Laparoscopic transperitoneal nephrectomy in non-functioning inflammatory kidneys with or without renal stone

OBJECTIVE

To compare our laparoscopic simple nephrectomy results in non-functioning inflammatory kidneys with or without renal stones.

PATIENTS AND METHODS

Patients, who underwent laparoscopic transperitoneal nephrectomy for non-functioning kidney between June, 2010 and October, 2014 were included to study. Overall, data of 32 patients including 15 patients with renal stone (Group 1) and 17 patients without renal stone (Group 2) were retrospectively reviewed.

RESULTS

Mean age was 44.4 ± 18.5 years (10-71) in group 1 and 35.2 ± 21 years (9-77) in group 2. Mean operation time was 95.0±25.9 minutes (70-175) in group 1 and 86.7 ± 15.1 minutes (70-125) in group 2. Mean estimated blood loss was found to be 64.13 ± 26.67 ml (30-120) in group 1 and 58.94 ± 24.24 ml (30-100) in group 2. Both groups had inflammatory findings in pathological analysis. There was no significant difference between groups regarding estimated blood loss, operation time, pre-operative and post-operative hemoglobin values, percent hemoglobin decrease, complications and hospitalization times (p > 0.05).

CONCLUSIONS

Non-functioning kidney with or without renal stone could be operated safely with comparable complication rates and success via laparoscopy in experienced hands.

Modified Raz operation backed with periurethral roll mesh in female stress urinary incontinence

OBJECTIVES

With the modifications that we made, the aim is to increase the effectiveness and the success rate of the Raz operation in the treatment of stress urinary incontinence (SUI) and to present a new approach in the treatment by reducing the complication rates.

PATIENTS AND METHODS

Between November 2002 and December 2010, the Raz operation that we modified with the changes such as the placement of cystostomy catheter with the Lowsley clamp, vaginal incision of the bilateral oblique, the placement of periurethral roll mesh, the use of a single 0-degree stamey needle instead of a double needle applicator, binding the sutures mutually and on the support of the polypropylene mesh in suprapubic region was performed to 81 female patients with SUI in lithotomy position under the regional anesthesia.

RESULTS

We performed the modified Raz operation to 81 female patients with SUI, who had the complaint of urinary incontinence with the effort lasting for about 4.5 years (between 1-16 years) and whose ages were 28-83 years (mean 55.2 years), childbirth numbers were 0-11 (mean 4.8), weights were 60-85 kg (mean 69.3 kg), and 32 of whom (39.5%) were of grade 1, 49 of whom (60.5%) were of grade 2 with the amnesia of SUI, and whose stress test was (+) in the physical examination. While the duration of the operation was 39.8 minutes (20-85 minutes) and the duration of the hospitalization was 2.9 days (2-4 days), the duration of the stay of the patients with the cystostomy catheter was determined to be 4.8 days (3-11 days). We found the rate of our success as 93.8% according to the objective criteria.

CONCLUSIONS

With the modifications that we made, we increased the success rate of the Raz operation and reduced the rates of the complication. We believe that the place of our modification method in incontinence surgery becomes more clearly with the comparison of the other anti-incontinence surgery techniques in patient groups with the same characteristics.

Complications of circumcision performed within and outside the hospital

OBJECTIVE

Comparison of incidence of complications observed in circumcisions performed by traditional unlicensed individuals outside the hospital under the non-sterile conditions and in those performed by surgeons within hospital under surgical procedures.

PATIENTS AND METHODS

This is a retrospective study to determine the sort of complications and their incidence in 407 cases performed in two towns in our region by unlicensed traditional circumcisers (group 1) and 782 circumcision cases performed in Urology clinic by licensed surgeons (group 2) between April 1999 and August 2002. The complications were proportionally and statistically compared. Correlation between groups was assessed by Pearson correlation test and to compare the complication parameters chi-square test was used (p < 0.05 was considered statistically significant).

RESULTS

The incidence of complications was higher in group 1. All complication parameters were found high in group 1 at a statistically significant extent.

CONCLUSION

We could conclude that if the circumcision is performed by unlicensed traditional circumcisers instead of surgeons at the sterile hospital conditions it could result in severe early phase complications such as life-threatening or some late phase disorders with life long negative influences.