1
|
Aydin M, Karatag T, Kadihasanoglu M, Tanriverdi O, Dondar C, Kendirci M. The Efficacy of Mid-Urethral Sling Procedures, Transobturator Tape and Tension-Free Vaginal Tape in the Treatment of Female Stress Urinary Incontinence: A Comparative Study of Twelve Months Follow-Up After Surgery. Istanbul Med J 2018. [DOI: 10.5152/imj.2018.46873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
|
2
|
Buldu I, Tepeler A, Kaynar M, Karatag T, Tosun M, Umutogluv T, Tanriover H, Istanbulluoglu O. Comparison of Anesthesia Methods in Treatment of Staghorn Kidney Stones with Percutaneous Nephrolithotomy. Urol J 2016; 13:2479-2483. [PMID: 26945650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 04/30/2015] [Revised: 10/16/2015] [Accepted: 11/09/2015] [Indexed: 06/05/2023]
Abstract
PURPOSE To compare the efficacy and safety of percutaneous nephrolithotomy (PNL) in the treatment of staghorn calculi (SC) under spinal anesthesia (SA) versus general anesthesia (GA). MATERIALS AND METHODS Patients with SC who treated with PNL from 2011 to 2014 were retrospectively reviewed. In total, 100 patients were divided into 2 groups according to anesthesia type: SA (group 1, n = 47) and GA (group 2, n = 53). Demographics, perioperative parameters, and postoperative analgesic requirements were compared between the two groups. RESULTS There was no significant difference in terms of age, sex, American Society of Anesthesiologists score, body mass index, or stone size between the two groups (P = .40, .30, .18, .20, and .50, respectively). The mean procedure times were 84.7 and 87.5 min in the SA and GA groups, respectively (P = .68). The complication rates were similar in the SA and GA groups (19.1% vs. 13.2%, respectively; P = .421). The stone-free rates were also similar in the SA and GA groups (61.7% vs. 52.8%, respectively; P = .374). No statistically significant difference was found in analgesic requirements. CONCLUSION SA is a safe method without the risks of GA and may be used for conditions in which GA is contraindicated or in patients with concerns about GA. Our outcomes indicated that SC can be treated safely and effectively under SA.
Collapse
Affiliation(s)
- Ibrahim Buldu
- Department of Urology, Faculty of Medicine, University of Mevlana, Konya 42000, Turkey.
| | - Abdulkadir Tepeler
- Department of Urology, Faculty of Medicine, Bezmialem Vakif University, Istanbul 34000, Turkey
| | - Mehmet Kaynar
- Department of Urology, Faculty of Medicine, Selcuk University, Konya 42000, Turkey
| | - Tuna Karatag
- Department of Urology, Faculty of Medicine, University of Mevlana, Konya 42000, Turkey
| | - Muhammed Tosun
- Department of Urology, Faculty of Medicine, Bezmialem Vakif University, Istanbul 34000, Turkey
| | - Tarik Umutogluv
- Department of Anesthesiology, Faculty of Medicine, Bezmialem Vakif University, Istanbul 34000, Turkey
| | - Hakan Tanriover
- Department of Anesthesiology, Faculty of Medicine, University of Mevlana, Konya 42000, Turkey
| | - Okan Istanbulluoglu
- Department of Urology, Faculty of Medicine, University of Mevlana, Konya 42000, Turkey
| |
Collapse
|
3
|
Kaynar M, Tekinarslan E, Keskin S, Buldu İ, Sönmez MG, Karatag T, Istanbulluoglu MO. Effective radiation exposure evaluation during a one year follow-up of urolithiasis patients after extracorporeal shock wave lithotripsy. Cent European J Urol 2015; 68:348-52. [PMID: 26568880 PMCID: PMC4643697 DOI: 10.5173/ceju.2015.547] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2015] [Revised: 04/17/2015] [Accepted: 06/02/2015] [Indexed: 01/21/2023] Open
Abstract
Introduction To determine and evaluate the effective radiation exposure during a one year follow-up of urolithiasis patients following the SWL (extracorporeal shock wave lithotripsy) treatment. Material and methods Total Effective Radiation Exposure (ERE) doses for each of the 129 patients: 44 kidney stone patients, 41 ureter stone patients, and 44 multiple stone location patients were calculated by adding up the radiation doses of each ionizing radiation session including images (IVU, KUB, CT) throughout a one year follow-up period following the SWL. Results Total mean ERE values for the kidney stone group was calculated as 15, 91 mSv (5.10-27.60), for the ureter group as 13.32 mSv (5.10-24.70), and in the multiple stone location group as 27.02 mSv (9.41-54.85). There was no statistically significant differences between the kidney and ureter groups in terms of the ERE dose values (p = 0.221) (p >0.05). In the comparison of the kidney and ureter stone groups with the multiple stone location group; however, there was a statistically significant difference (p = 0.000) (p <0.05). Conclusions ERE doses should be a factor to be considered right at the initiation of any diagnostic and/or therapeutic procedure. Especially in the case of multiple stone locations, due to the high exposure to ionized radiation, different imaging modalities with low dose and/or totally without a dose should be employed in the diagnosis, treatment, and follow-up bearing the aim to optimize diagnosis while minimizing the radiation dose as much as possible.
Collapse
Affiliation(s)
- Mehmet Kaynar
- Department of Urology, Selcuk University, Faculty of Medicine, Konya, Turkey
| | - Erdem Tekinarslan
- Department of Urology, Konya Education and Research Hospital, Konya, Turkey
| | - Suat Keskin
- Department of Radiology, Necmettin Erbakan University, Faculty of Medicine, Konya, Turkey
| | - İbrahim Buldu
- Department of Urology, Mevlana University, Faculty of Medicine, Konya, Turkey
| | | | - Tuna Karatag
- Department of Urology, Faculty of Medicine, Mevlana University, Konya, Turkey
| | | |
Collapse
|
4
|
Tok A, Akbulut F, Buldu I, Karatag T, Kucuktopcu O, Gurbuz G, Istanbulluoglu O, Armagan A, Tepeler A, Tasci AI. Comparison of microperc and mini-percutaneous nephrolithotomy for medium-sized lower calyx stones. Urolithiasis 2015; 44:155-9. [DOI: 10.1007/s00240-015-0804-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2015] [Accepted: 07/07/2015] [Indexed: 11/29/2022]
|
5
|
Karatag T, Tepeler A, Silay MS, Bodakci MN, Buldu I, Daggulli M, Hatipoglu NK, Istanbulluoglu MO, Armagan A. A Comparison of 2 Percutaneous Nephrolithotomy Techniques for the Treatment of Pediatric Kidney Stones of Sizes 10-20 mm: Microperc vs Miniperc. Urology 2015; 85:1015-1018. [PMID: 25917724 DOI: 10.1016/j.urology.2015.02.010] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2014] [Revised: 01/28/2015] [Accepted: 02/12/2015] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To compare outcomes of micro-percutaneous nephrolithotomy (PNL; microperc) with mini-PNL (miniperc) in the treatment of pediatric renal stones of sizes 10-20 mm. MATERIALS AND METHODS Patients aged <18 years who underwent PNL for renal stones of sizes 10-20 mm between August 2011 and March 2014 in 3 referral centers were reviewed retrospectively. Patients were evaluated in the following 2 groups: microperc (group 1) and miniperc (group 2). Demographics and perioperative parameters (fluoroscopy and operation time, hemoglobin drop, and stone-free and complication rates) were retrospectively analyzed. RESULTS A total of 119 patients were evaluated, including group 1 (n = 56) for microperc and group 2 (n = 63) for miniperc. We found mean stone sizes as 13.4 ± 3.4 and 14.8 ± 3.7 mm in the groups, respectively (P = .046). Mean operation and fluoroscopy times were 57.1 ± 31.2 minutes and 132.4 ± 92.5 seconds in the microperc group and 68.9 ± 36.7 minutes and 226.2 ± 166.2 seconds in the miniperc group, respectively (P = .110 and P <.001). Stone-free rates were similar in both groups (82.1% vs 87.3%; P = .433 and 92.8% vs 93.6%; P = 0673) on postoperative day 1 and at first-month follow-up. The mean hemoglobin drop in group 2 differed from that in group 1 significantly (P <.001). The difference of average hospitalization times was statistically significant (43.0 ± 15.4 vs 68.5 ± 31.7 hours; P <.001). CONCLUSION Our outcomes show that microperc may be preferred as an alternative to mini-PNL for the treatment of pediatric kidney stones of sizes 10-20 mm with comparable success and complication rates, as well as shorter hospitalization and fluoroscopy times.
Collapse
Affiliation(s)
- Tuna Karatag
- Department of Urology, Faculty of Medicine, Mevlana University, Konya, Turkey.
| | - Abdulkadir Tepeler
- Department of Urology, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey
| | - Mesrur Selcuk Silay
- Department of Urology, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey
| | - Mehmet Nuri Bodakci
- Department of Urology, Faculty of Medicine, Dicle University, Diyarbakir, Turkey
| | - Ibrahim Buldu
- Department of Urology, Faculty of Medicine, Mevlana University, Konya, Turkey
| | - Mansur Daggulli
- Department of Urology, Faculty of Medicine, Dicle University, Diyarbakir, Turkey
| | | | | | - Abdullah Armagan
- Department of Urology, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey
| |
Collapse
|
6
|
Karatag T, Tepeler A, Silay MS, Bodakci MN, Buldu I, Daggulli M, Hatipoglu NK, Istanbulluoglu MO, Armagan A. PD13-09 MICRO VERSUS MINI PERCUTANEOUS NEPHROLITHOTOMY FOR THE TREATMENT OF PEDIATRIC KIDNEY STONE DISEASE. J Urol 2015. [DOI: 10.1016/j.juro.2015.02.1073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|
7
|
Karatag T, Buldu I, Inan R, Istanbulluoglu MO. MP38-20 MICRO-PERCUTANEOUS NEPHROLITHOTOMY FOR THE TREATMENT OF MODERATE SIZED KIDNEY STONES; OUR CLINICAL EXPERIENCES IN FIRST 100 CASES FROM A SINGLE CENTER. J Urol 2015. [DOI: 10.1016/j.juro.2015.02.1395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|
8
|
Karatag T, Buldu I, Istanbulluoglu MO. Re: Sener et al.: asymptomatic lower pole small renal stones: shock wave lithotripsy, flexible ureteroscopy, or observation? A prospective randomized trial (Urology 2015;85:33-37). Urology 2015; 85:709. [PMID: 25733297 DOI: 10.1016/j.urology.2014.11.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2014] [Revised: 11/23/2014] [Accepted: 11/25/2014] [Indexed: 10/23/2022]
Affiliation(s)
- Tuna Karatag
- Department of Urology, Faculty of Medicine, Mevlana University, Konya, Turkey
| | - Ibrahim Buldu
- Department of Urology, Faculty of Medicine, Mevlana University, Konya, Turkey
| | | |
Collapse
|
9
|
Armagan A, Karatag T, Buldu I, Tosun M, Basibuyuk I, Istanbulluoglu MO, Tepeler A. Comparison of flexible ureterorenoscopy and micropercutaneous nephrolithotomy in the treatment for moderately size lower-pole stones. World J Urol 2015; 33:1827-31. [PMID: 25712308 DOI: 10.1007/s00345-015-1503-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2014] [Accepted: 01/29/2015] [Indexed: 11/26/2022] Open
Abstract
PURPOSE To present a retrospective comparative clinical study of micropercutaneous nephrolithotomy (microperc) versus flexible ureterorenoscopy (F-URS) in treatment of moderate-size lower-pole stones (LPSs). METHODS We retrospectively reviewed data on patients with isolated LPSs ≤2 cm in diameter treated with F-URS and/or microperc in two referral centers. Patients were divided into two groups by treatment modality: F-URS (Group 1) and microperc (Group 2). Demographics and perioperative parameters were analyzed. RESULTS A total of 127 patients with isolated LPSs were treated via F-URS (Group 1, n = 59) and microperc (Group 2, n = 68). Mean patient age in microperc group was slightly lower than in F-URS group (p = 0.112). We found no statistically significant difference in terms of either the size or number of stones in two groups (p = 0.113 and p = 0.209, respectively). Operative time was shorter in microperc, whereas fluoroscopy time was shorter in F-URS (60.1 ± 26.2 vs. 46.2 ± 24.3 min, p < 0.001; and 28.3 ± 19.1 vs. 108.9 ± 65.2 s, p < 0.001). Mean fall in hemoglobin level was statistically significantly lower in F-URS and hospitalization time was also significantly shorter in F-URS (0.68 ± 0.51 vs. 1.29 ± 0.88 mg/dL, p < 0.001; and 23.0 ± 58.1 vs. 33.8 ± 17.2 h, p < 0.001, respectively). Stone-free rates (SFRs) were 74.5 % (44/59) in Group 1 and 88.2 % (60/68) in Group 2 (p < 0.001). CONCLUSIONS We found that microperc was safe and efficacious when used to treat moderate-size LPSs and may be considered as an alternative to F-URS, affording a higher SFR. Our study supports the notion that microperc should play an increasing role in treatment of LPSs.
Collapse
Affiliation(s)
- Abdullah Armagan
- Department of Urology, Faculty of Medicine, Bezmialem Vakif University, Istanbul, 34093, Turkey.
| | - Tuna Karatag
- Department of Urology, Faculty of Medicine, Mevlana University, Konya, Turkey
| | - Ibrahim Buldu
- Department of Urology, Faculty of Medicine, Mevlana University, Konya, Turkey
| | - Muhammed Tosun
- Department of Urology, Faculty of Medicine, Bezmialem Vakif University, Istanbul, 34093, Turkey
| | - Ismail Basibuyuk
- Department of Urology, Faculty of Medicine, Bezmialem Vakif University, Istanbul, 34093, Turkey
| | | | - Abdulkadir Tepeler
- Department of Urology, Faculty of Medicine, Bezmialem Vakif University, Istanbul, 34093, Turkey
| |
Collapse
|
10
|
Karatag T, Buldu I, Inan R, Istanbulluoglu MO. Is Micropercutaneous Nephrolithotomy Technique Really Efficacicous for the Treatment of Moderate Size Renal Calculi? Yes. Urol Int 2015; 95:9-14. [PMID: 25720425 DOI: 10.1159/000368373] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2014] [Accepted: 09/16/2014] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To present our clinical experiences with micropercutaneous nephrolithotomy in the treatment of moderate-sized renal calculi from a single center. METHODS We retrospectively evaluated the patients with moderate-sized renal calculi who underwent micro-percutaneous nephrolithotomy between December 2012 and Septermber 2013. RESULTS A total of 68 patients and 70 renal units underwent microperc procedure. Mean age of patients was 41.4 ± 18.8. The mean stone size was 122 ± 83 mm(2). The operations were performed under spinal anesthesia in 89.7% of the patients. Stone-free rate was 95.7 % (67/70). Clinically significant residual fragments were observed in three patients. The average duration of operation and mean fluoroscopy time was 40 ± 23 min and 108 ± 72 s, respectively. The mean postoperative drop in hemoglobin was 0.95 ± 0.7 while no patient required blood transfusion. Patients were discharged after an average hospitalization time of 27.5 ± 12.4 h. A total of 4 complications (5.7%), including urinary tract infection (Clavien I) in one patient and renal colics requiring stent insertion (Clavien IIIa) in three patients, were observed postoperatively. CONCLUSION Microperc technique is safe, feasible, and efficacious. We suggest that micro-percutaneous nephrolithotomy should be considered for the treatment of moderate-sized renal stones as an alternative to SWL and RIRS failures and also may be considered even primarily.
Collapse
|
11
|
Karatag T, Buldu I, Kaynar M, Inan R, Istanbulluoglu MO. Does the presence of hydronephrosis have effects on micropercutaneous nephrolithotomy? Int Urol Nephrol 2015; 47:441-4. [PMID: 25563232 DOI: 10.1007/s11255-014-0907-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2014] [Accepted: 12/17/2014] [Indexed: 11/27/2022]
Abstract
PURPOSE To evaluate the effects of presence of hydronephrosis on micropercutaneous nephrolithotomy (micro-PNL) surgery. PATIENTS AND METHODS A retrospective analysis of 112 patients who underwent microperc surgery between December 2012 and April 2014 was performed. Patients were evaluated in two groups according to whether the presence of hydronephrosis. Stone size and location, fluoroscopy and operation time, stone-free rates and patient-related parameters were prospectively recorded into a centralized computer-generated system. RESULTS A total of 58 patients in Group 1 with hydronephrosis and 54 patients in Group 2 with no hydronephrosis were analyzed. There was no statistically significant difference in terms of stone sizes and body mass indexes (BMI) in comparison of groups (155.2 ± 93.06 vs. 143.70 ± 70.77 mm(2), p = 0.856 and 27.6 ± 4.2 vs. 26.7 ± 3.2 kg/m(2), p = 0.625). The success rates were similar (91.3 vs. 92.5%, p = 0.341). While the mean operation time and fluoroscopy time in Group 1 were 44.2 ± 23.62 min and 105.3 ± 47 s, it was 38.8 ± 26.4 min and 112.53 ± 68.3 s in Group 2, but there was no statistical difference in comparison of both groups. The mean attempts of percutan puncture were 1.35 ± 0.47 in Group 1 and 1.76 ± 0.31 in Group 2 (p = 0.185). We also found no statistical differences regarding mean hemoglobin change and hospitalization time, respectively (p = 0.685 and p = 0753). In comparison of grades of hydronephrosis, there was no statistically significant difference in subgroups analysis. CONCLUSIONS The presence of hydronephrosis does not affect success rates and operative time in micro-PNL procedures significantly. Micropercutaneous nephrolithotomy is technically feasible and efficacious both in hydronephrotic and non-hydronephrotic kidneys.
Collapse
Affiliation(s)
- Tuna Karatag
- Department of Urology, Faculty of Medicine, Mevlana University, Konya, 42200, Turkey,
| | | | | | | | | |
Collapse
|
12
|
Buldu I, Tepeler A, Karatag T, Bodakci MN, Hatipoglu NK, Penbegul N, Akman T, Istanbulluoglu O, Armagan A. Does aging affect the outcome of percutaneous nephrolithotomy? Urolithiasis 2014; 43:183-7. [PMID: 25395249 DOI: 10.1007/s00240-014-0742-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2014] [Accepted: 11/04/2014] [Indexed: 11/28/2022]
Abstract
To investigate whether aging affects surgical outcomes by comparing the results of two patient groups undergoing PNL: those over 60 and those under 60. A retrospective screen was made for patients undergoing conventional PNL surgery for renal stones performed in two separate centers between 2010 and 2013. 520 patients included were classified into age groups: patients aged 18-59 comprised Group-1 and those aged over 60 comprised Group-2. Those between 60-69 years (sexagenarian) were assigned to Group-2a; 70-79 years (septuagenarian) to Group-2b; and 80-89 years (octogenarian) to Group-2c. Patients' demographic characteristics (accompanying comorbidities, ASA scores, body mass indices and stone size) and perioperative values (duration of surgery and hospital stay, success and complication rates) were compared between the groups. Mean stone size was similar in groups (30.1 ± 15.5 vs. 31.5 ± 15.4 mm, p = 0.379). The mean ASA value for the patients in Group-1 was 1.61; significantly lower than that in the other groups (p = 0.000). The level of accompanying comorbidities in Group-1 was significantly lower than that of the other groups (p = 0.000). The mean duration of surgery, postoperative hematocrit drop, complication and success rate were statistically similar in Groups 1 and 2 (p = 0.860, p = 0.430, p = 0.7, and p = 0.66, respectively). The duration of hospital stay was significantly shorter in the patients in Group-1 compared to those in Group-2 (p = 0.008). In experienced hands, PNL can be safely and reliably performed in the treatment of renal stones in elderly patients.
Collapse
Affiliation(s)
- Ibrahım Buldu
- Department of Urology, School of Medicine, University of Mevlana, Konya, Turkey,
| | | | | | | | | | | | | | | | | |
Collapse
|
13
|
Karatag T, Buldu I, Inan R, Istanbulluoglu M. 614 The treatment of moderate size renal calculi with micro-percutaneous nephrolithotomy technique: Our clinical experiences. ACTA ACUST UNITED AC 2014. [DOI: 10.1016/s1569-9056(14)60604-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
14
|
Rifaioglu MM, Onem K, Buldu I, Karatag T, Istanbulluoglu MO. Tubeless percutaneous nephrolithotomy: yes but when? A multicentre retrospective cohort study. Urolithiasis 2014; 42:255-62. [PMID: 24468916 DOI: 10.1007/s00240-014-0638-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2013] [Accepted: 01/08/2014] [Indexed: 10/25/2022]
Abstract
The aim of our study is to determine the predictive factors for placement of percutaneous nephrostomy tube (PNT) in percutaneous nephrolithotomy (PCNL) procedure and to evaluate the optimal cutoff points of the predictive factors. 229 patients, who had undergone percutaneous nephrolithotomy operation between February 2009 and February 2013 were reviewed retrospectively. Five patients were excluded from the study because of solitary kidney. All characteristics of 224 patients, stones and operative data were investigated. Patient and stone-related factors, such as age, BMI, history of previous surgery or SWL, characteristics of the stone, renal parenchymal thickness (RPT), as well as procedural factors, such as percutaneous access number and location were analyzed by univariate and multivariate tests. The continuous variables were analyzed using Receiver operating characteristic curve analysis. There were no differences in sex, age, BMI and hemoglobin decrease between the groups. Previous operation status, RPT, stone size, multiplicity of the stone, stone localization, blood transfusion presence, access points, access number and operation time were found statistically different according to univariate analysis. Multivariate analysis showed that RPT, operation time and stone size were the independent factors that affected the PNT insertion. For RPT, operation time and stone size, the optimal cutoff points for insertion PNT were 13.75 mm, 75.5 min and 890 mm(2), respectively. Tubeless PCNL should be chosen in patients with stone area less than 890 mm(2), and parenchymal thickness thicker than 13.75 mm and procedure with operation period <75.5 min.
Collapse
Affiliation(s)
- Murat M Rifaioglu
- Urology Department, Medical Faculty, Mustafa Kemal University, 31005, Antakya, Serinyol, Hatay, Turkey,
| | | | | | | | | |
Collapse
|
15
|
Karatag T, Buldu I, Istanbulluoglu MO. Editorial comment from Dr Karatag et al. to tubeless simultaneous bilateral percutaneous nephrolithotomy: safety, feasibility and efficacy in an Indian setting. Int J Urol 2013; 21:503. [PMID: 24350684 DOI: 10.1111/iju.12381] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Tuna Karatag
- Department of Urology, Mevlana University, Konya, Turkey.
| | | | | |
Collapse
|
16
|
Hatipoglu NK, Tepeler A, Buldu I, Atis G, Bodakci MN, Sancaktutar AA, Silay MS, Daggulli M, Istanbulluoglu MO, Karatag T, Gurbuz C, Armagan A, Caskurlu T. Initial experience of micro-percutaneous nephrolithotomy in the treatment of renal calculi in 140 renal units. Urolithiasis 2013; 42:159-64. [PMID: 24337646 DOI: 10.1007/s00240-013-0631-2] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2013] [Accepted: 12/02/2013] [Indexed: 10/25/2022]
Abstract
The aim of this study was to investigate the effectiveness and reliability of the micro-percutaneous nephrolithotomy (PNL) method for the management of kidney stones. We performed a retrospective analysis of 136 patients (140 renal units) who underwent micro-PNL for renal stones between September 2011 and February 2013 in four referral hospitals in Turkey. The selection of treatment modality was primarily based on factors such as stone size and location. In this study, we analyzed patient- and procedure-related factors. The mean age of patients in this study was 28.7 ± 20.6 (1-69) years, and the mean stone size was 15.1 ± 5.15 (6-32) mm. Conversion to mini-PNL was required in 12 patients. All interventions were performed with the patient in the prone position, except for the 3-year-old patient with the pelvic kidney who was placed in the supine position. The mean hospital stay was 1.76 ± 0.65 (1-4) days, and the mean drop in the hemoglobin level was 0.87 ± 0.84 (0-4.1) mg/dL. One of our patients required transfusion. Ureteral J stent was implanted in nine (6.43 %) patients because of residual stones. Seven (6.43 %) patients complained of postoperative renal colic which was managed conservatively. Abdominal distension related to extravasation of the irrigation fluid was observed in three patients (2.19 %). There were no other postoperative complications. An overall success rate of 82.14 % was achieved. Micro-PNL can be effectively and safely used for small and moderate kidney stones resistant to shock wave lithotripsy or as an alternative to other minimally invasive treatment methods.
Collapse
|
17
|
Armagan A, Silay MS, Karatag T, Akman T, Tepeler A, Ersoz C, Akcay M. Circumcision during the phallic period: does it affect the psychosexual functions in adulthood? Andrologia 2013; 46:254-7. [DOI: 10.1111/and.12071] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/17/2012] [Indexed: 11/27/2022] Open
Affiliation(s)
- A. Armagan
- Faculty of Medicine; Department of Urology; Bezmialem Vakif University; Istanbul Turkey
| | - M. S. Silay
- Faculty of Medicine; Department of Urology; Bezmialem Vakif University; Istanbul Turkey
| | - T. Karatag
- Department of Urology; Karapinar State Hospital; Konya Turkey
| | - T. Akman
- Faculty of Medicine; Department of Urology; Bezmialem Vakif University; Istanbul Turkey
| | - A. Tepeler
- Faculty of Medicine; Department of Urology; Bezmialem Vakif University; Istanbul Turkey
| | - C. Ersoz
- Faculty of Medicine; Department of Urology; Bezmialem Vakif University; Istanbul Turkey
| | - M. Akcay
- Faculty of Medicine; Department of Urology; Bezmialem Vakif University; Istanbul Turkey
| |
Collapse
|
18
|
Silay MS, Sirin H, Tepeler A, Karatag T, Armagan A, Horasanli K, Miroglu C. "Snodgraft" technique for the treatment of primary distal hypospadias: pushing the envelope. J Urol 2012; 188:938-42. [PMID: 22819401 DOI: 10.1016/j.juro.2012.04.126] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2012] [Indexed: 10/28/2022]
Abstract
PURPOSE "Snodgraft" modification has been proposed to reduce the risk of meatal/neourethral stenosis in distal hypospadias. We applied the Snodgraft technique by using inner preputial graft in primary distal hypospadias repair. MATERIALS AND METHODS A total of 102 consecutive patients undergoing the Snodgraft procedure were prospectively studied between 2006 and 2011. Mean patient age was 7.2 years. Localization of the meatus was glanular in 5 patients, coronal in 49, subcoronal in 45 and mid penile in 3. In all patients the posterior urethral plate was incised, and the graft harvested from the inner prepuce was sutured from the old meatus to the tip of the glans. A neourethra was created over a urethral catheter using 6-zero polyglactin suture. An interpositional flap was laid over the urethra as a second barrier. All patients were followed at 3 to 6-month intervals for cosmetic and functional results. RESULTS At a mean of 2.4 years of followup no patient had meatal stenosis or diverticulum at the inlay graft site. However, urethrocutaneous fistula was observed in 10 patients (9.8%). A slit-like appearance of neomeatus was achieved in all patients. During followup no obstructive urinary flow pattern was detected, and early and long-term maximum urine flow rates were comparable. CONCLUSIONS No meatal/neourethral stenosis was observed in any patient undergoing a Snodgraft procedure. A randomized trial will be needed to prove that the incidence of meatal/neourethral stenosis is lower after Snodgraft repair compared to routine tubularized incised plate repair.
Collapse
Affiliation(s)
- Mesrur Selcuk Silay
- Department of Urology, Bezmialem Vakif University, Faculty of Medicine, Istanbul, Turkey.
| | | | | | | | | | | | | |
Collapse
|
19
|
Silay MS, Tanriverdi O, Karatag T, Ozcelik G, Horasanli K, Miroglu C. Twelve-year experience with Hinman-Allen syndrome at a single center. Urology 2011; 78:1397-401. [PMID: 21996110 DOI: 10.1016/j.urology.2011.08.018] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2011] [Revised: 08/06/2011] [Accepted: 08/06/2011] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To report the long-term follow-up results of patients with Hinman-Allen syndrome (HAS) at our institution. METHODS The data from 22 children with HAS were retrospectively analyzed. The patients were followed up every 3-6 months with serial physical examinations, voiding charts, urine culture, postvoid residual urine volume determination, serum creatinine measurement, and urinary imaging. The follow-up time was calculated from the day of the first visit to the day of the latest dimercaptosuccinic acid scan. Urotherapy, pharmacotherapy, clean intermittent catheterization, biofeedback therapy, and surgery were performed sequentially and/or combined, depending on the disease course. Renal deterioration was defined as any presence of a new scar or cortical thinning compared with the findings from the first dimercaptosuccinic acid scan. Upper urinary tract deterioration was defined as the persistence or progression of hydronephrosis on ultrasonography. RESULTS The mean age at referral was 9.18 ± 3.36 years (range 2-14), and the mean follow-up period was 80.90 ± 19.57 months (range 54-144). Conservative therapy resulted in improvement of the bladder function in 14 patients; however, 8 patients required surgery owing to failure of this approach. Asymptomatic bacteriuria developed in one half of the children (n = 11, 50%), and in 6 (22.7%), ≥1 febrile urinary tract infection developed. None of the patients had upper urinary tract deterioration; however, renal deterioration developed in 3 patients (13.6%). The mean creatinine levels had remained stable at the end of the follow-up. CONCLUSION Close follow-up at a single institution and proactive treatment resulted in successful stabilization of HAS in most of our children with HAS.
Collapse
Affiliation(s)
- Mesrur Selcuk Silay
- 2nd Urology Department, Sisli Etfal Training and Research Hospital, Istanbul, Turkey.
| | | | | | | | | | | |
Collapse
|