International Brazilian Journal of Urology : official journal of the Brazilian Society of Urology, 2020
Objectives Extraperitoneal laparoscopic radical prostatectomy (eLRP) is one of minimally invasive... more Objectives Extraperitoneal laparoscopic radical prostatectomy (eLRP) is one of minimally invasive surgical treatment modalities of prostate cancer (PCa). We here evaluated our clinical data on eLRP with 3 trocars. Materials and Methods All consecutive patients undergoing eLRP in similar surgical procedures by two different surgeons (Y.A. & R.L.M.) between 2017 and 2018 at two different centres were included. Various clinical data including patients’ demographics, intraoperative and postoperative data, complications, and follow-up were recorded and analysed. We are presenting a video of one such case of eLRP with simultaneously right inguinal hernia repair with using 3 trocars. Surgeons in different clinics performed similar modified surgical technique (Heilbronn technique) (1) for eLRP with 3 trocars. Results There were 28 cases in total (10 cases in Clinic 1 and 18 cases in Clinic 2). Mean follow-up was 8±0.4 months. Mean age was 69±3.2 years old. Mean prostate specific antigen was...
We aimed to evaluate prognostic significance of preoperatively assessed aspartate aminotransamina... more We aimed to evaluate prognostic significance of preoperatively assessed aspartate aminotransaminase (AST)/alanine aminotransferase (ALT) (De Ritis) ratio on survival in bladder cancer (BC) patients underwent radical cystectomy (RC). We, respectively, analysed clinical and pathological data of 153 patients who underwent RC for BC between February 2006 and December 2016 at a tertiary level hospital. The potential prognostic value of De Ritis ratio was assessed by using ROC curve analysis. The effect of the De Ritis ratio was analysed by the Kaplan-Meier method and Cox regression hazard models for patients' disease-specific survival (DSS) and overall survival (OAS). We had 149 BC patients, in total. Mean age was 61.65 ± 9.13 years. One hundred and thirty-nine (93.3%) of the patients were men. According to ROC analysis, optimal threshold of De Ritis ratio for DSS was 1.30. In Kaplan-Meier analyses, the high De Ritis ratio group showed worse progression in DSS and OAS (all parameters...
Saudi journal of kidney diseases and transplantation : an official publication of the Saudi Center for Organ Transplantation, Saudi Arabia
Urological anomalies can be seen in children with renal ectopia (RE) and can result in renal impa... more Urological anomalies can be seen in children with renal ectopia (RE) and can result in renal impairment. Therefore, we evaluated associated anomalies and renal outcome in our patients with RE. Sixty-eight children who were diagnosed with RE between January 2009-May 2014 were retrospectively studied. A total of 68 patients, 36 (52.9%) boys, with a median age of 67 months (4-201) and a median follow-up period of 14 months (3-113) were included in the study. Simple RE (S-RE) was found in 51 (75%) patients, of which 46 were unilateral and five were bilateral (discoid kidney). Crossed RE (C-RE) was detected in 17 (25%) patients. Voiding cystourethrogram was performed in 21/51 (41.2%) patients in S-RE group and 5/17 (29.4%) in C-RE group. We did not find vesicoureteral reflux (VUR) in any of the patients with C-RE, whereas, in S-RE group, VUR was demonstrated in six (6/21 - 28.6%) patients. Pelviureteric junction obstruction in ectopic kidney was found in two patients with S-RE and one wi...
Percutaneous nephrolithotomy (PCNL) is a commonly used type of minimally invasive treatment in ki... more Percutaneous nephrolithotomy (PCNL) is a commonly used type of minimally invasive treatment in kidney stone surgeries. Surgical success is assessed according to residual stone amount after surgery. The purpose of this study is to compare the two methods' success and practicality that are applied after the fracture of the stone in the patients who applied PCNL and which enable the removal of the residual stones. Among 102 patients who underwent a single-session of PCNL at our department between June 2015 and November 2016 were evaluated. Previously identified irrigation method and our aspiration method which described used in post-operative patients divided into two groups of residual fragments was assessed by computed tomography. The results were evaluated in statistical analyses. Significant p was accepted as p < 0.05. The age and gender distribution of patients in the irrigation and aspiration groups did not differ significantly (p > 0.05). In irrigation and aspiration g...
A 48-year-old man admitted to the urology outpatient clinic with major symptoms of right-side pai... more A 48-year-old man admitted to the urology outpatient clinic with major symptoms of right-side pain and intermittent lower urinary tract symptoms (LUTSs) such as low urine flow rate, dysuria, and frequency. Uroflowmetry showed low urine flow, and laboratory tests revealed no pathology. Ultrasound (US) showed a 7 cm calcific mass above the bladder and a kidney cyst with a diameter of 5.3 cm in the upper pole of the right kidney. Enhanced computed tomography confirmed the US findings. Laparoscopic transperitoneal renal cyst decortication was performed. There was no sign of additional tumors. An independent mass in the abdomen was diagnosed, and the mass was removed. Based on the pathology, the diagnosis was a benign mesenchymal calcific mass. This is the first report of LUTSs due to a free benign mesenchymal mass in the published literature.
To compare the efficacy between motorized articulating instruments (AI) and rigid conventional la... more To compare the efficacy between motorized articulating instruments (AI) and rigid conventional laparoscopic instruments (CI) in chancing visualizing systems, respectively two-dimension (2D) and three-dimension (3D). Sixty physicians were divided into three groups according to their previous experience as medical students (Group 1), residents (Group 2), and expert surgeons (Group 3). Four experimental sets were created, respectively CI-2D visualizing system (CI-2D), CI-3D visualizing system (CI-3D), AI-2D visualizing system (AI-2D), and AI-3D visualizing system (AI-3D) platforms. European training in basic laparoscopic urological skills (E-BLUS) and anastomosis tasks (ın total five tasks) was used. All participants were randomly required to perform tasks in each one of the technical platforms, except anastomosis exercises that were performed as the last exercises. Duration of tasks were measured, and predefined errors were counted. All these were recorded, and completion quality samples were evaluated. Significant p was p &amp;amp;amp;amp;lt; 0.05. Significant time reduction and improvement in quality of tasks were observed in favor of Group 3, in all sets for all tasks (p &amp;amp;amp;amp;lt; 0.001). Quality of the tasks was significantly improved in AI-3D in Group 1 and Group 2 for all tasks. Task 5 was the most difficult one and needed more experience to be completed with quality. Even, Group 3 was the experienced group; AI with 3D display enabled Group 3 to improve performance with increased quality without statistical significance. The AI-3D visualizing system can provide more successful completion in E-BLUS tasks than CI-2D, AI-2D, and CI-3D visualizing systems for the beginners in urologic laparoscopy, not for experts. Besides, AI with 3D display enable surgeons to improve their performance with increased quality of tasks, in anastomosis.
To compare the outcomes of mini-percutaneous nephrolithotomy (m-PCNL) and retrograde intrarenal s... more To compare the outcomes of mini-percutaneous nephrolithotomy (m-PCNL) and retrograde intrarenal surgery (RIRS) in treating renal stones in preschool-aged children. Forty-five patients treated with m-PCNL and 32 patients treated with RIRS for renal stones were compared retrospectively. The operative and postoperative outcomes of both groups were analyzed retrospectively. The mean age and gender were similar between the groups. The mean stone size was 19.30 ± 4.21 mm for the RIRS group and 21.06 ± 5.61 mm for the PCNL group (P = .720). The mean operative times, fluoroscopy times, and hospitalization times were statistically higher in the PCNL group. The stone-free rates (SFRs) after a single procedure were 84.4% in the PCNL group and 75% in the RIRS group (P = .036). After auxiliary procedures, the overall SFRs reached 91.1% for the PCNL group and 90.6% for the RIRS group (P = .081). No major complications were observed for both groups. Minor complication (Clavien 1-3) rates were 15.5% and 12.5% for the PCNL and RIRC group, respectively (P = .385). RIRS has some advantages over PCNL such as shorter hospitalization times, shorter fluoroscopy times, and shorter operative time in treating renal stones. However, PCNL achieves higher SFR after a single session.
To investigate the impact of neck circumference (NC) in the treatment of bening prostatic hyperpl... more To investigate the impact of neck circumference (NC) in the treatment of bening prostatic hyperplasia (BPH) patients with metabolic syndrome (MtS). Additionally, we determined dose response to alpha-blockers and cut-off values for NC and waist circumference (WC), in these patients. Non-randomized, open-labelled, and multi-centre study was conducted between March 2014 and September 2015. The BPH patients were enrolled and were divided into 2 groups: with MtS (Group 1; n=94) and without MtS (Group 2; n=103). Demographic data, anthropometric measurements, blood analyses, uroflowmetric parameters, post voiding residual urine (PVR), prostate volume, quality of life (QoL) index, NC and WC were recorded. Both groups were administered oral alphablockers and response to treatment was evaluated. Receiver-operating characteristic (ROC) curves were obtained and significant p was p&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.05. In total, 197 patients were enrolled with mean age of 60.5±8.1 years. Mean NC and WC were higher in MtS patients (p&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.001). Uroflowmetry parameters and QoL indexes were comparable between groups before treatment. International prostate symptom score, uroflowmetry parameters, and QoL significant improved in Group 2 than Group 1, at 1st and 6th months of treatment with alpha-blockers. Success rate of treatment was significant higher in Group 2 than Group 1 (p&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.001). Cut-off values were 42.5cm and 113.5cm for NC and WC respectively, for response to alpha-blockers in BPH patients with MtS. MtS can be related with BPH and can negatively affect the response to alpha-blocker treatment. NC can be used for predicting response to alpha-blocker treatment in BPH patients with MtS.
To evaluate the long-term surgical, functional, and quality-of-life (QoL) outcomes after Holmium ... more To evaluate the long-term surgical, functional, and quality-of-life (QoL) outcomes after Holmium laser enucleation of the prostate (HoLEP) in patients with symptomatic benign prostatic hyperplasia (BPH). We retrospectively reviewed recorded data on patients who underwent HoLEP between June 2002 and February 2005. Ninety-six patients were enrolled. Demographic, perioperative, and postoperative data were recorded. On follow-up, International Prostate Symptom Scores (IPSSs), prostate-specific antigen (PSA) levels, QoL scores, peak uroflowmetric data (Qmax values), and post-voiding residual urine volumes (PVR volumes), were recorded. Complications were scored using the Clavien system. Statistical significance was set at p&amp;amp;amp;amp;amp;amp;lt;0.05. The mean follow-up time was 41.8±34.6 months and the mean patient age 73.2±8.7 years. The mean prostate volume was 74.6±34.3mL. Significant improvements in Qmax values, QoL, and IPSSs and decreases in PSA levels and PVR volumes were noted during follow-up (all p values=0.001). The most common complication was a requirement for re-catheterisation because of urinary retention. Two patients had concomitant bladder tumours that did not invade the muscles. Eight patients (8.3%) required re-operations; three had residual adenoma, three urethral strictures, and two residual prostate tissue in the bladder. Stress incontinence occurred in one patient (1%). All complications were of Clavien Grade 3a. We noted no Clavien 3b, 4, or 5 complications during follow-up. HoLEP improved IPSSs, Qmax values, PVR volumes, and QoL and was associated with a low complication rate, during extended follow-up. Thus, HoLEP can be a viable option to transurethral resection of the prostate.
... Titre du document / Document title. UROLITHIASIS ON NON-ABSORBABLE SUTURE MATERIAL: A RARE CA... more ... Titre du document / Document title. UROLITHIASIS ON NON-ABSORBABLE SUTURE MATERIAL: A RARE CASE OF BLADDER STONE ON POLYPROPYLENE SUTURE MATERIAL. Auteur(s) / Author(s). AKIN Yigit ; BASARA Isil ; Revue / Journal Title. ...
riner sistem taş hastalığı tekrarlama oranı yüksek olan, sıklıkla altta yatan kazanıl-mış veya do... more riner sistem taş hastalığı tekrarlama oranı yüksek olan, sıklıkla altta yatan kazanıl-mış veya doğumsal anomaliler tarafından şiddetlenebilen kronik bir hastalıktır. Yapı-lan çalışmalar hastalık prevalansının %4-20 arasında göstermektedir. [1] Üriner sistem taş hastalığı tedavisi iki basamaktan oluşmaktadır; taşın temizlenme-si ve tekrar oluşumunun engellenmesi. Minimal invaziv endoürolojik tekniklerin geliş-mesiyle taşın temizlenmesi ile ilgili önemli ilerlemeler sağlanmasına rağmen, ikinci basamak olan taş oluşumunun engellenmesi, metaflaksi(=metabolik değerlendirme +medikal profilaksi konusunda tartışmalar devam etmektedir. Maalesef uzun süren klinik ve laboratuar araştırmaları etkin ve yaygın olarak kabul edilen bir metaflaksi protokolüne dönüştürülememiştir. [2] Rosenberg, 1954 yılında hiperkalsiürinin nef-rokalsinoza ve böbrek taşı oluşumuna neden olacağını, erken tanı ve alınacak etkili önlemlerle hastalığın renal komplikasyonlarını önlemede tatmin edici sonuçlar alına-cağını...
zet Böbrek taşların da, 2 cm çapa güvenle uygulanan şok dalga tedavisi (ŞDT) sonrası böbrekte kal... more zet Böbrek taşların da, 2 cm çapa güvenle uygulanan şok dalga tedavisi (ŞDT) sonrası böbrekte kalan 5mm'den küçük taşlar klinik önemsiz kalan böbrek taş-ları olarak kabul edilmektedir. Bu durumun yönetimi klinisyenler arasında ha-len tartışmalıdır. Bu taşlar hiçbir klinik belirti vermeden böbrekte sebat et-meye devam edebilirler veya klinik belirti verebilecek hale gelebilirler. Kli-nik belirti verdiği durumlarda detaylı ürolojik inceleme ve tedavi gerektirir-ler. Üriner sistem taşlarının cerrahi tedavisinde istenen sonuç, tamamen taş-tan arınmaktır, fakat enfekte olmayan, üriner sistemde herhangi bir tıkanma-ya sebep olmayan, klinik belirti vermeyen bu taşların büyümesinin ve tekrar etmesini önlemek amacıyla medikal tedavinin faydalı olduğu da bildirilmek-tedir. Ayrıca takiplerde klinik belirti veren taş kırıntıları için cerrahi müdaha-leler söz konusu olabilir. Abstract For kidney stones up to 2 cm in diameter shock wave therapy (SDT) is safely
Diagnostic and interventional radiology (Ankara, Turkey), Jan 2, 2015
We aimed to evaluate iatrogenic renal arterial lesions, including pseudoaneurysm, arteriovenous f... more We aimed to evaluate iatrogenic renal arterial lesions, including pseudoaneurysm, arteriovenous fistula, and arteriocaliceal fistula, their management by endovascular embolization, and the clinical results. Fifty-five patients (forty males, fifteen females) with a median age of 40 years (range, 8-85 years), who underwent endovascular embolization of iatrogenic renal arterial lesions between March 2003 and December 2013 were enrolled into this retrospective study. Types of iatrogenic lesions and details of embolization procedures were reported. Estimated glomerular filtration rate (eGFR), renal function tests, hemoglobin, and hematocrit levels before and after embolization were recorded and compared. Median follow-up was 24 months. We identified 53 pseudoaneurysms, 30 arteriovenous fistulas, and 11 arteriocaliceal fistulas in 55 patients, after percutaneous nephrolithotomy (n=26), renal biopsy (n=21), nephrostomy (n=3), renal surgery (n=3), and extracorporeal shock wave lithotripsy (...
The aim of the study was to investigate the incidence of contrast medium-induced nephropathy (CIN... more The aim of the study was to investigate the incidence of contrast medium-induced nephropathy (CIN) and risk factors for CIN following endovascular abdominal aortic aneurysm repair or thoracic endovascular aortic aneurysm repair. After exclusion criteria, 139 (121 males, 18 females) patients aged 20-86 (median 65.5) years who underwent endovascular aortic aneurysm repair between January 2002 and September 2013 were included in this retrospective study. CIN, with ≥25 % increase in serum creatinine levels within 3 days after contrast medium administration, was compared to the patients&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; demographics, risk factors, type and complexity of the endovascular operation, parameters regarding to the contrast medium, preoperative estimated glomerular filtration rate (eGFR), and preoperative and early postoperative serum parameters. Statistical analyses were performed with Kolmogorov-Smirnov, χ (2) and Student&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s t tests. CIN, detected in 39 of 139 patients (28 %), was correlated with preoperative eGFR &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;60 ml/min/1.73 m(2) (P = 0.04) and high preoperative and postoperative serum urea and creatinine levels. Postoperative serum urea levels (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001) were significant in multivariate analysis. In patients undergoing endovascular aortic aneurysm repair, CIN was correlated with preoperative and postoperative renal impairment, while it was not correlated with the contrast medium dose.
Perspectives in Vascular Surgery and Endovascular Therapy, 2012
Congenital portosystemic venous shunt is extremely rare and should be treated. Advances in treatm... more Congenital portosystemic venous shunt is extremely rare and should be treated. Advances in treatment techniques allow for patients to be treated safely. We present a 9-year-old boy with a large congenital portosystemic venous shunt. The shunt was occluded interventionally with the Amplatzer vascular plug II. Our case was unique with its clinical manifestation, the use of a 22-mm Amplatzer vascular plug II, and the presence of the patient&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s 1-year follow-up.
To describe our new surgical technique for preserving the bladder neck during robot-assisted lapa... more To describe our new surgical technique for preserving the bladder neck during robot-assisted laparoscopic prostatectomy (RALP) and to present the anatomy between the bladder neck and prostate. Between December 2012 and May 2014, 52 RALPs were performed at our institute. Demographic, perioperative, and postoperative data were recorded. Quality of life (QoL) scores were assessed before RALP, after urethral catheter removal, and at the first month after RALP. Fatty connective tissue between bladder neck and prostate was introduced, and circular muscle fibers of the internal sphincter were seen in all patients. Complications were classified according to the Clavien-Dindo classification. Statistical analyses were performed. Mean follow-up was 9.6±5.2 months; mean age was 61.1±6.5 years. Our novel surgical technique for preserving the bladder neck was performed in 52 patients, and they were continent after catheter removal; mean duration of the catheter was 9.4±1.4 days. There was a significant difference in QoL before RALP and after catheter removal, however, but there was no statistical difference between before and 1 month after RALP (respectively; P&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.001, P=0.5). Furthermore, there was no complication related to the bladder neck such as bladder neck stricture, acute/chronic urinary retention, as well as no Clavien III, IV, and V complications. In addition, conventional laparoscopy and/or open surgery was not needed in any of the RALP cases. Our novel technique provided very early continence at the time of catheter removal after RALP within short-term follow-up. This can help early recovery and develop QoL scores after RALP.
International Brazilian Journal of Urology : official journal of the Brazilian Society of Urology, 2020
Objectives Extraperitoneal laparoscopic radical prostatectomy (eLRP) is one of minimally invasive... more Objectives Extraperitoneal laparoscopic radical prostatectomy (eLRP) is one of minimally invasive surgical treatment modalities of prostate cancer (PCa). We here evaluated our clinical data on eLRP with 3 trocars. Materials and Methods All consecutive patients undergoing eLRP in similar surgical procedures by two different surgeons (Y.A. & R.L.M.) between 2017 and 2018 at two different centres were included. Various clinical data including patients’ demographics, intraoperative and postoperative data, complications, and follow-up were recorded and analysed. We are presenting a video of one such case of eLRP with simultaneously right inguinal hernia repair with using 3 trocars. Surgeons in different clinics performed similar modified surgical technique (Heilbronn technique) (1) for eLRP with 3 trocars. Results There were 28 cases in total (10 cases in Clinic 1 and 18 cases in Clinic 2). Mean follow-up was 8±0.4 months. Mean age was 69±3.2 years old. Mean prostate specific antigen was...
We aimed to evaluate prognostic significance of preoperatively assessed aspartate aminotransamina... more We aimed to evaluate prognostic significance of preoperatively assessed aspartate aminotransaminase (AST)/alanine aminotransferase (ALT) (De Ritis) ratio on survival in bladder cancer (BC) patients underwent radical cystectomy (RC). We, respectively, analysed clinical and pathological data of 153 patients who underwent RC for BC between February 2006 and December 2016 at a tertiary level hospital. The potential prognostic value of De Ritis ratio was assessed by using ROC curve analysis. The effect of the De Ritis ratio was analysed by the Kaplan-Meier method and Cox regression hazard models for patients' disease-specific survival (DSS) and overall survival (OAS). We had 149 BC patients, in total. Mean age was 61.65 ± 9.13 years. One hundred and thirty-nine (93.3%) of the patients were men. According to ROC analysis, optimal threshold of De Ritis ratio for DSS was 1.30. In Kaplan-Meier analyses, the high De Ritis ratio group showed worse progression in DSS and OAS (all parameters...
Saudi journal of kidney diseases and transplantation : an official publication of the Saudi Center for Organ Transplantation, Saudi Arabia
Urological anomalies can be seen in children with renal ectopia (RE) and can result in renal impa... more Urological anomalies can be seen in children with renal ectopia (RE) and can result in renal impairment. Therefore, we evaluated associated anomalies and renal outcome in our patients with RE. Sixty-eight children who were diagnosed with RE between January 2009-May 2014 were retrospectively studied. A total of 68 patients, 36 (52.9%) boys, with a median age of 67 months (4-201) and a median follow-up period of 14 months (3-113) were included in the study. Simple RE (S-RE) was found in 51 (75%) patients, of which 46 were unilateral and five were bilateral (discoid kidney). Crossed RE (C-RE) was detected in 17 (25%) patients. Voiding cystourethrogram was performed in 21/51 (41.2%) patients in S-RE group and 5/17 (29.4%) in C-RE group. We did not find vesicoureteral reflux (VUR) in any of the patients with C-RE, whereas, in S-RE group, VUR was demonstrated in six (6/21 - 28.6%) patients. Pelviureteric junction obstruction in ectopic kidney was found in two patients with S-RE and one wi...
Percutaneous nephrolithotomy (PCNL) is a commonly used type of minimally invasive treatment in ki... more Percutaneous nephrolithotomy (PCNL) is a commonly used type of minimally invasive treatment in kidney stone surgeries. Surgical success is assessed according to residual stone amount after surgery. The purpose of this study is to compare the two methods' success and practicality that are applied after the fracture of the stone in the patients who applied PCNL and which enable the removal of the residual stones. Among 102 patients who underwent a single-session of PCNL at our department between June 2015 and November 2016 were evaluated. Previously identified irrigation method and our aspiration method which described used in post-operative patients divided into two groups of residual fragments was assessed by computed tomography. The results were evaluated in statistical analyses. Significant p was accepted as p < 0.05. The age and gender distribution of patients in the irrigation and aspiration groups did not differ significantly (p > 0.05). In irrigation and aspiration g...
A 48-year-old man admitted to the urology outpatient clinic with major symptoms of right-side pai... more A 48-year-old man admitted to the urology outpatient clinic with major symptoms of right-side pain and intermittent lower urinary tract symptoms (LUTSs) such as low urine flow rate, dysuria, and frequency. Uroflowmetry showed low urine flow, and laboratory tests revealed no pathology. Ultrasound (US) showed a 7 cm calcific mass above the bladder and a kidney cyst with a diameter of 5.3 cm in the upper pole of the right kidney. Enhanced computed tomography confirmed the US findings. Laparoscopic transperitoneal renal cyst decortication was performed. There was no sign of additional tumors. An independent mass in the abdomen was diagnosed, and the mass was removed. Based on the pathology, the diagnosis was a benign mesenchymal calcific mass. This is the first report of LUTSs due to a free benign mesenchymal mass in the published literature.
To compare the efficacy between motorized articulating instruments (AI) and rigid conventional la... more To compare the efficacy between motorized articulating instruments (AI) and rigid conventional laparoscopic instruments (CI) in chancing visualizing systems, respectively two-dimension (2D) and three-dimension (3D). Sixty physicians were divided into three groups according to their previous experience as medical students (Group 1), residents (Group 2), and expert surgeons (Group 3). Four experimental sets were created, respectively CI-2D visualizing system (CI-2D), CI-3D visualizing system (CI-3D), AI-2D visualizing system (AI-2D), and AI-3D visualizing system (AI-3D) platforms. European training in basic laparoscopic urological skills (E-BLUS) and anastomosis tasks (ın total five tasks) was used. All participants were randomly required to perform tasks in each one of the technical platforms, except anastomosis exercises that were performed as the last exercises. Duration of tasks were measured, and predefined errors were counted. All these were recorded, and completion quality samples were evaluated. Significant p was p &amp;amp;amp;amp;lt; 0.05. Significant time reduction and improvement in quality of tasks were observed in favor of Group 3, in all sets for all tasks (p &amp;amp;amp;amp;lt; 0.001). Quality of the tasks was significantly improved in AI-3D in Group 1 and Group 2 for all tasks. Task 5 was the most difficult one and needed more experience to be completed with quality. Even, Group 3 was the experienced group; AI with 3D display enabled Group 3 to improve performance with increased quality without statistical significance. The AI-3D visualizing system can provide more successful completion in E-BLUS tasks than CI-2D, AI-2D, and CI-3D visualizing systems for the beginners in urologic laparoscopy, not for experts. Besides, AI with 3D display enable surgeons to improve their performance with increased quality of tasks, in anastomosis.
To compare the outcomes of mini-percutaneous nephrolithotomy (m-PCNL) and retrograde intrarenal s... more To compare the outcomes of mini-percutaneous nephrolithotomy (m-PCNL) and retrograde intrarenal surgery (RIRS) in treating renal stones in preschool-aged children. Forty-five patients treated with m-PCNL and 32 patients treated with RIRS for renal stones were compared retrospectively. The operative and postoperative outcomes of both groups were analyzed retrospectively. The mean age and gender were similar between the groups. The mean stone size was 19.30 ± 4.21 mm for the RIRS group and 21.06 ± 5.61 mm for the PCNL group (P = .720). The mean operative times, fluoroscopy times, and hospitalization times were statistically higher in the PCNL group. The stone-free rates (SFRs) after a single procedure were 84.4% in the PCNL group and 75% in the RIRS group (P = .036). After auxiliary procedures, the overall SFRs reached 91.1% for the PCNL group and 90.6% for the RIRS group (P = .081). No major complications were observed for both groups. Minor complication (Clavien 1-3) rates were 15.5% and 12.5% for the PCNL and RIRC group, respectively (P = .385). RIRS has some advantages over PCNL such as shorter hospitalization times, shorter fluoroscopy times, and shorter operative time in treating renal stones. However, PCNL achieves higher SFR after a single session.
To investigate the impact of neck circumference (NC) in the treatment of bening prostatic hyperpl... more To investigate the impact of neck circumference (NC) in the treatment of bening prostatic hyperplasia (BPH) patients with metabolic syndrome (MtS). Additionally, we determined dose response to alpha-blockers and cut-off values for NC and waist circumference (WC), in these patients. Non-randomized, open-labelled, and multi-centre study was conducted between March 2014 and September 2015. The BPH patients were enrolled and were divided into 2 groups: with MtS (Group 1; n=94) and without MtS (Group 2; n=103). Demographic data, anthropometric measurements, blood analyses, uroflowmetric parameters, post voiding residual urine (PVR), prostate volume, quality of life (QoL) index, NC and WC were recorded. Both groups were administered oral alphablockers and response to treatment was evaluated. Receiver-operating characteristic (ROC) curves were obtained and significant p was p&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.05. In total, 197 patients were enrolled with mean age of 60.5±8.1 years. Mean NC and WC were higher in MtS patients (p&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.001). Uroflowmetry parameters and QoL indexes were comparable between groups before treatment. International prostate symptom score, uroflowmetry parameters, and QoL significant improved in Group 2 than Group 1, at 1st and 6th months of treatment with alpha-blockers. Success rate of treatment was significant higher in Group 2 than Group 1 (p&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.001). Cut-off values were 42.5cm and 113.5cm for NC and WC respectively, for response to alpha-blockers in BPH patients with MtS. MtS can be related with BPH and can negatively affect the response to alpha-blocker treatment. NC can be used for predicting response to alpha-blocker treatment in BPH patients with MtS.
To evaluate the long-term surgical, functional, and quality-of-life (QoL) outcomes after Holmium ... more To evaluate the long-term surgical, functional, and quality-of-life (QoL) outcomes after Holmium laser enucleation of the prostate (HoLEP) in patients with symptomatic benign prostatic hyperplasia (BPH). We retrospectively reviewed recorded data on patients who underwent HoLEP between June 2002 and February 2005. Ninety-six patients were enrolled. Demographic, perioperative, and postoperative data were recorded. On follow-up, International Prostate Symptom Scores (IPSSs), prostate-specific antigen (PSA) levels, QoL scores, peak uroflowmetric data (Qmax values), and post-voiding residual urine volumes (PVR volumes), were recorded. Complications were scored using the Clavien system. Statistical significance was set at p&amp;amp;amp;amp;amp;amp;lt;0.05. The mean follow-up time was 41.8±34.6 months and the mean patient age 73.2±8.7 years. The mean prostate volume was 74.6±34.3mL. Significant improvements in Qmax values, QoL, and IPSSs and decreases in PSA levels and PVR volumes were noted during follow-up (all p values=0.001). The most common complication was a requirement for re-catheterisation because of urinary retention. Two patients had concomitant bladder tumours that did not invade the muscles. Eight patients (8.3%) required re-operations; three had residual adenoma, three urethral strictures, and two residual prostate tissue in the bladder. Stress incontinence occurred in one patient (1%). All complications were of Clavien Grade 3a. We noted no Clavien 3b, 4, or 5 complications during follow-up. HoLEP improved IPSSs, Qmax values, PVR volumes, and QoL and was associated with a low complication rate, during extended follow-up. Thus, HoLEP can be a viable option to transurethral resection of the prostate.
... Titre du document / Document title. UROLITHIASIS ON NON-ABSORBABLE SUTURE MATERIAL: A RARE CA... more ... Titre du document / Document title. UROLITHIASIS ON NON-ABSORBABLE SUTURE MATERIAL: A RARE CASE OF BLADDER STONE ON POLYPROPYLENE SUTURE MATERIAL. Auteur(s) / Author(s). AKIN Yigit ; BASARA Isil ; Revue / Journal Title. ...
riner sistem taş hastalığı tekrarlama oranı yüksek olan, sıklıkla altta yatan kazanıl-mış veya do... more riner sistem taş hastalığı tekrarlama oranı yüksek olan, sıklıkla altta yatan kazanıl-mış veya doğumsal anomaliler tarafından şiddetlenebilen kronik bir hastalıktır. Yapı-lan çalışmalar hastalık prevalansının %4-20 arasında göstermektedir. [1] Üriner sistem taş hastalığı tedavisi iki basamaktan oluşmaktadır; taşın temizlenme-si ve tekrar oluşumunun engellenmesi. Minimal invaziv endoürolojik tekniklerin geliş-mesiyle taşın temizlenmesi ile ilgili önemli ilerlemeler sağlanmasına rağmen, ikinci basamak olan taş oluşumunun engellenmesi, metaflaksi(=metabolik değerlendirme +medikal profilaksi konusunda tartışmalar devam etmektedir. Maalesef uzun süren klinik ve laboratuar araştırmaları etkin ve yaygın olarak kabul edilen bir metaflaksi protokolüne dönüştürülememiştir. [2] Rosenberg, 1954 yılında hiperkalsiürinin nef-rokalsinoza ve böbrek taşı oluşumuna neden olacağını, erken tanı ve alınacak etkili önlemlerle hastalığın renal komplikasyonlarını önlemede tatmin edici sonuçlar alına-cağını...
zet Böbrek taşların da, 2 cm çapa güvenle uygulanan şok dalga tedavisi (ŞDT) sonrası böbrekte kal... more zet Böbrek taşların da, 2 cm çapa güvenle uygulanan şok dalga tedavisi (ŞDT) sonrası böbrekte kalan 5mm'den küçük taşlar klinik önemsiz kalan böbrek taş-ları olarak kabul edilmektedir. Bu durumun yönetimi klinisyenler arasında ha-len tartışmalıdır. Bu taşlar hiçbir klinik belirti vermeden böbrekte sebat et-meye devam edebilirler veya klinik belirti verebilecek hale gelebilirler. Kli-nik belirti verdiği durumlarda detaylı ürolojik inceleme ve tedavi gerektirir-ler. Üriner sistem taşlarının cerrahi tedavisinde istenen sonuç, tamamen taş-tan arınmaktır, fakat enfekte olmayan, üriner sistemde herhangi bir tıkanma-ya sebep olmayan, klinik belirti vermeyen bu taşların büyümesinin ve tekrar etmesini önlemek amacıyla medikal tedavinin faydalı olduğu da bildirilmek-tedir. Ayrıca takiplerde klinik belirti veren taş kırıntıları için cerrahi müdaha-leler söz konusu olabilir. Abstract For kidney stones up to 2 cm in diameter shock wave therapy (SDT) is safely
Diagnostic and interventional radiology (Ankara, Turkey), Jan 2, 2015
We aimed to evaluate iatrogenic renal arterial lesions, including pseudoaneurysm, arteriovenous f... more We aimed to evaluate iatrogenic renal arterial lesions, including pseudoaneurysm, arteriovenous fistula, and arteriocaliceal fistula, their management by endovascular embolization, and the clinical results. Fifty-five patients (forty males, fifteen females) with a median age of 40 years (range, 8-85 years), who underwent endovascular embolization of iatrogenic renal arterial lesions between March 2003 and December 2013 were enrolled into this retrospective study. Types of iatrogenic lesions and details of embolization procedures were reported. Estimated glomerular filtration rate (eGFR), renal function tests, hemoglobin, and hematocrit levels before and after embolization were recorded and compared. Median follow-up was 24 months. We identified 53 pseudoaneurysms, 30 arteriovenous fistulas, and 11 arteriocaliceal fistulas in 55 patients, after percutaneous nephrolithotomy (n=26), renal biopsy (n=21), nephrostomy (n=3), renal surgery (n=3), and extracorporeal shock wave lithotripsy (...
The aim of the study was to investigate the incidence of contrast medium-induced nephropathy (CIN... more The aim of the study was to investigate the incidence of contrast medium-induced nephropathy (CIN) and risk factors for CIN following endovascular abdominal aortic aneurysm repair or thoracic endovascular aortic aneurysm repair. After exclusion criteria, 139 (121 males, 18 females) patients aged 20-86 (median 65.5) years who underwent endovascular aortic aneurysm repair between January 2002 and September 2013 were included in this retrospective study. CIN, with ≥25 % increase in serum creatinine levels within 3 days after contrast medium administration, was compared to the patients&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; demographics, risk factors, type and complexity of the endovascular operation, parameters regarding to the contrast medium, preoperative estimated glomerular filtration rate (eGFR), and preoperative and early postoperative serum parameters. Statistical analyses were performed with Kolmogorov-Smirnov, χ (2) and Student&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s t tests. CIN, detected in 39 of 139 patients (28 %), was correlated with preoperative eGFR &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;60 ml/min/1.73 m(2) (P = 0.04) and high preoperative and postoperative serum urea and creatinine levels. Postoperative serum urea levels (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001) were significant in multivariate analysis. In patients undergoing endovascular aortic aneurysm repair, CIN was correlated with preoperative and postoperative renal impairment, while it was not correlated with the contrast medium dose.
Perspectives in Vascular Surgery and Endovascular Therapy, 2012
Congenital portosystemic venous shunt is extremely rare and should be treated. Advances in treatm... more Congenital portosystemic venous shunt is extremely rare and should be treated. Advances in treatment techniques allow for patients to be treated safely. We present a 9-year-old boy with a large congenital portosystemic venous shunt. The shunt was occluded interventionally with the Amplatzer vascular plug II. Our case was unique with its clinical manifestation, the use of a 22-mm Amplatzer vascular plug II, and the presence of the patient&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s 1-year follow-up.
To describe our new surgical technique for preserving the bladder neck during robot-assisted lapa... more To describe our new surgical technique for preserving the bladder neck during robot-assisted laparoscopic prostatectomy (RALP) and to present the anatomy between the bladder neck and prostate. Between December 2012 and May 2014, 52 RALPs were performed at our institute. Demographic, perioperative, and postoperative data were recorded. Quality of life (QoL) scores were assessed before RALP, after urethral catheter removal, and at the first month after RALP. Fatty connective tissue between bladder neck and prostate was introduced, and circular muscle fibers of the internal sphincter were seen in all patients. Complications were classified according to the Clavien-Dindo classification. Statistical analyses were performed. Mean follow-up was 9.6±5.2 months; mean age was 61.1±6.5 years. Our novel surgical technique for preserving the bladder neck was performed in 52 patients, and they were continent after catheter removal; mean duration of the catheter was 9.4±1.4 days. There was a significant difference in QoL before RALP and after catheter removal, however, but there was no statistical difference between before and 1 month after RALP (respectively; P&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.001, P=0.5). Furthermore, there was no complication related to the bladder neck such as bladder neck stricture, acute/chronic urinary retention, as well as no Clavien III, IV, and V complications. In addition, conventional laparoscopy and/or open surgery was not needed in any of the RALP cases. Our novel technique provided very early continence at the time of catheter removal after RALP within short-term follow-up. This can help early recovery and develop QoL scores after RALP.
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