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Objectives: Congenital diaphragmatic hernia (CDH) is a rare congenital anomaly of the diaphragm with pulmonary hypoplasia and persistent pulmonary hypertension and has serious consequences. Despite recent diagnosis and treatment strategies, CDH is still a challenging condition. We aim to present our clinical experiences of CDH, and review of the literature. Methods: Data of CDH patients who were operated in our clinic between January 2010 and September 2018 were obtained from the patient's chart. The clinical course and results of the patients with Bochdalek type CDH were reviewed. Results: We performed diaphragmatic closure in 16 patients with Bochdalek CDH during study period. Fourteen (82%) cases were diagnosed antenatally. In 5 (29%) patients, preoperative pulmonary hypertension developed and nitric oxide was administered. Twelve of the sixteen patients (75%) underwent primary repair and 4 of them underwent prosthetic patch. Three patients were repaired thoracoscopically. Five (31%) patients died due to severe persistent pulmonary hypertension on postoperative period. There was no recurrence in our patients who were followed-up for a mean of 27 months. Conclusion: In the management of Bochdalek CDH, the clinical success has been increasing in parallel with the important developments with the application of new treatment modalities in the neonatal intensive care units and new surgical techniques in recent years.

Meatal stenosis (MS) is a common complication of circumcision. In this study, we aimed to examine the role of frenuloplasty in the development of MS in school-age boys undergoing circumcision.Medical data of 502 patients who were circumcised surgically in the hospital setting aged ≥6 years between July 2019 and July 2020 were retrospectively analyzed. The patients were divided into two groups based on the appearance of the frenular region. The patients whose integrity of the frenular region was protected during circumcision were classified as Group 1 (n = 262), and the patients whose frenulum was absent for some reason were classified as Group 2 (n = 240). Both groups were evaluated based on the development of complications following frenuloplasty after circumcision.The median age was 11 (range: 6 to 17) years. The median circumcision age was seven (range: 6 to 12) years, and the median time since circumcision was four (range: 1 to 11) years. The main complaints of the patients were gastrointestinal (n = 254, 51%), respiratory (n = 148, 29%), and urinary system-related pathologies (n = 100, 20%). Meatal stenosis was the most common complication of circumcision with an overall incidence of 4%, which was significantly higher in Group 2 (7% vs. 2%, respectively; p = 0.006).Our results suggested that MS is a common complication of circumcision. Performing frenuloplasty during circumcision might increase the risk of developing MS in school-age boys.

Objective: Phimosis is define as unretractable prepuce and has two different clinical presentation; pathological (PaP) and physiological. Physiological phimosis (PhP) is a common condition in children that does not require treatment. In our study, we aimed to determine the actual requirement for circumcision in patients with phimosis who were recommended circumcision. Material and Methods: Children who were offered circumcision due to phimosis between July 2019 and January 2020 and applied to the pediatric surgery and pediatric urology outpatient clinic were included in the study. They were evaluated in terms of referring physicians, genital examination findings and requirement for circumcision. Results: Between the study dates, 199 patients applied for circumcision due to phimosis. 126 patients are under one year old, 73 patients are over one year old. PhP was present in 194 of the patients and PaP in 5 of them. While PaP is not detected in patients under one year of age, there are 5 patients with PaP over one year of age (2%). There was no requirement for urgent circumcision in any of the patients. Genital examination revealed incidentally undescended testicle in 3 patients and hydrocele in 12 children. Conclusion: Male genital system examination and pathological findings are not well known by physicians. We think that there is a need for detailed training for physicians regarding PhP and childhood testicle pathologies.

Objectives: The benefits of circumcision, which is one of the most frequently performed surgical procedures, are controversial. In our study, before and after circumcision, uroflowmetry parameters were compared to evaluate the effects of circumcision on voiding. Methods: Children between the ages of 5-15 years who applied to the outpatient clinic for voluntary circumcision and who did not have underlying diseases and voiding problems were included in the study. Circumcision was performed by specialist in sterile conditions under general anesthesia. Uroflowmetry was evaluated by voiding volume, voiding time, maximum flow rate, average flow rate, shape of the curve. The pre-circumcision and post-circumcision uroflowmetry results were compared statistically. Results: Fifty patients with a median age of seven years (range: 5-10 years) were included in the study. When uroflow parameters were compared in our study, the maximum flow rate, mean flow rate and the time to maximum flow rate were found significantly different (p < 0.05). The plateau pattern was detected in 30% of patients before circumcision, while in 8% of patients after circumcision. Conclusions: Circumcision performed by specialists under sterile conditions has positive effects on uroflow parameters.

ÖZET Amaç: D vitamini, kalsiyum metabolizmasındaki rolü ile en belirgin etkisi kas iskelet sistemi üzerine olan yağda eriyen bir vitamindir. Bu klinikte pelvik taban kasları üzerine etkileri ile idrar ve gaita yapma mekanizmalarında da etkili olacağı hipotezini düşündürmektedir. Çalışmamız çocuklarda D vitamini eksikliği ile üriner inkontinans (Üİ) arasında ilişkiyi araştırmak amacıyla yapılmıştır. Gereç ve yöntem: D vitamini eksikliği olan çocuklarda Üİ araştırıldığı bir anket çalışması yapılmıştır. Çocuk polikliniklerine başvuran D vitamini düzeyi 30ng/dl altında 5 yaş üzerinde, rastgele seçilmiş 100 hasta değerlendirmeye alınmıştır. Üİ, kabızlık ve enkoprezis sorgulanmıştır. Bulgular: Yaş ortalaması 10.1(5-16) olan 53 kız, 47 erkek çocuk değerlendirildi. D vitamini düzeyi ortalama 15.42 (4.7-26.36) bulundu. D vitamini eksikliği olan çocuklarda Üİ %20, kabızlık %31, enkoprezis %3 tespit edildi. Toplamda 100 hastanın %40 ‘ında bu semptomlardan bir yada birkaçı mevcuttu. Sonuç: D vitamini eksikliği olan çocuklarda Üİ ile ilişki görülmüştür. Çocuklarda Üİ patogenez ve tedavisinde D vitamini ile ilgili ileri çalışmalara ihtiyaç vardır.

Objective Persistent Mullerian duct syndrome (PMDS) is a rare congenital disease characterized by the presence of rudimentary Mullerian structures within an intra-abdominal or hernial sac in a virilized male, often presenting as undescended testes. In this study, we aim to present a series of the PMDS patients who were managed by orchiopexy without removal of Mullerian remnants (MR). Material and methods Between May 2010 and June 2017, we treated six cases diagnosed as PMDS in our department. Laparoscopy and gonadal biopsy were performed in all patients, and vessel ligation was done in four patients for the first session of Stephen-Fowler orchiopexy. After initial diagnosis, genetic analyses and endocrine investigations were performed. Demographic and clinical features of the patients, operative methods and follow-up data were analyzed retrospectively. Results Mean age of the patients was 5.5 years. Three boys had undergone inguinal surgery due to hernia or undescended testis, while others were diagnosed during laparoscopic investigation of nonpalpable testis. As a definitive operation, testes and MR were completely removed in an adult patient, and the remaining patients were treated with laparoscopic or open orchiopexy with or without utero-cervical splitting and the MRs were left in situ. Two testes atrophied during follow-up period. Conclusion The goal of the approach in PMDS patients is to preserve testes, as well as carry them to their natural location. Leaving the MR in place is a suitable option for blood circulation of the testes but the long-term results are still unknown.

Simple renal cysts (SRC) in children are uncommon, usually asymptomatic, and discovered incidentally during investigation for other urinary or abdominal symptoms. The management of SRC in children depends on the symptoms and imaging. Patients can be followed by ultrasonography or other imaging or may be decided an intervention. The available procedures for the treatment of symptomatic cysts are percutaneous aspiration with or without sclerotherapy and open or laparoscopic approaches of the lesions. Only a few small series have been published SRC in children, and is not sufficient data available regarding laparoscopic approach. In this case report, we present a case of symptomatic SRC who underwent laparoscopic unroofing.

AIM To present cross-sectional imaging, surgical findings, and follow-up results of diaphragmatic mesothelial cysts. MATERIALS AND METHODS Radiological findings for location, size, shape, and internal structure of cysts were reviewed retrospectively. For patients that underwent surgery, surgical reports and laparoscopy images were reviewed. In conservatively managed patients, changes in size and imaging findings of the cyst were assessed during follow-up visits. RESULTS A total of 13 paediatric cases with an imaging and/or pathological diagnosis of diaphragmatic mesothelial cyst were identified. In all cases, the cystic lesions were located between the diaphragm and the posterolateral aspect of the right lobe of the liver. Eleven lesions (84.6%) had a bi-lobulate shape. Eight of these cases underwent laparoscopic cyst aspiration/unroofing. The postoperative course was uneventful and there were no cases of recurrence. The remaining five cases were managed conservatively with follow-up available in four cases. In three cases (75%), there was reduction in the size of the cysts with a mean volume reduction of 55%. CONCLUSION Diaphragmatic mesothelial cysts are congenital cystic lesions that are usually detected incidentally. A common pitfall is incorrect interpretation of the lesion as a hepatic cyst. Conservative management with imaging follow-up can be adopted in asymptomatic cases with typical imaging findings.

Objective: Temporary enterostomies are life-saving in neonatal surgery, however, causing loss of fluid electrolyte, delays in distal bowel adaptation and thus delayed growth of newborns. In this st...

Introduction: Intestinal malrotation is an anomaly that often manifests in newborn and infant childhood. This anomaly, which is rarely seen in older children and adults, is usually detected incidentally during imaging studies or during laparotomy. This article is presented with the aim of emphasizing the Computarised Tomography (CT) imaging for intestinal malrotation an adolescent patient with mesenteric volvulus. Case Report: A sixteen-year-old male patient presented with epigastric pain and bilious vomiting after feeding. In ultrasonography (US), intestinal loops were surrounding along the superior mesenteric artery (SMA) and venous (SMV) vessels tract. In CT, it was noted that SMA marks a whirl sign in the midline of the abdomen. At laparotomy, there were found 360° torsion of small intestine, due to intestinal malrotation. Ladd procedure was performed. Conclusion: In cases of intestinal malrotation, preoperative diagnosis can be difficult because of the lack of specific findings in the physical examination. The delayed diagnosis may be lead to volvulus and intestinal necrosis. The diagnosis of malrotation can brought to mind at an early age but it may be delayed in later ages. In practiced hand, the evaluation of vessels traseries by detailed US and contrast-enhanced CT are characteristics of malrotation diagnosis.

Omphalocele, exstrophy of cloaca, imperforate anus and spinal defect (OEIS Complex) is an extremely rare combination of serious defects, which was firstly described by Carey and colleagues. Surgical repair of cloacal exctrophy in patients with OEIS complex can be performed at one stage, but it can also be performed safely as staged to minimize the potential complications. In this case report, we aimed to present our early approach to the OEIS complex.

Many methods of laparoscopic gastrostomy have been described, but in the majority of these, purse-string sutures and fixation of the stomach to the abdominal wall are not performed simultaneously. In this study, we aim to present a new laparoscopic gastrostomy tube (GT) placement method developed in accordance with the classical Stamm method.Intracorporeal purse-string suture is placed at the anterior wall of the stomach where the GT is intended to be placed. While purse-string sutures are being placed, in each bite, the needle is passed through from a loop thread prepared by extracorporeal and the two threads are suspended outside. The stomach is punctured with the hook cautery, the GT is inserted, and both threads are knotted outside the abdomen.We prospectively placed GT by using our method in 16 patients with an average age of 5 years and most of them with neurological developmental delay. Fundoplication was performed in most of the cases in the same session. No complications were encountered.Our method is a feasible approach for GT placement by the purse-string suturing and the fixation of the stomach to the abdominal wall without extending the port incision.

The gastrointestinal duplication of stomach is uncommon congenital anomalies of gastrointestinal tract. Herein a rare case of gastric duplication with newborn is being reported. A 14-day-old term female baby was admitted to our clinic with intermittent bilious vomiting and abdominal distention. In evaluation, abdominal cystic mass was detected in the left upper quadrant. The cyst which was attached to both the pancreatic duct and spinal cord was removed totally by laparotomy. A histologic examination showed gastric duplication cyst. The postoperative course was uneventful. There were no any complications at the 8-month follow-up period. This rare entity should be included in the differential diagnosis of cystic masses of the gastrointestinal tract and treated surgically by complete resection due to the risk of malignant transformation and other complications. This is the first case report that the gastric duplication cyst has a connection with both the pancreatic duct and spinal cord.

Objectives. The acute scrotum frequently presents a diagnostic and therapeutic challenge. In cases where the testicular torsion cannot be excluded, a surgical exploration is recommended. The aim of the study was to present the results of our management in the patients with acute scrotum. Methods. We reviewed the medical records of 33 patients suffering from acute scrotal pain underwent scrotal exploration between 2011 and 2016. Anamnestic data (age of patient, duration of anamnesis prior to admission and the side that was involved), scrotal color Doppler ultrasound (SCDUS) results, intraoperative findings, mode of operative treatment, and the clinical outcomes were analyzed. Results. Patients aged from several hours up to 17 years of age (average 11.9 years). The duration of symptoms prior to admission ranged from 3 h to 4 days, (average 32 h). Acute scrotum was found 18 in right side, 15 in left side. SCDUS was diagnostic for testicular pathologies in 19 (51%) of 30 patients. In patients who underwent scrotal exploration, 18 (54%) had a testicular torsion, 11 (33%) had a torsion of the appendix testis, and 4 (12%) had an orchio-epididymitis. Three patients who found testicular torsion required an orchidectomy immediately because of necrosis. The rest had detorsion and ipsilateral fixation of testis. Three patients underwent second look, and orchiectomy was performed in 2 of them. In 2 of detorsioned testes, two testicular atrophies developed on follow-up period. Conclusion. Regardless of the etiology, the management of the patients with acute scrotum by urgent surgical intervention allows the salvage of a possible testicular torsion.

Aim: The appropriate anesthetic technique to be used in cases of proximal hypospadias in children is a subject of debate. Local or regional anesthesia as well as intubation can be used. In this study, it was aimed to evaluate retrospectively the different anesthesia and surgery techniques used and their perioperative outcomes in the cases of proximal hypospadias consulting our hospital.Materials and Methods: The hospital files of 30 cases operated on for proximal hypospadias were scanned retrospectively to evaluate the different methods of anesthesia and repair surgery implemented. The patients operated under general anesthesia were grouped on the basis of the airway equipment used for anesthesia as Laryngeal mask airway (Group 1) and endotracheal intubation (Group 2). Routine penile block implementation, effectiveness of anesthesia, side effects, hemodynamic changes and complications in all patients were recorded. Results: A total of 56 sessions of operations on 28 patients were carried out. In 26 of the session’s laryngeal mask and in 30 sessions endotracheal intubation were used. When the data of Group 1 and Group 2 were compared, the groups did not differ significantly with respect to age, anesthesia methods and duration, hypospadias repair methods, duration and sessions, intraoperative parameters, hospital stay and complications (all p>0.05). The two groups differed on the ASA physical status classification values with Group 2 values being significantly higher (p0.05).Conclusion: Effectiveness of anesthesia by using LMA or endotracheal intubation were perioperatively equivalent during repair of proximal hypospadias with different methods of surgery.

Objective: To evaluate the demographics and characteristics of children with Meckel’s diverticulum (MD). Material and Methods: In this retrospective study, we analyzed the medical records of all children who were treated for MD in the department of pediatric surgery of Tepecik Training and Research Hospital over a period of 10 years (1995-2004). Age, gender, clinical manifestations, diagnostic approaches, and histopathological reports were documented. Results: In total, 57 children were diagnosed with MD. Of these, 40 children were treated surgically. Furthermore, 26 had acute abdomen, 15 had intestinal obstruction, 10 had rectal bleeding, and 6 had some other diagnosis. The mean age of the boys (n=43) was 4.77±3.82 years, whereas that of the girls (n=14) was 3.85±3.67 years. Histopathological examination revealed ectopic mucosa in 9 patients, omphalomesenteric duct remnants in 4 patients, diverticulitis in 24 patients, and ulcerations in 14 patients. Conclusion: The prevalence of MD was 1.6%. Boys were approximately 3 times more commonly affected than girls. In most cases, the initial diagnosis was acute abdomen and the presenting symptoms on admission were intestinal obstruction and rectal bleeding.

Background. The experience with laparoscopic cholecystectomy in children remains limited. Therefore, we aimed to present our experience with this procedure. Methods. Between April 2011 and June 2016, retrospectively, data points of children who underwent laparoscopic cholecystectomy reviewed included demographics properties, indication for cholecystectomy, surgical technique, operative time, complications, and length of hospital stay. Results. Twenty-four children (5 were males with ages ranging from 2 to 17 years, mean: 10.5 years) underwent laparoscopic cholecystectomy. The indication for surgery was associated to symptomatic gallstones in all patients. The surgery was performed under general anesthesia and classical 4-port approach was done in twenty-two patients, and 2-port approach in combination with 2 portless 2.3-mm percutaneous graspers was used in two patients. The operating time ranged between 45 and 90 minutes (mean: 60 minutes). Two patients ended by open surgery. No complications occurred. Hospital stays ranged from 1-3 days. Conclusion. Laparoscopic cholecystectomy is safe and effective in children, and shows the same advantages reported in adults series.

Background: The purpose of this study is to determine the prevalence of nocturnal enuresis and its association with sociodemographic factors in 6- to 14-year-old children in the central district of Bursa, located in western Turkey. Methods: A cross sectional epidemiological study was performed among the 125,843 primary schoolchildren. In total, 3270 students aged 6-14 years participated (response rate 98.0%). Data were collected via a questionnaire completed by parents. The relationships between the prevalence of enuresis and various sociodemographic variables were assessed. Results: The overall prevalence of nocturnal enuresis was 23.5%, and the prevalence of the condition was higher in males than in females (52.5% vs. 47.5%). Of the students positive for nocturnal enuresis, 59.1% had primary and 41.9% had secondary enuresis. Male gender, history of enuresis, deep sleep, and constipation were significantly associated with enuresis. Conclusions: The prevalence of nocturnal enuresis may be higher than in previous studies in Turkey, a finding that may be due to the relatively low socioeconomic status of the families in this study. [TAF Prev Med Bull 2012; 11(2.000): 139-144]

Various techniques have been described to repair Morgagni–Larrey hernia. There is still concerns on the sufficiency of a simple laparoscopic anterior abdominal wall fixation. We aim to report of two children undergoingthe laparoscopic-assisted anterior abdominal wall repair for Morgagni–Larrey hernia, and to discuss this method.Keywords: diaphragm, laparoscopy, Morgagni–Larrey hernia

One of the main issues in the penile surgery is wound dressing. There are several varied methods have been reported for circumcision or hypospadias dressing. We aim to report our experiment with Coban™ dressing in penile surgery.

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Isolated epispadias is rare congenital anomaly. An uncommon variation of this anomaly may present with intact prepuce, and it may not be recognized until later during childhood. Herein, we aim to report a case of isolated epispadias with intact prepuce who underwent modified Cantwell-Ransley repair because of rarity.

Background / purpose The aim of the study was to present our clinical experience with the laparoscopic approach in patients with nonpalpable testes (NPTs) and review the literature on laparoscopic classifications. Materials and methods Between May 2010 and August 2012, 30 boys with NPT (mean age 3.9 years) underwent laparoscopy as a part of diagnosis and treatment in our clinic. The laparoscopic findings were classified into four types according to Castilho. The patients were managed according to the presence or position of the testes and testicular vessels. Results Six patients were excluded from the study. Twenty-six testicular units (19 left, three right, and four bilateral units) in 24 patients were managed laparoscopically. Laparoscopy was terminated in eight patients in whom blind-ending cord structures were detected intra-abdominally. An inguinal canal exploration was performed in 10 cases in whom cord structures were seen entering the internal inguinal ring. No viable testis was found, and testicular remnants were excised for histopathologic examination. Four canalicular testes (peeping) were treated with open orchiopexy. Laparoscopy-assisted orchiopexy without vascular ligation was performed in two testes. Fowler-Stephens orchiopexy in single stage was performed in one testicular unit and in two stages in another unit. All patients were discharged on the same day. The testes were normal in size and found in the scrotum after a mean follow-up period of 14 months. Conclusion The laparoscopic findings in NPT had an important influence on treatment decisions. To be able to interpret the definitive surgery relative to the laparoscopic classification, collaborative studies are required. Keywords : laparoscopy, nonpalpable testis, nubbin, orchiopexy, vas deferens

To compare fear of circumcision, before, immediately after, and ten days after the operation.This was a case-control study in which participants in the operation group consisted of children admitted for circumcision at the outpatient clinics of a hospital. The Children's Fear Scale and the Venham Picture Test were administered by face-to-face interviews.The sample consisted of 100 boys who were circumcised and 99 who have not been circumcised yet. Children's Fear Scale scores measured before (P = .000) and immediately after the operation (P = .000) were significantly different from scores obtained on the 10th day after the operation. Total fear scores of the Venham Picture Test of boys whose families were in the higher economic level were higher than those of boys from low-income families (P.05). The primary reason for admission for circumcision was religious, and the reason for the remaining boys was a combination of religious and hygienic factors. The boys who came to have circumcision solely because of religious reasons were found to be less fearful compared with the boys who were brought to surgery for both religious and medical reasons (P.05). The lowest fear scores were obtained for boys who were six years of age or older. Boys who knew what the circumcision meant were less afraid of circumcision compared with those who were unaware of the procedure.Fear from circumcision does not persist; it considerably vanishes within ten days. It seems reasonable to recommend circumcision for boys six years of age or older. Pre-operative education may help boys to overcome fear originated from circumcision.

Objective The aim of this study was to present the outcomes of children with distal hypospadias who were operated on outpatient basis. Methods Atotal of 47 consecutive children underwent surgical repair of distal hypospadias in our department. Urethroplasties were performed by the following techniques: stentless meatal advancement-glanuloplasty (MAGPI) or glans approximation procedure (GAP) for glanular hypospadias (14) and tubularized incised plate (TIP) urethroplasty for coronal, subcoronal and midpenil hypospadias with an indwelling urethral catheter or short stent (33). The indwelling urinary catheters were managed by the double diaper technique. Patients were discharged within 6 h after operation. Dressings and catheters were removed on the postoperative day 2 and 6, respectively. Results Voiding difficulty and urinary retention on early postoperative period were observed in 8 patients. Except meatal stenosis in 4 cases and meatal retractions in 2 cases, there were no major complications in any of our patients during the follow-up period, no postoperative fistula or urethral stricture. Conclusion In children, repair of distal penile hypospadias on outpatient basis is feasible. Catheters, urethral stents, drug therapy and dressing are not justifications for hospitalization in such cases. Keywords: hospital stay, hypospadias, outpatient, urethroplasty, wound dressing

Ich werde in diesem Beitrag versuchen, die wesentlichen Punkte des ideologischen und politischen Prozesses der Entstehung und Umsetzung der Praventionspolitik gegen “Gewalt gegen Frauen” auszufuhren.

Amaç: Bu çalışmanın amacı Bursa ili merkezinde yaşayan 6-14 yaş aralığındaki çocukların noktürnal enürezis prevalansını ve sosyodemografik faktörlerle ilişkisini belirlemektir. Gereç ve Yöntem: Bursa il merkezinde 125 843 ilkokul çocuğunda kesitsel epidemiyolojik araştırma gerçekleştirildi. Çalışmaya altı ondört yaş aralığında toplam 3270 çocuk katıldı (yanıt oranı % 98.0). Anne babalar tarafından cevaplanan anket formları değerlendirilerek enüresis prevalansı ve sosyodemografik özellikler arasındaki ilişki incelendi. Bulgular: Tüm çocukların %23.5’inde enürezis nokturna tespit edildi. Erkek çocuklarda prevalans kız çocuklarından daha yüksek (52.5% vs. 47.5%) bulundu. Saptanan enurezis vakalarının %59.1\'u primer, % 41.9’u ise sekonder enürezis olup; cinsiyet, aile öyküsü, derin uyku ve kabızlık ile enürezis arasında anlamlı bağlantı bulundu. Sonuç: Noktürnal enurezis prevalansı bu çalışmadaki ailelerin düşük sosyoekonomik durumuna bağlı olarak; Türkiyede daha önce yapılan çalışmalardan daha yüksek bulunmuştur., Background: The purpose of this study is to determine the prevalence of nocturnal enuresis and its association with sociodemographic factors in 6- to 14-year-old children in the central district of Bursa, located in western Turkey. Methods: A cross sectional epidemiological study was performed among the 125,843 primary schoolchildren. In total, 3270 students aged 6-14 years participated (response rate 98.0%). Data were collected via a questionnaire completed by parents. The relationships between the prevalence of enuresis and various sociodemographic variables were assessed. Results: The overall prevalence of nocturnal enuresis was 23.5%, and the prevalence of the condition was higher in males than in females (52.5% vs. 47.5%). Of the students positive for nocturnal enuresis, 59.1% had primary and 41.9% had secondary enuresis. Male gender, history of enuresis, deep sleep, and constipation were significantly associated with enuresis. Conclusions: The prevalence of nocturnal enuresis may be higher than in previous studies in Turkey, a finding that may be due to the relatively low socioeconomic status of the families in this study.

In nonpalpable testis cases, laparoscopically blind-ending vas deferens and testicular vessels prior to entering the internal ring is sufficient to diagnose a “vanishing” testis, which requires no further exploration. Laparoscopic identification of cord structures entering the internal ring is required the exploration of the inguinal canal to find a testis or to rule out a “vanishing” testis".However, the need for further investigation in cases that identified the blindending cord structures on inguinal canal is questioned. Herein, we present a case of the scrotal nubbin along with blind ending cord structures during inguinal exploration.

The goal of renal trauma management is preservation of functional renal parenchyma with minimal morbidity. In children with grade IV renal injury, the role and timing of surgical or endourologic intervention is less established and remains controversial. We report a case of a urinary extravasation after blunt renal trauma treated by internal ureteral stenting.

Although the bladder diverticula in children are seen commonly which is association with infravesical obstruction or neurogenic bladder function, the case of giant congenital bladder diverticula are rare. In this paper, an 11 years old boy with giant bladder diverticula presenting urinary infections is evaluated in terms of diagnosis and management by current literature.

Yerel Yönetimlerin Kadınların Toplumsal Cinsiyet Gereksinimlerine Duyarlılığı - Ankara Araştırması- -ÖZET- Bu çalışma, kentsel yaşam ve yerel yönetimler İle toplumsal cinsiyet örüntüleri arasındaki ilişkileri araştırmayı, kadınların toplumsal cinsiyet kaynaklı gereksinimleriyle yerel yönetim uygulamaları ve politikalarının bütünleştirilmesi olasılıklarını sorgulamayı amaçlamaktadır. Temel varsayım, yerel yönetimlerin örgütlenmesi ve politika yönelimlerinde kadınların gereksinimlerini ve gerçekliklerini yok sayan ya da kıyısallaştıran, erkek egemen değerlerle yüklü bir niteliğin egemen olduğudur. Amaç, bu toplumsal cinsiyet yanlılığın nasıl ortaya çıkıp sürdüğünü ortaya koymanın yanı sıra, toplumsal cinsiyet gereksinimlerine duyarlı bir değişimin olanaklarını araştırmaktır. Bu doğrultuda, ilk olarak, Ankara Büyükşehir Belediyesi sınırlan içinde yaşayan 18 yaş ve üzeri kadınların demografik özellikleri, hanehalkı bilgileri, kentsel yaşam içindeki çalışma deneyimleri, kent içi hareketlilikleriyle toplumsal ilişki ağlarının özellikleri, kentsel sorunları, hizmet öncelikleri, toplumsal cinsiyet gereksinimleri, yerel kurumsal politikayı nasıl algıladıkları ve yerel yönetimlerle ilişkileri, nicel ve nitel araştırma teknikleri kullanılarak araştırılmıştır. Bu araştırmanın sunduğu veri ve bulgular ışığında, ikinci olarak, Ankara Büyükşehir Belediyesi'yle S ilçe belediyenin kadınların özgül gereksinimleriyle sorunlarına karşı ne ölçüde ve nitelikte bir farkındalık ve / ya da duyarlılık geliştirmiş olduğu, derinlemesine görüşme ile belge taraması teknikleri kullanılarak, sorgulanmıştır. Bu araştırmada, kamusal-özel alan karşıtlığıyla türevi bölünmeler (üretim-yeniden üretim, işyeri-ev, çalışma alam-oturma alam, politik olan-olmayan gibi) merkezi bir yer tutmuştur. Söz konusu karşıtlıkların cinsiyetçi kodlanmasıyla kentsel toplumsal-mekanın yanı sıra yerel politikaların da cinsiyetçi yapılanması arasında karşılıklı bir ilişki olduğu önermesi temel bir düğüm noktası olmuştur. Gender Sensitivity of Local Governments * Sample of Ankara - - ABSTRACT - This study aims to highlight the relations between gender patterns, urban life and local governmental organizations which are accepted as the principal actor of urban policies. In this context, it is aimed to search the possibilities of integrating women's gender needs with local governmental practices and policies. Main hypothesis is that local governmental organisation and policy-orientation is based on patriarchal values which neglect or marginalize women's needs and realities. The aim of the study is to expose how this gender-biased structure is maintained. Besides, the possibilities of change towards a gender-sensitive structuring is searched. For this aim, firstly, by using quantitative and qualitative methods, we researched 18 years old and older women who live at the Urban Metropolitan Area of Ankara to define their demographic and household characteristics, experiences of work in the urban life, dynamics of spatial mobility and social relations, urban problems, urban service priorities and other gender needs. In addition, we researched their perceptions about local institutional politics and the peculiarities of the relations with local governmental offices. In the light of data and findings of this first step survey, by using depth interview and documental search, we examined the dimensions of gender awareness and / or sensitivity of the Metropolitan Municipality of Greater Ankara and secondary municipalities. It is thought that the public-private space and derivative dichotomies (i.e. production-reproduction, workplace-home, political-non political) are central to this search. Proposing that there is a relation between the gender-biased structuring of urban social-space, also local policies and coding of these dichotomies, is one of the main themes of the study. 300 300

This study aims to examine the perspective of woman of Turkish political parties, in the context of critics of feminist theory on some basic concepts of political science and law. In this view, how woman and man define politics and interact with politics is analysed in a comparative way. Equality, freedom, democracy, representation, participation, citizenship, power, politics, public and private sphere constitute the conceptual framework of this thesis. The thesis consists of three main chapters. In the first chapter, the method of the research, the techniques of gathering data and conceptual framework are introduced. The technique used in this research is qualitative research method. Data were collected through, over four and a half months in pilot local branch of a political party, the techniques of participant observation, face-to-face interview and oral and written text analysis. In the second chapter, the position of women in the programme of the parry is examined, in the light of the party's political position in Turkish political life and its women politics. The objective of the third chapter is to make relations between women, men and politics in this political party evident, in the light of data gathered through the techniques noted above. 112

168 ÖZET Özet `Türkiye Solu ve Siyasal Kültür` başlıklı bu çalışmanın konusu, Türkiye'nin siyasa! kültürü ile Türkiye sosyalist hareketinin siyasa! kültürü arasındaki ilişki ve etkileşimdir. Bu çalışmada, öncelikle, Türkiye sosyalist hareketinin Türkiye'nin siyasal kültüründen farklı ve alternatif olabilecek bir siyasal kültüre sahip olup olmadığı sorusu yanıtlanmaya çalışıldı. Jean FYan-*ois Sa^'art'm si^'as?! kü!*ür kavrams^Ha^tirmsKi benimsendi* si%/as?l kültür, `heterojen siyasal [söylemsel] türlerin farklı birleşmelerinden îKarp'ltir ` T»`ır1ov#» ertuvııliel har#»V^fÎTiîıı sit/ae»] Vi'ilii'minim t»l** aTlTÎTOHSI e^r^cTjif tîj y-j'yBİı îj^etmlerir* `^f **$#aTjrn**K'» yılı > benıms^^d1 `Türkiye'nin Siyasal Kültünü` başlığını taşıyan birinci bölümde, Türkiye'nin sij'asai kültürünün nitelikleri, Türkiye'nin siyasal ve toplumsal sırasıyla: Osmanlı Devîeti'nm mirası, Türkiye'nin modernleşme süreci ve askeri darbelerdir Özetleyecek oV.*r«sk, f>~i Tsînır'm değerlerine olumlu anlamlar yüklenmesi; Anayasa ve parlamento gibi yurttaşların siyasal katılımmı sağlamaya yönelik kunamlann yanı sıra, toplumun ezilen kesimlerini, kadınları ve farkh etnik kimliklerle siyasete katılmak istenenlerin siyasete katılımını uörece emıeîîeven elitist bir siyasal çerçevenin oluşturulmasıdır. Askeri darbelerin en önemli katkısı ise, yönetilenlerin siyasete katılımım özendirmek bir yana, siyasetten soğutan bir siyasa! kültür olduğu sonucuna varıldı.W) `Türkiye Solu 'nun Sivasal Kültürü` başlıklı ikinci bölümde, Türkiye sosyalist hareketini» siyasal kültürü.., tarihsel bağlan»» ``.'imle değerlendirildi. Cumhuriyet dönemi Türkiye soyalisî iıareketinin selisimi. TYırlrî-*/**,r!*T`' tMv*J^'J^ ViiltiiWt rst/-r h.Tii/t/Atı. //ıi// %y/Aı iT*u1qt`*V Ar%rt fqrîîıo«î fl//rı'A{/i3rnfAi>r%rt rslAt-trrtt cvftri'AAiı Plaulı^o irw»1.t>^lr»orriif> vAvtrAvtr*' mr/Ar*rr/1if%ofx*f^ projenin eleştirel olmayan, bir biçimde sahipleniknesi; siyasetin meşru fetişleştiriimesi benzer biçimde oartinm fetişleştiriîınesi; ulusal kurtuluş mücadelelerinin de etkisiyle milliyetçi bir söyleme kayılması; cinsiyetçiîik; ideolojik ve kültürel muhafazakarlık; militarizm; öîümseverîik; devrimcinin küitlestirilmesidir. Türkiye sosyalist hareketinin tarihi bir bütün olarak ele alındığında da, Türkiye sosyalist hareketinin alternatif bir siyasal kültür geliştiremediği öne sürüldü. `Türkiye Sosyalist Hareketmdeki /kî Siyasal Kültür` başlığım taşıyan ikinci böh'imfm geri kalanında-, önceki bölümde varılan sonuçların ışığında, Türkiye Solu'nun ilk üç döneminin siyasal kültür açısından önemli farklılaşmaları barındırmasına rağmen, siyasal kültürdeki esas dönüşümün AfSrAftrtrn't Annc*mAn -%/iYv»Vl*M?tı*ri 1tftf»'*t rMftHtr/fc `redomiii-£mes of £uihorztaziazi sdii*,?'`straiion perspective oriîîimited ironi Ottoman State's heritage and the perception of modernisation as a project; îjfrirîîT'ütîvs s^Sîiss J#iW44 U11U tULl*114«rf WUlbUIUl L/l/lltiVUI identities* alienati*``*.'1* citizens from ``olitical Ti2i*ticir*2tion rather t fi?» t? feciîitatiîîe political participation. After that, political culture of the Turkey's Left is analysed in four periods: from the birth of Turkish Communist Party to the first coup d'etat m I960; 1960 to second coup d'etat in 1971; 1971 to the third coup d'etat in 1980; from 19S0 to today. In determining the periods of the developments of political culture of the Turkey's socialist movement considered. Tn the first forty years of the Republican era, the Turkey's Left lived in symbiosis with Kemalist regime in Turkey and USSR. Due to this relation, Turkey's Left could not produce an independent political culture and a Marxist accumulation. Tn the second period of Turkey's Left, Turkish Worker's Party established in 1961 and for the first time in its history had an important election result in 1965. Also in this period Turkey's student movement reached to its peak. The third period characterized with the heyday of anti-fascist movement. Tn this three periods with the affects of îCsmsiist herila,re the violence acts of the rightist movement and symbioticÎ72 relation with Comintern, Turkey's Leo disinterested with its political culture and acquired many aspects of Turkey's political culture. September 12th 1980 coup d'etat mainly targeted Turkey's Left. The last two decades marked with a partial self-criticism of past, and new cultural anr>roaches -like a nosiai^calb' attitude towards ``oldeii a°e~ 1 Q7f)'r*ta AiA rjot fhaHÜC es^ecisdl11' in sexisi*11 or^^tiiiii&iion models hîîU ıtHlîûnsılİsnî. After ait mvesiigaLion of Turkey's Left's history, we arrive to a political culture to Turkey's political culture as a whole. ÎİKBMAKrASYÖN 172

Tol, Uğraş Ulaş, Halkçı Söylem - Sınıf Söylemi, Yüksek Lisans Tezi, Danışman: Doç. Dr. Serpil Sancar Üşür, 153s. ÖZET: İktidar her yerde cereyan eden ve her yere sızan dinamik bir ilişki biçimidir. İktidarın çoğulluğu kabulü ile yola çıkarsak, çeşitli söylemler içerisinde bir çok mikro iktidarın inşa olduğunu, bu iktidarların, çeşitli adlandırmalar yoluyla bazı özneleri çağırdığını ye belli bir kitle üzerinde nüfuz oluşturduğunu ve belli bir kitlenin iktidarın inşasına bizzat katıldığını görürüz. Bu yüzden iktidarları analiz ederken, meydana geldikleri söylemi çözümlemek, bu söylem içerisindeki pratikleri ve teknikleri deşifre etmek elverişli bir yöntemdir. Türkiye solundaki söylemlerde de iktidarların etkin bir biçimde meydana geldiği ve hüküm sürdüğü göze çarpar. Bu söylemlerden, demokratik- popüler adlandırmalar ve sınıf adlandırmalarından ağırlığı sırasıyla birincisine veren halkçı söylemi temsil eden Devrimci Yol hareketi ve ikincisine veren sınıfçı söylemi temsil eden Türkiye Komünist Partisi için de bu dediklerimiz doğrudur. Her iki söylem de iktidarın kuruluşu ve işleyişi itibari ile aynı teknikleri kullanmakta ve benzerlikler sergilemektedir. Adlandırmaların farklılıkları dışında kalan temel farklılık, sınıfçı söylemin daha yapılaşmış ve kapalı bir söylem oluşturmasındadır. Söylemlerin farklılıklarına rağmen, iktidar, benzer bir şekilde inşa olmakta ve işlemektedir. İktidar ve kitle dinamik ve kuvvetli bir ilişki içerisindedir. İktidar kitle üzerinde nüfuz oluşturmakta ve kitleyi büyütmektedir; kitle de iktidara tabi olmakta ve onu geliştirmektedir. Özneler farklılaştırılmakta, dost ve düşman belirlenmekte ve özne olmanın normları, biçimleri düzenlenmektedir. İktidar çeşitli teknikler uygulayarak çeşitli özneler inşa ederken, insan varlıkların bedenlerini disipline etmekte, yaşamlarını düzenlemekte, zihinlerini denetim altına almaktadır. Tol, Uğraş Ulaş, Populist Discourse - Class Discourse, Master's Thesis, Advisor: Doç. Dr. Serpil Sancar Üşür, 153 p. ABSTRACT: Power is a kind of dynamic relationship which diffuses everywhere. We start from the supposition that the power is multiple. As a result we can say that there are several micro powers and they are built in during a process in which the usage of various interpellations calls in certain subjects. We can also say that it is the masses themselves that participate in the building of this power that is is going to be exercised over them. It is for this reason that while analysing power, it is important to clearly understand the practices and techniques that are part of this discourse. It is impressive that in Turkey the discussions in the socialist left actively include power relations. In the Turkish case we see two movements, nameley the Revolutionary Path movement which attempts to realize democratic-popular interpellations represents populist discourse; and Turkish Communist Party which attempts to realize class interpellations represents class discourse. In both discourses the establishment and the practice of power is similar as far as techniques are concerned and interpellation differences hide the basic difference that is the class discourse is more strucrured and closed. Despite the differences in the discourses, power in them is built and functions in similar ways. The relationship betweeen power and the people is dynamic and strong. Power dominates masses and aims at the growth of masses; masses are subordinate to power and they reproduce it. The difference betweeen friends and foes is cleared up and emphasized and the norms for the subjects are set up and regulated. Power uses various techniques when it is building different subjects, when it disiplines peoples bodies and existances and takes under control their intelligence. 153

Son on beş yıl içinde hükümetler ve uluslararası örgütlerin kadın istihdamının yaygınlaştırılması konusunda özel bir çaba gösterdikleri görülmektedir. Kadın istihdamının yaygınlaştırılması için kullanılan en önemli araçlardan biri, kadınları kendi hesabına çalışmaya teşvik etmektir. Uluslarası örgütler ve hükümetler, 1980 sonrasında kapitalist üretim teknolojisindeki değişikliklere koşut olarak kadınlara ücretli istihdamın dışında istihdam olanakları yaratmaya çalışmaktadırlar. Kadınları ücretli istihdamın dışında kendi hesabın çalışmaya yönlendirmelerinin nedenleri: 1. 1980 sonrası hükümetlerin refah devleti ve sosyal devlet anlayışından uzaklaşmaları ve bunun doğurduğu işsizlik sorunu 2. Özellikle Dünya Bankası ve IMF'nin, az gelişmiş ülkeler için uyguladıkları yapısal uyum programlarının kadınların da piyasa için üretim yapmalarını gerektirmesi 3. Toplumdaki cinsiyet eşitsizliğinin kadınların ekonomik etkinliklerinin artması ile kendiliğinden ortadan kalkacağına dair ön kabuldür. Bütün bu uygulamalarla, hükümetler ve uluslararası örgütler, hem 1980 sonrası kapitalist sermaye birikimine katkıda bulunacak düşük işgücü gereksinimini karşılamakta, hem de kadınların toplumsal cinsiyet eşitliğinin sağlanması için talep ettikleri toplumsal örgütlenmelerin maliyetinden kaçınmaktadır. Kadınlar, kendi hesabına çalışmaya yönlendirilerek hem ev içindeki yeniden üretim etkinliklerini üstlenmekte, hem de piyasa mekanizması içinde temel gereksinimlerini karşılayacak gelir getirici etkinliklerde bulunarak sermaye birikimine katkıda bulunmaktadır. Ancak, Türkiye'de dahil olmak üzere, tüm bu destek politikaları, kadınların işgücü piyasasında düşük statülü, düşük ücretli, güvencesiz işleri yapmayı sürdürmelerine engel olmamaktadır. Bu durum, ancak kadınların bu alandaki toplumsal cinsiyet eşitsizliklerini aşmak için çaba gösterdiklerinde onları özgürleştirmek için bir araç olabilecektir. In the last fifteen years governments and international donor organizations have a special effort to expand women employment. One of the important ways of expanding of women employment is to encourage self-employment of women. International organizations and governments have been triying to set up employment possibilities for women with accord of changes in production technologies. The reasons of women self-employment are as follows: 1. Unemployment problems, which is comes from that governments are increasingly far away from the concepts of welfare state and social states. 2. In particular, World Bank and IMF's structural adjustment programmes needs of much nore women labour in the production of market economy. 3. Assumptions that gender inequalities in society will be extinguished by increased economical activities of women. After 1980 governments and international organizations increasingly needs the low-cost labour, because of women's growing contribution to capitalist accumulation. On the other hand, these institutions avoid the cost of social organisations, which are demanded by women. In present situation women are oriented to self-employment and then are going on to be responsible for reproductive activities of household. However, the policies of encouraging self-employment of women are not obstacle for women's low status without struggle of women to go beyond gender inequalities in self-employment area. 130

127 ÖZET Tez, Türkiye'de 1980'lerden itibaren yükselen siyasal islamın islamcı romanlar bağlamında söylemini ele almakta ve siyasal islamın söylemsel olarak `öteki` kimliğini çatışmak mı yoksa uyumlu mu kurduğunu incelemektedir. Tezin birinci bölümü, söylem kavramını ve söylem çözümlemesi yöntemini tartışarak `çözümlemede kullanılacak, söylem, söylem-kimlik ilişkisi, söylem de öteki kimliği gibi temel kavramları ele almakttadır. Tezin ikinci bölümünde ise araştırma malzemesi olarak seçilen islamcı romanlarda islamcı siyasal söylem çözümlenmeye çalışılmıştır. Romanlarda söylem çözümlemesine en uygun olan ve sadece Öteki kimliğini yansıtacak bölümler -metinler- seçilmiştir. Romanlarda, öteki erkek, öteki kadın, öteki zengin, öteki uluslar, öteki ideolojiler vb. tüm öteki kimliklerinin söylemsel olarak nasıl kurulduğu ele alınmıştır. Yapılan söylem çözümlemesinde öteki kimliklerinin son derece çatışmak olarak kurulduğunu, çatışmanın ise, en temel nedeninin ` öteki `lerin `islam dışı` olmalarından kaynaklandığıdır. Böyle bir bulgu şeyler ya İslama uyar ya da ona karşıttır ve insanlar ya müslümandır ya da `kafir` dir biçiminde özetlenebilir. 128 SUMMARY In this thesis, the discourse of the rising political İslam in Turkey after 1980, is being dicussed with focussing upon the Islamic novels and it is being searched that political Islam discursively constucts the other's identity either in controversy or in harmony. In the first part of this thesis, the concept of discourse and the methodology of the discourse analysis are being argued. In addition to this, this part is deal ing with the concepts of discourse, the relationship between discourse and identity and the other's identity constructed in discourses which are used in discourse analysis. In the second part of this thesis, the Islamic political discourse is analyzed in the Islamic oriented novels, which have been selected for the research. In these novels, the chosen parts are selected by looking to their suitable structure for discourse analysis and reflection capability of the other's identity. It is being examined that how the other's identity is constructed discursively in these novels, such as the other woman, the other man, the other nation, the ot her ideology. After such a criticism it can be concluded that the other's identities are ref lected in a contradictory form in Islamic oriented novels. This is due to the fact that the other's identities are non-Islamic. As a result it can be said that according to such an ideology, the things and identities exist only either in harmony with Islam or they exist in contradiction with Islam. That is to say according to this ideology the men are either Muslim or they are infidel i.e. iteEKilirrli rarau İMANTASYOM MERKEZ'* 131