Person: ŞİMŞEK, FERRUH
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ŞİMŞEK
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FERRUH
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Publication Open Access Can Surgical Technique Affect the Success of Endoscopic Treatment in Children with Vesicoureteral Reflux and Overactive Bladder Syndrome?(GALENOS YAYINCILIK, 2015-09-05) ŞEKERCİ, ÇAĞRI AKIN; Sahan, Ahmet; Akbal, Cem; Garayev, Asgar; Sekerci, Cagri Akin; Sulukaya, Muhammed; Tanidir, Yiloren; Tinay, Ilker; Tarcan, Tufan; Simsek, FerruhObjective Traditional subureteral transurethral injection (STING) and Double hydrodistention-implantation (Double-HIT) injection techniques for vesicoureteral reflux (VUR) treatment are a less invasive, yet very effective options. The influence of injection techniques in treatment success is not adequately searched in children with overactive bladder syndrome (OAB). The objective of this study to compare the short-term success rates of STING and Double-HIT techniques in children with OAB-VUR complex. Materials and Methods Children who underwent endoscopic injection for VUR between 2010 and 2013 were retrospectively evaluated. Patients were grouped into two groups according to the surgical techniques (STING or Double-HIT). Success of the treatment was defined with a negative voiding cystourethrogram at the 6th postoperative week. Patients were evaluated according to sex, age, pre- and postoperative reflux grades, laterality, type and volume of bulking agent and presence of OAB. Results Both groups were similar in terms of sex, age, lower urinary tract dysfunction, reflux grade and success rates. Surgical technique, score of pediatric lower urinary tract symptom questionnaire, age, sex, laterality of reflux and type of the bulking agent found to have no effect on the overall success rates (p>0.05). Presence of OAB and/or a high grade reflux were identified as statistically significant predictive factors that could affect the treatment results. Conclusion The short-term surgical success of the double-HIT and STING techniques showed no difference in children with OAB. The presence of a high grade reflux and/or OAB seemed to be the main factors for overall success in endoscopic VUR surgery.Publication Open Access Utility of Voiding Dysfunction Symptom Score in Diagnosis and Treatment of Enuresis Nocturna(GALENOS YAYINCILIK, 2017-03-13) ŞEKERCİ, ÇAĞRI AKIN; Tanidir, Yiloren; Sekerci, Cagri Akin; Top, Tuncay; Talibzade, Farhad; Sahan, Ahmet; Sener, Tarik Emre; Tarcan, Tufan; Simsek, Ferruh; Akbal, CemObjective: The aim of this study was to determine the effectiveness of the voiding dysfunction symptom score (VDSS) in evaluation of children with nocturnal enuresis. Materials and Methods: Four hundred children with nocturnal enuresis were included in the study. They were evaluated with VDSS, physical examination, urinalysis and 2-day voiding diary. All children with nocturnal enuresis symptoms were treated with desmopressin and/or urotherapy. However, children with overactive bladder symptoms were also treated with anticholinergics. Treatment success and change in VDSS were compared and assessed between different treatment methods. Results: Two hundred forty-five children (61.25%) were male and 155 (38.75%) were female. The mean age was 7.6 +/- 3.0 years (range: 5-18). The mean VDSS was 9.2 +/- 6.3. 35% of children with nocturnal enuresis had concomitant daytime symptoms. 126 children (31.5%) had a VDSS of nine or above and majority of these children were treated with anticholinergic therapy. VDSS questionnaire could not help determine treatment success in children with non-monosymptomatic nocturnal enuresis. However, children treated with urotherapy and desmopressine showed significant difference in VDSSs according to their treatment response. Conclusion: VDSS has shown to decrease after treatment in children with mono-symptomatic nocturnal enuresis. The treatment strategies should be checked and modified if VDSS does not decrease after proper therapy as this would increase the success of treatment.Publication Open Access Assessment of Differential Renal Function in Children with Hydronephrosis: Comparison of DMSA and MAG-3(GALENOS YAYINCILIK, 2015-09-05) ŞEKERCİ, ÇAĞRI AKIN; Akbal, Cem; Sahan, Ahmet; Garayev, Asgar; Sekerci, Cagri Akin; Sulukaya, Muhammed; Alpay, Harika; Tarcan, Tufan; Simsek, FerruhObjective Nuclear imaging techniques such as 99mTc-dimercaptosuccinic acid (DMSA) and (99)mTc-mercaptoacetyltriglycine (MAG-3) are widely used for the diagnosis and follow-up of urinary tract obstructions. Both imaging techniques provide the differential renal function (DRF) in slightly different ways. The aim of this study was to assess the MAG-3 scan as an adjunct or alternative to DMSA for evaluating DRF in children with hydronephrosis. Materials and Methods Eighty-one patients with hydronephrosis were enrolled in this study. Patient age, sex, anteroposterior renal pelvis diameter (RPD) at the time of diagnosis, parenchymal thickness and the DRF percentage found by both DMSA and MAG-3 were recorded. DMSA scintigraphy was used for detecting renal scars and estimating DRF. MAG-3 scintigraphy was used for evaluation of renal clearance, the collecting system's outflow pattern and estimating DRF. Results A total of 102 renal units (38 left, 22 right and 21 bilateral) were evaluated. High correlation rates were found when we compared both tests' DRF values according to antero-posterior renal pelvic diameter and patient age (p>0.05). In all groups compared in the present study, both tests demonstrated very similar results and DRF values. Statistical analysis of cut-offs (45%, 40%, 10%) were also similar in both methods (p>0.05, kappa > 0.7, r=0.926 Pearson). Conclusion DMSA and MAG-3 are tests that are of assistance in the evaluation of hydronephrosis. Compared to DMSA, MAG-3 also provides valuable information to evaluate DRF values in hydronephrotic renal unit (RU). Avoiding unnecessary DMSA imaging will save time and cost and prevent over-radiation of the pediatric population.Publication Open Access Assessment of Voiding Dysfunction and Nocturnal Enuresis Rates in Primary School Children in an Anatolian City with a Validated Dysfunctional Voiding Scoring System Questionnaire(GALENOS YAYINCILIK, 2018-12-01) ŞİMŞEK, FERRUH; Tavukcu, Hasan Huseyin; Tanidir, Yiloren; Tavukcu, Esra; Akbal, Cem; Simsek, Ferruh; Tarcan, TufanObjective: To investigate the prevalence of voiding dysfunction (VD) and nocturnal enuresis (NE) in Turkish primary school children using a previously validated Dysfunctional Voiding Scoring System (DVSS) questionnaire and a self-administered questionnaire. Materials and Methods: The previously validated DVSS questionnaire was completed by the parents of 3015 randomly selected children. Another questionnaire was also administered for studying VD and NE rates, demographic characteristics, and learning or behavioral problems of children. Results: Of all children, 6.6% (n=199) had a score suggesting VD and 6.1% (n=185) had NE. No significant differences were found between children with and without VD in terms of age, gender, and fluid intake. Children with VD had significantly high rates of constipation (19.7% vs 5.2%; p<0.001) and fecal soiling (32.1% vs 5.1%; p<0.01) compared with children without VD. Children with a higher DVSS score had more frequent behavioral or psychological problems (20.7% vs 4.7%; p<0.01) and learning disabilities (14.7 0 M vs 5.5%; p<0.01). VD had no correlation with overall maternal education level and the type of school (government or private). Conclusion: VD and NE are highly frequent in early childhood and positively correlated with children's learning disabilities and psychological problems.Publication Open Access The Significance of the Contralateral Testis Size Measurement with Ultrasonography in Predicting Monorchism in Boys with Nonpalpable Testicles(GALENOS YAYINCILIK, 2017-06-16) ŞEKERCİ, ÇAĞRI AKIN; Sekerci, Cagri Akin; Tanidir, Yiloren; Sener, Tarik Emre; Asadov, Ruslan; Sahan, Ahmet; Tarcan, Tufan; Simsek, Ferruh; Akbal, CemObjective: The aim of this study was to determine the significance of contralateral testis size in predicting monorchism in pediatric patients with unilateral undescended testis. Materials and Methods: The data of patients who underwent surgical operation by a single pediatric urologist for undescended testis between 2013 and 2016 was evaluated retrospectively. The patients were grouped as having monorchism (M), nonpalpable intra-abdominal testis (NPIAT), and palpable undescended testis (PUDT). The dimensions of the testes were measured ultrasonographically and recorded before operation. Patients with nonpalpable testis underwent diagnostic laparoscopy and patients with PUDT underwent inguinal orchiopexy. Results: A total of 57 children with a mean age of 31 (11-60) months were evaluated. Of the children, 12 had M, 9 had NPIAT and 36 had PUDT with a similar mean age (p>0.05). The size of the descended testis was found to be significantly small in NPIAT* and PUDT** groups compared to the M group (*p<0.05, **p<0.001). However, the size of the undescended and descended testes was found to be similar between NPIAT and PUDT groups (p>0.05). Conclusion: The size of the testis in the scrotum might help to localize the position of the undescended testis.