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    The Application of Kidney Injury Molecule-1 to Determine the Duration Between Shockwave Lithotripsy Sessions
    (Mary Ann Liebert, Inc, 2016) Aydin, Hasan R.; Irkilata, Lokman; Aydin, Mustafa; Daggulli, Mansur; Taskin, Mehmet H.; Demirel, Huseyin C.; Adanur, Senol
    Purpose: We aimed to evaluate the role of kidney injury molecule-1 (KIM-1) in determining the intervals between shockwave lithotripsy (SWL) sessions. Patients and Methods: This was a prospective, controlled study. It included 40 patients with unilateral kidney stones and 40 healthy persons of a similar age group as controls. The patients' midflow urine samples were collected before SWL and 1 hour, 1 day, 1 week, and 1 month after the procedure. Results: The average age in the SWL and control groups was 4514 and 39 +/- 15 years, respectively (P=0.336). The average KIM-1 value before SWL was 0.74 +/- 0.35ng/mL, which was significantly higher than that of the control group (0.51 +/- 0.14ng/mL) (P<0.001). Similarly, the average values of the urine samples after SWL were higher than those of the control group (P<0.001). When the KIM-1 values of the patients given SWL were compared within the group, the KIM-1 values 1 hour (1.06 +/- 0.51) and 1 day (0.99 +/- 0.67) after the procedure were statistically clearly higher than those before the procedure (P<0.001) and statistically clearly higher than those of the control group (P=0.005). The KIM-1 values 1 week and 1 month after the procedure were not significantly different than the preprocedure values (P=0.652 and P=0.747, respectively). Conclusion: KIM-1 is a noninvasive biomarker that may be used to show renal damage because of stones and early-stage renal damage linked to SWL. In addition, post-SWL KIM-1 values may be used to determine the interval between SWL sessions.
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    Colon perforation related to percutaneous nephrolithotomy: from diagnosis to treatment
    (Springer, 2015) Akbulut, Fatih; Tok, Adem; Penbegül, Necmettin; Daggulli, Mansur; Eryildirim, Bilal; Adanur, Senol; Gurbuz, Gokhan
    We present our experience with the largest series of colon perforation (CP) as complication of percutaneous nephrolithotomy (PNL). From January 1998 to August 2014, 22 cases that presented with PNL-related CP from seven referral centers were retrospectively reviewed. The patients with CP were evaluated in terms of probable risk factors. Peri-operative and postoperative findings, timing of diagnosis, and treatment modalities of the CP were reviewed. Of the 22 patients, previous ipsilateral renal surgery (n:2) and retrorenal colon (n:5) were the risk factors for CP. The CP was directly visualized via nephroscopy during the surgery in 3 (13.6 %) and with nephrostography at the end of the procedure in 4 patients (18.2 %). In two patients, perforation was realized via the passage of contrast into the colon with nephrostography on the postoperative second day. Postoperative passage of feces through the nephrostomy tube was seen in six patients. The clinical signs in 13 cases directed CP diagnosis. The confirmation of the CP was achieved with a CT scan in all the patients. The patients with extraperitoneal perforation were primarily managed conservatively. Open surgical treatment was performed in cases with intraperitoneal perforation (n:5) and those with extraperitoneal perforation resistant to conservative treatment (n:5). Meticulous evaluation of the risk factors preoperatively is the initial step in the prevention of CP. Timely diagnosis plays essential role in the management of this PNL complication. Although extraperitoneal CP may be managed conservatively, surgery is required for intraperitoneal CPs.
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    ENDOUROLOGIC MANAGEMENT OF PEDIATRIC FORGOTTEN STENTS: 22 PATIENTS FROM 4 CLINICS
    (Mary Ann Liebert, Inc, 2012) Sancaktutar, Ahmet Ali; Adanur, Senol; Resorlu, Berkan; Tepeler, Abdulkadir; Ziypak, Tevfik; Atar, Murat; Bozkurt, Yasar
    [Abstract Not Available]
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    The Forgotten Ureteral Stent in Children: From Diagnosis to Treatment
    (Elsevier Science Inc, 2013) Sancaktutar, Ahmet Ali; Adanur, Senol; Resorlu, Berkan; Tepeler, Abdulkadir; Ziypak, Tevfik; Soylemez, Haluk; Atar, Murat
    Purpose: We conducted a multicenter pediatric study of ureteral stents unintentionally left in situ. Materials and Methods: A total of 22 patients with encrusted Double-J (R) ureteral stents unintentionally left in situ were treated at 4 centers between January 2007 and March 2012. Stone burdens were estimated using plain radiography and computerized tomography. Treatment decision was made based on clinical and radiological findings or stone burden. Results: Nine girls and 13 boys with a mean age of 9.5 years (range 2 to 16) were analyzed. Mean indwelling time of ureteral stent was 21.7 months (range 6 to 60). Stents were inserted for the indication of urolithiasis (17 patients) and reconstructive urological intervention (5). In 2 patients stents had been placed bilaterally. Mean stent stone burden was 184 mm(2) on plain radiography and 247 mm(2) on computerized tomography, a difference that was statistically significant (p = 0.002). Shock wave lithotripsy was done in 6 cases. Endoscopic procedures were performed in all patients, including ureteroscopy in 8, simple stent removal in 7, endoscopic cystolithotripsy in 6, percutaneous nephrolithotomy in 5, retrograde intrarenal surgery in 3 and percutaneous cystolithotripsy in 2. Surgical removal of each stent required a mean of 1.5 interventions and a mean hospital stay of 4.4 days. Conclusions: At experienced centers combined endourological techniques can achieve successful and safe management of forgotten stents even in the pediatric age group. Thus, routine preprocedural tomography is a must in children with forgotten ureteral stents.
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    Micropercutaneous Nephrolithotomy in the Management of Bilateral Renal Stones in a 7-Month-Old Infant: The Youngest Case in the Literature
    (Karger, 2016) Sancaktutar, Ahmet Ali; Adanur, Senol; Ziypak, Tevfik; Hatipoglu, Namik Kemal; Bodakci, Mehmet Nuri; Soylemez, Haluk; Ozbey, Isa
    During infancy, the renal parenchyma and pelvicalyceal system are relatively fragile. Therefore, percutaneous nephrolithotomy for the management of renal stones in this age group is a challenging procedure for urologists. Herein, we present the uneventful management of bilateral renal stones using micropercutaneous nephrolithotomy (microperc) administered to a 7-month-old infant with recurrent urinary tract infections. In this paper, the advantages and disadvantages of the microperc procedure are discussed. As far as we know, our patient is the youngest case in whom the microperc procedure has been performed. (C) 2014 S. Karger AG, Basel
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    Percutaneous nephrolithotomy for the treatment of radiolucent renal stones in children: is it different opaque stone treatment?
    (Springer, 2014) Adanur, Senol; Ziypak, Tevfik; Sancaktutar, Ahmet Ali; Tepeler, Abdulkadir; Resorlu, Berkan; Soylemez, Haluk; Daggulli, Mansur
    We aimed to evaluate the effectiveness of percutaneous nephrolithotomy (PNL), stone-free rates, and related complications in children with radiolucent renal stones. A total of 56 patients aged < 16 years from four institutions were enrolled in our study. Asymptomatic, clinically insignificant residual fragments measuring < 4 mm or a complete stone-free status was accepted as the criterion for clinical success. Complications were evaluated according to the modified Clavien classification. The mean age of the patients was 7.8 +/- A 4.5 years. The mean stone size was calculated as 24.07 +/- A 10.4 mm. The median operative and fluoroscopy times were 53.2 min (15-170 min) and 172.4 s (5-520 s), respectively. The success rate after PNL monotherapy was 87.4 %; the total success rate with shock wave lithotripsy used as an auxillary treatment method was detected as 94.6 %. The total complication rate was 19.6 % (11 patients). No adjacent organ injury was observed. All of the complications that occurred were minor according to the Clavien classification (Clavien Grades I-II). PNL can be applied to radiolucent pediatric renal stones in children with similar success, and complication rates as noted for radiopaque stones.