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know all 200 techniques for hypospadias, but you should be proficient in three or four techniques and be able to adapt and change techniques depending on the patient's needs. This level of skill comes with experience. When performing hypospadias surgery, it is important to be able to assess all aspects of the penis and determine what is best for each individual patient. For example, one technique may focus on the urethral plate while another may focus on the corpora spongiosum. You should work with the best tissue available and adjust your technique accordingly. Hypospadias surgery is complex and varies depending on the specific characteristics of each patient, so it is not possible to use a one-technique-fits-all approach.
T.S.: According to your experience, how does urolithiasis management in children differentiate from the adult setting?
Prof. S.T.: We Greece and Turkey both are in the stone belt. We have a lot of stones in children. I believe that endourology has led to many advances in the treatment of pediatric stone disease. This type of surgery is considered minimally invasive, but it is different from laparoscopic minimally invasive surgery. In laparoscopy, we perform the same procedures as in open surgery. However, in endourology, the approach is quite different when performing procedures such as pyelotomy or ureterolithotomy. We work from the inside, which is the main advantage
of endourology and why it has been so beneficial in treating urolithiasis.
When it comes to children, smaller instruments and instruments that can control pressure are preferred. The main limitation of endourology in children is the small spaces in the collecting system and urethra, which can lead to high pressures. High pressures can cause backflow into the collecting system and increase the risk of complications such as sepsis. Therefore, it is crucial to be well-trained in endourology before treating children to ensure skillful and careful procedures. I strongly believe that being trained in endourology in adults first before moving on to children will make you more proficient and cautious in your approach.
F.N.: You are one of the 25 members of the World Pediatric Urological Surgeons group (SPUS). This scientific group is limited to 25 members and it can only be attended by invitation. You also served as SPUS president for the period 2022 to 2023. What are your feelings for your participation in this group?
Prof. S.T.: First of all, it is a great honor for me to be a part of this group. It is a highly selective group. What I want to convey is that Medical Societies or Surgical Societies are not as efficient as they should be. When you attend a Society, whether it is Turkish, Hellenic, or European, there are many members.
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