Person: ŞİMŞEK, FERRUH
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ŞİMŞEK
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FERRUH
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Publication Metadata only Durability of a single successful endoscopic polytetrafluoroethylene injection for primary vesicoureteral reflux: 14-year followup results(ELSEVIER SCIENCE INC, 2007) ŞİMŞEK, FERRUH; Yucel, Selcuk; Tarcan, Tufan; Simsek, FerruhPurpose: We reviewed our 14-year experience with successful single endoscopic subureteral polytetrafluoroethylene injection for the treatment of primary vesicoureteral reflux in children. Materials and Methods: We retrospectively reviewed the charts of 42 patients with primary vesicoureteral reflux who were treated with a single successful subureteral polytetrafluoroethylene injection between 1989 and 1993 and followed with routine 1, 3 and 10-year voiding cystourethrography. Results: The study included 30 girls and 12 boys 2 to 14 years old (median age 6 years). Four patients were lost to followup. Of the 38 remaining patients 28 had unilateral and 10 had bilateral primary vesicoureteral reflux. Endoscopic treatment with subureteral. polytetrafluoroethylene injection was performed in 48 ureters. Followup ranged from 10 to 14 years (mean 12.5 +/- 2.1). Voiding cystourethrography in 38 patients and 48 ureters revealed that 35 ureters (73%) remained free of reflux, whereas reflux recurred in 13 (27%) at a median of 2 years. Of these 13 ureters recurring reflux was grade I to II in 5 and grade III to V in 8. Reflux recurred in 11 of 24 ureters with grade IV to V reflux. Of the 13 recurrences 10 presented as febrile urinary tract infections and only 3 grade I recurrences were detected on voiding cystourethrography alone. No untoward effects were seen in any of these patients with injection of polytetrafluoroethylene. Conclusions: Long-term followup may be warranted after a single successful endoscopic injection for vesicoureteral reflux, particularly high grade reflux. However, followup voiding cystourethrography is unnecessary in patients presenting with febrile urinary tract infection.Publication Open Access Resistant pediatric priapism: A real challenge for the urologist(CANADIAN UROLOGICAL ASSOCIATION, 2015-08-10) ŞEKERCİ, ÇAĞRI AKIN; Sekerci, Cagri Akin; Akbal, Cem; Sener, Tarik Emre; Sahan, Ahmet; Sahin, Bahadir; Baltacioglu, Feyyaz; Simsek, FerruhPriapism in pediatric patients is a rare entity. We present an 8-year-old boy with known cerebral palsy. He came to the emergency department with sustained painful erection for 12 hours. Physical examination showed rigid penis. Blood count and biochemical analysis were normal. Although penile Doppler ultrasound revealed normal arterial and venous flow, cavernosal blood gas was hypoxic. A total of 50 mL of dark blood was aspirated, and 2 mL of 0.001% adrenalin solution was applied to both corpus cavernosum, twice within 20 minutes, which eventually did not achieve detumescence. A distal Winter shunt was performed at the end of which the penis was semi-flaccid. By the 18th hour of surgery, the penis re-gained painful erection status, so an Al-Ghorab shunt was performed. After the Al-Ghorab shunt, the penis was still in the semi-flaccid state. The next day, an angiography was performed and an arteriovenous fistula was discovered and treated by embolization. The flaccid state was achieved and the patient was discharged the day after the embolization.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 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.