK; TANIDIR, YILÖREN; Tanıdır Y., Şekerci Ç. A., Bülent E., Tarcan T., Yücel S.Amaç: Son yıllarda üreteropelvik bileşke (UP) darlığı olan çocuklarda laparoskopik yaklaşım ile piyeloplasti birçok merkezde uygulanmaya başlamıştır. Öğrenim eğrisi uzun olduğu bilinen bu minimal invaziv yaklaşımın her aşaması için çeşitli yöntemler tarif edilmiştir. Bu video bildiride çocuklarda laparoskopik piyeloplasti sırasında üreteral stent yerleştirilmesini kolaylaştıran bir yöntemin sunulması amaçlanmıştır. Materyal ve Metot: Sağ UP darlık nedeniyle laparoskopik piyeloplasti uygulanan bir hastanın cerrahisini paylaştık. Genel anestezi altında umblikus hizasında orta hattan Hasson tekniği ile 5 mm’lik trokar yerleştirildi. 5 mm’lik ve 30 derecelik laparoskopi lensi görüntüsü altında karaciğer ekartörü ve iki el aleti için biri orta hatta, diğeri krista iliaka anteriorsuperiorun 2 cm mediosüperiorunda olacak şekilde toplam üç adet daha 5 mm’lik trokar yerleştirildi. Ardından 10 mmHg karın içi basınç altında transperitoneal yaklaşım ile çıkan kolon medialize edildi ve UP diseke edildi. Bir adet çaprazlayan aksesuar damar olduğu izlendi. Renal pelvis iki adet askı sütürü ile batın ön duvarına çadır şeklini alacak şekilde asıldı. Bu asma işlemi içinden sütür mataryeli geçirilen bir anjiokat yardımıyla vücut dışına alınıp, cilt üzerinden bir klemp yardımıyla sabitlenerek gerçekleştirildi. Pelvis asıldıktan sonra UP insizyonu ve üreter spatülasyonu yapıldı. Ardından cilt üzerinden üretere ulaşılacak en uygun nokta belirlenerek no 18 anjiokatla batına giriş yapıldı. İğne dışarı alınarak 4 Fr üreter stentin kılavuz teli anjiokat üzerinden üreter içerisinde yeterince ilerletildikten sonra anjiokat çekilerek vücut dışına alındı. Ardından stentin batın katlarından girişini kolaylaştırmak için kılavuz telinin cilde giriş yerine No 11 bistüri ile milimetrik bir insizyon yapıldı. Daha sonra stentin ittiricisi kılavuz teli üzerine yüklenerek cilt girişi ile batın duvarında uygun yol oluşturuldu. Ardından ittirici çıkartılarak kılavuz üzerinden 4 Fr 16 cm üreteral stent yerleştirildi ve kılavuz vücut dışına alındı. Stentin proksimal ucu renal pelvise yerleştirildi. Ardından aksesuar damarlar posteriora yerleştirilerek UP anastomozu yapılarak operasyona son verildi. Bulgular: 2019 – 2021 yılları arasında ortanca yaşı 8,5 yıl (3–14) olan 18 çocuğa bu yöntemle ile laparoskopik piyeloplasti sırasında üreteral stent yerleştirilmiştir. Tüm olgularda postoperatif yapılan direkt üriner sistem grafisinde stentler yerinde olması gereken pozisyonda izlenmiştir. Hiçbir olguda stent pozisyonu ile ilgili bir komplikasyon izlenmemiştir. Sonuç: Perkütan yolla üreteral stent yerleştirilmesinin laparoskopik piyeloplastinin bu aşamasında alternatif bir yöntem olabileceğini düşünmekteyiz. Anahtar Kelimeler : PİYELOPLASTİ,LAPAROSKOPİK,PERKÜTAN,UPBDPublication Metadata only İnvaziv ve non-invaziv ürodinamik çalışmalar uygulanan çocuklarda kaygı düzeylerinin karşılaştırılması(2022-11-09) TANIDIR, YILÖREN; ŞEKERCİ, ÇAĞRI AKIN; TARCAN, TUFAN; YÜCEL, SELÇUK; Şekerci Ç. A. , Özkan O., Tanıdır Y., Tarcan T., Yücel S.Publication Metadata only The comparasion of anxiety levels in children who underwent invasive or non-invasive urodynamic studies(2022-05-01) ÖZKAN, ONUR CAN; TARCAN, TUFAN; ŞEKERCİ, ÇAĞRI AKIN; YÜCEL, SELÇUK; TANIDIR, YILÖREN; Şekerci Ç. A., Özkan O. C., Tanıdır Y., Tarcan T., Yücel S.Publication Open Access The results of three times repeated filling cystometry and pressure flow studies in children with non-neurogenic lower urinary tract dysfunction(2022-06-01) YÜCEL, SELÇUK; ŞEKERCİ, ÇAĞRI AKIN; TARCAN, TUFAN; TANIDIR, YILÖREN; Ergun R., ŞEKERCİ Ç. A., TANIDIR Y., Ozturk N. I., TARCAN T., YÜCEL S.Aim We previously reported that some urodynamic parameters change with repetitive filling in children with neurogenic lower urinary tract dysfunction (LUTD). In this study, we aimed to search if three-times repeated filling cystometries (FC) and pressure-flow studies (PFS) would change the urodynamics parameters in children with non-neurogenic LUTD. Materials and Methods All children with three repeated FC and PFS between June 2017 and December 2018 were included in the study. Urodynamic reports and charts were evaluated retrospectively. The first sensation of bladder filling (FSBF), maximum cystometric capacity (MCC), detrusor pressure at the FSBF (P-det.first.sens), maximum detrusor pressure during filling (P-det.fill.max), presence of detrusor over activity, compliance, maximum urine flow (Qmax), detrusor pressure at the maximum urine flow (PdetQmax), residual urine and presence of detrusor sphincter dyssynergy (DSD) were compared among three-times repeated urodynamic studies. Results Forty children were included in the study. 27 (67.5%) were girls and 13 (32.5%) were boys. Median age was 9 (3.4-17) years. Indications were LUTD with low grade vesicoureteral reflux in 19 (47.5%), LUTD refractory to conservative management in 13 (32.5%), urinary tract infection with LUTD in 6 (15%) and secondary enuresis in 2 (5%). P-det.first.sens, presence of DO, MCC, Qmax, PdetQmax, residual urine, flow pattern, and presence of DSD were comparable in all three repeated tests. The third FC may show decreased filling detrusor pressures and increased compliance with no change on capacity. Conclusion In children with non-neurogenic LUTD, three-times repeated FC and PFS present comparable results except FSBF, P-det.fill.max,P- and compliance at the third test.