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Amaç: Vezikoüreteral reflü (VUR) genelde tekrarlayan üriner enfeksiyonlarla birlikte olan ve böbrek parankiminde hasara yol açabilen, çocukluk çağında sık görülen bir sorundur. Tüm çocuk nüfusunun %0,5-1,5’inde görülür. Tedavi edilerek kontrol edilmezse, kronik böbrek yetmezliğine neden olabilir. Vezikoüreteral reflüde prognozun kötüleşmesi; reflü nefropatisi, skar gelişmesi ve kronik böbrek yetersizliği tablosunun gelişmesi ile anlaşılmaktadır. Bu çalışmada, VUR’lü olguların özelliklerini tanımlamak ve kötü prognoza neden olan riskleri saptamak amaçlanmıştır, Gereç ve Yöntem: 1990-2014 yılları başvurularını kapsayan kesitsel bir çalışma gerçekleştirildi. Retrospektif olarak veriler kayıtlardan toplandı. Sonuç değişkeni VUR kötü prognozudur ve skar varlığı, reflü nefropatisi, kronik böbrek hastalığı gelişmesi ile belirlenmiştir. Kayıtlardan alınan demografik, öz-soygeçmiş, klinik özellikler nedenler olarak incelenmiştir. Veri analizinde sayı ve yüzdelerle tanımlayıcı sunulan veriler ki-kare ve çok değişkenli lojistik regresyon analizi ile SPSS 24.0 programı ile çözümlenmiştir, p, Objective: Vesicoureteral reflux (VUR) is a common problem in childhood, often associated with recurrent urinary infections, which can cause damage to the renal parenchyma. It occurs in 0.5-1.5% of the whole children population. If not treated and controlled, it may cause chronic renal failure. Worsening prognosis of VUR becomes evident as reflux nephropathy, scarring and chronic renal failure. in this study, we aimed to define the characteristics of VUR patients and to determine the risks that cause a poor prognosis. Material and Method: A cross-sectional study of 1990-2014 was performed. Data were collected retrospectively. the outcome variable was poor prognosis of VUR and was determined by the presence of scarring, reflux nephropathy, and the development of chronic kidney disease. the demographic, self-family history and clinical characteristics of the children were examined as causes. in the data analysis, descriptive data with numbers and percentages were analyzed by chisquare and multivariate logistic regression analysis with SPSS 24.0 program. Results: the fact that the child with VUR was 2 years or younger and the presence of urinary infection reported in the history was found to be the cause of worsening of the prognosis. the number of urinary infections after follow-up did not affect the prognosis. Conclusion: According to the results obtained as an indirect finding in this study, good management of the child with VUR has a positive contribution to prognosis.

46,XY pure gonadal dysgenesis (Swyer syndrome) is characterized by normal female genitalia at birth. It usually first becomes apparent in adolescence with delayed puberty and amenorrhea. Rarely, patients can present with spontaneous breast development and/or menstruation. A fifteen-yearold girl presented to our clinic with the complaint of primary amenorrhea. on physical examination, her external genitals were completely female. Breast development and pubic hair were compatible with Tanner stage V. Hormonal evaluation revealed a hypergonadotropic state despite a normal estrogen level. Chromosome analysis revealed a 46,XY karyotype. Pelvic ultrasonography showed small gonads and a normal sized uterus for age. SRY gene expression was confirmed by multiplex polymerase chain reaction. Direct sequencing on genomic DNA did not reveal a mutation in the SRY, SF1 and WT1 genes. After the diagnosis of Swyer syndrome was made, the patient started to have spontaneous menstrual cycles and therefore failed to attend her follow-up visits. After nine months, the patient underwent diagnostic laparoscopy. Frozen examination of multiple biopsies from gonad tissues revealed gonadoblastoma. With this report, we emphasize the importance of performing karyotype analysis, which is diagnostic for Swyer syndrome, in all cases with primary or secondary amenorrhea even in the presence of normal breast development. We also suggest that normal pubertal development in patients with Swyer syndrome may be associated with the presence of a hormonally active tumor.