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Bayrak O, Demirbas A, Doluoglu OG, Karakan T, Resorlu B, Kardas S, Tepeler A, Tangal S, Adanur S, Celik O. Is a contrast study really necessary prior to ureteroscopy? ACTA ACUST UNITED AC 2016; 49:e4855. [PMID: 26577846 PMCID: PMC4678656 DOI: 10.1590/1414-431x20154855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2015] [Accepted: 07/23/2015] [Indexed: 11/22/2022]
Abstract
This study aimed to evaluate the effect of preoperative imaging techniques on the
success and complication rates of ureteroscopy. We performed a retrospective analysis
of 736 patients (455 males and 281 females), with a mean age of 45.5±15.2 years
(range, 1-88 years), who underwent rigid ureteroscopic procedures for removal of
ureteral stones. Patients were divided into 4 groups according to the type of imaging
modality used: group I, intravenous urography (n=116); group II, computed tomography
(n=381); group III, computed tomography and intravenous urography (n=91), and group
IV, ultrasonography and abdominal plain film (n=148). Patients’ demographics, stone
size and location, prior shock wave lithotripsy, lithotripsy technique, operation
time, success rate, and rate of intraoperative complications were compared among the
groups. There were no significant differences in success and complication rates among
the groups. The stone-free rate after primary ureteroscopy was 87.1% in group I,
88.2% in group II, 96.7% in group III, and 89.9% in group IV (P=0.093). The overall
incidence of intraoperative complications was 11.8%. According to the modified Satava
classification system, 6.1% of patients had grade 1, 5.1% had grade 2, and 0.54% had
grade 3 complications. Intraoperative complications developed in 12.1% of patients in
group I, 12.6% of patients in group II, 7.7% of patients in group III, and 12.2% of
patients in group IV (P=0.625). Our findings clearly demonstrate that ureteroscopic
treatment of ureteral stones can be safely and effectively performed with no use of
contrast study imaging, except in doubtful cases of anatomical abnormalities.
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Affiliation(s)
- O Bayrak
- Department of Urology, School of Medicine, Gazi University, Ankara, Turkey
| | - A Demirbas
- Department of Urology, Ankara Training and Research Hospital, Ankara, Turkey
| | - O G Doluoglu
- Department of Urology, Ankara Training and Research Hospital, Ankara, Turkey
| | - T Karakan
- Department of Urology, Ankara Training and Research Hospital, Ankara, Turkey
| | - B Resorlu
- Department of Urology, Ankara Training and Research Hospital, Ankara, Turkey
| | - S Kardas
- Department of Urology, Faculty of Medicine, Bezmialem University, Istanbul, Turkey
| | - A Tepeler
- Department of Urology, Faculty of Medicine, Bezmialem University, Istanbul, Turkey
| | - S Tangal
- Department of Urology, Faculty of Medicine, Ufuk University, Ankara, Turkey
| | - S Adanur
- Department of Urology, Faculty of Medicine, Ataturk University, Erzurum, Turkey
| | - O Celik
- Department of Urology, Tepecik Training and Research Hospital, Izmir, Turkey
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Resorlu B, Kara C, Ozyuvali E, Unsal A. Percutaneous Nephrolithotomy in Hypertensive Patients with Different Sizes of Instruments. Acta Chir Belg 2016. [DOI: 10.1080/00015458.2011.11680743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- B. Resorlu
- Kecioren Training and Research Hospital, Department of Urology, Ankara, Turkey
| | - C. Kara
- Kecioren Training and Research Hospital, Department of Urology, Ankara, Turkey
| | - E. Ozyuvali
- Kecioren Training and Research Hospital, Department of Urology, Ankara, Turkey
| | - A. Unsal
- Kecioren Training and Research Hospital, Department of Urology, Ankara, Turkey
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Unsal A, Resorlu B, Kara C, Bayindir M. The Role of Percutaneous Nephrolithotomy in the Management of Medium-Sized (1–2 cm) Lower-Pole Renal Calculi. Acta Chir Belg 2016. [DOI: 10.1080/00015458.2011.11680759] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- A. Unsal
- Kecioren Training and Research Hospital, Department of Urology, Ankara, Turkey
| | - B. Resorlu
- Kecioren Training and Research Hospital, Department of Urology, Ankara, Turkey
| | - C. Kara
- Kecioren Training and Research Hospital, Department of Urology, Ankara, Turkey
| | - M. Bayindir
- Kecioren Training and Research Hospital, Department of Urology, Ankara, Turkey
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Doluoglu OG, Karakan T, Kabar M, Ozgur BC, Hascicek AM, Huri E, Resorlu B. Effectiveness of retrograde intrarenal stone surgery in obese patients. Ir J Med Sci 2015; 185:847-851. [PMID: 26560111 DOI: 10.1007/s11845-015-1379-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2015] [Accepted: 10/31/2015] [Indexed: 11/25/2022]
Abstract
BACKGROUND A number of comorbid health problems can be found in obese patients. These problems increase the surgical risk in obese patients. AIMS To determine the effectiveness of retrograde intrarenal surgery for renal stone treatment in obese patients. METHODS We retrospectively reviewed the data of 106 patients who had retrograde intrarenal surgery with the diagnosis of renal stone in our clinic. The patients were divided into three groups regarding their body mass indexes: ≥30 kg/m2 being obese (group 1), 25-29.9 kg/m2 being overweight (group 2), and <25 kg/m2 being normal weight (group 3). The patients were compared for age, gender, and stone characteristics. In addition, the duration of surgery, stone-free rate (SFR), complication rate, and the duration of the hospital stay were compared among the groups. RESULTS Twenty eight patients were obese (group 1), 49 patients were overweight (group 2), and 29 patients were normal weight (group 3). The mean ages of groups 1, 2 and 3 were 51.5 (29-84), 47 (30-76) and 35 (19-84) years, respectively (p = 0.001). SFR was 85.7 % in group 1, 89.8 % in group 2, and 75.9 % in group 3 (p = 0.24). The duration of surgery was similar in groups 1, 2, and 3, being 45.5 (25-95), 50 (30-120), and 45.5 (10-100) min, respectively (p = 0.23). None of the patients had major complications. CONCLUSIONS Our results indicate that retrograde intrarenal surgery is a safe and efficient surgical method for renal stone treatment in obese and overweight patients.
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Affiliation(s)
- O G Doluoglu
- Department of Urology Clinic, Ankara Training and Research Hospital, Sukriye Mahallesi, Ulucanlar Caddesi, No: 89, 06340, Ankara, Turkey.
| | - T Karakan
- Department of Urology Clinic, Ankara Training and Research Hospital, Sukriye Mahallesi, Ulucanlar Caddesi, No: 89, 06340, Ankara, Turkey
| | - M Kabar
- Department of Urology Clinic, Ankara Training and Research Hospital, Sukriye Mahallesi, Ulucanlar Caddesi, No: 89, 06340, Ankara, Turkey
| | - B C Ozgur
- Department of Urology Clinic, Ankara Training and Research Hospital, Sukriye Mahallesi, Ulucanlar Caddesi, No: 89, 06340, Ankara, Turkey
| | - A M Hascicek
- Department of Urology Clinic, Ankara Training and Research Hospital, Sukriye Mahallesi, Ulucanlar Caddesi, No: 89, 06340, Ankara, Turkey
| | - E Huri
- Department of Urology Clinic, Ankara Training and Research Hospital, Sukriye Mahallesi, Ulucanlar Caddesi, No: 89, 06340, Ankara, Turkey
| | - B Resorlu
- Department of Urology Clinic, Ankara Training and Research Hospital, Sukriye Mahallesi, Ulucanlar Caddesi, No: 89, 06340, Ankara, Turkey
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Unsal A, Resorlu B, Kara C, Bayindir M. The role of percutaneous nephrolithotomy in the management of medium-sized (1-2 cm) lower-pole renal calculi. Acta Chir Belg 2011; 111:308-311. [PMID: 22191133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
OBJECTIVES The objective of this study was to determine the efficacy (defined by stone-free rates) and safety of percutaneous nephrolithotomy (PNL) in the treatment of medium sized (1-2 cm) symptomatic lower pole renal calculi, and establishment of the short-term morbidity. METHODS We performed a retrospective analysis of 60 evaluable patients who had undergone PNL for 1 to 2 cm diameter lower-pole (LP) stones between November 2006 to March 2009 and compared these results with other treatment modalities in published literature. RESULTS In all cases, stones were located in the lower calix. Thirty-six procedures were performed on the left side, and 24 were performed on the right side. The mean time to access the collecting system was 20.4 minutes (range 8-70 min) and mean operative time was 62.2 minutes (range 13-155 min). Abdominal radiography performed on postoperative day 1 demonstrated a stone free status in 56 (93.3%) patients. However, 4 patients (6.7%) required ancillary procedures (secondary PNL in 1, retrograde intrarenal surgery in 1, and SWL in 2). After this secondary procedures a complete stone-free status was achieved in 98.3% of patients. The morbidity of patients undergoing PNL at our hospital was minimal, with a mean hospital stay of 3.7 days. CONCLUSIONS We demonstrated that, PNL is a safe and effective method for medium sized (1 to 2 cm) lower pole renal calculi and percutaneous removal should be considered the primary approach for lower pole stones greater than 10 mm.
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Affiliation(s)
- A Unsal
- Kecioren Training and Research Hospital, Department of Urology, Ankara, Turkey
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Resorlu B, Kara C, Ozyuvali E, Unsal A. Percutaneous nephrolithotomy in hypertensive patients with different sizes of instruments. Acta Chir Belg 2011; 111:228-231. [PMID: 21954739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
OBJECTIVES The risk of major complications, especially hemorrhage, is significantly elevated during surgery in hypertensive patients. To determine whether percutaneous nephrolithotomy (PCNL) can be safely performed in the hypertensive patients using different sized instruments. METHODS We reviewed the records of 602 patients undergoing PCNL at our institution and identified 53 who were on antihypertensive therapy at the time of surgery. Patients were categorized into three groups according to size of devices used in surgery : those 24 F percutaneous tract with 22 F nephroscope (Group 1, n = 12 [22.7%]; 26 F percutaneous tract with 24 F nephroscope (Group 2, n = 19 [35.8%]) and 30 F percutaneous tract with 26 F nephroscope (Group 3, n = 22 [41.5%]). We compared the groups with regard to baseline characteristics, intraoperative parameters, stone-free and complication rates, and the length of hospitalization. RESULTS There were no differences between the three groups in age, gender, weight and stone laterality. Fluoroscopy time, access to the collecting system and mean operative time for per cm2 stone did not differ between the groups. Hemoglobin decrease, postoperative hospital stay and blood transfusion rate was higher in group 3. Stones were completely cleared in 83.3%, 84.2% and 81.3% of patients, which increased to 91.6%, 89.5%, and 90.1% with adjunctive therapy in the group 1,2 and 3, respectively. CONCLUSIONS PCNL with smaller devices is a safe and effective method in hypertensive patients. It has significantly a shorter hospital stay and less bleeding rates compared to classical PCNL.
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Affiliation(s)
- B Resorlu
- Kecioren Training and Research Hospital, Department of Urology, Ankara, Turkey.
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Kara C, Resorlu B, Bayindir M, Unsal A. MP-07.08: A Randomized Controlled Trial of Nephrostomy Placement Versus Totally Tubeless Percutaneous Nephrolithotomy in Elderly Patients. Urology 2009. [DOI: 10.1016/j.urology.2009.07.976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Kara C, Resorlu B, Cicekbilek I, Unsal A. UP-3.075: Analgesic Efficacy and Safety of Nonsteroidal Anti-Inflammatory Drugs after Transurethral Resection of Prostate. Urology 2009. [DOI: 10.1016/j.urology.2009.07.079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Unsal A, Resorlu B, Kara C, Bozkurt O, Ozyuvali E. MP-07.10: Safety and Outcome of Percutaneous Nephrolithotomy in Infants and Preschool Children: Retrospective Comparison to Adult Patient Group. Urology 2009. [DOI: 10.1016/j.urology.2009.07.978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Kara C, Resorlu B, Bayýndýr M, Unsal A. UP-3.178: Transurethral Cystolithotripsy with Holmium Laser under Local Anesthesia in Selected Patients. Urology 2009. [DOI: 10.1016/j.urology.2009.07.183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Kara C, Resorlu B, Sahin E, Unsal A. UP-3.127: Sexual Function and Psychiatric Status of Premenopausal Women with Behcet's Disease. Urology 2009. [DOI: 10.1016/j.urology.2009.07.131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Resorlu B, Kara C, Oguz U, Unsal A. UP-2.006: Surgical Treatment of Female Stress Urinary Incontinence: In Situ Anterior Vaginal Wall Sling Versus Transobturator Midurethral Tape. Urology 2009. [DOI: 10.1016/j.urology.2009.07.225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Unsal A, Kara C, Resorlu B, Bayindir M. MP-07.09: Percutaneous Antegrade Treatment of Large Upper Ureteral Calculi. Urology 2009. [DOI: 10.1016/j.urology.2009.07.977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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