An evaluation of parental attitudes and attachment in children with primary monosymptomatic nocturnal enuresis: A case-control study.

INTRODUCTION: Enuresis is a common childhood disorder associated with the lack of bladder control that would be expected based on the child's age or developmental stage. Enuresis affects the lives of both children and their parents due to the burden it entails in daily life. OBJECTIVE: In this study, we aimed to evaluate the dimensions of attachment between children with enuresis and their mothers, as well as the relationship with parental attitudes. METHODS: This study included 70 children were diagnosed with primary monosymptomatic nocturnal enuresis (PMNE) based on the guidelines of the International Children's Continence Society (ICCS) along with 70 children with not enuresis and any psychiatric disorders. We asked the mothers of all participants to complete the Parental Attitude Research Instrument, and the children to complete The Experiences in Close Relationships Scale Revised - Middle Childhood. RESULTS: Both groups in our study were well balanced in terms of gender, age, and sociodemographic data. Children with enuresis were found to score higher on the anxiety and avoidance dimensions of the attachment scale with statistical significance (p < 0.01). Also, on the scale completed by the mothers of children with enuresis, the subtests indicating overprotective parenting and strict discipline presented significant differences (p < 0.01). DISCUSSION: Data obtained in our study demonstrate that enuresis can have a negative effect on the mother-child attachment and parental attitudes. The use of harsh language or punishment by the mother in response to the failure of the child to achieve nocturnal dryness may affect the attachment between the mother and the child, and cause the child to experience negative emotions such as shame, anxiety, embarrassment, frustration, and loneliness. CONCLUSION: We think that it would be useful to evaluate the mother-child attachment and the crisis experienced by the family after each wetting incidence in combination with parental attitudes and behaviors in the treatment of enuresis cases.

An unexpected long-term complication of genital burn in a child: Secondary cryptorchidism.

Genital and perineal burns are rare and challenging injuries with serious long-term complications. Involvement of the testes is a sign of severity. There is limited knowledge in the literature about the management of complications and testes involvement in genital and perineal burns. In this report, we present the case of an 8-year-old boy with secondary cryptorchidism due to burn contracture who was treated by increasing the scrotal volume by Z-plasties, skin graft, and orchidopexy.

The effect of urethral catheter size on meatal stenosis formation in children undergoing tubularized incised plate urethroplasty.

PURPOSE: Meatal stenosis is still a common problem in tubularized incised plate urethroplasty. In this study, we aimed to seek for a relationship between the size of urethral catheter and meatal stenosis formation in children undergoing tubularized incised plate urethroplasty. MATERIALS AND METHODS: We retrospectively reviewed 83 children who underwent tubularized incised plate urethroplasty for hypospadias. The whole group was classified into the groups A and B based on the catheter size. One group (group A) consisted of 44 patients (mean age, 4.82 ± 3.83 years) with tubularized neourethra over a 6 Fr catheter, while the other group (group B) included 39 patients (mean age, 5.19 ± 3.83 years) with tubularized neourethra over a 8 Fr catheter. RESULTS: There were no significant differences between the groups according to their age, location of urethral meatus, dehiscence and urethrocutaneous fistula formation. Meatal stenosis formation in group B was markedly higher than that in group A. Number of meatal dilatation was higher in group B compared to group A. CONCLUSION: We suggest that the tubularization of urethral plate over a small-sized (6 Fr) catheter, regardless of the age of the patients, prevents meatal stenosis by reducing foreign body reaction and pressure injury and by hindering secondary healing.

Delayed and incidental diagnosis of transverse testicular ectopia.

Transverse testicular ectopia is a rare malformation in which both testes are placed in the same inguinal region. Most of the patients are diagnosed incidentally during inguinal exploration. We here report three cases of transverse testicular ectopia and discuss the causes of delayed and incidental diagnosis of this infrequent malformation. Although the mean age at presentation was reported as 4 years, the mean age of our patients was 7.7 months. We detected the contralateral testis in the inguinal canal in all of our patients preoperatively. The most important diagnostic criteria are to be aware of this rare malformation and getting suspicious in patients with one side inguinal hernia and an empty hemiscrotum on the other side. It is essential to perform an ultrasound scan in patients with such a clinical presentation.

Appendicitis within an umbilical hernia sac: previously unreported complication in children.

Umbilical hernia is one of the most common congenital pathologies of the anterior abdominal wall in children. Umbilical hernia in children has a high tendency for spontaneous closure. Surgical treatment is performed only for rarely occurring complications. Appendicitis within an umbilical hernia sac is a previously unreported complication for umbilical hernias. We report here the first case in the current English language literature.

Assessment of the efficacy of absorbable adhesion barriers on dissection in esophagus operations.

OBJECTIVE: During childhood, recent repeated operations for esophagus are normally conducted if long gap esophageal atresia exists. During multistaged extrathoracic esophageal elongation procedure, the dissection of the esophagus poses severe problems due to adhesion. However, Gore-Tex membrane may simplify esophagus dissection. The most popular adhesion barriers used today are sodium hyaluronate (Seprafilm; Genzyme Corp., Cambridge, MA) and oxidized regenerated cellulose (Interceed; Johnson&Johnson Medical Inc., New Brunswick, NJ). The purpose of this study is to investigate the efficacy of adhesion barriers on esophagus dissection. METHODS: In the study, 21 Wistar albino adult male rats were worked on. The rats were randomly divided into three groups, each including seven rats. About 1cm-segment of the esophagus, located just behind the trachea, was dissected from the surrounding tissues through blunt dissection. Rats in group 1 were wrapped with Seprafilm, and in group 2 with Interceed. But the rats in group 3 underwent only esophagus dissection. Three weeks later, during esophagus dissection, adhesion scoring was performed and esophagus was divided into two parts: one for the assessment of hydroxyproline level, and the other for histological examination. RESULTS: When the adhesion scores of the three groups were compared, there was not a significant difference between the groups (p=0.75). In terms of tissue hydroxyproline levels, mean scores of hydroxyproline revealed no significant difference between the three groups (p=0.19). When the histopathological results were examined, esophagus looked normal and no connective tissues were seen around esophagus. CONCLUSION: Seprafilm and Interceed had no effect on esophagus dissection. Although Seprafilm had the best mean score, this was statistically insignificant. Gore-Tex might play a better role than Interceed in preventing adhesion formation; however, it is still not certain whether adhesion barrier should be used in such organs as esophagus having no serosa.