Objective: This study aimed to evaluate the compliance of four different artificial intelligence applications (ChatGPT-4.0, Bing AI, Google Bard, and Perplexity) with the American Urological Association (AUA) vesicoureteral reflux (VUR) management guidelines. Materials and Methods: Fifty-one questions derived from the AUA guidelines were asked of each AI application. Two experienced paediatric surgeons independently scored the responses using a five-point Likert scale. Inter-rater agreement was analysed using the intraclass correlation coefficient (ICC). Results: ChatGPT-4.0, Bing AI, Google Bard, and Perplexity received mean scores of 4.91, 4.85, 4.75 and 4.70 respectively. There was no statistically significant difference between the accuracy of the AI applications (p = 0.223). The inter-rater ICC values were above 0.9 for all platforms, indicating a high level of consistency in scoring. Conclusions: The evaluated AI applications agreed highly with the AUA VUR management guidelines. These results suggest that AI applications may be a potential tool for providing guideline-based recommendations in paediatric urology.

Background: The standard method for diagnosing Meckel diverticulum and identifying ectopic gastric mucosa is ^{99 m}Tc-pertechnetate imaging. Premedication with H₂ receptor antagonists enhances the scan’s sensitivity by reducing the washout of ^{99 m}Tc-pertechnetate activity from the intestinal lumen. Objective: After the withdrawal of ranitidine, we compared the efficacy of the proton pump inhibitor pantoprazole as an alternative premedication agent for ^{99 m}Tc-pertechnetate Meckel diverticulum imaging. Materials and methods: This study assessed the scan quality of 141 children (aged 1 month to 204 months (median = 84 months)) who underwent Meckel scintigraphy over 10 years at a single institution. Before its withdrawal in December 2020, ranitidine was utilized for premedication, while pantoprazole was used thereafter. Therefore, patients were divided into two premedication groups: ranitidine (n = 88) and pantoprazole (n = 53). A high-quality scan was defined as having no ^{99 m}Tc-pertechnetate activity in the duodenal and other intestinal lumens. The effectiveness of pantoprazole in reducing ^{99 m}Tc-pertechnetate release in the duodenum and other intestinal lumens was compared to that of ranitidine. Differences in scan quality between the groups were analyzed using the two-proportion Z-test. In patients with positive scans, the lesion-to-background activity ratio of the Meckel diverticulum was measured and compared between the premedication groups. Results: Premedication with pantoprazole resulted in 47.2% of scans showing no ^{99 m}Tc-pertechnetate release, 37.7% with activity localized either in the duodenum or other intestine, and 15.1% exhibiting activity in both regions. In comparison, ranitidine resulted in 45.5% of scans with no ^{99 m}Tc-pertechnetate release, 40.9% with activity localized either in the duodenum or other intestine, and 13.6% showing activity in both regions. P-values were not found to be significant in all comparisons. Twelve scans were positive; all patients had Meckel diverticulum confirmed at surgery. For positive scans, the lesion-to-background activity ratio for the Meckel diverticulum was similar between the ranitidine and pantoprazole groups. Conclusion: This study demonstrates that pantoprazole is statistically non-inferior to ranitidine regarding scan quality and lesion-to-background activity ratios for Meckel diverticulum detection. Pantoprazole offers a reliable alternative for clinical protocols in the absence of ranitidine. Graphical

Cryptorchidism, a common congenital condition in male children, has been associated with impaired testicular function and increased risk of infertility. Recent evidence suggests that gut microbiota-derived metabolites, such as trimethylamine N-oxide (TMAO), may influence reproductive health via systemic inflammation and oxidative stress. This study aimed to investigate serum levels of TMAO, insulin-like 3 factor (INSL3), and human chorionic gonadotropin (hCG) in patients with undescended testes. Serum TMAO was quantified by LC-MS/MS and INSL3 and hCG by ELISA in 30 patients and 30 healthy age-matched controls. Results showed significantly elevated TMAO and reduced INSL3 levels in the patient group ( p < 0.01 and p = 0.025, respectively), whereas hCG levels showed no significant difference. These findings support the hypothesis that metabolic and hormonal alterations may play a role in the pathophysiology of cryptorchidism. TMAO may reflect systemic dysbiosis or inflammation potentially associated with impaired testicular function. Further studies are warranted to explore the gut–testis axis and asses the potential clinical relevance of TMAO and INSL3 as biomarkers in male reproductive health.

Background/Objectives: A subset of children with monosymptomatic nocturnal enuresis (MNE) remains unresponsive to standard treatments such as desmopressin and alarm therapy. This study aimed to identify clinical predictors of response to biofeedback therapy in treatment-resistant MNE and to evaluate the role of bladder capacity as a stratification parameter. Methods: In this prospective study, 89 children with treatment-resistant MNE underwent six weekly sessions of biofeedback therapy involving visual pelvic floor feedback. Based on treatment outcomes, patients were classified as complete responders or partial/non-responders. Clinical characteristics including age-adjusted maximal voided volume (MVV), nocturnal polyuria, and wetting frequency were compared. Results: Patients with a complete response had significantly lower baseline MVV and age-adjusted MVV (p < 0.001). Nocturnal overactivity was more common among responders (60.6% vs. 33.9%, p = 0.017), whereas nocturnal polyuria was more frequent in non-responders (p = 0.027). Age-adjusted MVV emerged as the only independent predictor of treatment success in multivariate analysis (p = 0.045), with ROC analysis confirming its predictive value (AUC = 0.767, 95% CI: 0.667–0.866). Conclusions: These findings suggest that reduced bladder capacity and frequent night-time wetting may help identify patients who are more likely to benefit from biofeedback therapy. Bladder capacity assessment may thus serve as a useful tool in tailoring management strategies for refractory MNE.

Purpose: Infantile hypertrophic pyloric stenosis is the most common cause of gastric outlet obstruction in the first month of life. Botulinum toxin (BT) is a neurotoxin produced by clostridium botulinum, which causes paralysis in skeletal muscles. We aimed to evaluate the effectiveness of BT in the experimental pyloric stenosis model. Methods: The study protocol was approved by the Selcuk University Medical Faculty Ethics Committee (2017/20). We performed an experimental study using 32 Wistar-Albino newborn rats. Rats were divided randomly into four groups with six rats in both control (C), and L-nitro-arginine methyl ester hydrochloride group, and 10 rats in each sham (S), and BT group. 100 mg/kg per day L-NAME was applied to all groups intraperitoneally for 14 days from birth except control group. 0.2 mL saline and 20 U/kg BT was injected by surgery to S and BT groups, respectively, at 21 days from birth. After 35 days all rats were sacrificed and biopsies were performed from pyloric muscle for histopathological examination. The results were evaluated with the “one-way ANOVA” test. Results: Total and circular muscle thickness of the groups were compared. The total muscle thickness of the L-NAME group was significantly higher than the control group ( P = .031). Comparing the circular muscle thickness of botox group (BTG) with control group (CG) and L-NAME GROUP (LNG), muscle thickness was significantly smaller ( P < .001, P < .001). The total muscle thickness of BTG was significantly different between LNG ( P < .001). Conclusions: Hypertrophy of pylor in an experimental model was reduced by BT injection in this study. We think that Botox injection through endoscopic or interventional radiological methods may be an alternative method for surgery.

Aim: The aim of this retrospective study is to evaluate clinical features, treatment approaches and outcomes of children with ovarian mass. Materials and Methods: In our clinic, the oncologic charts of children with a mass in the ovary between 2009 and 2020 were analyzed retrospectively. The patients' demographic features, symptoms and signs, diagnosis, treatments and outcomes were noticed. Results: The age of 55 patients included in the study ranged from two months to 18 years (median, 12.9 years). While the ages of 38 patients were ≥ 10 years (69.1%), 17 of them were