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An Alternative and Inexpensive Percutaneous Access Needle in Pediatric Patients
(Elsevier Science Inc, 2012) Penbegül, Necmettin; Soylemez, Haluk; Bozkurt, Yasar; Sancaktutar, Ahmet Ali; Bodakci, Mehmet Nuri; Hatipoglu, Namik Kemal; Atar, Murat
INTRODUCTION The most important factor that increases the cost of percutaneous surgery is the disposable instruments used for the surgery. In this study we present the advantages of using an intravenous cannula instead of a percutaneous access needle for renal access. TECHNICAL CONSIDERATIONS Recently, percutaneous stone surgery has grown in use in pediatric cases and is considered a minimally invasive surgery. The most important step in this surgery is access to the renal collecting systems. Although fluoroscopy has been used frequently at this stage, the use of ultrasound has recently increased. During percutaneous accesses under all types of imaging techniques, disposable 11- to 15-cm-long 18-ga needles are used. In pediatric cases, these longer needles are difficult to use. Using disposable materials in percutaneous nephrolithotomy increases the cost of the procedure. Therefore, we asserted that percutaneous access especially in pediatric cases could be performed using a 16-ga intravenous cannula (angiocath). Indeed, percutaneous access was performed successfully, especially in pediatric preschool patients. Shorter needle length, easy skin entry, comfort of manipulation, clear visualization of the metal needle on ultrasound, and wide availability can be considered advantages of this method. The angiocath is also less expensive than a percutaneous access needle. CONCLUSION Angiocath is inexpensive, easily available, and practical, and it is the shortest needle to perform percutaneous access in pediatric patients. UROLOGY 80: 938-940, 2012. (C) 2012 Elsevier Inc.
Antioxidant Signal and Kidney Injury Molecule-1 Levels in Shockwave Lithotripsy Induced Kidney Injury
(Mary Ann Liebert, Inc, 2014) Hatipoglu, Namik Kemal; Evliyaoglu, Osman; Isik, Birgul; Bodakci, Mehmet Nuri; Bozkurt, Yasar; Sancaktutar, Ahmet Ali; Soylemez, Haluk
Purpose: Shockwave lithotripsy (SWL) induces acute kidney injury (AKI) that extends from the papilla to the outer cortex by causing ischemia and the production of nephrotoxic agents. Direct ischemic damage and the generation of free radicals cause injury to the proximal tubular cells. Kidney injury molecule-1 (KIM-1) is a transmembrane glycoprotein that is upregulated in proximal tubular cells after ischemic or nephrotoxic injury and is not expressed in healthy kidneys. We evaluated the extent of free radical production in response to SWL by measuring urinary total antioxidant capacity (TAC) and total oxidant status (TOS). Furthermore, we investigated the severity of SWL-induced kidney injury by measuring KIM-1 expression levels. Patients and Methods: The study population comprised 30 patients who were carefully selected and 30 age and sex matched control subjects. All patients received the same SWL procedure. Midstream urine samples were collected from patients before SWL and at 120 minutes after SWL. Urine KIM-1 levels were measured by enzyme-linked immunosorbent assay, and TAC and TOS were measured via spectrophotometry. Results: Mean levels of TAC (2.880.56mmolTxEq/L),TOS (8.27 +/- 1.57molH(2)O(2)Eq/L), and KIM-1 (0.55 +/- 0.08ng/mL) before SWL were not significantly different from mean TAC, TOS, and KIM-1 levels measured from the control group at 2.81 +/- 0.42mmolTxEq/L, 10.73 +/- 1.4molH(2)O(2)Eq/L, and 0.51 +/- 0.07ng/mL, respectively. Two hours after SWL, mean urine TAC levels (2.81 +/- 0.85mmolTxEq/L, P=0.02) were decreased and mean KIM-1 expression (0.85 +/- 0.11ng/mL, P=0.01) was significantly increased, but there was no significant difference in mean TOS levels (11.24 +/- 1.9molH(2)O(2)Eq/L, P=0.627) compared with the control group. Conclusions: The increased burden of free radical oxidants in the setting of decreasing antioxidant capacity may be one of the initial indicators of AKI after SWL. Moreover, KIM-1 demonstrates great potential as an early and noninvasive biomarker of SWL-induced kidney injury.
Bacterial profile and drug susceptibility pattern of urinary tract infection in pregnant women with ureteral stones and hydronephrosis
(Academic Journals, 2012) Atar, Murat; Bozkurt, Yasar; Sancaktutar, Ahmet Ali; Soylemez, Haluk; Penbegül, Necmettin; Sak, Muhammet Erdal; Tekin, Recep
The aim of this study is to identify bacterial agents and their antibiotic susceptibility patterns isolated from pregnant women with symptomatic ureterolithiasis. Seventeen patients who had proven ureteral stones, positive urine cultures and underwent intervention for ureterolithiasis treatment between January, 2008 to December, 2011 were included in this study. Bacteriuria was defined as accounts of 10(5) cfu/ml in urine culture. The mean age and gestational period was 24.5 years and 25.5 weeks. The major symptoms were renal colic, hematuria and fever-chills. The overall prevalence of urinary tract infection (UTI) in pregnancy with ureteral stones was 17/65 (26.2%). Escherichia coli are the most common etiological agent (64.7%), followed by Klebsiella and Staphylococcus. The rate of resistance of E. coli to amoxicillin-clavulanate, ampicilin, cefotaxime, ciprofloxacin, trimethoprim/sulfamethoxazol, ceftriaxone, piperacillin/ tazobactam and imipenem were 50, 45.5, 100, 18, 36.4, 28.6, 36.4, 0%, respectively. The rate of resistance of Klebsiella to Ampicilin were 80% and Amoxicillin-Clavulanate, Cefazolin, Cefepime, Ceftazidim were 60%. There were no resistance of Klebsiella to ciprofloxacin, gentamicin, meropenem and amikacin. Significant bacteriuria was observed in these patients and we recommend urine cultures in all pregnant women with ureteral stones during pregnancy. Ceftriaxone is recommended for the patients who have UTI with ureteral stones during pregnancy because of its high specificity and sensitivity.
Caffeic Acid Phenethyl Ester Protects Kidneys against Acetylsalicylic Acid Toxicity in Rats
(Taylor & Francis Ltd, 2012) Bozkurt, Yasar; Bozkurt, Mehtap; Turkcu, Gul; Sancaktutar, Ahmet Ali; Soylemez, Haluk; Penbegül, Necmettin; Atar, Murat
Aim: The aim of this study was to investigate the protective effect of caffeic acid phenethyl ester (CAPE) on acetylsalicylic acid (ASA)-induced renal damage in rats. Materials and methods: A total of 40 rats were randomly divided into five groups, with eight rats in each group-group 1: control, not receiving any medication; group 2: ASA (50 mg/kg/day); group 3: ASA (50 mg/kg/day) + CAPE (20 mu g/kg/day); group 4: ASA (100 mg/kg/day); and group 5: ASA (100 mg/kg/day) + CAPE (20 mu g/kg/day). ASA and CAPE were given via orogastric gavage for 5 days. The total oxidant status (TOS), total antioxidant capacity (TAC), and paraoxonase-1 (PON-1) activity of the blood samples and kidney tissues were determined. Histopathological examinations of the kidneys were performed using light microscopic methods. Results: The TOS level in the serum of rats and kidney tissues given ASA (groups 2 and 4) significantly increased, but the levels of TAC and PON-1 in these tissues significantly decreased in group 4 when compared with the control rats (p < 0.05). The levels of TAC and PON-1 in the kidney tissues increased and the levels of TOS decreased in the CAPE treatment groups (groups 3 and 5) when compared with the rats in the no CAPE treatment groups (groups 2 and 4). The PON-1, TAC, and TOS values reverted to normal levels in group 5 when compared to group 4 (p < 0.05). These results were supported by histopathological observation. Conclusion: Oxidative stress plays an important role in ASA-induced nephrotoxicity, and CAPE may protect against ASA-induced nephrotoxicity in rats.
Central serous chorioretinopathy due to tadalafil use
(Springer, 2013) Turkcu, Fatih Mehmet; Yuksel, Harun; Sahin, Alparslan; Murat, Mehmet; Bozkurt, Yasar; Caca, Ihsan
Phosphodiesterase-5 (PDE5) inhibitors are commonly used in the treatment of erectile dysfunction. There are a small number of case reports that associate this agent with central serous chorioretinopathy (CSCR). Our report presents the treatment approach to a 42-year-old patient who described blurred vision and metamorphopsia and was diagnosed with CSCR following the use of tadalafil, a PDE5 inhibitor.
A Cheap Minimally Painful and Widely Usable Alternative for Retrieving Ureteral Stents
(Karger, 2011) Soylemez, Haluk; Sancaktutar, Ahmet Ali; Bozkurt, Yasar; Atar, Murat; Penbegül, Necmettin; Yildirim, Kadir
Objective: To describe a cheap, minimally painful and widely usable method for retrieving ureteral stents by using an ureteroscope. Subjects and Methods: Sixty-seven patients with ureteral stents were enrolled in this study. The patients were randomized into a cystoscopic (35 patients) and a ureteroscopic (32 patients) group. All stents were retrieved by a flexible cystoscope in the first group and by a ureteroscope in the second group under local anesthesia. Patients in each group were assessed for stented time, stent side, cause of stent placement, operative time, peroperative pain, postoperative pain, irritative voiding symptoms and hematuria. Also costs of instruments were calculated. Results: Stents were successfully retrieved in 67 patients. There were no statistical differences in the two groups regarding patient gender and age or stent side, operative time, stented time, mean operative pain score, irritative voiding symptom scores and hematuria. Total selling price was USD 20.399 for flexible instruments and USD 10.516 for rigid ones. Total maintenance price was higher in flexible instruments than in the rigid ones (USD 197.8 and 51.7 per use, respectively). Conclusion: Ureteroscopic stent retrieval is a minimally painful, safe and highly tolerable method under local anesthesia as well as flexible cystoscopic retrieval. Also, it is a cheap and widely usable method. Copyright (C) 2011 S. Karger AG, Basel
Comparison of a 4.5 F semi-rigid ureteroscope with a 7.5 F rigid ureteroscope in the treatment of ureteral stones in preschool-age children
(Springer, 2012) Atar, Murat; Sancaktutar, Ahmet Ali; Penbegül, Necmettin; Soylemez, Haluk; Bodakci, Mehmet Nuri; Hatipoglu, Namik Kemal; Bozkurt, Yasar
The aim of this study was to compare the success and complication rates of a 4.5 F ureteroscope with a 7.5 F ureteroscope in the treatment of urolithiasis in preschool-age children. We retrospectively reviewed 69 ureteroscopy (URS) procedures in a pediatric population (40 boys, 29 girls). We divided the patients into two groups according to the type of ureteroscope used: group 1 (n = 42, Storz 7.5 F) and group 2 (n = 27, Wolf 4.5 F). We statistically compared all the procedures performed in both groups regarding patient age, complication rates, whether the procedure was therapeutic, and whether we used a guidewire. Additionally, in cases with ureteral stones, we also compared the stone clearance rate and the necessity of X-ray imaging between the two groups. The mean patient age was 56.04 months in group 1 and 47.48 months in group 2 (p = 0.057). The stone-free rate was 78.6 % in group 1 and 92.6 % in group 2 (p > 0.05). However, when we compared the stone-free rates for patients younger than 3 years, the rate was 66.7 % in group 1 and 93.8 % in group 2 (p < 0.05). The difference was not statistically significant for patients between the ages of 4 and 7 years. The success and failure rates revealed better outcomes for treatment of ureteral stones with a 4.5 F ureteroscope. We recommend the use of the mini-ureteroscope, especially in infants and preschool-age children.
Comparison of Laparoscopic and Microscopic Subinguinal Varicocelectomy in terms of Postoperative Scrotal Pain
(Soc Laparoendoscopic Surgeons, 2012) Soylemez, Haluk; Penbegül, Necmettin; Atar, Murat; Bozkurt, Yasar; Sancaktutar, Ahmet Ali; Altunoluk, Bulent
Background and Objectives: In this study, 2 different varicocelectomy methods were compared with regard to postoperative scrotal pain, length of operation, and complications. Methods: Forty varicocele patients, who visited our clinic because of infertility or scrotal pain between 2008 and 2009, were enrolled in this clinical study. Microscopic subinguinal varicocelectomy was performed on 20 patients in Group I, and laparoscopic varicocelectomy was performed on 20 patients in Group II. Following surgery, the patients were assessed for postoperative requirements for analgesia; return to normal activity; varicocele recurrence; hydrocele formation; scrotal pain at postoperative days 1, 3, and 7; and other complications. Results: Mean age was 24.2 +/- 3.4 years in Group I and 25.1 +/- 12.1 years in Group II. Mean pain scores at postoperative 1, 3, and 7 days in Group I were (5.20 +/- 11.14, 4.60 +/- 10.97, and 3.50 +/- 0.97, respectively) significantly higher than those of Group 11 (0.70 +/- 0.82, 0.60 +/- 10.84, and 0.10 +/- 10.32, respectively). Time to return to normal activity was significantly shorter in Group 11 (3.7 +/- 2.1 days) compared with Group I (6.8 +/- 13.4 days) (p = 0.028). However, the number of recurrences and hydroceles, as a complication of varicocelectomy, was 2 times higher in Group II (10%) than in Group I (5%). Conclusions: We believe that laparoscopic varicocelectomy is a safe, effective, and minimally invasive procedure. Furthermore, reduced postoperative discomfort and earlier return to normal activity are additional advantages of this method.
Comparison of pneumatic and laser lithotripsy in the treatment of pediatric ureteral stones
(Elsevier Sci Ltd, 2013) Atar, Murat; Bodakci, Mehmet Nuri; Sancaktutar, Ahmet Ali; Penbegül, Necmettin; Soylemez, Haluk; Bozkurt, Yasar; Hatipoglu, Namik Kemal
Objective: To compare the effectiveness and safety of pneumatic and holmium: YAG laser lithotripters in the treatment of pediatric ureterolithiasis. Patients and methods: Medical records of patients treated using pneumatic (PL) (n = 29) or laser (LL) (n = 35) lithotripter between 2009 and 2011 were retrospectively analysed. The patients were evaluated with respect to age, gender, stone size, complications, and stone-free rates 1 month after the operation. Results: For the PL and LL groups, mean ages (8.8 +/- 3.4 and 8.3 +/- 3.5 years), male/ female ratios (19:10 and 22:13) and stone locations were similar (p > 0.05). Mean stone sizes were 55.6 mm(2) and 47.6 mm(2) in the PL and LL group, respectively, with no statistically significant difference (p = 0.850). Mean operative times were 20.5 min in the PL group and 25.2 min in the LL group, with a statistically significant difference (p = 0.020). Stone-free rates 1 month after intervention were 79% in the PL group and 97% in the LL group (p = 0.022). Stone migration was detected in the PL group (n = 6) and in the LL group (n = 1). No major complication was found in either group. Conclusion: In the ureteroscopic treatment of pediatric ureterolithiasis, both pneumatic and laser lithotripters are effective and successful. However, laser lithotripsy has a higher stone-free rate and lower complication rate. (C) 2012 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.
Comparison of Shockwave Lithotripsy and Microperc for Treatment of Kidney Stones in Children
(Mary Ann Liebert, Inc, 2013) Hatipoglu, Namik Kemal; Sancaktutar, Ahmet Ali; Tepeler, Abdulkadir; Bodakci, Mehmet Nuri; Penbegül, Necmettin; Atar, Murat; Bozkurt, Yasar
Purpose: We aimed to compare the outcomes of microperc and shockwave lithotripsy (SWL) for treatment of kidney stones in children. Patients and Methods: The medical records of 145 patients under the age of 15 years with opaque and single kidney stones treated with either SWL or microperc were retrospectively reviewed. Both groups were compared in terms of fluoroscopy and operative time, re-treatment, complications, success rate, and secondary and total number of procedures. Results: Microperc and SWL were performed on 37 and 108 pediatric patients, respectively. The mean age of the patients was 5.914.03 years (1-15) and 8.43 +/- 4.84 (1-15) years in the SWL and microperc groups, respectively (P=0.004). The mean stone size was 11.32 +/- 2.84 (5-20) mm in the SWL group and 14.78 +/- 5.39 (6-32) mm in the microperc group (P<0.001). In the SWL group, 31 (28.7%) patients underwent a second SWL session and 6 (5%) had a third session. Finally, 95 (88%) patients were stone free at the end of the SWL sessions. In the microperc group, the stone-free rate was 89.2% in a single session (P=0.645). The mean duration of hospitalization was 49.2 +/- 12.3 (16-64) hours in the microperc group and 8.4 +/- 2.3 (6-10) hours per one session in the SWL group (P<0.001). The fluoroscopy time was significantly longer in the microperc group compared with the SWL group (147.3 +/- 95.3 seconds vs 59.6 +/- 25.9 seconds, P<0.001). The rate of requirement for an auxiliary procedure was higher in the SWL group than in the microperc group. The overall complication rates for the microperc and SWL groups were 21.6% and 16.7%, respectively (P=0.498). Conclusions: The results of our study demonstrate that microperc provides a similar stone-free rate and a lower additional treatment rate compared with SWL in the treatment of kidney stone disease in children.
Debate on monoplanar percutaneous nephrolithotomy
(Springer, 2013) Hatipoglu, Namik Kemal; Bodakci, Mehmet Nuri; Penbegül, Necmettin; Bozkurt, Yasar; Sancaktutar, Ahmet Ali; Atar, Murat; Soylemez, Haluk
[Abstract Not Available]
Effectiveness and safety of ureteroscopy in pregnant women: a comparative study
(Springer, 2013) Bozkurt, Yasar; Soylemez, Haluk; Atar, Murat; Sancaktutar, Ahmet Ali; Penbegül, Necmettin; Hatipoglu, Namik Kemal; Bodakci, Mehmet Nuri
The aim of this study was to investigate the efficacy and safety of ureteroscopy (URS) in pregnant patients compared with non-pregnant patients. We reviewed the cases of 41 pregnant and 62 non-pregnant women who developed ureteral stones and were treated with URS in our center between April 2005 and September 2011. A semi-rigid 9.5 F ureteroscope was used. The calculi were fragmented with pneumatic lithotripsy or a holmium laser, and if necessary, a double-J (JJ) stent was inserted during the procedure. Among the pregnant women, the mean gestation period was 23.22 +/- 4.61 weeks (range 13-34), and the mean number of pregnancies per patient was 3 +/- 2.02 (range 1-10). The mean ages of the pregnant and non-pregnant patients were 27.41 +/- 5.79 and 28.54 +/- 7.94 years, respectively (p = 0.734). There were no statistically significant differences in stone localization, anesthesia type, stone diameter, methods of stone manipulation, JJ stent insertion rate, hospitalization length, or operative times between the two groups. For pregnant and non-pregnant patients, the stone-free rates achieved in a single session were 87.8 and 85.5 %, respectively (p = 0.737). There was no statistically significant difference in preoperative and postoperative complication rates between the two groups. The positive urine culture rate was statistically significantly higher for pregnant patients than non-pregnant patients (29.3 vs. 11.3 %; p = 0.021). We did not observe any serious obstetric complications. URS is a safe and reasonable treatment option for pregnant patients with ureteral stones refractory to medical treatment during pregnancy.
Effectiveness of 4.5 F semirigid ureteroscope (Mini-URS) in the management of ureteral stones in children younger than 3 years of age
(Aves, 2011) Sancaktutar, Ahmet Ali; Atar, Murat; Soylemez, Haluk; Bozkurt, Yasar; Penbegül, Necmettin; Bodakci, Mehmet Nuri; Gumus, Hatice
Objective: We investigated the effectiveness of ureteroscopy (URS) performed with the smallest caliber (4.5 F) semirigid ureteroscope in children younger than 3 years. Materials and methods: URS was performed with a 4.5 F semirigid ureteroscope (Mini-URS). The operative outcomes of 16 children [7 females, 9 males; mean age 30.5 months (range 10-36 months)] who underwent URS in our clinics were evaluated retrospectively. Results: The mean stone diameter was 5.1 mm (range 3-15 mm). A Holmium: YAG laser lithotripter was used. Double J stents were inserted in 3 patients, while ureteral catheterization was performed in 6. In 7 patients, we were unable to insert a double J stent. At the end of the first postoperative week, 13 (84%) patients were completely stone-free. Double J stents were inserted in two patients because of poor endoscopic visualization and inadequate stone fragmentation. In these patients repeat URS was performed to retrieve residual stones during removal of the double J stents. After 1 month, 15 (93.75%) patients were stone-free. No perioperative or early postoperative complication was observed in any patient. Conclusion: URS performed with a 4.5 F semirigid ureteroscope is an ideal alternative for retrieving ureteral stones, with lower complication rates, faster ureteral engagement, and shorter operating times, even in very young patients.
EFFECTIVENESS OF 4.5 F SEMIRIGID URETEROSCOPE (MINI-URS) IN THE MANAGEMENT OF URETERAL STONES IN CHILDREN YOUNGER THAN 3 YEARS OF AGE
(Mary Ann Liebert, Inc, 2012) Sancaktutar, Ahmet Ali; Atar, Murat; Soylemez, Haluk; Bozkurt, Yasar; Hatipoglu, Namik Kemal; Penbegül, Necmettin; Bodakci, Mehmet Nuri
[Abstract Not Available]
Effectiveness of ureteroscopy among the youngest patients: One centre's experience in an endemic region in Turkey
(Elsevier Sci Ltd, 2017) Utangac, Mehmet Mazhar; Daggulli, Mansur; Dede, Onur; Sancaktutar, Ahmet Ali; Bozkurt, Yasar
Background In recent years, the incidence of urinary stone disease reportedly has been increasing. The use of shockwave lithotripsy has seen low success rates, the inefficacy of a single session, and the need for general anaesthesia in children; additionally, children are exposed to radiation. These suboptimal treatment conditions have all led to ureteroscopy (URS) becoming the treatment method of choice for paediatric ureter stones. The aim of this study is to examine the effectiveness of 4.5-Fr URS when used on children younger than 1 year of age. Patients and methods The operation results of 34 patients (12 girls and 22 boys) who had undergone intervention for ureter stones at our clinic were retrospectively evaluated. For URS, a 4.5-Fr semi-rigid ureteroscope was used; a Holmium: YAG laser machine was used as a lithotripter. Result The mean patient age was 9.6 months (range 4-12 months) (Table). The mean stone surface area was 25.39 mm2 (range 11.84-84.78 mm(2)). In six cases, a ureteral catheter was inserted, because of minimal oedema in the ureters; in nine cases, a Double J (DJ) stent was inserted. The mean operation time was 45.3 min (range 22-87 min). In the first week of control with urinary ultrasonography and kidney-ureter and bladder radiograph, a stone-free condition was determined in 28 (82.3%) patients. In two cases-in which sufficient fragmentation could not be achieved, because of minimal bleeding during operation-during the exertion of a DJ stent, another URS was performed. In the first postoperative month, a stone-free condition was established in 32 (94.1%) patients. The mean hospital stay period was 28.6 h (range 12-72 h). There were seven cases (20.5%) with Clavien II-III complications. Conclusion Use of a ureteroscope is safe and effective with paediatric patients: we found that a 4.5-Fr ureteroscope can be safely used on children under 1 year of age. We therefore consider a 4.5-Fr ureteroscopic instrument to be an appropriate tool for treating URS in children within this age range.
Effects of micronised purified flavonoid fraction on pain, semen analysis and scrotal color Doppler parameters in patients with painful varicocele; results of a randomized placebo-controlled study
(Springer, 2012) Soylemez, Haluk; Kilic, Suleyman; Atar, Murat; Penbegül, Necmettin; Sancaktutar, Ahmet Ali; Bozkurt, Yasar
Aim Aim of this study is to evaluate the effects of micronised purified flavonoid fraction (Daflon (R)) on pain, semen analysis and color Doppler parameters in patients with painful varicocele. Materials and methods Forty varicocele patients whom have normal sperm concentration (>20 million/ml) were involved in the study. The patients were divided into two groups such as Daflon (n = 20) and placebo (n = 20) group. Pain score, semen analyses and Doppler sonography were performed in all patients before and after the treatment. Results In the first group, mean pain scores at 1, 3, 6 and 12 months were 1.80 +/- 1.32, 1.15 +/- 0.93, 1.05 +/- 0.95 and 0.95 +/- 0.89, respectively, all were significantly lower (P < 0.001 for each) than baseline (5.25 +/- 1.07). While semen volume, total sperm count, sperm concentration and morphology were not changed significantly, the motility of sperm increased significantly (P = 0.015) due to decrease in grade 1 sperms at the 6th month in the first group. Reflux time of left spermatic vein during the Valsalva maneuver decreased significantly (P < 0.001). Conclusions Results of this study suggest the safety and efficacy of Daflon in the treatment of varicocele-associated pain. However, these results of the present study must be confirmed by randomized placebo-controlled studies by using different drug doses and durations before making any recommendation for the use of Daflon.
The efficacy and safety of ureteroscopy for ureteral calculi in pregnancy: our experience in 32 patients
(Springer, 2012) Bozkurt, Yasar; Penbegül, Necmettin; Soylemez, Haluk; Atar, Murat; Sancaktutar, Ahmet Ali; Yildirim, Kadir; Sak, Muhammet Erdal
The aim of this study was to investigate the efficacy and safety of ureteroscopy (URS) in pregnant women. A retrospective analysis was performed on 32 pregnant patients referred to our center between April 2005 and November 2010 with hydronephrosis requiring surgical intervention. A semirigid URS of 9.5 F was used in all patients. The mean age of patients was 27.8 years (range 20-39), and the mean gestation duration was 24 weeks (15-34). The ultrasound findings were diagnostic of obstructive ureteral calculi in 16 (50%) patients and the mean stone diameter was 8 mm. Spinal anaesthesia was performed in 22 (68.8%) patients, while general anaesthesia was performed in 7 (21.8%) patients. Ureteric stones were found in 27 (84.3%) patients during endoscopy, 10 being distal, 9 middle and 8 proximal. There were no stones in five patients. The stones were fragmented with pneumatic lithotripsy in 8 patients and with holmium laser in 17 patients and the fragments were retracted with forceps. Of the 32 patients, 19 (59.4%) required JJ stent insertion peroperatively. There was no serious complication intraoperatively, while urinary tract infection developed in four and renal colic in two patients postoperatively. In one patient, sepsis developed postoperatively, and improved with appropriate treatment. All babies were born normally. Semirigid ureteroscopy for diagnosing and treating ureteral calculi by intracorporeal pneumatic or holmium laser lithotripsy is a safe and reasonable treatment option for pregnant patients.
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]
THE EXPERIENCE OF LAPAROSCOPIC RADICAL NEPHRECTOMY IN TREATMENT OF RENAL CANCER
(Mary Ann Liebert, Inc, 2012) Bozkurt, Yasar; Soylemez, Haluk; Penbegül, Necmettin; Atar, Murat; Sancaktutar, Ahmet Ali; Hatipoglu, Namik Kemal; Bodakci, Mehmet Nuri
[Abstract Not Available]
Frequency and awareness of inguinal and genital organ anomalies among men in military age
(Aves, 2011) Soylemez, Haluk; Atar, Murat; Bozkurt, Yasar; Penbegül, Necmettin; Sancaktutar, Ahmet Ali
Objective: Early diagnosis and treatment of external genital abnormalities is important for protecting fertility potential in the future. In this cross-sectional study, it was aimed to determine the prevalence, treatment rate, and awareness of inguinal and genital abnormalities, among Turkish young men. Materials and methods: A total of 2,061 young men in military in Izmir were included into the study. All soldiers were examined by same urologist in a special room, and inguinal and genital abnormalities were recorded. Subjects detected with anomalies were asked for the treatment modalities, age of treatment, treatment results, and awareness about their anomalies. Results: The mean age of the subjects was 20.3 +/- 1.0 years (range 19-27 years). A total of 746 anomalies were identified in 681 subjects (33.0%). The anomalies according to frequency were varicocele (24.2%), meatal stenosis (4.0%), penile curvature (2.0%), inguinal hernia (1.8%), undescended testis (1.8%), hypospadias (0.9%), hydrocele (0.7%), atrophic testis (0.4%), and retractile testis (0.4%). Eighteen men (0.9%) were not circumcised. Among the subjects with anomaly, only 35 (4.7%) had operations including varicocelectomy, inguinal herniography, orchiopexy, orchiectomy, and hypospadias repair. Conclusion: The frequency of inguinal and external genital organ anomalies is high among Turkish young men. However, public awareness on this subject is not sufficient, and these anomalies are not treated on time.

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