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Juliebø-Jones P, Gauhar V, Castellani D, Fong KY, Sofer M, Zawadzki M, Gadzhiev N, Pirola GM, Mahajan AD, Maheshwari PN, Malkhasyan V, Biligere S, Gökce Mİ, Cormio L, Enikeev D, Gómez Sancha F, Herrmann TRW, Somani BK. Real world propensity score matched analysis evaluating the influence of en-bloc vs. non en-bloc techniques, energy and instrumentation on enucleation outcomes for large and very large prostates. World J Urol 2024; 42:299. [PMID: 38710824 DOI: 10.1007/s00345-024-04959-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2023] [Accepted: 03/25/2024] [Indexed: 05/08/2024] Open
Abstract
PURPOSE The primary aim of the study was to evaluate if en-bloc vs. non en-bloc made a difference to intra-, peri- and post-operative surgical outcomes of anatomical endoscopic enucleation (AEEP) in large (> 80 cc) and very large prostates (> 200 cc). The secondary aim was to determine the influence of energy and instruments used. METHODS Data of patients with > 80 cc prostate who underwent surgery between 2019 and 2022 were obtained from 16 surgeons across 13 centres in 9 countries. Propensity score matching (PSM) was used to reduce confounding. Logistic regression was performed to evaluate factors associated with postoperative urinary incontinence (UI). RESULTS 2512 patients were included with 991 patients undergoing en-bloc and 1521 patients undergoing non-en-bloc. PSM resulted in 481 patients in both groups. Total operation time was longer in the en-bloc group (p < 0.001), enucleation time was longer in the non en-bloc group (p < 0.001) but morcellation times were similar (p = 0.054). Overall, 30 day complication rate was higher in the non en-bloc group (16.4% vs. 11.4%; p = 0.032). Rate of late complications (> 30 days) was similar (2.3% vs. 2.5%; p > 0.99). There were no differences in rates of UI between the two groups. Multivariate analysis revealed that age, Qmax, pre-operative, post-void residual urine (PVRU) and total operative time were predictors of UI. CONCLUSIONS In experienced hands, AEEP in large prostates by the en-bloc technique yields a lower rate of complication and a slightly shorter operative time compared to the non en-bloc approach. However, it does not have an effect on rates of post-operative UI.
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Affiliation(s)
- Patrick Juliebø-Jones
- Department of Clinical Medicine, University of Bergen, Bergen, Norway.
- Department of Urology, Haukeland University Hospital, Bergen, Norway.
- Department of Urology, University Hospital Southampton, Southampton, UK.
| | - Vineet Gauhar
- Department of Urology, Ng Teng Fong Hospital, Singapore, Singapore
| | - Daniele Castellani
- Urology Division, Azienda Ospedaliero-Universitaria Ospedali Riuniti Di Ancona, Università Politecnica Delle Marche, Ancona, Italy
| | - Khi Yung Fong
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Mario Sofer
- Department of Urology, Sackler Faculty of Medicine, Tel-Aviv Sourasky Medical Center, Tel-Aviv University, Tel-Aviv, Israel
| | | | - Nariman Gadzhiev
- Department of Urology, Saint-Petersburg State University Hospital, Saint-Petersburg, Russia
| | - Giacomo Maria Pirola
- Urology Unit, IRCCS Multimedica, Multimedica Group, San Giuseppe Hospital, Milan, Italy
| | - Abhay D Mahajan
- Sai Urology Hospital and Mahatma Gandhi Mission's Medical College and Hospital, Aurangabad, India
| | | | - Vigen Malkhasyan
- Urology Unit, A.I. Evdokimov Moscow State University of Medicine and Dentistry, Moscow, Russia
| | | | - Mehmet İlker Gökce
- Department of Urology, Ankara University School of Medicine, Ankara, Turkey
| | - Luigo Cormio
- Andrology and Urology Unit, Bonomo Teaching Hospital, Andria, Italy
- Department of Urology, Ospedali Riuniti di Foggia, University of Foggia, Foggia, Italy
| | - Dmitry Enikeev
- Department of Urology, Medical University of Vienna, Vienna, Austria
- Urology Department, Rabin Medical Center, Petah Tikva, Israel
- Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia
| | | | - Thomas R W Herrmann
- Department of Urology, Kantonspital Frauenfeld, Spital Thurgau AG, Frauenfeld, Switzerland
- Department of Clinical Medicine, Hannover Medical School, Hannover, Germany
| | - Bhaskar K Somani
- Department of Urology, University Hospital Southampton, Southampton, UK
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Ibis MA, Özsoy AF, Özkaya MF, Erdem E, Erkmen S, Güler AD, Gökce Mİ. Comparison of lithotripsy methods during mini-PNL: is there a role for ballistic lithotripsy in the era of high-power lasers. BMC Urol 2024; 24:54. [PMID: 38454412 PMCID: PMC10921753 DOI: 10.1186/s12894-024-01443-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 01/25/2024] [Accepted: 03/01/2024] [Indexed: 03/09/2024] Open
Abstract
BACKGROUND For renal stones > 20 mm, percutaneous nephrolithotomy (PNL) offers the best stone clearance rates with acceptable complication rates. This study aimed to compare the efficiency of high-power holmium YAG laser and ballistic lithotripsy during mini-PNL. METHODS Data from 880 patients who underwent mini-PNL for renal stones was investigated retrospectively. The study utilized propensity score matching to create two groups: laser lithotripsy (n = 440) and ballistic lithotripsy (n = 440). The groups were matched based on stone size, Guy's stone score, and stone density. The main objectives of the study were to assess the stone-free rate (SFR), duration of surgery, and complication rates. RESULTS The average age of the population was 51.4 ± 7.1 years, with a mean stone size of 28.6 ± 8.3 mm and a mean stone density of 1205 ± 159 HU. There were no significant differences between the groups. The SFRs of the laser lithotripsy and ballistic lithotripsy were 92.5% and 90.2%, respectively (p = 0.23). The laser lithotripsy group had a notably shorter surgery time (40.1 ± 6.3 min) compared to the ballistic lithotripsy group (55.6 ± 9.9 min) (p = 0.03). Complication rates were similar (p = 0.67). CONCLUSIONS Our study shows that a high-power holmium YAG laser provides quicker operation time compared to ballistic lithotripsy. However, ballistic lithotripsy is still an effective and safe option for stone fragmentation during mini-PNL. In places where a high-power holmium YAG laser is not available, ballistic lithotripters are still a safe, effective, and affordable option for mini-PNL.
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Affiliation(s)
- Muhammed Arif Ibis
- Department of Urology, Ankara University School of Medicine, Adnan Saygun Caddesi, Ankara, Altındağ, Turkey.
| | - Ahmet Furkan Özsoy
- Department of Urology, Ankara University School of Medicine, Adnan Saygun Caddesi, Ankara, Altındağ, Turkey
| | - Mehmet Fatih Özkaya
- Department of Urology, Ankara University School of Medicine, Adnan Saygun Caddesi, Ankara, Altındağ, Turkey
| | - Emre Erdem
- Department of Urology, Ankara University School of Medicine, Adnan Saygun Caddesi, Ankara, Altındağ, Turkey
| | - Serhat Erkmen
- Department of Urology, Ankara University School of Medicine, Adnan Saygun Caddesi, Ankara, Altındağ, Turkey
| | - Ahmet Doruk Güler
- Department of Urology, Ankara University School of Medicine, Adnan Saygun Caddesi, Ankara, Altındağ, Turkey
| | - Mehmet İlker Gökce
- Department of Urology, Ankara University School of Medicine, Adnan Saygun Caddesi, Ankara, Altındağ, Turkey
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Gökce Mİ, Güven S, Petkova K, Tefik T, İbiş MA, Sönmez G, Gadzhiev N, Kiremit MC, Karagöz MA, Villa L, Sarıca K. Patient compliance for metabolic evaluation and medical treatment (CoMET) in calcium-oxalate stone patients: prospective study by EULIS eCORE study group. World J Urol 2023; 41:3135-3140. [PMID: 37758934 DOI: 10.1007/s00345-023-04610-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 03/06/2023] [Accepted: 08/31/2023] [Indexed: 09/29/2023] Open
Abstract
PURPOSE In this study, we aimed to identify the compliance rates of calcium-oxalate stone patients for metabolic evaluation, diet and medical treatment and also determine the factors that are associated with poor compliance rates. METHODS This study was conducted by the EULIS eCORE working group prospectively. In the initial visit, demographic and stone-related characteristics were recorded. Patients were suggested metabolic evaluation, dietary advices and medical treatment. Follow-up visit was performed after 3 months and compliance rates were recorded. Logistic regression analysis was performed to determine factors associated with poor compliance to metabolic evaluation, diet and medical treatment. RESULTS Data of 346 patients from nine centers were analyzed. Compliance rates were 71.7%, 65.3%, and 63.7% for metabolic evaluation, diet, and medical treatment, respectively. In multivariate analysis, level of education (p = 0.003), history of emergency department visit (p = 0.04), number of stone surgeries (p = 0.03), patient care in dedicated stone clinic (p = 0.03), and history of shock wave lithotripsy (p = 0.005) were detected as independent predictors of compliance to metabolic analysis. Level of education (p < 0.001) and history of emergency department visit (p = 0.01) were detected as independent predictors of patient compliance to diet. Number of stone episodes (p = 0.03), family history of stones (p = 0.02), and polypharmacy (p < 0.001) were detected as independent predictors of patient compliance to medical treatment. CONCLUSIONS Patient compliance to metabolic evaluation, diet, and medical therapy is important for successful management of urolithiasis. Dietary advices and medications should be personalized by taking in to account the factors associated with poor compliance.
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Affiliation(s)
- Mehmet İlker Gökce
- Department of Urology, Ankara University School of Medicine, Sancak Mahallesi Turan Güneş Bulvarı, 39/23, Çankaya, 06550, Ankara, Turkey.
| | - Selçuk Güven
- Department of Urology, NEÜ Meram Medicine Faculty, Konya, Turkey
| | - Kremena Petkova
- Department of Urology and Nephrology, Military Medical Academy, Sofia, Bulgaria
| | - Tzevat Tefik
- Department of Urology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Muhammed Arif İbiş
- Department of Urology, Ankara University School of Medicine, Sancak Mahallesi Turan Güneş Bulvarı, 39/23, Çankaya, 06550, Ankara, Turkey
| | - Giray Sönmez
- Department of Urology, NEÜ Meram Medicine Faculty, Konya, Turkey
| | - Nariman Gadzhiev
- Department of Urology, Pavlov First Saint Petersburg State Medical University, Saint Petersburg, Russia
| | - Murat Can Kiremit
- Department of Urology, School of Medicine, Koc University, Istanbul, Turkey
| | - Mehmet Ali Karagöz
- Department of Urology, Prof. Dr. Cemil Tascıoglu City Hospital Training and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Luca Villa
- Division of Experimental Oncology/Unit of Urology, Urological Research Institute, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Kemal Sarıca
- Department of Urology, Biruni University School of Medicine, Istanbul, Turkey
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Gökce Mİ, Babayiğit M, Kubilay E, Aydoğ E, Oktar A, Akpınar Ç, Süer E, Gülpınar Ö. Is it necessary to have a guidewire down through the ureter during mini percutaneous nephrolithotomy? Single-centre experience with 1052 cases. Int J Clin Pract 2021; 75:e14430. [PMID: 34080262 DOI: 10.1111/ijcp.14430] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Revised: 05/18/2021] [Accepted: 05/31/2021] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVES In this study, it is aimed to identify the rate of successful placement of a guidewire down through the ureter during PNL and to compare the outcomes of different locations of guidewires in the collecting system following renal puncture in terms of success and complications rates. PATIENTS AND METHODS Data of 1052 patients who underwent miniPNL in our institution between January 2014 and November 2020 were analysed. Patients were divided into three groups. Group I consisted of patients with the guidewire coiled within the punctured calyx, group II consisted of patients with the guidewire reaching the renal pelvis and group III consisted of patients with the guidewire passed down through the ureter. The groups were compared for successful tract creation and complication rates. RESULTS There were 303 (28.8%) patients in group I, 330 (31.4%) patients in group II and 419 (39.8%) patients in group III. Successful tract dilation at the first attempt was established in 298 (94.7%) patients in group I, 328 (99.4%) patients in group II and in all of the 419 (100%) patients in group III. Successful tract creation was established in a second attempt in all of the patients failed in the first attempt. The groups were similar for stone-free and complication rates. CONCLUSIONS Placement of guidewire down through the ureter could not be established in more than 60% of the cases. Location of guidewire prior to dilation did not affect the outcomes. Therefore, we suggest to proceed with tract creation even when the guidewire coils within the punctured calyx.
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Affiliation(s)
- Mehmet İlker Gökce
- Department of Urology, Ankara University School of Medicine, Ankara, Turkey
| | - Muammer Babayiğit
- Department of Urology, Ankara University School of Medicine, Ankara, Turkey
| | - Eralp Kubilay
- Department of Urology, Ankara University School of Medicine, Ankara, Turkey
| | - Ezel Aydoğ
- Department of Urology, Ankara University School of Medicine, Ankara, Turkey
| | - Alkan Oktar
- Department of Urology, Ankara University School of Medicine, Ankara, Turkey
| | - Çağrı Akpınar
- Department of Urology, Ankara University School of Medicine, Ankara, Turkey
| | - Evren Süer
- Department of Urology, Ankara University School of Medicine, Ankara, Turkey
| | - Ömer Gülpınar
- Department of Urology, Ankara University School of Medicine, Ankara, Turkey
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5
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Gökce Mİ, Karaburun MC, Babayiğit M, Aydoğ E, Akpınar Ç, Süer E, Gülpınar Ö. Effect of Active Aspiration and Sheath Location on Intrapelvic Pressure During Miniaturized Percutaneous Nephrolithotomy. Urology 2021; 153:101-106. [PMID: 33417928 DOI: 10.1016/j.urology.2020.12.028] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Revised: 12/21/2020] [Accepted: 12/27/2020] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To evaluate the effects of location of the tip of percutaneous sheath and nephroscope in the collecting system together with active aspiration on the Intrapelvic pressure measurements (IPP) during miniaturized percutaneous nephrolithotomy (miniPNL). MATERIALS AND METHODS The data of 20 patients underwent miniPNL in supine position was collected prospectively. IPP measurements were done with an 8 Fr urodynamic pressure measurement catheter in 4 different settings with respect to location of tip of sheath and nephroscope. All 4 settings were repeated with active aspiration. Totally measurements were done and compared in 8 different settings for 90 seconds in each patient. RESULTS Highest mean IPP measurements were recorded in setting II (35.3 ± 11.8 cm H2O) where the sheath was located in the calyx and the tip of the nephroscope was in the renal pelvis. When active aspiration was applied, the mean pressure measurements were significantly lower than the counterpart settings without aspiration (all P values <.0001). When the active aspiration was applied, intrarenal pressure measurements did not exceed 40 cm H2O in any settings in any of the patients. CONCLUSION Location of the tip of the sheath and the nephroscope has significant effect on IPP measurements. Active aspiration significantly lowers the IPP and keeps it <40 cm H2O. Endourologists should be aware of possible alterations in IPP during miniPNL and active aspiration should be kept in mind as an effective solution to decrease the risk of complications related to high IPP.
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Affiliation(s)
- Mehmet İlker Gökce
- Ankara University School of Medicine, Department of Urology, Ankara, Turkey.
| | | | - Muammer Babayiğit
- Ankara University School of Medicine, Department of Urology, Ankara, Turkey
| | - Ezel Aydoğ
- Ankara University School of Medicine, Department of Urology, Ankara, Turkey
| | - Çağrı Akpınar
- Çubuk State Hospital, Department of Urology, Ankara, Turkey
| | - Evren Süer
- Ankara University School of Medicine, Department of Urology, Ankara, Turkey
| | - Ömer Gülpınar
- Ankara University School of Medicine, Department of Urology, Ankara, Turkey
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6
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Gökce Mİ, Akpinar Ç, Obaid K, Süer E, Gülpinar Ö, Bedük Y. Comparison of retrograde ureterorenoscopy (URS) and percutaneous anterograde ureteroscopy for removal of impacted upper ureteral stones >10mm in the elderly population. Int Braz J Urol 2020; 47:64-70. [PMID: 32840338 PMCID: PMC7712678 DOI: 10.1590/s1677-5538.ibju.2019.0638] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Accepted: 01/16/2020] [Indexed: 12/23/2022] Open
Abstract
PURPOSE We aimed to compare the success and complication rates of the anterograde and retrograde Ureterorenoscopy (URS) for impacted upper ureteral stones in patients > 65 years of age. MATERIALS AND METHODS Data of 146 patients >65 years of age and underwent anterograde URS (n=68) in supine position or retrograde URS (n=78) for upper ureteral impacted stones>10 mm between January 2014 and September 2018 were collected prospectively. The groups were compared for success and complication rates, duration of operation, hospital stay, and ancillary procedures. RESULTS Anterograde and retrograde URS groups were similar for demographic and stone related characteristics. The success rate of the anterograde URS group was significantly higher than the retrograde URS group (97.1% vs. 78.2%, p=0.0007). The complication rates were similar for the two groups (p=0.86). Clavien grade I and II complications were observed in 3 patients in each group. The mean hemoglobin drop was 0.5 g/dL in the anterograde URS group and blood transfusion was not performed in any of the patients. The mean duration of operation was 41.2±12.5 minutes in the mini-PNL group and 59.6±15.1 minutes in the RIRS group and the difference was statistically significant (p=0.02). The median duration of hospitalization was 1 day for both groups. CONCLUSIONS Performing anterograde URS in supine position provided better success rates and similar complication rates compared to retrograde URS. Based on these results anterograde URS shall be considered as one of the primary treatment options for management of impacted upper ureteral stones in the elderly population.
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Affiliation(s)
- Mehmet İlker Gökce
- Department of Urology, Ankara University School of Medicine, Ankara, Turkey
| | - Çağri Akpinar
- Department of Urology, Ankara University School of Medicine, Ankara, Turkey
| | - Khaled Obaid
- Department of Urology, Ankara University School of Medicine, Ankara, Turkey
| | - Evren Süer
- Department of Urology, Ankara University School of Medicine, Ankara, Turkey
| | - Ömer Gülpinar
- Department of Urology, Ankara University School of Medicine, Ankara, Turkey
| | - Yaşar Bedük
- Department of Urology, Ankara University School of Medicine, Ankara, Turkey
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Gökce Mİ, Yin S, Sönmez MG, Eryildirim B, Kallidonis P, Petkova K, Guven S, Kiremit MC, de Lorenzis E, Tefik T, Villa L, Zeng G, Sarica K. How does the COVID-19 pandemic affect the preoperative evaluation and anesthesia applied for urinary stones? EULIS eCORE-IAU multicenter collaborative cohort study. Urolithiasis 2020; 48:345-351. [PMID: 32436005 PMCID: PMC7239347 DOI: 10.1007/s00240-020-01193-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Accepted: 05/04/2020] [Indexed: 12/28/2022]
Abstract
Stone disease is a unique condition that requires appropriate management in a timely manner as it can result in both emergent conditions and long term effects on kidney functions. In this study it is aimed to identify the up-to-date practice patterns related to preoperative evaluation and anesthesia for stone disease interventions during COVID-19 pandemic. The data of 473 patients from 11 centers in 5 different countries underwent interventions for urinary stones during the Covid-19 pandemic was collected and analyzed retrospectively. Information on the type of the stone related conditions, management strategies, anesthesiologic evaluation, anesthesia methods, and any alterations related to COVID-19 pandemic was collected. During the preoperative anesthesia evaluation thorax CT was performed in 268 (56.7%) and PCR from nasopharyngeal swab was performed in 31 (6.6%) patients. General anesthesia was applied in 337 (71.2%) patients and alteration in the method of anesthesia was recorded in 45 (9.5%) patients. A cut-off value of 21 days was detected for the hospitals to adapt changes related to COVID-19. Rate of preoperative testing, emergency procedures, conservative approaches and topical/regional anesthesia increased after 21 days. The preoperative evaluation for management of urinary stone disease is significantly affected by COVID-19 pandemic. There is significant alteration in anesthesia methods and interventions. The optimal methods for preoperative evaluation are still unknown and there is discordance between different centers. It takes 21 days for hospitals and surgeons to adapt and develop new strategies for preoperative evaluation and management of stones.
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Affiliation(s)
- Mehmet İlker Gökce
- Department of Urology, Ankara University School of Medicine, Ankara Universitesi Tip Fakultesi Ibni Sina Hastanesi Uroloji Klinigi, Altindag, 06480, Ankara, Turkey.
| | - Shanfeng Yin
- The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Mehmet Giray Sönmez
- Department of Urology, Meram School of Medicine, Necmettin Erbakan University, Konya, Turkey
| | - Bilal Eryildirim
- Dr. Lütfi Kirdar Training and Research Hospital, Urology Clinic, Health Sciences University, Istanbul, Turkey
| | | | - Kremena Petkova
- Department of Urology and Nephrology, Military Medical Academy, Sofia, Bulgaria
| | - Selcuk Guven
- Department of Urology, School of Medicine, Medipol University, Istanbul, Turkey
| | - Murat Can Kiremit
- Department of Urology, School of Medicine, Koç University, Istanbul, Turkey
| | - Elisa de Lorenzis
- Department of Urology Foundation, IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Tzevat Tefik
- Department of Urology, School of Medicine, Istanbul University, Istanbul, Turkey
| | - Luca Villa
- Division of Experimental Oncology/Unit of Urology, Università Vita-Salute San Raffaele, Milan, Italy
| | - Guohua Zeng
- The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Kemal Sarica
- Department of Urology, School of Medicine, Medicana Bahcelievler Hospital, Biruni University, Istanbul, Turkey
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Gülpınar Ö, Esen B, Akpınar Ç, Baklacı U, Gökce Mİ, Süer E, Bedük Y. Potassium sensitivity test predicts hydrodistention efficacy in patients with bladder pain syndrome/interstitial cystitis. Turk J Urol 2019; 46:231-235. [PMID: 31747364 DOI: 10.5152/tud.2019.19084] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Accepted: 09/25/2019] [Indexed: 01/07/2023]
Abstract
OBJECTIVE To determine the possible role of potassium sensitivity test (PST) in predicting the success of hydrodistention (HD) in patients with bladder pain syndrome/interstitial cystitis (BPS/IC). MATERIAL AND METHODS Patients who underwent PST before diagnostic cystoscopy and HD were evaluated to collect data regarding the visual analog score (VAS) to assess pain, the voiding diary for frequency of urination/nocturia, mean urine volume per void, interstitial cystitis symptom index, and problem index before HD. Patients were requested to provide the VAS of pain at 1 month and 6 months post-HD. A reduction 2 or more on the VAS of pain was considered as a response adequate to be noted. RESULTS The median age of the patients was 46 years. The PST was positive for 27 patients (27/39; 69.2%). At 1 month post-HD, out of the 27 patients with positive PST, 23 (85.2%) were found to have been responsive to HD and 4 (14.8%) were non-responsive. Of the 12 (12/39; 30.8%) patients who showed a negative PST, 7 (58.3%) were non-responsive and 5 (41.7%) were responsive to HD. A logistic regression analysis revealed that PST (p=0.009) was the only parameter that was able to predict HD efficacy at 1 month post-HD. CONCLUSION PST was found to be a predictive factor for the short-term efficacy of HD. BPS/IC patients with positive PST are likely to be more susceptible to the damage of mucosal afferent nerve endings, which results in them benefiting from HD to a greater degree.
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Affiliation(s)
- Ömer Gülpınar
- Department of Urology, Ankara University School of Medicine, Ankara, Turkey.,Department of Urology, Ankara University School of Medicine, Ankara, Turkey
| | - Barış Esen
- Department of Urology, Ankara University School of Medicine, Ankara, Turkey.,Department of Urology, Ankara University School of Medicine, Ankara, Turkey
| | - Çağrı Akpınar
- Department of Urology, Ankara University School of Medicine, Ankara, Turkey.,Department of Urology, Ankara University School of Medicine, Ankara, Turkey
| | - Utku Baklacı
- Department of Urology, Ankara University School of Medicine, Ankara, Turkey.,Department of Urology, Ankara University School of Medicine, Ankara, Turkey
| | - Mehmet İlker Gökce
- Department of Urology, Ankara University School of Medicine, Ankara, Turkey.,Department of Urology, Ankara University School of Medicine, Ankara, Turkey
| | - Evren Süer
- Department of Urology, Ankara University School of Medicine, Ankara, Turkey.,Department of Urology, Ankara University School of Medicine, Ankara, Turkey
| | - Yaşar Bedük
- Department of Urology, Ankara University School of Medicine, Ankara, Turkey.,Department of Urology, Ankara University School of Medicine, Ankara, Turkey
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9
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Gökce Mİ, Gülpınar Ö, Akpınar Ç, Tangal S, Süer E, Göğüş Ç, Yaman Ö. Description of a novel method for renal puncture in supine percutaneous nephrolithotomy and comparison with a previously described method. Turk J Urol 2019; 45:444-448. [PMID: 31603419 DOI: 10.5152/tud.2019.33958] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2018] [Accepted: 01/29/2019] [Indexed: 12/23/2022]
Abstract
OBJECTIVE The supine position is becoming increasingly popular in percutaneous nephrolithotomy (PNL). Renal puncture is the key step for a successful PNL procedure. The aim of this study was to describe a novel method for renal puncture and compare it with a previously described method. MATERIAL AND METHODS Data of 358 patients who underwent PNL in the supine position were collected prospectively. In 165 patients, the puncture was performed by a previously described method (Group 1), and in 193 patients, the puncture was performed with the novel method (Group 2). Groups were compared with regard to total time and fluoroscopy time to successful puncture. In the novel puncture technique, the needle is advanced toward the targeted calyx under monoplane fluoroscopy. To determine the needle depth, the C-arm is rotated by 10°. If the needle projection is beyond the targeted calyx in fluoroscopy, the puncture is deeper than desired. If the needle projection does not reach the targeted calyx, the puncture is more superficial than desired. RESULTS Groups were similar with regard to the mean age, gender distribution, body mass index, stone size, and site of puncture. The mean total time to puncture was 88.2±25.3 seconds in Group 1 and 54.3±22.3 seconds in Group 2, and the difference was statistically significant (p=0.03). The mean fluoroscopy time to puncture was 16.1±5.3 seconds in Group 1 and 9.3±3.4 seconds in Group 2, and the difference was statistically significant (p=0.03). CONCLUSION This novel method to determine the depth of the needle is simple, reproducible, and has the potential to diminish radiation exposure with the aid of intermittent fluoroscopy.
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Affiliation(s)
- Mehmet İlker Gökce
- Department of Urology, Ankara University School of Medicine Ankara, Turkey
| | - Ömer Gülpınar
- Department of Urology, Ankara University School of Medicine Ankara, Turkey
| | - Çağrı Akpınar
- Department of Urology, Ankara University School of Medicine Ankara, Turkey
| | - Semih Tangal
- Department of Urology, Ufuk University School of Medicine Ankara, Turkey
| | - Evren Süer
- Department of Urology, Ankara University School of Medicine Ankara, Turkey
| | - Çağatay Göğüş
- Department of Urology, Ankara University School of Medicine Ankara, Turkey
| | - Önder Yaman
- Department of Urology, Ankara University School of Medicine Ankara, Turkey
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Gökce Mİ, Gülpinar O, Ibiş A, Karaburun M, Kubilay E, Süer E. Retrograde vs. antegrade fl exible nephroscopy for detection of residual fragments following PNL: A prospective study with computerized tomography control. Int Braz J Urol 2019; 45:581-587. [PMID: 30901169 PMCID: PMC6786124 DOI: 10.1590/s1677-5538.ibju.2018.0695] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2018] [Accepted: 12/04/2018] [Indexed: 12/23/2022] Open
Abstract
INTRODUCTION The main aim of stone surgery is to establish stone free status. Performing fl exible nephroscopy is an effective tool in this manner. The aim of this study was to evaluate the role of retrograde fl exible nephroscopy for detection of residual fragments following percutaneous nephrolithotomy (PNL) in comparison with antegrade approach. MATERIALS AND METHODS Data of 137 patients underwent ECIRS was collected prospectively. In all cases following stone clearance, collecting system was checked for residual fragments. First antegrade than retrograde fl exible nephroscopy was performed and success rates to reach all calices and detection of residual fragments were noted. All patients underwent CT and success rate of antegrade and retrograde approaches were compared. PPV and NPV of retrograde approach to detect residual fragments were calculated. RESULTS Antegrade and retrograde nephroscopy successfully accessed all of the calices in 101 (73.7%) and 130 (94.9%) patients respectively (p<0.0001). Residual fragments were observed in 18 (13.1%) patients following antegrade fl exible nephroscopy. Retrograde approach identifi ed residual stones in 17 more cases. These cases were treated with fl exible nephroscopy or secondary percutaneous tract. Postoperative CT revealed residual stones in 10 (7.3%) patients. PPV and NPV of retrograde fl exible nephroscopy were 83.3% and 96.2%. CONCLUSIONS Flexible nephroscopy effectively detects residual fragments following PNL. Retrograde approach was more successful than antegrade approach to reach all calices. We recommend performing retrograde fl exible nephroscopy following PNL especially in complex cases as it has the potential to increase SFR, decrease the need for second look surgery and unnecessary postoperative imaging.
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Affiliation(s)
- Mehmet İlker Gökce
- Department of Urology, Ankara University School of Medicine, Adnan Saygun Caddesi, Altindağ, Ankara, Turkey
| | - Omer Gülpinar
- Department of Urology, Ankara University School of Medicine, Adnan Saygun Caddesi, Altindağ, Ankara, Turkey
| | - Arif Ibiş
- Department of Urology, Ankara University School of Medicine, Adnan Saygun Caddesi, Altindağ, Ankara, Turkey
| | - Muratcan Karaburun
- Department of Urology, Ankara University School of Medicine, Adnan Saygun Caddesi, Altindağ, Ankara, Turkey
| | - Eralp Kubilay
- Department of Urology, Ankara University School of Medicine, Adnan Saygun Caddesi, Altindağ, Ankara, Turkey
| | - Evren Süer
- Department of Urology, Ankara University School of Medicine, Adnan Saygun Caddesi, Altindağ, Ankara, Turkey
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Özkıdık M, Gökce Mİ, Yaman Ö. Efficacy of tadalafil treatment on erectile dysfunction in patients under dutasteride treatment: A prospective non-randomized comparative study. Turk J Urol 2018; 44:294-297. [PMID: 29799405 DOI: 10.5152/tud.2018.46666] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2017] [Accepted: 12/29/2017] [Indexed: 11/22/2022]
Abstract
OBJECTIVE In this study, we aimed to evaluate the efficacy of tadalafil in the management of erectile dysfunction in patients under dutasteride medication for bladder outlet obstruction. MATERIAL AND METHODS In this study the data of consecutive patients that admitted to our outpatient clinics treated with dutasteride for bladder outlet obstruction and tadalafil (10 or 20 mg on demand) for concomitant complaint of erectile dysfunction (ED) between October 2013 and March 2016 were evaluated. An age-matched control group of patients treated with tadalafil for ED but did not receive any other medication for either lower urinary tract symptoms (LUTS) or ED was also included. Groups were compared for tadalafil efficacy with International Index of Erectile Function (IIEF) scores. RESULTS Each one of the dutasteride and control groups included 104 patients. The groups were similar for pretreatment IIEF score, serum cholesterol, low-density lipoprotein (LDL), triglyceride and testosterone measurements. The number of hypertensive patients was comparable between two groups but the number of diabetic patients were significantly higher in the control group. IIEF score improved significantly in both groups following tadalafil treatment but the difference between the two groups was not statistically significant. CONCLUSION Tadalafil treatment provides significant improvement in erectile functions of patients under dutasteride treatment for bladder outlet obstruction. However, the current study does not focus on a population of dutasteride induced ED and therefore a further prospective study on this issue would be helpful.
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Affiliation(s)
- Mete Özkıdık
- Department of Urology, Ankara University School of Medicine, Ankara, Turkey
| | - Mehmet İlker Gökce
- Department of Urology, Ankara University School of Medicine, Ankara, Turkey
| | - Önder Yaman
- Department of Urology, Ankara University School of Medicine, Ankara, Turkey
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12
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Gülpinar B, Akinci A, Süer E, Sanci A, Babayiğit M, Bedük Y, Baltaci S, Gökce Mİ. Prospective evaluation of kidney displacement during supine mini-percutaneous nephrolithotomy: Incidence, significance, and analysis of predictive factors. Can Urol Assoc J 2018; 12:E475-E479. [PMID: 29989888 DOI: 10.5489/cuaj.5247] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
INTRODUCTION Kidney displacement may alter the quality of renal puncture during percutaneous nephrolithotomy (PCNL). The aim of this study was to identify the rate of kidney displacement and parameters associated with kidney displacement in patients who underwent supine mini-PCNL. METHODS Data of 98 consecutive patients who underwent mini-PCNL was collected prospectively. The patients were grouped as displacement-positive vs. -negative. The parameters collected were age, gender, body mass index, side of the kidney, punctured calyx, fluoroscopy time to successful puncture and tract dilation, stone-free and complication rates, stone diameter, length of the renal artery, and quantity of peri-renal and abdominal fat. Groups were compared for the above listed parameters and logistic regression analysis was performed to identify factors associated with kidney displacement. RESULTS There were 34 and 64 patients in the displacement-positive and -negative groups, respectively. Groups were similar for stone-free and complication rates. Fluoroscopy time to puncture and tract dilation were longer in the displacement-positive group. Groups were different for renal artery length and peri-renal fat measurements. In multivariate analysis, lower pole puncture, renal artery length, and peri-renal fat measurement were found to be independent predictors of kidney displacement. CONCLUSIONS Kidney displacement does not alter the success and complication rates, but is associated with longer fluoroscopy times during supine PCNL. In the current study, parameters in preoperative non-contrast computerized tomography (NCCT) associated with kidney displacement were identified. We recommend surgeons evaluate and take into account these parameters during preoperative planning to establish better outcomes and diminish fluoroscopy times.
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Affiliation(s)
- Başak Gülpinar
- Department of Radiology, Ankara University School of Medicine, Ankara, Turkey
| | - Aykut Akinci
- Department of Urology, Ankara University School of Medicine, Ankara, Turkey
| | - Evren Süer
- Department of Urology, Ankara University School of Medicine, Ankara, Turkey
| | - Adem Sanci
- Department of Urology, Ankara University School of Medicine, Ankara, Turkey
| | - Muammer Babayiğit
- Department of Urology, Ankara University School of Medicine, Ankara, Turkey
| | - Yaşar Bedük
- Department of Urology, Ankara University School of Medicine, Ankara, Turkey
| | - Sümer Baltaci
- Department of Urology, Ankara University School of Medicine, Ankara, Turkey
| | - Mehmet İlker Gökce
- Department of Urology, Ankara University School of Medicine, Ankara, Turkey
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Gökce Mİ, Esen B, Sancı A, Akpınar C, Süer E, Gülpınar Ö. A Novel Decision Aid to Support Informed Decision-Making Process in Patients with a Symptomatic Nonlower Pole Renal Stone <20 mm in Diameter. J Endourol 2018; 31:725-728. [PMID: 28467724 DOI: 10.1089/end.2017.0077] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION Stone disease is an important health problem, and patients have different treatment choices. Shared decision making is recommended for deciding the treatment type, but patient education is necessary. Decision aids (DAs) are used for this aim, and herein, we developed a novel DA for patients with symptomatic nonlower pole renal stones <20 mm in diameter. MATERIALS AND METHODS The DA development process was established based on the recommended guides. General characteristics of the stone disease and details of the shockwave lithotripsy and retrograde intrarenal surgery were included in the content of the DA. The DA was further revised based on the suggestions of different physician groups and patients. The DA was evaluated by three physicians (Delphi assessment-International Patient Decision Aid Standards [IPDAS] Collaboration standards) and 25 patients (questionnaire of six questions with five-point Likert scale). RESULTS The DA was designed as a booklet, and Delphi group assessment resulted in a total score of 50/54. Patient evaluation of the DA resulted in favorable outcomes, and patients generally recommended its use by other patients. CONCLUSIONS This novel DA for patients with a symptomatic nonlower pole renal stone <20 mm showed promising results and was well accepted by the patients. We believe that this DA will have a positive impact on patients' level of knowledge. Increased level of knowledge will also improve the patients' contribution to the shared decision-making process. A further prospective randomized trial to compare with the standard patient informing process is also planned.
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Affiliation(s)
- Mehmet İlker Gökce
- Department of Urology, Ankara University School of Medicine , Ankara, Turkey
| | - Barış Esen
- Department of Urology, Ankara University School of Medicine , Ankara, Turkey
| | - Adem Sancı
- Department of Urology, Ankara University School of Medicine , Ankara, Turkey
| | - Cağrı Akpınar
- Department of Urology, Ankara University School of Medicine , Ankara, Turkey
| | - Evren Süer
- Department of Urology, Ankara University School of Medicine , Ankara, Turkey
| | - Ömer Gülpınar
- Department of Urology, Ankara University School of Medicine , Ankara, Turkey
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Gökce Mİ, Ibiş A, Sancı A, Akıncı A, Bağcı U, Ağaoğlu EA, Süer E, Gülpınar Ö. Comparison of supine and prone positions for percutaneous nephrolithotomy in treatment of staghorn stones. Urolithiasis 2017; 45:603-608. [PMID: 28357451 DOI: 10.1007/s00240-017-0977-y] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2017] [Accepted: 03/20/2017] [Indexed: 12/23/2022]
Abstract
INTRODUCTION Percutaneous nephrolithotomy (PNL) is the primary treatment modality for management of staghorn stones. PNL in supine position has important advantages over prone positon. However, studies comparing prone and supine positions for PNL in staghorn stone patients have conflicting results, and the aim of the current study was to compare prone and supine positions for PNL in staghorn stone cases. PATIENTS AND METHODS Data of patients underwent PNL for staghorn stones in supine or prone position by a single urologist were collected prospectively. The supine and prone position groups were compared for stone free rate (SFR) and complication rates. All patients were evaluated with NCCT for evaluation of SFR. Chi-square test was used to compare categorical variables and Student t test was applied for continuous variables of the treatment groups. RESULTS The groups were similar for demographic and stone-related characteristics. Multi-caliceal and intercostal access was more common in prone position. Operation duration was significantly shorter and hemoglobin drop was significantly less in supine group. SFR was 64.1 and 60.4% in the supine and prone groups, respectively (p = 0.72). Complication rates were similar in the two groups but Clavien III complications were observed in two patients in the prone group. CONCLUSIONS PNL in supine position is an effective treatment for management of staghorn stones. The need for multi-caliceal and intercostal puncture is less when combined with retrograde intrarenal surgery. PNL in supine position should be considered as primary treatment option in staghorn stone cases.
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Affiliation(s)
- Mehmet İlker Gökce
- Department of Urology, Ankara University School of Medicine, Ankara, Turkey.
| | - Arif Ibiş
- Department of Urology, Ankara University School of Medicine, Ankara, Turkey
| | - Adem Sancı
- Department of Urology, Ankara University School of Medicine, Ankara, Turkey
| | - Aykut Akıncı
- Department of Urology, Ankara University School of Medicine, Ankara, Turkey
| | - Uygar Bağcı
- Department of Urology, Ankara University School of Medicine, Ankara, Turkey
| | - Eylül Asya Ağaoğlu
- Department of Urology, Ankara University School of Medicine, Ankara, Turkey
| | - Evren Süer
- Department of Urology, Ankara University School of Medicine, Ankara, Turkey
| | - Ömer Gülpınar
- Department of Urology, Ankara University School of Medicine, Ankara, Turkey
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Gülpınar O, Haliloğlu AH, Gökce Mİ, Arıkan N. Instillation of Hyaluronic Acid via Electromotive Drug Administration Can Improve the Efficacy of Treatment in Patients With Interstitial Cystitis/Painful Bladder Syndrome: A Randomized Prospective Study. Korean J Urol 2014; 55:354-9. [PMID: 24868341 PMCID: PMC4026663 DOI: 10.4111/kju.2014.55.5.354] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2013] [Accepted: 09/07/2013] [Indexed: 11/18/2022] Open
Abstract
PURPOSE In the treatment of interstitial cystitis, intravesical hyaluronic acid application may be suggested as a treatment option. In this randomized prospective study, the authors aimed to identify whether instilling the hyaluronic acid with electromotive drug administration (EMDA) would increase the tissue uptake and improve the efficacy. MATERIALS AND METHODS The data of 31 patients who had been diagnosed with bladder pain syndrome/interstitial cystitis (BPS/IC) between 2004 and 2005 were examined. The patients were randomized to two groups: patients in group A received hyaluronic acid directly with a catheter and patients in group B received hyaluronic acid with EMDA. The patients were followed for 24 months and the two groups were compared at certain time intervals. The primary end points of the study were visual analogue scale (VAS) score, global response assessment, and micturition frequency in 24 hours. RESULTS There were 6 males and 25 females. The two groups were similar in baseline parameters. The decrease in VAS score and the micturition frequency in 24 hours were significantly lower with EMDA at months 6 and 12. The difference between the two groups was not significant at months 1 and 24. Also, treatment with EMDA, positive KCl test, and pretreatment voiding frequency >17 were associated with higher response rates. CONCLUSIONS Hyaluronic acid installation is an effective glycosaminoglycan substitution therapy in patients with BPS/IC. Instillation of hyaluronic acid via EMDA can improve the efficacy of the treatment; however, lack of long-term efficacy is the major problem with this glycosaminoglycan substitution therapy.
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Affiliation(s)
- Omer Gülpınar
- Department of Urology, Ankara University Faculty of Medicine, Ankara, Turkey
| | | | - Mehmet İlker Gökce
- Department of Urology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Nihat Arıkan
- Department of Urology, Ankara University Faculty of Medicine, Ankara, Turkey
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Göğüş Ç, Gökce Mİ, Süer E, Tulunay Ö, Şafak M. Primary malignant fibrous histiocytoma of the kidney: report of a case and literature review. Turk J Urol 2013; 39:194-7. [PMID: 26328107 DOI: 10.5152/tud.2013.039] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2013] [Accepted: 01/25/2013] [Indexed: 11/22/2022]
Abstract
We report a 44-year-old woman with a malignant fibrous histiocytoma (MFH) of the kidney. Primary renal MFH is an extremely rare tumor with a poor prognosis. Renal MFH is differentiated from renal cell carcinoma, renal sarcoma, and sarcomatoid renal tumors only by histological and immunohistochemical studies. Because the therapeutic options for MFH are different, its early diagnosis is imperative.
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Affiliation(s)
- Çağatay Göğüş
- Department of Urology, Faculty of Medicine, Ankara University, Ankara, Turkey
| | - Mehmet İlker Gökce
- Department of Urology, Faculty of Medicine, Ankara University, Ankara, Turkey
| | - Evren Süer
- Department of Urology, Faculty of Medicine, Ankara University, Ankara, Turkey
| | - Özden Tulunay
- Department of Pathology, Faculty of Medicine, Ankara University, Ankara, Turkey
| | - Mut Şafak
- Department of Urology, Faculty of Medicine, Ankara University, Ankara, Turkey
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Gülpınar O, Süer E, Gökce Mİ, Haliloğlu AH, Oztürk E, Arıkan N. Functional Outcomes and Long-term Durability of Artificial Urinary Sphincter Application: Review of 56 Patients With Long-term Follow-up. Korean J Urol 2013; 54:373-6. [PMID: 23789045 PMCID: PMC3685636 DOI: 10.4111/kju.2013.54.6.373] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2013] [Accepted: 02/27/2013] [Indexed: 11/18/2022] Open
Abstract
Purpose To evaluate the long-term outcomes of artificial urinary sphincter (AUS) implantation and to report the complication rates, including mechanical failure, erosion, and infection. Materials and Methods From June 1990 to May 2011, AUS (AMS 800) implantations were performed in 56 adult males by one surgeon. Various demographic and preoperative variables, surgical variables, and postoperative outcomes, including success and complication rates with a median follow-up of 96 months, were recorded retrospectively. Results The mean age of the patients at the time of AUS implantation was 61.8 (±14.2) years. During the follow-up period, the total complication rate was 41.1% (23 patients). The incidence of complications was significantly lower during the follow-up period after 48 months (p<0.05). Kaplan-Meier analysis revealed that 5- and 10-year failure-free rates were 50.3% and 45.2%, respectively. Conclusions Long-term durability and functional outcomes are achievable for the AMS 800, but there are appreciable complication rates for erosion, mechanical failure, and infection of up to 30%.
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Affiliation(s)
- Omer Gülpınar
- Department of Urology, Ankara University Faculty of Medicine, Ankara, Turkey
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Süer E, Burgu B, Gökce Mİ, Türkölmez K, Bedük Y, Baltaci S. Comparison of radical and partial nephrectomy in terms of renal function: A retrospective cohort study. ACTA ACUST UNITED AC 2010; 45:24-9. [DOI: 10.3109/00365599.2010.521186] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Evren Süer
- Department of Urology, Faculty of Medicine, Ankara University, Ankara, Turkey
| | - Berk Burgu
- Department of Urology, Faculty of Medicine, Ankara University, Ankara, Turkey
| | - Mehmet İlker Gökce
- Department of Urology, Faculty of Medicine, Ankara University, Ankara, Turkey
| | - Kadir Türkölmez
- Department of Urology, Faculty of Medicine, Ankara University, Ankara, Turkey
| | - Yaşar Bedük
- Department of Urology, Faculty of Medicine, Ankara University, Ankara, Turkey
| | - Sümer Baltaci
- Department of Urology, Faculty of Medicine, Ankara University, Ankara, Turkey
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Gökce Mİ, Burgu B, Aydoğdu Ö, Fitöz S, Soygür T. Transverse testicular ectopia associated with persistent Müllerian duct syndrome: another entity in which magnetic resonance imaging is unreliable. Urology 2010; 76:1475-7. [PMID: 20813400 DOI: 10.1016/j.urology.2010.03.043] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2010] [Revised: 03/16/2010] [Accepted: 03/18/2010] [Indexed: 11/24/2022]
Abstract
In this case report we describe a case of persistant Müllerian duct syndrome together with transverse testicular ectopia. These 2 entities are discussed to assess the relationship between them and the lack of necessity for magnetic resonance imaging in cases of undescended testes, and relevant literature is reviewed.
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Affiliation(s)
- Mehmet İlker Gökce
- Ankara University Faculty of Medicine, Department of Urology, Ankara, Turkey.
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