Scopus İndeksli Açık & Kapalı Erişimli Yayınlar

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    Anocutaneous Reflex Revisited: How Valuable Is Its Determination in Children with Spina Bifida? A Descriptive Study in A Cohort of 217 Patients
    (2022) Ozel, Kerem; Canmemis, Arzu; Goknar, Nilufer; Candan, Cengiz; Alizada, Orkhan; Alatas, Ibrahim; 35147971
    AIM: To determine the clinical value of anocutaneous reflex (AR) in children with neurogenic bladder due to spina bifida (SB). MATERIAL and METHODS: Patients who were diagnosed with SB were prospectively evaluated; moreover, AR and bulbocavernous reflex were examined. Patients were divided into those with and without AR. Age, gender, diagnosis, ventriculoperitoneal shunt presence, symptomatic urinary tract infections, leg movements, clean intermittent catheterization and anticholinergic therapy, lesion level, urodynamic detrusor, and sphincter activity were evaluated. Chi-square test and univariate regression analysis were done. The AR value was evaluated by two by two contingency table. RESULTS: This study evaluated 217 patients (109 boys and 108 girls). AR was present and absent in 53 and 164 patients, respectively. Anticholinergic therapy was necessary in 37.7% and 23.8% of patients with and without AR (p=0.015), respectively. Patients with AR had higher lesion level (p=0.005), more detrusor overactivity, and less detrusor underactivity (p=0.007). Less detrusor sphincter dyssynergia (DSD) was noted in patients with AR (p=0.029). AR specificity was 83%, and positive predictive value in predicting detrusor overactivity and DSD was 76% and 80, respectively. CONCLUSION: AR determination is a valuable and simple tool in neurogenic bladder. This report delineates the clinical significance of this reflex and is the largest cohort describing this significance. This simple examination should not be skipped in the initial evaluation and follow-up of these patients
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    Prevalence Of Inguinoscrotal Pathologies And Risk Factors In A Cohort Of 388 Children With Spina Bifida
    (2022) Ozel, S. Kerem; Kucuknane, Mustafa Alper; Ozgenel, Dicle Ozge; Ozer, Vuslat; Canaz, Huseyin; Alatas, Ibrahim; 35899567
    Background. There is limited information about the prevalence and risk factors of inguinal hernia and undescended testis in patients with spina bifida (SB). The aim of this study was to identify the properties and prevalence of inguinoscrotal diseases in these patients. Methods. A questionnaire was completed by parents of patients with the diagnosis of SB in our center. Together with demographic data, presence an of inguinal hernia, side, operation history, presence of ventriculoperitoneal (VP) shunt, type of SB aperta or occulta, recurrence and presence of undescended testis were questioned. Patients were grouped into 2 as SB aperta and occulta. The prevalence of these pathologies and their clinical properties were evaluated. Results. In this study, 388 patients were evaluated. Of these, 238 patients had SB aperta and 150, SB occulta. There was no significance in comparison of gender. The prevalence of inguinal hernia was 12.6% in general. A hernia was noted in 37 SB aperta patients (15.6%) whereas this was seen in 12 of the SB occulta patients (8%) (p=0.029). When there was a VP shunt, hernia prevalence was 21.5% and when there was no shunt, this ratio was 7.1% (p=0.0001). Prevalence of inguinal hernia was 21.8% in males and 3.2% in females (p=0.0001). When there was a VP shunt with SB aperta the prevalence was 21.9% and when a VP shunt was present with SB occulta, this number was found to be 13.3% (p=0.006). The prevalence of undescended testis was 17.7% and there was no difference between SB aperta and occulta patients. Conclusions. Inguinal hernia and undescended testis are more frequent in SB patients when compared to the normal population. VP shunts and male gender may be risk factors for inguinal hernia in these children. These findings may imply neurological factors in the etiology of inguinal hernia and undescended testis.