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Copyright of Acibadem Saglik Bilimleri Dergisi is the property of Acibadem University Medical School 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 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: Water for human consumption is water that is used for all kinds of human needs in its original form or after processing. In this study, it was planned to examine the effect of sociodemographic characteristics and drinking water preferences of individuals on kidney stone formation. Methods: In this cross-sectional study, 237 patients aged 18-55 years who applied to Karabük Training and Research Hospital Family Medicine Outpatient Clinic in 2020 were included. Individuals who had undergone renal ultrasonography (USG) for any reason in the last six months were included in the study. Patients with diabetes mellitus (DM), hypertension (HT), acute and chronic renal failure (AKI and CRF) were excluded. Sociodemographic characteristics of the participants such as age, gender, occupation, the type of drinking water they used, the average amount of water consumed per day, the criteria affecting the water preference of those using ready-to-drink water and ultrasonography results were recorded. Mann-Whitney U test was used for two-group comparisons and Kruskall-Wallis H test was used for comparisons with three or more groups. The relationship between categorical variables was analyzed by Chi-Square analysis. Results: 51.1% of the participants were male, 38.8% were primary school graduates, 38.8% were unemployed, 67.5% were married, 79.2% lived in an apartment building, 55.5% had a family structure consisting of 3-4 people. 40.1% of the participants preferred ready-to-drink water. Ultrasonography of the participants revealed that 14.8% had urinary calculi. Of the individuals with stones, 17.2% were female, 19.6% were primary school graduates, 18.8% were self-employed, and 33.3% were widowed/divorced. Among the individuals with stones, 26% used tap water as drinking water. The likelihood of stones in renal ultrasonography increased significantly with increasing age. Conclusion: It was found that the individuals with stones in the renal system were more likely to be female, primary school graduates, widowed/divorced and consumed tap water as drinking water. In terms of drinking water consumption, it should be paid attention that tap water has been analyzed. Water should not be consumed from sources that do not meet the reliability conditions and the water source with the highest suitability should be preferred. [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.)

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.)

Aim: Shockwave lithotripsy is a painful procedure and requires adequate analgesia. This study aimed to determine the effect of effective pain management in extracorporeal shock wave lithotripsy on objective parameters such as radiation dose and operation time. Material and Method: A total of 202 patients were included in the study. The patients were divided into two groups. The first group was administered a triple analgesia combination (hyoscine N-butylbromide, metamizole, pethidine) for adequate pain control. The second group was administered diclofenac sodium alone. Results: There were 100 patients in group 1 and 102 in group 2. There was a statistically significant difference between the groups in the duration of treatment, lithotripsy period, frequency of shock waves, and radiation doses used (p<0.05). Conclusion: Effective pain management in ESWL reduces the procedure time, period, and radiation dose, thus increasing the success of the treatment. [ABSTRACT FROM AUTHOR]

Objective: Urinary system stone diseases are common in our country and in the world. The flexible ureterorenoscope (flex URS) was first described by Marshall in 1964 and took its place in the guidelines as a surgical technique in 1987 with the advancing technology. Its indications are expanding rapidly. In this study, the data of patients who underwent retrograde intrarenal surgery (RIRS) in our clinic were evaluated retrospectively. Material and Method: Demographic data, stone sizes, localizations, fluoroscopy duration, stone-free rates and postoperative complications of 106 patients who underwent RIRS in the urology clinic of Süleyman Demirel University Faculty of Medicine (SDU) between March 2017 and January 2019 were evaluated retrospectively. After the procedure, all patients were evaluated with direct urınary system graphy and computer tomography imaging methods 4 weeks later. Results: The median age of 106 patients (66 males, 40 females) who underwent RIRS was 52 (23-73 years) and the mean stone size was calculated as 13.9 (7-19) mm. The mean duration of operation and fluoroscopy were respectively;74 (30-135 minutes is 62 (20-136) seconds. None of the patients had a DJ catheter before the procedure, but a DJ catheter was placed in all patients at the end of the procedure and the catheter was removed under local anesthesia 4 weeks later. A second session was performed in 11 (10.3%) cases due to ureteral stenosis and in 8 (7.5%) cases because of residual stones. calyx, 40 (37.7%) lower calyx, 38 (35.8%) cases were found in the renal pelvis. It was found that 82.1% of our patients were stone-free in the first session. After the second session, the stone-free rate was 92.5%. Conclusion: RIRS is a reliable method in terms of efficacy and complications in stone surgery. It is an important surgical alternative especially in ESWL resistant stones, obese patients with musculoskeletal deformities, solitary kidney stones, pregnancy and bleeding diathesis. Considering the advantages of the technique together with the technological advances, we think that it will be used more actively and become widespread in the future. [ABSTRACT FROM AUTHOR]

Purpose: The incidence of pediatric nephrolithiasis/urolithiasis (NL/UL) has increased in the last few decades due to dietary habits and a sedentary lifestyle. This study aimed to determine the etiological factors and six months of follow-up results of patients with NL/UL in pediatric nephrology and urology clinics in our center. Materials and Methods: Children with NL/UL between December 2018 and December 2020 were enrolled in this study. The medical records were reviewed to collect data about admission complaints, consanguinity, metabolic risk factors for NL/UL, medical treatments, surgical interventions, and presence of stones after 6 months of follow-up. Results: A total of 93 patients (46 male and 47 female) were included in the study. Consanguinity and a positive family history for stones was present in 46.2% and 78.5% of patients, respectively. The urinary metabolic risk factors were hyperuricosuria (11/83, 13.3%), hypercalciuria (12/93, 12.9%), hyperoxaluria (6/51, 11.8%), cystinuria (7/90, 7.8%), and hypocitraturia (2/41, 4.9%). Twenty patients (29.9%) with NL/UL and without cystinuria received potassium citrate therapy. After 6 months of follow-up (n = 27) of these patients, stone progression was not observed in any of the patients who received potassium citrate treatment (n=11) or underwent surgical intervention (n=10). Conclusions: Most patients had a family history of stones. Hyperuricosuria was the most common urinary risk factor for NL/UL. Potassium citrate therapy might be useful to prevent stone progression in patients with NL/UL.

Amaç Bu çalışmada böbrek taşı tedavisi için kliniğimizde retrograt intrarenal cerrahi(RİRC) uygulanılan geriatrik yaş grubu erkek hastaların etkinlik ve güvenlik sonuçlarının, daha genç yaş hasta grubu ile karşılaştırılarak sunulması amaçlanmıştır. Gereç ve Yöntem Kliniğimizde böbrek taşı nedeniyle RİRC uygulanmış olan, 40 yaş üzeri erkek hastaların verileri retrospektif olarak değerlendirildi. Hastalar yaşlarına göre iki gruba ayrıldı: 40-64 yaş (Grup 1) ve 65 yaş ve üzeri (Grup 2). Komorbidite değerlendirilmesi için anestezi risk skoru (ASA) ve modifiye Charlson komorbidite indeksi (MCKİ) kullanıldı. Hastanenin kayıt sisteminden ve hastaların dosyalarından genel bilgiler, komplikasyon bilgileri, renal anormallik varlığı, taşın bulunduğu böbrek ve lokalizasyonu, taşın dansitesi, taşın boyutu, taş sayısı verileri ve postoperatif taş temizlenme verileri elde edildi. Bulgular Çalışmaya 233 tanesi Grup 1 (40-64 yaş) ve 61 tanesi Grup 2 (65 yaş ve üstü) olmak üzere toplam 294 hasta alınmıştır. ASA ve MCKİ skorları bakımından Grup 2’de yer alan hastaların skorları Grup 1’e göre istatistiksel olarak anlamlı olarak daha yüksek olarak bulunmuştur (sırasıyla p=.000, p=.000). Gruplar arasında taş dansitesi, taş boyutu, taş hacmi, operasyon süresi, hastanede yatış süreleri ve postoperatif taşsızlık oranları bakımından fark bulunmamıştır. Grup 1’de toplam 25 (%10.7) hastada ve Grup 2’de toplam 10 (%16.4) hastada komplikasyon geliştiği tespit edilmiştir ve gruplar arasında genel komplikasyon oranları açısından istatistiki fark bulunmamıştır (p=.265). Sonuç Dünya nüfusunun giderek yaşlanması ile beraber bu hasta grubunun hastalıklarının da en uygun tedavi metodlarıyla tedavi edilmesinin önemi artmıştır. Çalışmamızda RİRC yöntemi ile böbrek taşı tedavisi yaşlı hasta grubunda da güvenli ve etkili olarak çıkmıştır.

Background: this study, we aimed to investigate the efficacy and safety of (Retrograde Intrarenal Surgery) RIRS in patients over 65 years of age. Materials and Methods: 107 patients over 65 who underwent RIRC in our clinic were evaluated retrospectively. The patients were divided into two groups, according to whether there were complications (Group 1: without complications, Group 2: with complications) and according to age (Group 1: 65-74 years, Group 2: 75 years and above). The groups were compared with each other regarding stone-free rate, complication rate, stone characteristics, and hospital stay. Results: When divided into groups according to age, no difference was observed between group 1 (65-74 years old) and group 2 (75 years and older) in terms of American Society of Anesthesiogists score, stone size, number of stones, and Hounsfield unit of the stone. On the other hand, it was observed that the hospital stay and complication rate of group 2 were higher than group 1. (p value 0.01 and 0.02, respectively). The patients were divided into two groups according to whether there were complications. There was no significant difference in ASA score, Hounsfield unit of stone, and stone-free rate between group 1 (without complications) and group 2 (with complications). (p value respectively: 0.127, 0.915, 0.379 ) Conclusions: The number of elderly patients with kidney stones is increasing day by day. The most appropriate and reliable treatment modalities gain importance in treating kidney stones in these patients. The result of our study revealed that RIRC is an effective and safe procedure in geriatric patients with kidney stones. [ABSTRACT FROM AUTHOR]

Objective: In urology guidelines, endourological treatments such as percutaneous nephrolithotomy (PCNL) and retrograde intrarenal surgery (RIRS) are recommended for lower pole stones with a diameter of 10-20 mm, especially in cases where extracorporeal shock wave lithotripsy (SWL) fails or SWL is not appropriate. In this study, we compared the results of patients who underwent RIRS and mini percutaneous nephrolithotomy (m-PCNL) for lower pole stones with a diameter of 10-20 mm. Material and Method: The data of 187 patients (116 RIRS, 71 m-PCNL) who underwent endourological treatment (RIRS or m-PCNL) for 10-20 mm lower pole kidney stones between 2020 and 2022 were retrospectively analyzed. To avoid preoperative biases, propensity score-matching was applied based on a 1:1 ratio. According to the results of the analysis, 65 patients who underwent RIRS and 65 patients who underwent m-PCNL were included in the study. Intraoperative (operation time, fluoroscopy time) and postoperative findings (hospitalization time, drop in hematocrit, stone-free rates, and complications) were compared between the two groups. Postoperative stone detection of 4 mm or larger was defined as clinically significant residue. Complications were classified according to the Clavien scoring system and as intraoperative-postoperative. Results: When the two groups were compared in terms of demographic characteristics (age, gender, body mass index) and radiographic stone characteristics (stone size, stone laterality, stone opacity, and stone density), no statistically significant difference was observed. When the groups were compared in terms of operation time, fluoroscopy time and hospitalization time, these periods were statistically significantly shorter in the RIRS group (p<0.001). In addition, the decrease in the amount of hematocrit in the RIRS group was significantly less than in the m-PCNL group (p<0.001). When the postoperative stone-free rates and intraoperative and postoperative complication rates were examined, it was seen that the results in both groups were similar. Conclusion: RIRS operation is an effective and successful endourological treatment alternative with stonefree rates and complication rates similar to m-PCNL operation in lower pole kidney stones between 10-20 mm. However, the fact that the RIRS operation has shorter operation, fluoroscopy and hospitalization times compared to the m-PCNL operation and causes less blood loss shows that it can be applied more reliably. [ABSTRACT FROM AUTHOR]

Copyright of Pamukkale Medical Journal is the property of Pamukkale Journal of Medicine 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 Pamukkale Medical Journal is the property of Pamukkale Journal of Medicine 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: The aim of this study is to examine the incidence of kidney stones, mortality status, length of stay in the intensive care unit and length of hospitalization according to the gender and age of the patients hospitalized in the intensive care unit. Materials and Methods: This study was designed as a retrospective cross-sectional study. Between 2020-2021, Health Sciences University Sanliurfa Mehmet Akif İnan Education Research Hospital was carried out with 376 patients between the ages of 10-94 who applied to the hospital. In the scope of the study, gender, age, renal stone or cyst status as a result of imaging, mortality status, duration of intensive care hospitalization, and hospitalization period of the patients were recorded. Data were analyzed using Chi-square, ANOVA and independent t-test. Results: According to the findings, the overall incidence of kidney stones in the patients participating in this study was found to be 7%. In this study, when the incidence of kidney stones in female and male patients was examined, it was found as 6% in female patients and 8% in male patients. However, this difference was not statistically significant. It has also been understood that the incidence of kidney stones increases with age. The mortality rate of those with kidney stones was found to be 2%. Conclusions: The findings obtained at the end of this study show parallels with the literature. Due to the different geography and patient profile of the study, the existing data were supported by different demographic data. [ABSTRACT FROM AUTHOR]

Copyright of Pamukkale Medical Journal is the property of Pamukkale Journal of Medicine 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: Supine Percutaneous Nephrolithotomy (PCNL) is a minimally invasive method that is frequently used in the treatment of kidney stones larger than 2 cm. It has been suggested that one of the risk factors that may affect the success of PCNL is the stone to skin distance (SSD). We aimed to investigate the effect of SSD on surgical outcomes in patients who underwent supine PCNL surgery. Material and Method: One hundred and thirteen patients who underwent PCNL operation in the Galdakao modified supine Valvidia position between January 2017 and October 2021 were included in this study. Patients' demographic information, stone characteristics, SSD, operation time, fluoroscopy time, complications and hospital stay data were collected retrospectively from the hospital database. The patients were divided into 2 groups according to the median skin to stone distance (11.80 cm (min-max: 8.20-13.10)). Patients with SSD ≤11.80 cm formed Group 1 (n = 64) and patients with SSD>11.80 cm formed Group 2 (n =49). Results: The mean age of 113 patients included in the study was 45.17±15.2 years. BMI in Group-1 was significantly lower than Group-2 (28.37; 29.89, p <0.0001). It was found to be significantly shorter in SSD than in Group-1 (9.77 mm; 12.48 mm, p <0.0001). Although stone-free rates were high in Group-1, this was not statistically significant (84.3%; 79.6%, p =0.663). There was no significant difference between the groups in secondary interventions (p >0.05). Conclusion: According to our data, SSD has no effect on success rate, complications, hospitalization time, fluoroscopy time and re-operation rates in supine PCNL surgeries. [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.)

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.)

Purpose: The incidence of pediatric nephrolithiasis/urolithiasis (NL/UL) has increased in the last few decades due to dietary habits and a sedentary lifestyle. This study aimed to determine the etiological factors and six months of follow-up results of patients with NL/UL in pediatric nephrology and urology clinics in our center. Materials and Methods: Children with NL/UL between December 2018 and December 2020 were enrolled in this study. The medical records were reviewed to collect data about admission complaints, consanguinity, metabolic risk factors for NL/UL, medical treatments, surgical interventions, and presence of stones after 6 months of follow-up. Results: A total of 93 patients (46 male and 47 female) were included in the study. Consanguinity and a positive family history for stones was present in 46.2% and 78.5% of patients, respectively. The urinary metabolic risk factors were hyperuricosuria (11/83, 13.3%), hypercalciuria (12/93, 12.9%), hyperoxaluria (6/51, 11.8%), cystinuria (7/90, 7.8%), and hypocitraturia (2/41, 4.9%). Twenty patients (29.9%) with NL/UL and without cystinuria received potassium citrate therapy. After 6 months of follow-up (n = 27) of these patients, stone progression was not observed in any of the patients who received potassium citrate treatment (n=11) or underwent surgical intervention (n=10). Conclusions: Most patients had a family history of stones. Hyperuricosuria was the most common urinary risk factor for NL/UL. Potassium citrate therapy might be useful to prevent stone progression in patients with NL/UL. [ABSTRACT FROM AUTHOR]

The diagnosis and detection of kidney stones in medical images are important in terms of determining disease progression and treatment methods. Noisy and lowresolution Abdominal Computed Tomography (CT) images are factors that complicate the diagnosis of kidney stones. The goal of this study is to determine the borders and number of stones found in the kidney on abdominal CT images. Firstly, the Gamma Correction method is used to sharpen CT images and eliminate noise. Secondly, the kidneys are selected manually using the Region of Interest (ROI) method. The detection of kidney stones is carried out by applying a threshold to the selected kidney regions. By applying morphological erosion and dilation processes to the stones within the limits of the kidney, the stones detected adjacent in the image are separated, and the stones are counted. The confusion matrix is created to calculate the performance of the study. In the performance analysis of the proposed method, the Accuracy, Sensitivity, and Specificity values using the Confusion Matrix are calculated at 97%, 96%, and 100%, respectively. The results show that the proposed method is successful in detecting and counting kidney stones. [ABSTRACT FROM AUTHOR]

Objective: Cystinuria is a rare genetic disorder. Many patients suffer from significant recurrent urolithiasis, repeated surgical interventions, and the risk of progressive renal impairment. In the current study, the outcomes of patients with cystine stones were investigated. Material and Methods: A total of Twenty-six cystinuria patients with cystine stones, aged between 3 months and 18 years, in our Pediatric Nephrology Department, were retrospectively analyzed. Results: The mean age of patients at diagnosis was 45.2±45.5 months and 88,5% were male. Sixteen (62%) children had recurrent urinary tract infections. Only 10 (38%) patients showed additional metabolic abnormalities. The urinary pH had significantly increased with treatment and the number of stone recurrence was lower in the patients with urinary pHs ≥ 6.5. There was a significant positive correlation between the last-visit serum creatinine level and the number of surgical interventions. There was no significant correlation between the last-visit eGFR and the number of surgical interventions. On the other hand, eGFR values decreases as the total number of surgical interventions increases. No stone events were observed at the end of the follow-up period in 10 patients (38%) and the stone events per patient-year were 0.36 for all patients. Four patients with low eGFRs at the beginning of the study get normal with treatment after the follow-up period. Conclusion: Cystinuria has significant morbidity if not controlled properly. Despite all treatments, it should be kept in mind that renal impairment may develop in cystine stones with cystinuria and surgical treatment should be planned by considering minimally invasive options. [ABSTRACT FROM AUTHOR]

Objective: In this study, it was aimed to present the efficacy and safety results of geriatric male patients who underwent retrograde intrarenal surgery (RIRC) in our clinic for the treatment of kidney stones, by comparing them with the younger age group. Material and Methods: The data of male patients over 40 years of age who underwent RIRC for kidney stones in our clinic were evaluated retrospectively. The patients were divided into two groups according to their age: 40-64 years (Group 1) and 65 years and older (Group 2). The data on the comorbidity status of the patients were compiled from their files. American Society of Anesthesiologists score(ASA) and modified Charlson comorbidity index(MCCI) were used for comorbidity assessment. General information, complication information, presence of renal abnormality, kidney and location of the stone, density of the stone, size of the stone, number of stones and postoperative stone clearance data were obtained from the hospital’s registry system and the files of the patients. Results: A total of 294 patients were included in the study, of which 233 were in Group 1 (40-64 years old) and 61 in Group 2 (65 years and older). In terms of ASA and MCKI scores, the scores of the patients in Group 2 were found to be statistically significantly higher than Group 1 (p<0.001, p<0.001, respectively). There was no difference between the groups in terms of preoperative DJ catheter set, presence of renal abnormalities and non-functioning kidneys. There was no difference between the groups in terms of stone density, stone size, stone volume, operation time, hospital stay, and postoperative stone-free rates. Complications were detected in 25 (10.7%) patients in Group 1 and in 10 (16.4%) patients in Group 2, and there was no statistical difference between the groups in terms of overall complication rates (p=.265). Conclusion: With the aging of the world population, the importance of treating the diseases of this patient group with the most appropriate treatment methods has increased. In our study, kidney stone treatment with the RIRC method was found to be safe and effective in the elderly patient group. [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.)

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: Percutaneous nephrolithotomy (PCNL) is a minimally invasive surgical procedure recommended to remove kidney stones larger than 2 cm. Miniaturized nephroscopes developed over the years to treat pediatric kidney stones have been increasingly used in surgeries referred to as mini PCNL (mPCNL). This study will evaluate the success rates and results of mPCNL operations performed on adult patients. Materials and Methods: The study will examine mPCNL (20-24f) performed in the prone position on adults over 18 years old with kidney stones between January 2018 and June 2020. Further, the pre-operative (pre-op) and post-operative (post-op) features of 42 patients were retrospectively evaluated. The patients' features, including post-op stone-free status and complications, were determined and included in the research. Results: The mean age of the patients was 33.64 ± 6.8 years, and 18 (42.8%) of them had at least grade 1 hydronephrosis. The average stone size was 300 ± 26 mm². Three (7.1%) patients had a "staghorn" type stone. The mean operation time was 52 ± 18 minutes and post-op stone-free rate was present in 33 (78.5%) patients. Additionally, post-op blood transfusions were provided to three (7.1%) patients. Tubeless PCNL was not applied to any patients. After the removal of the nephrostomy tubes, double-J stents were placed in four (9.5%) patients for drainage and in another due to postoperative pyelonephritis. The average length of time a nephrostomy tube was used on patients was 2.5 ± 0.6 days. Conclusions: mPCNL should be one of the first options for resolving ureteral obstructions in adult patients with a high risk of bleeding or co-morbidities from the operation. Thus, it is a more reliable option that can be used to reduce the risk of complications. [ABSTRACT FROM AUTHOR]

Copyright of Erzincan University Journal of Science & Technology is the property of Erzincan Binali Yildirim Universitesi 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.)

ÖzetGiriş: Çocukluk çağı taş hastalığında en sık görülen taş tipi kalsiyum taşlarıdır ve genellikle altta yatan metabolik bir anormalliğe bağlı görülür. Kalsiyum taşlarının tedavisinde potasyum sitrat sık kullanılan bir tedavi seçeneğidir. Bu çalışmada kalsiyum taşı tanısı ile takip edilen ve hiperkalsiüri/hiperokzalüri/hipositratüriye ek olarak hipomagnezürisi çocuklarda potasyum sitrat tedavisi ile potasyum sitrat ve magnezyum kombinasyonunun etkinliği araştırılmıştır.Metod: Kliniğimizde üriner sistem taş hastalığı tanısı ile takip edilen hasta dosyaları geriye dönük incelendi. Metabolik taramada hiperkalsiüri/hiperokzalüri/hipositratüri (biri veya birden fazlası) anormalliklerine ek olarak hipomagnezüri saptanan hastalar çalışmaya dahil edildi. Hiperürikozüri, primer hiperokzalüri, sistinüri ile başlangıç taş boyutu ≤3 mm ve 2 yaşın altında olan hastalar çalışma dışı bırakıldı. Tedavide sadece potasyum sitrat kullanan grup ile potasyum sitrata ek olarak magnezyum tedavisi ilave edilen grup arasında tedavi öncesi ve sonrası taş boyutları, taş düşürme oranları ve tedavi süreleri karşılaştırıldı.Bulgular: Çalışmaya potasyum sitrat kullanan 14 hasta (grup I) ile potasyum sitrat ve magnezyum kullanan 15 hasta (grup II) olmak üzere toplam 29 hasta alındı. Grup I’de 9 kız ve 5 erkek, (yaş ortalaması 9.3±4.3 yıl), grup II’de ise 7 kız ve 8 erkek (yaş ortalaması 7.0±3.9 yıl) mevcuttu. Her iki grupta yaş ve cinsiyet açısından fark yoktu (p˃0.05). Tedavi süreleri açısından iki grup arasında fark bulunmadı (grup I, 3.2±1.2 ay vs. grup 2, 3.1±1.4 ay, p=0.872). Tedavi öncesi taş boyutları grup I’de ortalama 5.2±1.6 mm, grup II’de 5.1±0.9 mm iken, tedavi sonrası grup I’de 3.4±1.3 mm, grup II’de 4.6±1.6 mm idi. Tedavi sonrası taş düşürme grup I’de 2 hastada (%14.3), grup II’de ise 5 hastada (%33.3) gözlendi. Tedavi öncesi ve sonrası taş boyutları ile taş düşürme oranları açısından her iki grupta anlamlı fark saptanmadı.Sonuç: Kalsiyum taşlarında risk faktörlerine eşlik eden hipomagnezürinin tedavi edilmesi kısa dönemde çocukluk çağı taş hastalığında etkili bulunmamıştır.

ÖzetGiriş: Çocukluk çağı taş hastalığında en sık görülen taş tipi kalsiyum taşlarıdır ve genellikle altta yatan metabolik bir anormalliğe bağlı görülür. Kalsiyum taşlarının tedavisinde potasyum sitrat sık kullanılan bir tedavi seçeneğidir. Bu çalışmada kalsiyum taşı tanısı ile takip edilen ve hiperkalsiüri/hiperokzalüri/hipositratüriye ek olarak hipomagnezürisi çocuklarda potasyum sitrat tedavisi ile potasyum sitrat ve magnezyum kombinasyonunun etkinliği araştırılmıştır.Metod: Kliniğimizde üriner sistem taş hastalığı tanısı ile takip edilen hasta dosyaları geriye dönük incelendi. Metabolik taramada hiperkalsiüri/hiperokzalüri/hipositratüri (biri veya birden fazlası) anormalliklerine ek olarak hipomagnezüri saptanan hastalar çalışmaya dahil edildi. Hiperürikozüri, primer hiperokzalüri, sistinüri ile başlangıç taş boyutu ≤3 mm ve 2 yaşın altında olan hastalar çalışma dışı bırakıldı. Tedavide sadece potasyum sitrat kullanan grup ile potasyum sitrata ek olarak magnezyum tedavisi ilave edilen grup arasında tedavi öncesi ve sonrası taş boyutları, taş düşürme oranları ve tedavi süreleri karşılaştırıldı.Bulgular: Çalışmaya potasyum sitrat kullanan 14 hasta (grup I) ile potasyum sitrat ve magnezyum kullanan 15 hasta (grup II) olmak üzere toplam 29 hasta alındı. Grup I’de 9 kız ve 5 erkek, (yaş ortalaması 9.3±4.3 yıl), grup II’de ise 7 kız ve 8 erkek (yaş ortalaması 7.0±3.9 yıl) mevcuttu. Her iki grupta yaş ve cinsiyet açısından fark yoktu (p˃0.05). Tedavi süreleri açısından iki grup arasında fark bulunmadı (grup I, 3.2±1.2 ay vs. grup 2, 3.1±1.4 ay, p=0.872). Tedavi öncesi taş boyutları grup I’de ortalama 5.2±1.6 mm, grup II’de 5.1±0.9 mm iken, tedavi sonrası grup I’de 3.4±1.3 mm, grup II’de 4.6±1.6 mm idi. Tedavi sonrası taş düşürme grup I’de 2 hastada (%14.3), grup II’de ise 5 hastada (%33.3) gözlendi. Tedavi öncesi ve sonrası taş boyutları ile taş düşürme oranları açısından her iki grupta anlamlı fark saptanmadı.Sonuç: Kalsiyum taşlarında risk faktörlerine eşlik eden hipomagnezürinin tedavi edilmesi kısa dönemde çocukluk çağı taş hastalığında etkili bulunmamıştır.

GirişAtnalı böbrek, renal füzyon anomalilerinin en yaygın görülen tipidir. En sık görülen komplikasyonu ise böbrek taşlardır. Bu çalışmanın amacı, atnalı böbrek anomalisi olan hastalarda, renal taşların tedavisinde uygulanan perkütan nefrolitotomi (PNL) cerrahisinin sonuçlarını değerlendirmektir.Gereç ve YöntemlerÇalışmaya kliniğimizde 2014 ile 2018 yılları arasında, atnalı böbreğinde taş bulunan ve PNL yapılan yedi hasta dahil edildi. Hastaların yaş (yıl), cinsiyet, taş özellikleri (taş yüzey alanı, taraf ve lokalizasyon), operasyon süresi (dk), floroskopi süresi (dk), hemoglobin değişim miktarı, Hounsfield Ünitesi (HU) değerleri, nefrostomi alınma zamanı (gün), komplikasyonları ve rezidüel taşları değerlendirildi. Tüm hastalar için PNL genel anestezi altında prone pozisyonda gerçekleştirildi. Postoperatif 1. ayda, kontrastsız bilgisayarlı tomografi ile hastalar kontrol edildi. 4 mm'den büyük taşlar rezidü taş olarak kabul edildi. BulgularHastaların yaş ortalaması 50,50±2,12 (48-69) yıl idi ve hepsi erkekti. Ortalama taş yüzey alanı ve HU değerleri sırasıyla 441,50±156,20 mm2 ve 1317,50±123,70 olarak bulunmuştur. PNL yapılan hastaların ikisinde başarısız ekstrakorporeal şok dalga litotripsi (ext­racorporeal shock wave lithotripsy =ESWL) öyküsü vardı. Ameliyat sırasında veya postoperatif dönemde hiçbir hastada majör komplikasyon gelişmedi. Toplam rezidü taş oranı 42,80% (3/7). Sonuç Bizim sonuçlarımıza göre, PNL operasyonu atnalı böbreklerde güvenli ve etkili bir şekilde uygulanabilir.

Objective: The frequency of kidney stones is gradually increasing and it is endemic in our country. The aim of our study is to evaluate the clinical, laboratory, radiological and follow-up findings of children with kidney stones and to investigate the etiology and factors affecting prognosis. Methods: The files of 209 children who were followed up in the pediatric nephrology outpatient clinic for kidney stones were analyzed retrospectively. Demographic data, laboratory and radiological findings, and follow-up data of the patients were recorded. The patients were grouped by age and the groups were compared in terms of demographic characteristics and underlying metabolic abnormalities. Multivariate logistic regression analysis was used to determine the factors that may affect the resolution of the stone at the end of the follow-up. Results: Of the 209 children included in the study, 107 were girls and 102 were boys. The median age was 18 months (1-214 months). Kidney stones were present in the family in 56% of the patients. It was noteworthy that approximately half of the patients were diagnosed at the first two years of age, and the most common symptom was restlessness. At least one metabolic abnormalities were detected in 52% of the patients, the most common metabolic disorders were hypocitraturia (34.3%) and hypercalciuria (27%). In follow-up, the frequency of stone disappearance was significantly higher in children with microlithiasis (71% and 46% p <0.001). When the age, gender, family stone history, stone size, number and underlying metabolic abnormality of the factors that may affect stone disappearance in the follow-up were evaluated with multiple logistic regression analysis; only small stone size was found to affect prognosis (p: 0.009, odds ratio: 2.39, 95% confidence interval 1.2- 4.6). Conclusion: Kidney stones may present with nonspecific symptoms in childhood, so care should be taken in terms of stone in such patients with a family history of stones. The most common cause of stone is hypocitraturia and hypercalciuria, especially hypocraturia is thought to be underdiagnose in clinical practice. The most important factor in resolution od stones during follow-up has been shown to be the size of the stone. [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.)

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.)

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]

Background: Our a im i s t o e valuate t he t reatment r esults o f c hildren w ho u nderwent E SWL f or urolithiasis Materials and Methods: Records of children who underwent ESWL between October 2018 and October 2020 were retrospectively reviewed. The patients were divided into two groups according to success and compared in terms of age, gender, stone size, stone location, complications, and additional interventions. Results: Of the 50 cases, 34(68%) were boys and 16(32%) were girls. The mean age was 8.8 ± 5.0 years. 36 of the stones were located in the kidney and 14 were in the proximal ureter. The average stone size was 9.4±1.8 mm in the successful ESWL group and 13.8±3.2 mm in the unsuccessful group (p <0.05). While the success was 90% for stones less than 10 mm, it was found to be 56.7% for stones over 10 mm (p <0.05). T otal success w as 70%. T here w as no significant correlation between age, gender, side and localization of stones and ESWL success (p> 0.05). Conclusion: ESWL is an effective and safe treatment method for children with urolithiasis. Stone size is an important factor affecting success. Especially for stones ≥10 mm, there is a need for studies that will provide the maximum benefit per session and reveal the predictions that can prevent an unsuccessful application. [ABSTRACT FROM AUTHOR]

Copyright of Namık Kemal Tıp Dergisi is the property of Galenos Yayinevi Tic. LTD. STI 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 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.)

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, we aimed to compare the results in patients undergoing the oneshot dilatation (OD) technique and the conventional serial dilatation (SD) technique with amplatz dilators in percutaneous nephrolithotomy (PNL) operations. Methods: We retrospectively evaluated the data of 213 patients who had undergone PNL between January 2016 and June 2018. The patients who had undergone SD were classified as Group 1 and the patients undergoing OD as Group 2. All of the patients had undergone contrast-free computed tomography (CT) before the operation. The PNL procedure was performed by experienced endo-urologists. Follow-up CT was performed in the 3rd postoperative month. The PNL procedure was considered unsuccessful in patients who had a stone larger than 4 mm on the CT scan. The patients were accepted as 'stone free' when there was no residual stone or there was a stone less than 4 mm in diameter on the CT scan. The groups were compared concerning demographic characteristics, operation duration, fluoroscopy duration, amount of hemoglobin change, complication rate (according to the modified Clavien classification), length of hospital stay and the operation success rate. Results: There was no statistically significant difference between the groups concerning operation data, rate of stone-free patients and complication rates. The mean length of hospital stay was shorter in the OD group (p<0.001). Conclusion: The conventional SD procedure is similar to the OD procedure with amplatz dilators concerning the total fluoroscopy time, complication rates and the surgical success rate. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Objective: We aimed to compare the safety and efficacy of upper, middle and lower calyx accesses obtained as isolated and single access in percutaneous nephrolithotomy (PCNL) operation which is performed for treating renal stones. Materials and Methods: The records of patients who had undergone PCNL via isolated single pole access due to renal stone between September 2007 and June 2018 were retrospectively evaluated. The patients were divided into three groups as isolated single upper calyceal access patients (group 1), isolated single middle calyceal access patients (group 2) and isolated single lower calyceal access patients (group 3). The patient groups were compared in terms of patient characteristics, stone size and location, operative data, postoperative outcomes and complications. Results: Fifty-seven (2.8%) patients who underwent isolated single calyceal access PCNL were included in group 1 (upper calyx), 542 (26.9%) in group 2 (middle calyx) and 1427 (70.4%) were included in group 3 (lower calyx). The mean age of the patients in groups 1, 2 and 3 was 43.09±15.00, 38.23±22.47 and 39.40±19.93, respectively. A thousand hundred and seventy-six (58%) patients were male and 850 (42%) were female. The mean stone burden was 367.19±266.48, 335.7±301.85 and 353.73±346.47 mm2 in groups 1, 2 and 3, respectively and there was no statistically significant difference between the groups (p=0.45, p=0.77, p=0.29, respectively). The mean operative time, mean fluoroscopy time, and mean nephrostomy time, and the mean length of hospitalization were statistically significantly longer in group 2 than in group 3. Stone-free rates in patients with clinically insignificant stones (SF + CIRF) were 89.5%, 89.6% and 91.6% in group 1, 2 and 3, respectively and there was no statistically significant difference between the groups (p=0.25, p=0.43 and p=0.6 respectively). There was no significant difference between the three groups in terms of postoperative fever, blood transfusion and overall complications. Conclusion: As a result, different isolated single calyceal accesses do not have superiority over each other in terms of stone-free rate and complications. A proper access is required while performing PCNL to remove the stones, decrease the comorbidity rates and prevent complications and the ideal way is the way that provides the shortest and the smoothest reach all stones [ABSTRACT FROM AUTHOR]

Amaç: Pediatrik hastalarda böbrek taşlarınının cerrahi tedavisinde mikro-PERC’nin etkinliğini ve güvenilirliğini araştırmayı amaçladık..Gereç ve Yöntem: Kliniğimizde Ocak 2015 - Ocak 2017 tarihleri arasında pediatrik böbrek taş hastalığı nedeniyle mikro-PERC uygulanan 32 pediatrik hastanın bilgileri retrospektif olarak değerlendirildi. Operasyon süreleri, floroskopi süresi, hastanede yatış süreleri, komplikasyon oranları ve taştan yoksunluk oranları kayıt edildi.Bulgular: Toplam 32 hastanın ortalama yaşları 5±4.1 yıl, ortalama taş boyutu ise 13.35±3.12 mm olarak hesaplandı. Operasyon süresi açısından bakıldığında 74.2±14.2 dakika iken, ortalama floroskopi süreleri 109±31.2 saniyeydi.Sonuç: Mikro-PERC gibi minimal invazif yöntemler çocuklarda etkin ve güvenilir bir tedavi yöntemidir

Objective: Several methods including extracorporeal shock wave lithotripsy(ESWL), standard percutaneous nephrolithotomy(PCNL), mini-PCNL and retrograde intrarenal surgery(RIRS) have been recommended to treat kidney stones. A major advantage of mini-PCNL is that it provides similar stone-free and success rates and is less invasive when compared with standard PCNL. In this report, we evaluated our experiences and outcomes with mini-PCNL in a pediatric population. Material and Methods: From January 2011 to November 2016, the medical records and radiographic images of children who underwent mini-PCNL with a 15 Fr peel-away sheath and 12 Fr miniature nephroscope were evaluated. We reviewed the patients' demographic details, hemogram, stone characteristics, stone free rate and success rates, additional procedures, complications, hospital stay and nephrostomy retrieval. Stones were classified according to kidney localization as simple (single calyx or pelvic stones) or complex (choraliform, pelvic+calyx stones or multiple calyx stones). Results: The study included 12 girls and 28 boys, with a mean age of 7.84±5.62 years (1-17 years). The mean diameter of the stones was 24.4±15.3 mm (10-65 mm). The mean stone size was 14.76±6.52 mm for the simple stone group and 35.05±15.22 mm for the complex stone group (p=0.000). The mean operative and fluoroscopy times were 89.17±31.48 minutes and 146.35±63.16 seconds. The first success rate was 55% (n=22). 8 patients underwent additional procedures and the success rate increased to 77.5% (n=31). The success rate was significantly higher in simple stones (95.2% vs. 57.9%; p=0.005). The complication rate of the mini-PCNL procedure was 22.5% (n=9). The mean hemoglobin decrease was 0.73±1.06 mg/dl and only 1 patient required a blood transfusion. The mean hospital stay and nephrostomy retrieval time was 3.77±2.32 and 2.00±1.70 days, respectively. Conclusion: Our experiences indicate that mini-PCNL is a safe and effective procedure for the management of renal stones in children and stone-free and success rates similar to standard PCNL are obtained. [ABSTRACT FROM AUTHOR]

Although Double-J stents have become very common in the urological practice and are effectively used for various reasons, several complications related to it, such as hematuria, infection, irritative symptoms, pain, perforation, encrustation, and migration, have been observed. The present study reports five case reports of stent encrustation due to forgotten stents. [ABSTRACT FROM AUTHOR]

Amaç: Perkütan nefrolitotripsi (PNL), ürolojinin son yıllarına damga vurmuş, pek çok merkezde uygulanabilen, morbiditesi ve mortalitesi son derece düşük bir tedavi yöntemi olarak karşımıza çıkmaktadır. Biz bu çalışmamızda, PNL öncesi serum kreatinin değerindeki yüksekliğin post operatif kanama durumuna etkisini araştırmayı amaçladık. Materyal ve Metod: Kliniğimizde PNL uygulanmış olan hastalar arasında üre ve kreatinin değerleri yüksek olan hastalar ayrıldı. Bu hastaların yaşları, taş boyutları, cinsiyetleri, tedavi öncesi hematokrit değerleri ve ek ko-morbiditeleri kaydedilerek hastaların bu değerlerine benzer değerleri olan hastalar ile diğer grup oluşturuldu. Serum kreatinin Araştırma Makalesi / Research Article 221 Şener ve ark. Cukurova Medical Journal değerleri yüksek olanlar Grup 1, normal olanlar ise Grup 2 olarak adlandırıldı. Hastaların beden kitle endeksi, taş boyutları, operasyon öncesi ve sonrası kreatin değeri, operasyon öncesi ve sonrası hematokrit değeri, preoperatif trombosit sayısı, koagülasyon parametreleri (aPTT, INR değerleri), trakt sayısı, operasyon süresi, preoperatif trombosit sayısı, taşsızlık oranları ve eritrosit transfüzyonu olup olmadığı kaydedilerek kıyaslandı. Bulgular: Gruplarda preoperatif kreatinin değerleri sırası ile Grup 1 ve 2 için 2,11 ± 0,44 ve 0,98 ± 0,27 idi. Taş boyutları 1. Grup için 29,41 ± 3,83 mm, 2. Grup için ise 29,49 ± 2,99 idi (p=0,317). Hastaların operasyon öncesi hematokrit değerleri 1 ve 2. Gruplar için sırasıyla 44,88 ± 5,61 ve 47,51 ± 4,61 idi (p=0,381). Bu değerler operasyon sonrası her iki grup için sırası ile 30,27 ± 7,01 ve 37,74 ± 7,11 idi (p=0,044). Sonuç: Çalışmamızda kreatinin değerlerinin PNL sonrası kanama için bir risk faktörü olduğu, serum kreatinin değerlerinin yüksekliği olan hastalarda, olmayanlara oranla hematokrit düşüşünün daha fazla olduğu görülmektedir.

Amac: Perkutan nefrolitotripsi (PNL), urolojinin son yillarina damga vurmus, pek cok merkezde uygulanabilen, morbiditesi ve mortalitesi son derece dusuk bir tedavi yontemi olarak karsimiza cikmaktadir. Biz bu calismamizda, PNL oncesi serum kreatinin degerindeki yuksekligin post operatif kanama durumuna etkisini arastirmayi amacladik. Materyal ve Metod: Klinigimizde PNL uygulanmis olan hastalar arasinda ure ve kreatinin degerleri yuksek olan hastalar ayrildi. Bu hastalarin yaslari, tas boyutlari, cinsiyetleri, tedavi oncesi hematokrit degerleri ve ek ko-morbiditeleri kaydedilerek hastalarin bu degerlerine benzer degerleri olan hastalar ile diger grup olusturuldu. Serum kreatinin degerleri yuksek olanlar Grup 1, normal olanlar ise Grup 2 olarak adlandirildi. Hastalarin beden kitle endeksi, tas boyutlari, operasyon oncesi ve sonrasi kreatin degeri, operasyon oncesi ve sonrasi hematokrit degeri, preoperatif trombosit sayisi, koagulasyon parametreleri (aPTT, INR degerleri), trakt sayisi, operasyon suresi, preoperatif trombosit sayisi, tassizlik oranlari ve eritrosit transfuzyonu olup olmadigi kaydedilerek kiyaslandi. Bulgular: Gruplarda preoperatif kreatinin degerleri sirasi ile Grup 1 ve 2 icin 2,11 +/- 0,44 ve 0,98 +/- 0,27 idi. Tas boyutlari 1. Grup icin 29,41 +/- 3,83 mm, 2. Grup icin ise 29,49 +/- 2,99 idi (p=0,317). Hastalarin operasyon oncesi hematokrit degerleri 1 ve 2. Gruplar icin sirasiyla 44,88 +/- 5,61 ve 47,51 +/- 4,61 idi (p=0,381). Bu degerler operasyon sonrasi her iki grup icin sirasi ile 30,27 +/- 7,01 ve 37,74 +/- 7,11 idi (p=0,044). Sonuc: Calismamizda kreatinin degerlerinin PNL sonrasi kanama icin bir risk faktoru oldugu, serum kreatinin degerlerinin yuksekligi olan hastalarda, olmayanlara oranla hematokrit dususunun daha fazla oldugu gorulmektedir. [Cukurova Med J 2015; 40(2.000): 221-225]

Objective: Percutaneous nephrolithotomy (PNL) has become the primary treatment option for large or multiple renal stones and inferior caliceal stones where ESWL (extracorporeal shock wave lithotripsy) therapy fails. In our study, we investigated the factors that predict the success of PNL operations and the development of complications. Material-Method: A total of 64 cases above 18 years old with renal stones, who would undergone only PNL surgery by a single specialist between December 2008 and June 2009 dates have been included in this study. Data of the patients were collected prospectively. Percutaneous access tract was established by using semi-rigid amplatz dilators, under C-armed fluoroscopy, while the patient was at prone position. During the operation, pneumatic litotriptor device was used to break the stones. The effect of some factors related to stone (size and localization), operation (number of access and localization) and patient (age) on the successfull outcome rate and complications of PNL was investigated. Results: We have gained a 89.1% of success rate after including also clinically unimportant stones. This rate has increased to 93.8% with additional treatment. In 10.9 % of the patients, additional treatment was applied. The size, localization and dilatation degree of the stone are the predictor factors of successfull outcome. It has been found that making numerous percutaneous entrance has no effect on results. Our complication rate was 59.4% (38 patients) in this study. Postoperative high fever was observed in 14 patients (21.9%) and this was the most frequent complication. There was no serious complication excluding hemorrhage which requires blood transfusion. Bleeding was encountered with 12.5% rate. Increased or complex stone burden, multiple entrance number and intercostal intervention were factors affecting the complication rates. Patient related factors such as age did not affect this rate. Conclusions: We have conluded that stone related factors (size, localization and dilatation grade) have effect on the outcomes of PNL operations, whereas percutaneous entrance numbers and localization are independent factors which predict the development of complications. Also, as a result of this study, we can say that PNL is an effective, reliable and applicable method in elderly patients. [ABSTRACT FROM AUTHOR]