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    Conservative management of cicatrix after circumcision: Retraction and steroid
    (2020) Hakalmaz, Ali Ekber; Huseynov, Mirzaman
    Aim: Our study aims to study the combined manual retracting and topical steroid application method for the treatment of post-circumcision cicatrix in neonates and infants and to establish the need for a secondary intervention. Material and Methods: A total of 20 patients applying to our clinic with post-circumcision cicatrix between April 2018 and January 2019 were evaluated retrospectively. Multivariable analyses assessed the association between the age of the patients and the onset of complaints associated with cicatrix, the time to onset of symptoms, and the duration of recovery.Results: The mean age at admission was 7.8 months (4-13 months), and the mean age at circumcision was 3.4 months (2 weeks-6 months). In our study, all the patients had been fully recovered after the treatment with combination of topical 0.1% betamethasone ointment and manual retraction. The mean duration of treatment was 30.6 days (14-56 days). Conclusion: In this study, we reported our observations related to the treatment only with 0.1% Betamethasone ointment and manual retraction for the first time in the literature. We believe that before choosing secondary applications which potentially traumatize the patient, insisting on topical steroid and manual retraction will provide a satisfactory outcome.
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    Does prematurity indicate poor prognosis in the treatment of infant ureteropelvic junction obstruction?
    (2019) Huseynov, Mirzaman; Emre, Senol; Ozcan, Rahsan; Bakir, Ayten Ceren; Canpolat, Nur; Elicevik, Mehmet
    Aim: To evaluate the outcomes of management of ureteropelvic junction obstruction in premature patients by comparing them to a group of non-premature. Material and Methods: We reviewed the medical records of 102 patients with isolated hydronephrosis which were referred from pediatric nephrology outpatient clinic or those who admitted directly to pediatric urology clinic under one year of age between the years of 2005 and 2016. Two groups were set up; premature and term. The gestational age, sex, management for ureteropelvic junction obstruction, complications were recorded. Chi-Square, Fisher’s and Mann-Whitney-U tests were used for statistical analyzes. Results: There were 92 patients in the term group and 10 in the premature group. All patients were operated. Preoperative symptoms such as pyonephrosis, renal calculi, and hypertension were relatively common in the premature group. Preoperative low function, postoperative loss of function, and poor outcome were statistically more common in premature patients. Conclusion: In our limited experience, prematurity is an independent factor associated with UPJO, and it may indicate a poor prognosis. We advocate that this issue should be considered in practice.
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    Interlabial fusion: As a new subtype of labial fusion
    (2019) Huseynov, Mirzaman; Cafarov, Vusal
    Aim: to determine a new subtype of the labial fusion and to arrange treatment options according to this type. Material and Methods: We reviewed the medical records of patients with labial fusion, malodorous vaginal discharge and vulvar pruritus from July 2016 and August 2018 in pediatric surgery outpatient clinic. Anomalous fusion between labia minora and labia majora was observed in some patients, especially with vaginal discharge and pruritus. These patients were separated, characterized by common features and identified as a new subtype. Definition and Nomenclature: In this subtype, fusion is between the labia minora and majora, bilaterally. As the fusion is between the labia minora and labia majora, we prefer naming this condition as Interlabial ( inter. lat=between) Fusion. Results: A total of 86 patients were included. Of this 86 patients 6 were admitted due to malodorous vaginal discharge and vulvar pruritus. Four of the six patients had abnormal adhesions between the labias. These patients were defined as interlabial fusion. Interlabial fusion was detected in only 4.7% of the patients. Topical steroid therapy was started in each of the four patients. All of the patients were fully recovered. Conclusion: Interlabial fusion is a rare condition, but it is not a separate disease. It is the result of different diseases affecting the genital area. It should be brought to mind in patients presenting with complaints of vaginal discharge and pruritus, especially if these complaints have recurred. Topical steroid therapy should be started as an initial treatment.
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    Pre-pubertal labial adhesion surgery: The first study to compare manual or surgical separation
    (2019) Huseynov, Mirzaman
    Aim: Labial adhesion (LA) is one of the most common causes of admission to the pediatric surgery outpatient clinic among the prepubertal girls. There is no consensus on the best interventional technique (manual or surgical separation) for LA. The aim of this study is to compare the results of the manual and surgical separation of LA, and to decide which one is superior. Material and Methods: We reviewed the medical records of sixty-six patients with LA operated between July 2016 and Mart 2018 by the same surgeon. The patients were divided into two groups: patients treated with a manual separation technique (group 1) and with a surgical separation technique (group 2). Patients were evaluated regarding age at presentation, referral indication, symptoms, surgical technique, recurrence and time of recurrence. Results: There were 27 cases in Group 1 and 39 cases in Group 2. There were 14 recurrences in Group 1 (51.8%) and 5 recurrences in Group 2 (12.8%). The recurrence rate was significantly higher in Group 1. This difference between groups was statistically significant (p=0.0006). The relative risk for recurrence in Group 1 was found to be 4.0444 (OR 7.3231; p=0.0012), and 0.2473 in Group 2 with a significance level of p=0.0022. Conclusion: The treatment of labial adhesion with the surgical separation technique is superior to manual separation in terms of the possibility of recurrence. Additional prospective studies are still needed to strengthen these data.