Publications by authors named "Seyİthan Özaydin"

15 Publications

  • Page 1 of 1

What is the main factor in predicting the morbidity and mortality in patients with Gastroschisis: Delivery time, delivery mode, closure method, or the type of Gastroschisis (simple or complex)?

Turk J Med Sci 2021 Feb 8. Epub 2021 Feb 8.

Background/aim: There are numerous debates in the management of Gastroschisis (GS). The current study aimed to evaluate perinatal outcomes, surgical and clinical characteristics among Gastroschisis (GS) patients based on their type of GS, abdominal wall closure method, and delivery timing.

Materials And Methods: This study was a retrospective analysis of prospectively collected data of 29 fetuses with GS that were prenatally diagnosed, delivered, and managed between June 2015 and December 2019 at the Obstetrics and Pediatric Surgery Clinics of Kanuni Sultan Süleyman Training and Research Hospital.

Results: Twenty-three of the patients were simple GS, and six of them were complex GS. The reoperation requirement, number of operations, duration of mechanical ventilation, time to initiate feeding, time to full enteral feeding, total parenteral nutrition (TPN) duration, TPN-associated cholestasis, wound infection, sepsis, and necrotizing enterocolitis were significantly lower in the simple GS group than the complex GS group. The mean hospital length of stay was 3.5 times longer in the complex GS group (121.50±24.42 days) than that of the simple GS group (33.91±4.13 days, p=0.009). There were no cases of death in the simple GS group. However, two deaths occurred in the complex GS group.

Conclusion: This study indicated that simple GS, compared with complex GS, was associated with improved neonatal outcomes. We suggest that the main factor affecting the patients? outcomes is whether the patient is a simple or complex GS rather than the abdominal wall closure method.
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http://dx.doi.org/10.3906/sag-2011-166DOI Listing
February 2021

Peritoneal dialysis as a life-saving procedure in an extremely low birth weight infant: case report and review of the literature.

Turk J Pediatr 2020 ;62(6):1069-1076

Pediatric Surgery, Health Sciences University, Kanuni Sultan Suleyman Training and Research Hospital, İstanbul.

Background: Acute kidney injury (AKI) is a common condition in the neonatal intensive care unit (NICU), particularly in preterm infants. Management of AKI in neonates is challenging. Peritoneal dialysis (PD) has been preferred as the most applicable modality in neonates when medical therapy fails.

Case: A female infant was born at 24 and 4/7 weeks with a birth weight of 460 grams after an emergency cesarian section from a preeclamptic pregnacy. She developed AKI secondary to sepsis. A neonatal, straight single-cuff Tenckhoff catheter was inserted and PD was started on day 12. PD was discontinued after 6 days, on day 18 with adequate urine output and normalization of kidney function tests. However, the patient died on day 152 secondary to a nosocomial infection.

Conclusion: To the best of our knowlegde, our case is the smallest infant in whom PD was performed succesfully with a PD catheter. PD is a relatively safe, effective and a feasible therapy in the neonatal population even in the smallest infants. PD may be a live-saving procedure in extremely low birth weight infants with severe AKI.
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http://dx.doi.org/10.24953/turkjped.2020.06.020DOI Listing
January 2020

Congenital esophageal diverticulum in a very low birth weight infant: case report and review of literature.

Turk J Pediatr 2020 ;62(3):520-524

Departments of Neonatology, Kanuni Sultan Suleyman Training and Research Hospital, İstanbul, Turkey.

Background: A diverticulum is an outpouching of a tubular organ that is classified as congenital and acquired according to the involved layers of the gastrointestinal wall. Congenital true diverticulum has been very rarely seen in neonatal period and it is very difficult to diagnose it especially in premature infants.

Case: A male infant was born with birth weight of 1000 g at 28th gestational week, was hospitalized for prematurity and respiratory distress. During follow up intermittent CO2 retention was observed in blood gases. On the 17th day of hospitalization, esophageal dilatation was detected on X-ray and barium swallowed esophagram showed a saccular pouch on the distal esophagus. The patient was operated on 26th day of life and pathological specimen revealed true diverticulum of esophagus. The patient died due to respiratory failure and septic shock during hospitalization.

Conclusion: To the best of our knowledge this case is the smallest and youngest preterm infant diagnosed with congenital esophageal diverticulum. Prolonged and intermittent CO2 retention such as in our case can be an atypical symptom of congenital diverticulum and it should be suspected in the differential diagnosis. Congenital esophageal diverticulum may be also seen in extremely preterm infants and can present with unusual symptoms.
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http://dx.doi.org/10.24953/turkjped.2020.03.026DOI Listing
January 2020

Giant Infantile Hepatic Hemangioma: Case Report and Surgical Technique.

Sisli Etfal Hastan Tip Bul 2020 25;54(1):108-112. Epub 2020 Mar 25.

Department of Pediatric Surgery, Health Sciences University, Kanuni Sultan Süleyman Training and Research Hospital, Istanbul, Turkey.

Infantile hepatic hemangioma is the most common liver tumor in children. The most common symptoms are mass in her stomach, anemia and heart failure. According to the findings of the patient, the treatment may vary from the clinical follow-up to liver transplantation. In our study, the details of the surgical technique were presented. An 11-day-old newborn case with giant hepatic hemangioma causing postnatal respiratory arrest was presented in this study. Large and symptomatic patients with infantile hepatic hemangiomas who face us with different clinical behaviors are operated. It will be useful to share the surgical technique for these rarely seen cases for surgeons.
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http://dx.doi.org/10.14744/SEMB.2018.00087DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7192244PMC
March 2020

The Effect of Technical Problems on the Operation Process in Pediatric Laparoscopy.

Sisli Etfal Hastan Tip Bul 2019 11;53(2):110-113. Epub 2019 Jul 11.

Department of Pediatric Surgery, Kanuni Sultan Suleyman Training and Research Hospital, Istanbul, Turkey.

Objectives: The aim of this study was to determine the technical problems in pediatric laparoscopic surgery and to evaluate its results.

Methods: The technical problems encountered in 30 laparoscopic operations performed between 3 November 2012 and 31 December 2017 were retrospectively analyzed.

Results: The technical problems experienced in 30 laparoscopic surgeries were analyzed. There were 6 splenectomies, 15 appendectomies, 1 hernioplasty, 2 ovarian cyst excisions, 4 cholecystectomies, 1 intra-abdominal exploration of the testes, and 1 varicocele surgery. The technical errors included instrument failure in 10, human errors in 8, device problems in 12, and multiple problems in 2 cases. In 5 patients, we switched to open surgery.

Conclusion: Technical problems prolong the operation, and cause a conversion to open surgery. In order to solve these problems, it is necessary to register and report these problems and take the necessary preventive measures.
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http://dx.doi.org/10.14744/SEMB.2018.74436DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7199834PMC
July 2019

Vitelline duct pathologies in neonates.

North Clin Istanb 2018 Sep;5(3):211-215

Department of Pediatric Surgery, Kanuni Sultan Suleyman Training and Research Hospital, Istanbul, Turkey.

Objective: The aim of this study was to review the management of pediatric cases of vitelline duct pathology (VDP) detected surgically or incidentally during the neonatal period and the outcomes.

Methods: The data of newborns who were symptomatic and underwent VDP resection or who were incidentally diagnosed with VDP at a single institution between 1985 and 2015 were retrospectively analyzed in terms of age, sex, clinical features, treatment, perioperative findings, ectopic tissue pathology, and postoperative follow-up information.

Results: Among the 36 newborns enrolled in this study, 26 were male and 10 were female (2.6:1). The median weight was 2400 g (range: 800-3090 g). In 16 cases (14 males and 2 females; 7:1) the VDP was surgically repaired. Pathological evaluation indicated that 43% (n=7) of the cases had ectopic gastric mucosa. VDP was incidentally discovered in 12 males and 8 females (1.5:1). VDP was removed in 10 cases (50%) and left intact in others. Ectopic gastric mucosa was observed in 10% of the VDP removal cases. Ectopic gastric tissue was more prevalent in the surgical VDP cases than in the incidentally discovered and VDP removal cases (p<0.05). Male predominance was greater in the surgically repaired cases than in the incidentally discovered cases (p<0.05). One patient whose VDP was discovered incidentally was admitted 3 years later with obstruction due to intussusception caused by Meckel's diverticulum, and 1 patient was admitted with rectal bleeding at 11 years of age.

Conclusion: Symptomatic VDP in the newborn demonstrates a significant gender difference. Symptomatic cases are more likely to have ectopic gastric tissue than non-symptomatic cases. Incidentally detected cases without removal should be followed closely for future complications.
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http://dx.doi.org/10.14744/nci.2017.60590DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6323573PMC
September 2018

Penetrating injury caused by a long iron bar: A case report.

North Clin Istanb 2018 11;5(1):75-78. Epub 2018 Jan 11.

Department of Pediatric Surgery, Kanuni Sultan Suleyman Training and Research Hospital, Istanbul, Turkey.

Foreign bodies that strike the body with their long edges can cause severe problems. From the hospitalization of the patients to the removal of the foreign body and from surgery to follow-up, working as a team in a well-organized manner is necessary. In the present research, we present our experience, including the hospitalization, initial assessment by the emergency team, examination, and treatment plan, of a pediatric patient who had a 12-m long iron bar that traversed from the right side of the anus to the loin; this impalement happened while the patient was sliding through a snow-covered street, and the patient had to wait on the snow until the fire department arrived and cut the iron bar.
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http://dx.doi.org/10.14744/nci.2017.75508DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5864715PMC
January 2018

Neonatal gastric perforations in very low birth weight infants: a single center experience and review of the literature.

Pediatr Surg Int 2018 Jan 27;34(1):79-84. Epub 2017 Oct 27.

Department of Neonatology, Kanuni Sultan Suleyman Training and Research Hospital, Turgut Ozal Caddesi No:1 34303 Altınsehir, Kucukcekmece, Istanbul, Turkey.

Purpose: Gastric perforation is a rare condition with high mortality rates in preterm infants. The aim of this retrospective study was to define the risk factors and prognosis in very low birth weight (VLBW) infants with gastric perforations.

Methods: VLBW infants with a diagnosis of gastric perforation between 2012 and 2016 were included. The data including birth weight, gestational age, gender, risk factors, time and location of the perforation and prognosis were recorded.

Results: A total of eight infants were identified. The median gestational age and birth weight of the infants were 26 weeks and 860 g, respectively. Five were male and 6 (75%) had a diagnosis of hemodynamically significant patent ductus arteriosus (PDA), early sepsis, persistent hypotension, and drug administration (paracetamol, ibuprofen). The main clinical finding was abdominal distension and pneumoperitoneum was detected in all infants. The median diagnosis was 6 days of life. The median perforation size was 2.5 cm and curvature major and anterior wall were the most common locations. The mortality rate was 62.5%.

Conclusion: Male gender, chorioamnionitis, early sepsis, asphyxia, hemodynamic PDA, persistent hypotension, ibuprofen and paracetamol usage, and orogastric catheter administration were the main risk factors for gastric perforations in VLBW infants.
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http://dx.doi.org/10.1007/s00383-017-4205-1DOI Listing
January 2018

Increasing the Reliability of the Grading System for Voiding Cystourethrograms Using Ultrasonography: An Inter-Rater Comparison.

Nephrourol Mon 2016 Sep 31;8(5):e38685. Epub 2016 Jul 31.

Department of Pediatric Urology, Kanuni Sultan Suleyman Education and Research Hospital, Istanbul, Turkey.

Background: To assess the effectiveness of the current vesicoureteral reflux (VUR) grading system according to the international classification of VUR (ICVUR) and to evaluate whether VUR grading accuracy could be improved by renal ultrasonography (RU) according to the Society for Fetal Urology (SFU) grading system.

Objectives: Therefore, this study assessed the accuracy of the current VCUG staging system by assessing inter-rater reliability among pediatric radiologists and urologists; it also evaluated whether accuracy is increased by RU without consensus (with respect to VCUG grading).

Methods: Four pediatric urologists and four pediatric radiologists independently graded 120 voiding cystourethrograms (VCUGs). Middle VUR grades were divided into the following three groups: VUR consensus grade III (group 1), VUR consensus grade IV (group 3), and VUR non-consensus grades III and IV (group 2). All groups were compared with respect to hydronephrosis grade using RU.

Results: The intraclass correlation coefficient (ICC) values ranging from 0.86 to 0.89 reflected good reliability. The lowest agreement was associated with middle grades (III and IV). A marked difference in sensitivity was observed between groups 1 and 3 (35% and 95%, respectively, P < 0.05), indexed by SFU hydronephrosis grade, suggesting that VCUG cases in group 2 (n = 16 at SFU 0 or 1) could be accepted as grade III, and SFU scores of 2, 3, or 4 could be considered grade IV.

Conclusions: Inter-rater accuracy could be improved at middle grades using renal ultrasonography (USG), which could promote communication between different specialists.
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http://dx.doi.org/10.5812/numonthly.38685DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5111094PMC
September 2016

Unusual Presentation of Duplex Kidneys: Ureteropelvic Junction Obstruction.

Adv Urol 2016 18;2016:7960794. Epub 2016 Oct 18.

Department of Pediatric Urology, Kanuni Sultan Suleyman Education and Research Hospital, Istanbul, Turkey.

. Ureteropelvic junction obstruction (UPJO) is rarely associated with a duplex collecting system. We review this unusual anomaly in terms of presentation, diagnostic evaluation, and surgical management. . We retrospectively reviewed the medical records of patients diagnosed with a duplex system with UPJO. . Sixteen patients (6 girls, 10 boys) with 18 moieties were treated surgically and four patients were treated conservatively. The median age at surgery was two years (range, 2 months to 7 years). The lower pole and upper moiety were affected in 12 and two kidneys, respectively, and both were affected in two patients. The anomaly was right-sided in 12 moieties and left-sided in six. The duplication was incomplete in seven patients and complete in nine. The mean renal pelvis diameter at the time of surgery was 25.6 (range 11-48 mm) mm by USG. The mean renal function of the involved moiety was 28.3% before surgery. Management included pyelopyelostomy or ureteropyelostomy in six moieties, dismembered pyeloplasty in eight moieties, heminephrectomy in four cases, and simultaneous upper heminephrectomy and lower pole ureteropyelostomy in one patient. . There is no standard approach for these patients and treatment should be individualized according to physical presentation, detailed anatomy, and severity of obstruction.
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http://dx.doi.org/10.1155/2016/7960794DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5088327PMC
October 2016

A bladder diverticulum model in rabbits.

J Pediatr Urol 2016 Oct 16;12(5):311.e1-311.e6. Epub 2016 Apr 16.

Department of Pediatric Urology, Kanuni Sultan Suleyman Education and Research Hospital, Istanbul, Turkey.

Purpose: Shuttling of some of the bladder volume into the bladder diverticulum (BD) can cause urinary retention, lower urinary tract dysfunction, infection, and stone formation. This experimental study is the first to create a rabbit BD to study micturition physiology (urodynamics and pathology) that mimics clinical findings.

Materials And Methods: The study included 16 New Zealand adult male rabbits in the BD group and 16 sham-operated controls. BD creation consisted of a lower midline laparotomy and bladder entry via the spacing between the detrusor muscle fibers and the mucosa, posterolaterally from the bladder wall. The detrusor was excised to provide a mucosal prolapsus, creating a narrow BD neck (Figure). The sham group underwent bladder exposure with a midline incision. All rabbits underwent urodynamic study preoperatively and postoperatively, consisting of postmicturition residue (PMR), maximum bladder capacity (MBC), voiding detrusor pressure (VPdet), filling detrusor pressure (FPdet), compliance, and urine flow (Qflow). The animals were then sacrificed and their bladders assessed for pathology and stone formation.

Results: Preoperative MBC, Pdet, and Qmax were within reference ranges. No animals had PMR or urinary tract infections (UTIs). The BD group showed urodynamic and pathologic bladder changes, including decreased (28%) cystometric bladder capacity and compliance (Sham: 26.8 ± 0.4; BD: 4.46 ± 1.08, p = 0.0001) and increased post-void residual PMR (8.3 ± 2.4 mL). Pathology revealed increased bladder detrusor thickness correlated with urodynamic findings of increased filling detrusor pressures (Sham: 1.58 ± 0.2; BD: 4.89 ± 0.93, p = 0.0001). Urodynamics revealed intermittent BD bladder contraction during the filling phases. Eight BD group rabbits had UTIs; five had stone formation (4-9 mm).

Discussion: In the literature, it has not been determined whether lower urinary tract disorders (LUTD) could cause diverticula, or if a congenital diverticula could be reason for LUTD. Anatomical or neurological reasons for a low-compliance bladder can cause diverticulosis. As demonstrated in our study with rabbits, the congenital diverticulum could further reduce the compliance of the bladder. Further, a decrease in compliance logically correlates with the progressive decompensation of the bladder.

Conclusions: The nature of diverticula remains undetermined. All the information presented for this model is relevant to our clinical observations. We conclude that the rabbit bladder can be used for research into experimental diverticulum-induced changes in the activity of the bladder and for experimental detrusor research.
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http://dx.doi.org/10.1016/j.jpurol.2016.03.010DOI Listing
October 2016

Reliability of the Grading System for Voiding Cystourethrograms in the Management of Vesicoureteral Reflux: An Interrater Comparison.

Adv Urol 2016 16;2016:1684190. Epub 2016 Mar 16.

Department of Pediatric Urology, Kanuni Sultan Suleyman Education and Research Hospital, 34300 Istanbul, Turkey.

Aim. Vesicoureteral reflux (VUR) is one of the most common conditions seen in pediatric urology. Fortunately, there are many treatment options for this disorder. The grading system for VUR varies among doctors, and the literature on its reliability is sparse. Here, we assessed the effectiveness of the current VUR grading system. Methods. A series of 40 voiding cystourethrogram (VCUG) studies were selected. Four pediatric urologists (PU) and four pediatric radiologists (PR) independently graded each VCUG and then agreed on a uniform interpretation. For statistical analysis the intraclass correlation coefficient (ICC) was applied to assess interrater agreement. Results. ICC values ranging from 0.82 to 0.88 reflected the strong reliability of VCUG for grading cases of VUR among pediatric urologists and radiologists as separate groups, and the reliability between the two groups was also good, as indicated by an ICC of 0.89. Despite the high ICC, disagreement existed between raters; the lowest agreement was associated with middle grades (III and IV). Conclusions. The interrater reliability of the international grading system for VUR was high but imperfect. Thus, grading differences at middle grades can profoundly influence the type of treatment pursued.
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http://dx.doi.org/10.1155/2016/1684190DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4812193PMC
April 2016

The effect of bladder diverticula on bladder function: An experimental study in rabbits.

J Pediatr Surg 2016 Sep 10;51(9):1538-42. Epub 2016 Mar 10.

Kanuni Sultan Suleyman Education and Research Hospital, Department of Pediatric Urology, Turkey.

Objective: This study aims to evaluate the effect of bladder diverticula (BD) on bladder function using a rabbit model, based on urodynamic findings.

Methods: A total of 32 New Zealand white rabbits were randomly assigned to four groups: (1) sham surgery; (2) a single, 1-cm-diameter BD; (3) a single, large, 3-cm-diameter BD; and (4) four (multi) 1-cm-diameter BD. Urodynamic evaluations were performed preoperatively, and 1week and 1month postoperatively, to measure the postmicturition residual (PMR), maximum bladder capacity (MBC), filling and voiding detrusor pressure (Pdet), compliance, and unstable detrusor contractions. At the end of the study, the animals were sacrificed and assessed for pathologic evaluation and stone formation.

Results: In groups 3 and 4, the rabbits all had PMR. At 30days postsurgery, the MBC was found to be 28% and 31% lower than the reference range in groups 3 and 4 and compliance was decreased (p<0.05). Further, the filling Pdet was significantly higher for large and multiple BD than in the 1-cm diverticula or sham groups (6.33±1.73, 4±1.26, p=0.0001). Groups 3 (62%) and 4 (50%) had unstable detrusor contractions. There was also a muscular/collagen ratio increase in the large and multiple BD groups. Four rabbits in the large group and one rabbit in the multiple BD group exhibited stone formation.

Conclusions: Large or multiple BD can alter bladder storage and emptying, and can decrease the capacity of the bladder and reduce its elasticity. Large or multiple bladder diverticula can lead to involuntary contractions, causing dysfunctional voiding.
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http://dx.doi.org/10.1016/j.jpedsurg.2016.02.087DOI Listing
September 2016

Congenital Prepubic Sinus with Remnant Tissue Mimics Corpus Spongiosum: A Rare Case.

European J Pediatr Surg Rep 2015 Jun 12;3(1):43-5. Epub 2014 Dec 12.

Division of Pediatric Nephrology, Kanuni Sultan Suleyman Training and Research Hospital, Istanbul, Turkey.

A congenital prepubic sinus is a tract that originates in the skin and overlays the base of the penis; however, its embryologic basis is still debated. We herein present a case involving a 3-year-old boy who was admitted for examination of overlying tissue located a few centimeters distal to the dorsal base of the penis. Examination revealed a tiny sinus in the prepubic area, and 3 cm of tissue was attached to the sinus. Pathologic examination showed that the tissue was lined with squamous epithelium and continued along the sinus tract, which was lined with urothelial epithelium. According to Stephens' classification, the sinus appeared to be a variant of type 2 dorsal urethral duplication, and the remnant tissue mimicked the corpus spongiosum of the penis.
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http://dx.doi.org/10.1055/s-0034-1396787DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4487123PMC
June 2015

Misdiagnoses caused by use of indwelling urethral catheters in children with ureterovesical junction anomalies.

Int Urol Nephrol 2015 Apr 26;47(4):579-83. Epub 2015 Feb 26.

Department of Pediatric Surgery, Kanuni Sultan Suleyman Education and Research Hospital, Istanbul, Turkey,

Purpose: Children commonly undergo vesicograms for diagnosing vesicoureteral reflux (VUR). This requires urethral catheterization with transurethral replacement. We report misdiagnosed or related complications due to indwelling urethral catheters unintentionally placed in the ureter.

Methods: From our computerized urology records over an 18-year period from January 1995 to May 2013, we retrospectively identified nine cases of 1850 vesicograms that had misdirection of a urethral catheter placed in a ureter. Foley catheters with inflating balloons were used to obtain the vesicograms.

Results: In all, 1850 vesicograms were performed (746 males, 1104 females; age 1 week to 14 years, mean age 3.8 years) using standard radiological techniques. Size 6-10 Fr indwelling urethral catheters were used, depending on the patient's age and gender. In nine cases (five females, four males), a misdirected urethral catheter was discovered in one of the ureters. The urethral catheter was in the left ureter in four patients and in the right ureter in five patients. Cystoscopic examination found ectopic ureteral openings in six patients: at the bladder neck in four and just below the bladder trigone in two. Three patients in this group with ectopic ureters were followed due a misdiagnosis of VUR. The remaining three patients had grade 3 or 4 VUR. In this group, the catheter passed into the ureter because of the enlarged ureterovesical junction. In one patient with VUR, intraparenchymal fluid leakage and transient hematuria occurred due to the rapid tension increase following the fast injection of contrast with liquid to one ureter.

Conclusion: Although placing an indwelling urethral catheter is a relatively safe procedure, complications can occur, particularly in patients with ureterovesical anomalies, such as high-grade VUR or an ectopic ureter. Using catheters with inflating balloons can cause rapid increases in tension in the ureter, and related complications.
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http://dx.doi.org/10.1007/s11255-015-0934-zDOI Listing
April 2015