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Purpose: To investigate the prevalance of constipation among children presenting with bedwetting. Material and Methods: Charts of children applying with only bedwetting complaint were evaluated. Those with daytime voiding symptoms and urinary tract infections were excluded. Symptoms of voiding dysfunction were sought with detailed history. Parents were given questionnaires designed to reveal constipation according to Rome III criteria, and they were filled after at least one month of observation without any treatment. Diagnosis of constipation was made when direct graph revealed an intestinal fullness obscuring the rectal image and/or when the symptoms fulfilled the Rome III criteria. Results: A total of 88 patients were evaluated (female:24, male:64, mean age: 8.65 yrs). Primary and secondary enuresis nocturna (EN) was diagnosed in 79 and 9 patients respectively. Constipation was diagnosed in 62% and 67% of the patients with primary and secondary EN respectively. Daytime irritative symptoms coexisted in 20.5% of the cases, and when these cases were excluded, constipation existed in 53.2% of the cases with primary monosymptomatic enuresis nocturna. This is a higher rate than the similar population according to the literature. Conclusions: A significant rate of constipation coexist in patients presenting with bedwetting, and these cases should not be labelled as monosymptomatic nocturnal enuretics. This subgroup of patients should be identified as cases with elimination dysfunction and treated accordingly. Lack of daytime voiding symptoms do not exclude defecation disorders. [Copyright &y& Elsevier]

PURPOSE: The causal relationship between circumcision and meatal strictures is controversial. We reviewed our data and assessed the roles of possible etiologic factors. MATERIAL AND METHODS: Seventy six patients who underwent circumcision both for traditional and medical reasons at the department of Urology between 2004 and 2006 were included in the study. Meatal calibrations were achieved using lubricated polyethyhlene tubes by the same surgeon, such that the largest caliber tube that did not stretch the external meatus and fossa navicularis represented the meatal size. Postoperative meatal caliber was assessed at 1 to 3 months (mean:1.4) after the circumcision. Circumcision techniques were categorized with respect to the competence of phrenular artery. Circumferential incision was made at a more proximal level on the ventral aspect of the penis and no cautery to, or ligation of phrenular artery was performed in those who underwent phrenulum-sparing circumcisions. The influence of phrenulum sparing, diapers and preoperative gonadotropin treatment on the postoperative percent change in meatal calibration was assessed statistically. RESULTS: Mean patient age was 35.4 months (range 1 to 102). Pre and postoperative mean meatal calibers were 10.53F and 10.11F respectively. Overall decrease in meatal caliber (3.98%) was statistically significant (p=0.0001). Preoperative gonadotropins, although statistically insignificant, seemed to have a protective effect. Phrenulum sparing did not prevent meatal downsizing (p=0.005). Having diapers seemed to be a greater risk factor for meatal strictures (p=0.001). CONCLUSIONS: Decrease in meatal caliber as early as 1 to 3 months after circumcision is statistically significant, though clinical importance of this decrease is yet to be determined. [Copyright &y& Elsevier]

Abstract: PURPOSE: We sought to find out how testicular apoptosis is influenced by BHCG treatment in an experimental cryptorchidism model. MATERIAL AND METHODS: Three main groups of 22 day-old healthy male Sprague-Dawley rats were formed (Sham-operated (SO), experimental cryptorchidism (EC), hormone treated EC groups (HT)). Each main group was also divided into early and late orchidectomy groups. HT group received 50 IU/kg BHCG daily for 7 days starting on first postoperative day. Eight and 30 days after EC surgery, all rats underwent left orchidectomy to reveal early and late changes in the testes. Apoptosis index (AI) was defined as the mean number of apoptotic cells per tubule. All groups were compared to each other, while each group was evaluated in terms of the differences between early and late periods. RESULTS: Study was carried out with 60 rats in 6 groups totally. AI was significantly greater in EC and HT groups than SO group in both early and late periods. AI in HT group was smaller than EC group; the difference was statistically significant in late period while it was not so in early period. AI was found to be significantly decreased with time in all 3 groups. CONCLUSIONS: Testicular apoptosis was found to be increased in experimental cryptorchidism. In HT group, AI was smaller than that of EC. For this reason, we suggest that hormone treatment in EC may have an effect that prevents or decreases apoptosis in EC model. [Copyright &y& Elsevier]

Objective: To determine possible acute kidney injury with new marker neutrophil gelatinase-associated lipocalin (NGAL) in urine and to show the relationship between changes of this marker and conventional markers in patients undergoing shock wave lithotripsy (SWL). Methods: In patients with kidney stones, serum urea, creatinine, urine microalbumin, and NGAL levels were determined before SWL and at the first, second, and seventh days after SWL. In addition, patients who had undergone SWL were evaluated with Technetium-99m (Tc99m)-dimercaptosuccinic acid (DMSA) and Tc99m-diethylenetriaminepenta acetate renal scintigraphy 1 week before and 3 months after SWL. Results and Limitations: Forty patients were included in the study. All patients had a single stone in the kidney with an average size of 9.25 mm (range 5–15). No statistical change was found in the levels of average serum urea and creatinine levels, urine microglobulin, and NGAL levels, which were measured before SWL and after SWL. No significant difference was identified in urine NGAL and microalbumin levels of the groups, which were separated by shock wave number and shock energy amount on the first, second, and seventh days after SWL. In the high-energy SWL group, 3 patients had a statistical decrease in their differential kidney function measured with Tc99m difference between differential function rates of the kidney before and after SWL (DMSA) after 3 months after SWL. Conclusion: Our study found that, using both new and conventional parameters in the acute stage and 3 months later, SWL treatment does not cause acute kidney damage. [ABSTRACT FROM AUTHOR]