Search

Copyright of Androloji Bülteni (Andrology Bullettin) is the property of BAYT Ltd. Co and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Journal of Reconstructive Urology is the property of Turkiye Klinikleri and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Online Turkish Journal of Health Sciences (OTJHS) / Online Türk Sağlık Bilimleri Dergisi is the property of Oguz KARABAY and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: We aimed to investigate the efficacy and safety of same session ureteroscopy (URS) in the treatment of bilateral ureteral calculi. Materials and Methods: 841 patients who underwent unilateral URS for unilateral ureteral stone (group 1) and 41 patients who underwent bilateral URS for bilateral ureteral stones in single session (group 2) were compared in terms of demographic data, urinary stone disease history, stone characteristics and operation outcomes. Results: There were 582 (69.2%) male and 259 (30.8%) female patients in group 1, 27 (65.9%) male and 14 (34.1%) female patients in group 2. The stone area was calculated as 70.9±52.6 mm2 in Group 1 while 271.1±180.2 mm2 in Group 2 cumulatively and it was significantly larger than Group 1 (p˂0.001). Mean operation time was also longer in Group 2 (Group 1: 36.0±19.3 min and Group 2: 48.9±23.7 min; p˂0.001). General anesthesia was preferred in 50 patients (5.9%) in Group 1 and 7 (17.1%) patients in group 2 (p=0.013). A total of 127 (15.1%) patients needed analgesia at postoperative first day in Group 1 and 12 (29.3%) patients in Group 2 (p=0.025). The hospitalization times and stone free rates were similar between the groups (1.4±1.3 vs 2.1±2.6 days; p=0.082 and 90.6% vs 85.4%; p=0.274). No complication was found in 816 (97.0%) patients in Group 1 and 40 (97.6%) patients in Group 2 (p = 0.970). Conclusion: We believe that bilateral URS in the same session is an effective and reliable method in the treatment of bilateral ureter stones.

Objective: Post-Ureteroscopic Lesion Scale (PULS) is used to classify ureteral wall injury that occurs during ureteroscopy. In this study we presented the preliminary results of absorbed irrigation fluid volumes according to PULS grades. Material and Methods: Forty-four patients to whom 7F semirigid ureteoscopy was performed due to ureteral stone were included in the study. All patients received general anesthesia. Izotonic containing 1% ethanol was used as irrigation fluid. Ethanol concentration in venous blood was commenced to be measured at the start of irrigation use and was carried on at 15-minute intervals including the post-operative period in the recovery room. Absorbed fluid volume was calculated by using blood ethanol concentrations. Irrigation time, stone size and PULS grade were recorded. Results: Mean operation time was found to be 44.2 ± 19.9 minutes. Mean stone size was measured to be 12.7± 6 mm and mean irrigation fluid amount used was 1371±1262 ml. PULS grade of 0 was seen in 26 patients and that of 1 or more was seen in 18 patients. No patient had a PULS grade of 3 or 4. Mean absorbed fluid volume was measured to be 58 ± 50,6 ml. No significant correlation was found between PULS grade and mean absorbed fluid volume. Conclusion: Fluid absorption during URS is not correlated with the PULS grade. Semirigid URS is a safe treatment option for ureteral stone disease in terms of the level of irrigation fluid being absorbed.

Objective: We aimed to evaluate the efficacy and safety of balloon dilatation in ureteroscopy (URS) for the treatment of distal ureteral stones. Material and Methods: The retrospective data of patients who underwent URS for distal ureter stones between January 2008 and June 2018 were evaluated. Patients were divided into two groups according the need of balloon dilatation. Group 1 was consisted of balloon dilatation (-) patients and Group 2 was consisted of balloon dilatation (+) patients. These two groups were compared in terms of demographic of patients, stone characteristics, operation outcomes and complications. Results: Group 1 was consisted of 359 (70.4%) male and 151 (29.6%) female; group 2 was consisted of 32 (80%) male and 8 (20%) female patients (p=0.197). The mean age of patients was 43.3±14.3 years in group 1 and 44.2±14.9 years in group 2 (p=0.704). Operation time was significantly higher in group 2 (32.8±20.5 min vs 40.1±16.0; p=0.029). Although stone free rate was significantly higher in group 1 (%98.6 vs %90.0; p=0.017); the complication rate was similar between groups (%3.2 vs %2.5; p=0.787). Conclusions: The same session balloon dilatation for ureteral structures in URS for the treatment of distal ureteral stones seems safe and cost-effective method. Although this procedure may lead to elongation in operation times and decrease the stone free rates; it does not affect the complication rates and prevents patients from needing a new operation for same stone. Further randomized and prospective studies are needed for long term outcomes of this procedure

Amaç: Üst üreter taşlarının tedavisinde beden dışı şok dalga (ESWL) ve üreteroskopi (URS ) uygulamalarının etkinliğini ve başarı üzerine etkili olabilecek faktörleri değerlendirmek. Yöntemler: Üst üreter taşı tanısı ile tedavi edilen 233 hastanın verileri retrospektif olarak değerlendirildi. ESWL uygulanan hastalar Grup 1, URS yapılan hastalar ise Grup 2 olarak ayrıldı. Tüm hastalar kontrastsız abdominal bilgisayarlı tomografi ile değerlendirildi. Hastaların yaş ve cinsiyetleri, vücut kitle indeksi, taş boyutu, ortalama taş dansitesi, cilt-taş mesafesi gibi faktörler kayıt edilerek tedavi başarısı üzerine etkileri değerlendirildi. Bulgular: Hastaların yaş ortalaması 47,4 yıl idi. Ortalama taş boyutu 119,7 mm3 idi ve ortalama taş dansitesi 690,5 Hounsfield Ünitesi idi. Grup 1’de %55,2 taşsızlık tespit edildi. Grup 2’de ise bu oran %74,1 idi. Kadın cinsiyet, taş boyutu ve cilt taş mesafesi ESWL başarısı için prediktif faktörlerdi. URS için herhangi bir prediktif faktör tespit edilmedi. Taş cilt mesafesi 10 cm’den uzun olanların kısa olanlara göre başarısız olma riski 13 kat daha fazlaydı (p lt;0.001). URS yapılan grupta ise herhangi bir parametrenin istatistiksel olarak başarıyı etkilemediği görülmüştür. Sonuç: Bu çalışma, üst üreter taşı olan hastalarda URS’nin ESWL’ye kıyasla daha yüksek taşsızlık oranına sahip olduğunu göstermiştir. URS daha fazla hastanede kalma süresi ve daha fazla cerrahi enstrüman gerektirmektedir. ESWL uygulanan hastalarda ise ikincil tedavi ihtiyacı daha fazladır

Aim:To compare the results of micro-percutaneous nephrolithotomy (micro-PNL) and retrograde intrarenal surgery (RIRS) for symptomatic renal stones 5-10 mm in diameter.Methods:A total of 86 patients, who underwent RIRS (n=53) and micro-PNL (n=23), were evaluated retrospectively. Urine analysis, serum creatinine level, urine culture and non-contrast computed tomography scan were performed in all patients preoperatively. Kidney stones were opaque in all cases. Unresolved coagulopathy, active urinary infection, morbid obesity, missing data and pregnancy were considered the criteria for exclusion. The groups were compared in terms of operative time, Visual analogue scale score, analgesic requirement, retreatment, transition to other treatment, complication and stone-free rates and length of hospital stay.Results:Both surgical techniques were similar for all parameters except need for analgesics, which was higher in the micro-PNL group (p=0.026). The stone-free rate was 85.7% in the RIRS group and 78.2% in the micro-PNL group (p=0.43).Conclusion:Both methods can be administered as alternative modalities with high success and low complication rates. However, analgesics requirement was higher in micro-PNL group.

Copyright of Journal of Reconstructive Urology is the property of Turkiye Klinikleri and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: In our study, we aimed to compare the efficiency and reliability of using semirigid ureteroscopy (S-URS) and flexible ureteroscopy (F-URS) in the treatment of patients with stones smaller than 2 cm in isolated renal pelvis. Materials and Methods: The data of 45 patients who underwent ureteroscopic stone treatment for isolated renal pelvis stones smaller than 2 cm were evaluated retrospectively. S-URS was routinely applied to all patients. If the stones can be accessed in the renal pelvis with S-URS, direct treatment with holmium laser was applied. If the stone was not accessible, F-URS was made. Groups were compared in terms of stone-free rates, operation times, hemoglobin reduction, and complications. Results: S-URS was performed in 24 (53.3%) patients and F-URS in 21 (46.7%) patients. There was no significant difference between the two groups in terms of age, degree of hydronephrosis, mean stone size and stone side. Mean operation time was 64.62 ± 9.34 minutes in the S-URS group and 96.43 ± 14.26 minutes in the F-URS group (p=0.001). There was no statistically significant difference between the groups in terms of postoperative complications (p = 0.548). In the postoperative 1st day and 1st month follow-up, stone-free rates were 79.2% and 83.3% in the S-URS group, and 80.9% and 85.7% in the F-URS group, respectively (p = 0.768 and p = 0.574). Conclusions: We observed that the use of S-URS and F-URS were very successful and safe methods in kidney stones smaller than 2 cm. S-URS is a safe treatment method that can be applied if the stone in the renal pelvis can be reached without any problem, especially in selected cases. [ABSTRACT FROM AUTHOR]

Objective: The purpose of this study was to determine the perioperative risk factors for postoperative fever (POF)/systemic inflammatory response syndrome (SIRS) among geriatric patients after semi-rigid ureterorenoscopy with laser lithotripsy (RURSLL). Materials and Methods: We retrospectively reviewed data of 139 procedures from 129 consecutive geriatric patients who had undergone RURSLL for stone disease in our department. Preoperative and intraoperative characteristics between patients with and without POF/SIRS were compared using univariate analyses. The significant variables on univariate analyses were included in a multivariate logistic regression analysis to evaluate the risk factors associated with POF/SIRS following RURSLL. Results: Twenty-nine (21%) patients had POF/SIRS after RURSLL. Patients were found with higher percentage of comorbidities, body mass indices, and lower estimated glomerular filtration rates. On univariate analysis, positive preoperative urine culture, stone size, operation time, and the presence of postoperative double-J (DJ) stent were found to be significant variables (p=0.004; p=0.016; p=0.01; p=0.01, respectively). On multivariate analysis, positive preoperative urine culture [odds ratio (OR): 8.36; 95% confidence interval (CI): 2.20-31.79; p=0.002) and postoperative DJ stent insertion (OR: 6.14; 95% CI: 1.16-32.57; p=0.033) were found to be the most significant dependent variables. Conclusion: We found that positive preoperative urine culture and postoperative DJ stent insertion were the most important determinants for infectious complications after RURSLL in geriatric population. So, the procedure should be kept as short as possible, and indications for postoperative DJ catheter insertion should be reduced as much as possible. [ABSTRACT FROM AUTHOR]

Objective: Urinary system stone disease is a very common health problem that affects 2 to 3% of people and causes serious complications when it is not treated. The prevalence of renal stones has been increasing worldwide and surgical methods have changed over time. However, there is no comprehensive bibliometric analysis of the retrograde intrarenal surgery (RIRS) method in the literature. This study aimed to conduct a bibliometric analysis of all articles regarding RIRS published between 1980 and 2019. Materials and Methods: The literature search was performed using only the following keywords: "RIRS" and "flexible ureterorenoscopy/flexible ureteroscopy", in the "title" part of the search. Using this search method, all the articles published between 1980 and 2019 on this topic were accessed and downloaded from the Web of Science database, and the articles were analyzed using bibliometric methods. Results: Totally, 1378 publications were found as a result of the literature search, of which 619 were articles. We noted that there has been a rapid increase in the number of publications, especially from the year 2011. Turkiye was found to be the most productive country with regard to RIRS. The journals that contributed most to the literature were: Journal of Endourology, Urology, Journal of Urology, Urolithiasis, and World Journal of Urology. Conclusion: One of the notable findings of this study is that Turkiye is among the world countries that produced the highest number of publications with regard to this topic and that the hospitals where this technique is used the most are located in Turkiye. [ABSTRACT FROM AUTHOR]

Objective: Ureteral stents inserted to prevent obstruction to the flow of urine need to be removed after they serve the purpose of their insertion. The most commonly practiced method for stent removal is using a rigid cystoscope in an office setting. However, it is quite painful and may require general anesthesia especially in males. Due to their small caliber, rigid ureteroscope can reduce patient discomfort during ureteral stent retrieval procedure. In this study, we compared the pain scores during ureteral stent retrieval using a rigid cystoscope and a rigid ureteroscope. Materials and Methods: A prospective study was conducted with 64 male patients with ureteral stents who were divided into two groups. Group A had 36 patients who underwent stent retrieval with rigid cystoscope while group B had 28 patients who underwent with rigid ureteroscope. Pain experienced during the procedure and during the first void thereafter were recorded using visual analog scale. Results: The patients who underwent stent retrieval using rigid cystoscope (mean 7.05±1.21) had a significantly higher (p<0.0001) pain score compared to those who underwent it using rigid ureteroscope (mean 2.57±1.04). The pain scores during the first void after the procedure as reported by patients in groups A and B were 6.58±1.27 and 3.03±0.96 (p<0.0001), respectively. Conclusion: Rigid ureteroscopic stent retrieval is a less painful, safe, and dependable method, with a reduced requirement for postoperative analgesics as compared to rigid cystoscopic stent retrieval. [ABSTRACT FROM AUTHOR]

Copyright of Yeni Üroloji Dergisi is the property of Ali Ihsan Tasci and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: In this study, it was aimed to show the changes in the sexual function of the male patients who underwent ureterorenoscopic (URS) and who had JJ stent (DJS) because of ureteral calculi and their spouses before and after the procedure. Methods: The male patients and their spouses who were admitted to the Urology Outpatient Clinic of Eskişehir State Hospital between May and August 2018 due to unilateral ureteral stones were included in the study. In order to determine sexual life, all of the male patients filled the International Index of Erectile Function (IIEF) form while their spouses filled the Female Sexual Function Index (FSFI) form. The patients with DJS and their spouses completed the forms just before the removal of DJS while the patients without DJS and their spouses filled the same forms 4 weeks after the procedure. The patients who were applied DJS after the operation of URS were defined as the study group, the patients who were not applied DJS after the operation of URS were defined as the control group. Results: Thirty one (34.4%) of 90 males who participated in the study were included in the study group. Fifty nine males (65.6%) without DJS included in the control group. There was no statistically significant difference between preoperational and post-operational scores of the male patients and their spouses on the scales of IIEF and FSFI, respectively (p>0.05). There was statistically significant decreases in the postoperational total and subscale scores of the male patients on the IIEF scale and the female patients on the FSFI scale compared to their total and subscale pre-operational scores (p<0.001). Conclusion: The male patients should be informed about their sexual life before endo-urologic procedures while their spouses should be informed about their sexual life after the procedure. DJSs should not be inserted except unavoidable circumstances; if they are inserted, they should be removed as soon as possible for minimizing their effects on the sexual lives of couples. [ABSTRACT FROM AUTHOR]

Background: In this study, we aimed to investigate the treatment outcomes and safety profile of flexible and semi-rigid ureteroscopy performed for the treatment of proximal ureteral calculi smaller than 10 mm. Materials and Methods: Patients who underwent ureteroscopy in our clinic between 2013 and 2019 for proximal ureteral stones smaller than 10 mm were assessed retrospectively. Patients were divided into two groups with regard to ureteroscopy type. Each group were compared in terms of demographic, operative and postoperative parameters and success rates. Results: No differences were found between flexible (266) and semirigid ureteroscopy (116) groups in terms of demographic features and stone sizes. Mean operative times were 45±10.9 minutes and 37.2±10.2 minutes for flexible and semi-rigid ureteroscopy groups, respectively. Success rates were %91,4 (266/243) in flexible ureteroscopy group and %79.3 (116/92) in semi-rigid ureteroscopy group. No differences were detected in terms of complication rates (10.5% in flexible, 16.4% in semi-rigid group). Conclusion: Given its high success rate, flexible ureteroscopy appears to be more advantageous than semirigid ureteroscopy for treatment of proximal ureteral stone smaller than 10 mm. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Reconstructive Urology is the property of Turkiye Klinikleri and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: To report our ureteroscopic laser lithotripsy experiences in the treatment of symptomatic ureter stones in pregnants which do not respond to conservative treatment Methods: A total of 6 pregnants aged between 22-33 years in second or third trimester were studied. Holmium- YAG laser lithotripsy was performed with 6.5 F semirigid uretroscope. Results: The diagnosis of ureter stone was made with abdominal ultrasonography in 5 patients and with magnetic resonance in one patient. Adequate stone fragmentation was performed in 2 mid-ureter and 4 distal-ureter stones. J stent was applied in one patient after the fragmentation process. The mean operation time was 24.8 ± 10.0 minutes after the entry of bladder with ureteroscope under spinal anesthesia. No urologic, anesthetic or obstetric complication was seen and all patients gave healthy birth at term. Conclusion: Fine calibrated ureteroscopes for the treatment of ureter stones in pregnants are fast and effective treatment modalities which decrease the operation time and remove difficulties in entering the ureter. [ABSTRACT FROM AUTHOR]

Urinary stone disease is a common health problem in the community. In the last two decades, percutaneous nephrolithotomy (PNL), extracorporeal shock wave lithotripsy (ESWL), and retrograde intrarenal surgery (RIRS) have become popular as minimally invasive methods. The European Association of Urology 2014 urinary stones guideline recommends PNL as the first line of treatment for kidney stones above 20 mm. ESWL remains the first choice for stones of <1 cm within the renal pelvis and upper or middle calices. For kidney stones between 10 to 20 mm, the location and movement of the stone, stone type, calyx anatomy, and patients status contribute to the choice of treatment. RIRS in combination with holmium YAG laser is effective and safe. Initially, RIRS was offered for was lower calyceal stones, multiple stones, post-ESWL failure, comorbid illnesses, reduction in the diameter of development of surgical experience ureteroscopy, the development of optics providing better visibility, and the diversification of the equipment. At present, RIRS has become an alternative treatment modality to other minimally invasive therapy. It is thought that advances in technology will lead to more flexible instruments and surgical equipment for RIRS therapy. [ABSTRACT FROM AUTHOR]

Objective: We aimed to compare the effectiveness of holmium YAG laser and pneumatic lithotripsy in the treatment of ureteral stones. Material and methods: A total of 216 patients who had established indications of ureteroscopy between November 2011 and June 2012 were included in this study. Patients' files were retrospectively reviewed by dividing cases as groups that underwent pneumatic (PL) or laser lithotripsy (LL) procedures. Age, sex, stone burden and localization, duration of follow-up, operative times were evaluated. Stone-free rates were evaluated by ureteroscopical examination, postoperative scout films and ultrasonography. Results: Group PL consisted of 109 and group LL of 107 patients. Median age was 43.93±15.94 years in Group PL and 46.15±14.54 years in Group LL. Male to female ratio, stone burden and localization were similar for both groups. Overall success rate was 89.9% in Group PL and 87.9% in Group LL, respectively (p<0.791). With the aid of additional procedures, success rate was 100% for both groups at the end of the first month. Groups were not different as for operative time, rate of insertion of an ureteral catheter and its removal time. Hospitalization period was apparently somewhat shorter in Group LL (p=0.00). Conclusion: Pneumatic lithotripsy can be as efficacious as laser lithotripsy and be used safely in the endoscopic management of ureteral stone. In comparison of both methods, we detected no differences as to operative time, success of operation and the time to removal of the catheter, however, hospitalization period was shorter in Group LL. [ABSTRACT FROM AUTHOR]

Objective: Ureteroscopic lithotripsy (URSL) is a common treatment alternative in ureteral stones. We aimed to evaluate pneumatic and laser lithotripsy techniques, which are used for fragmentation of stones. Materials and methods: The data of 100 patients who underwent URSL by using pneumatic and laser lithotriptors were analyzed. The sample divided in 2 groups, each including 50 patients. URSL was performed in lithotomy position under general anesthesia. The absence of residual stone at second week urinary system graphy was accepted as the criteria of success. We evaluated the presence of differences in terms of efficiency and cost-effectivity of pneumatic and laser lithotripsy techniques. Results: The mean ages were 42 and 45 years, respectively. The mean operation time was 43.1 min in pneumatic group and 40 min in laser group. Stone-free rates were found 93.9% and 78%, respectively. The stone migration rate was determined 16% in pneumatic group and 4.1% in laser group. Complication rates were 4.1% in pneumatic group and 8% in laser group. The cost analysis showed that pneumatic lithotriptor device cost 10000 TL and laser lithotriptor system cost 76000 TL. Nevertheless, the Social Security Administration paid the same cost for both lithotripsy techniques. Conclusion: Higher stone-free and lower stone migration rates were determined in laser lithotripsy application. Therefore, low incidence of the requirement of subsequent secondary treatments for residual stones in laser treatment decreased the treatment costs. Nevertheless, the cost is significantly higher in laser technique. It requires more detailed studies. [ABSTRACT FROM AUTHOR]

Objective: We aimed to search for the outcome of the ureteroscopic procedures performed for ureteral stones at our department, and discuss the necessity of intraoperative ureteral stent placement. Material and Methods: One hundred and sixtyone cases who underwent ureteroscopic ureterolithotripsy between the years 2004 and 2007 were evaluated in terms of location and size of the stones, pre and postoperative ureteral and calyceal dilatation, use of ureteral stents, and the outcome. Results: Our series included 121 males and 40 females whose mean age was 37,4±16,2 years. Eightyfour and 71 of the stones were on the right and left sides respectively whereas 6 patients had bilateral. Stones were located in the lower, middle, and upper part of the ureter in 84, 67, and 10 patients, respectively. Sixtyfive of the cases had proximal dilatation. Stones were =10 mm in 63 patients. Ureteral stents were placed in 22 patients due to the ureteral strictures or traumatic procedure. Ureteral stents were not required in 145 cases who did not have above-mentioned indications. A direct urinary system radiograph for residual fragments on the first postoperative day, and an ultrasound for upper tract dilatation on the 15th postoperative day and thirth month were obtained. Of the patients in whom no ureteral stent was placed intraoperatively, 3 needed stents due to severe pain and/or persistent upper tract dilatation (suspicion for obstruction) postoperatively. Conclusion: Routine intraoperative ureteral stent use during a ureteroscopic lithotripsy is not required except for traumatic procedures and patients with severe ureteral strictures. This is a cost-effective approach as well. [ABSTRACT FROM AUTHOR]

Objective: To determine the efficiency of rigid ureteroscopy and pneumatic lithotripsy in ureteral stones. Materials and methods: We retrospectively evaluated 349 patients (356 renal units) with ureteral stones treated with rigid ureteroscopy and pneumatic lithotripsy. Results were evaluated 3 months after treatment by using excretory urography and/or ultrasonography. Complications and treatment success according to stone localization were compared. Results: The mean age of the patients was 43.2 (range 17-80). Of the patients 236 (66.6%) were male and 113 (33.4%) were female. Of the stones 271 (76.1%) were localized to lower ureter, compared to middle ureter in 51 (14.3%) and upper ureter in 34 (9.6%). The mean stone diameter was 13.6 (range 5-30) mm. The mean stone free rate was 92.4% (79.4% in upper ureter, 94.1% in middle ureter and 93.7% in lower ureter, p=0.020). Overall complication rate was 7.6% (7.7% in lower ureter, 3.9% in middle ureter and 11.8% in upper ureter, p=0.413). Most common peroperative complications of the procedure were infection 2.6% (n=9), ureteral perforation 4% (n=14), and mucosal laceration 1.1% (n=4). The most common late complication was ureteral stricture in 1.1% (n=4) of patients. Patients with lower ureteral stone were divided into two groups according to stone size; Group 1 ≤10 mm (n=154) and Group 2 >10 mm (n=117). Although statistically insignificant, overall stone free rate (95.5% vs 91.5%, p= 0.178) was higher and complication rate (5.2% vs %11.1, p=0.071) was lower in Group 1. Conclusion: Ureteroscopic treatment of ureteral stones with pneumatic lithotripsy and rigid ureteroscopy applied in all localizations provides high success rates, quick stone clearance, short hospital stay, and low complication rates. In the lower ureteral localization, stone size does not affect the overall stone free and complication rates when treated with rigid ureteroscopy and pneumatic lithotripsy. [ABSTRACT FROM AUTHOR]

Objective: The prevalence of urinary system stone disease is 1-13% worldwide with a steady increase parallel to the increasing modern life style. Turkey is among the countries where the disease is endemic. In this study adequacy of technical equipment used in diagnosis and treatment of ureteral stone along with treatment approaches were evaluated. Materials and methods: A total of 106 urology residents and specialists practicing in 10 different urology departments of training hospitals in Istanbul were asked to fill a questionnaire to evaluate the adequacy of necessary equipment and the treatment approaches in terms of diagnosis and treatment of ureteral calculi. Results: More than 6 patients per month have been evaluated by the 78% of physicians participated to the study. All physicians had rigid ureterorenoscope and pneumatic lithotriptor in their clinics. While plain radiography of urinary system was the inital imaging choice for 63% of these physicians for patients with renal colic; 14% of them stated that they have to use a different imaging technique other than they aimed due to technical availability. For medical expulsive treatment 90% of the doctors were using alpha-blockers among which tamsulosin was the most commonly preferred one. Conclusion: Technical systems necessary for an efficient ureteral stone management seems to be adequate in clinics of physicians involved in this study. Answers given to questions regarding the diagnosis and treatment of ureteral stones were generally compatible with the existing literature data. [ABSTRACT FROM AUTHOR]

Objective: It was aimed to compare the clinical efficacy of Stone Cone™ and NTrap™ for preventing retropulsion in ureterorenoscopic stone surgery. Materials and methods: Stone Cone™ or NTrap™ were used randomly in patients who were operated with uretroscopic method for ureter stone in our clinic between June 2008-August 2009. Routine procedures that are used in ureterorenoscopic stone surgery were applied to all patients. The patients who had opaque, upper ureteral stones were included in this study. Stone Cone™ catheter was used in 72 patients, NTrap™ catheter was used in 57 patients. The existence of a stone that was larger or equal to 4 mm and/or migrated proximally in the urinary system radiograpy at postoperative 24 hours were accepted as failure. Results: Catheter couldn't be passed to the proximal of the stone in 4 (%5.6) of 72 cases with Stone Cone™ and in 8 (%14) of 54 cases with NTrap™. Proximal retropulsion of the stone was seen in 7 (%10.3) of 68 cases and in 2 (%4.1) of 49 cases that Stone Cone™ and NTrap™ could be used respectively. According to these two criteria, Stone Cone™ was successful in 61 (%84.7) of 72 cases, NTrap™ was successful in 47 (%82.4) of 57 cases. There was no statistically significant difference between two products in term of the success rates (p>0.05). Conclusion: Both of these products are the catheters that can be used safely in ureterorenoscopic surgery and increase the surgery success significantly. No statistically significant difference was found between Stone Cone™ and NTrap™ in terms of clinical efficacy. [ABSTRACT FROM AUTHOR]

Objectives: We retrospectively evaluated our rigid ureteroscopy (URS) treatment results in ureteric stones and assessed its effectiveness concerning ureteric stone localisation. Materials and methods: Overall, 101 patients were retrospectively evaluated including lower (n=69), mid (n=23) and upper ureteric (n=9) stones which were treated with rigid URS (Wolf 8.0-9.8Fr, Germany) in our hospital between January 2007- June 2009. Stones were removed by stone forceps/basket catheter either as single piece or fragmented by pneumatic lithotripsy (EMS-Swisslithoclast-Master). Results: Mean patient age was 45.1 (19-78) years. Stones were located in the right (n=52) and left (n=49) ureters, respectively. Mean stone size was 7,4 mm (5-15). Of the 9 patients with upper ureteric stones, 7 were (77.8%) stone-free. However, stone migrated into renal pelvis in two patients but passed into ureter again in the follow-up and removed by URS. Of the 23 patients with mid-ureteric stones, 22 were (95.7%) stone-free. Ureter perforation occurred in one patient and ureteroneocystostomy was performed. Of the 69 patients with lower ureteric stones, 68 were (98.6%) stone-free. Ureter perforation occurred in one patient and healed spontaneously by ureter catheter replacement. Stone was removed afterwards by URS. Overall (n=101), ureter perforation occurred in 1.9% (n=2) in our series. Resistant urinary tract infection developed in one patient (0.9%) (P.aeroginosa). Conclusion: Due to results of this preliminary study, rigid URS and pneumatic lithotripsy can be performed successfully particularly in lower ureteric stones. However, as stone location shifts to upper ureter, success rate decreases. Although URS can be performed safely with low complication rates in the treatment of ureteric stones, severe complications like ureter perforation might occur. [ABSTRACT FROM AUTHOR]