Yazar "Daggulli, Mansur" seçeneğine göre listele

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    Acquired Urethral Diverticulum Following Hypospadias Repair: A Case Report
    (Derman Medical Publ, 2014) Dede, Onur; Daggulli, Mansur; Utangac, Mazhar; Penbegül, Necmettin; Dede, Gulay
    Urethral diverbculurn is a rare condition in men. Patients often presented with voiding symptoms and mass with related urethra. In this study, diverticula did not detected after result of ultrasound, MRI and physical examination, Retrograde urethrography was performed and diverticulum and 2.5 cm stone was detected in diverticula. The exision of urethral diverticula and urethroplasty were performed.
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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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    Association Between Neuropathic Pain, Pregabalin Treatment, and Erectile Dysfunction
    (Wiley-Blackwell, 2014) Bozkurt, Mehtap; Gocmez, Cuneyt; Soylemez, Haluk; Daggulli, Mansur; Em, Serda; Yildiz, Mehmet; Atar, Murat
    Introduction. The pathophysiology of erectile dysfunction (ED) may be vasculogenic, hormonal, anatomical, neurogenic, drug-induced and/or psychogenic in origin. Neuropathic pain (NP) may facilitate ED, because it is frequently associated with anxiety, depression, and its drug, pregabalin, may also contribute ED. Aim. The objective of this study was to determine whether pregabalin treatment for patients with neuropathic pain promotes erectile dysfunction. Methods. The study sample consisted of a total of 102 male subjects that were subdivided into three groups. Group 1 patients (n = 31) had a pre-existing diagnosis of NP and was treated with 300 mg/day of pregabalin for at least 3 months. Group 2 patients (n = 34) were diagnosed with NP for at least 3 months; however, neither were they treated with pregabalin nor did they received physical therapy throughout the study. Lastly, healthy age-matched control subjects comprised group 3 (n = 37). Main Outcome Measures. Patients in all groups completed the International Index for Erectile Function (IIEF) questionnaire. Results. Mean age and mean body mass index did not differ significantly between each of the three groups. The cause of NP and the mean duration of having a diagnosis of NP did not differ significantly in groups 1 and 2. However, IIEF scores were significantly lower for group 1 when compared to group 2 in terms of erectile function, orgasmic function, overall satisfaction and total score. Yet groups 1 and 2 did not diverge significantly in the intercourse satisfaction and sexual desire scores. Overall IIEF scores for group 3 were significantly higher than those of group 2 except for mean erectile function scores. Conclusion. Taking pregabalin for the treatment of neuropathic pain poses an increased risk for developing ED in male patients. Thus, clinicians prescribing pregabalin to patients diagnosed with neuropathic pain should assess for ED before and during treatment with this medication.
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    Bilateral microperc in a severe kyphoscoliosis
    (Aves, 2016) Daggulli, Mansur; Penbegül, Necmettin; Dede, Onur; Utangac, Mehmet Mazhar
    Percutaneous nephrolithotomy is the standard modality for large renal calculi in normal and abnormal renal anatomic situations. This case report describes a 57-year-old male patient who presented with bilateral kidney stones and severe kyphoscoliosis. He had successfully been treated with a bilateral microperc technique.
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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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    A Comparison of 2 Percutaneous Nephrolithotomy Techniques for the Treatment of Pediatric Kidney Stones of Sizes 10-20 mm: Microperc vs Miniperc
    (Elsevier Science Inc, 2015) Karatag, Tuna; Tepeler, Abdulkadir; Silay, Mesrur Selcuk; Bodakci, Mehmet Nuri; Buldu, Ibrahim; Daggulli, Mansur; Hatipoglu, Namik Kemal
    OBJECTIVE To compare outcomes of micro-percutaneous nephrolithotomy (PNL; microperc) with mini-PNL (miniperc) in the treatment of pediatric renal stones of sizes 10-20 mm. MATERIALS AND METHODS Patients aged <18 years who underwent PNL for renal stones of sizes 10-20 mm between August 2011 and March 2014 in 3 referral centers were reviewed retrospectively. Patients were evaluated in the following 2 groups: microperc (group 1) and miniperc (group 2). Demographics and perioperative parameters (fluoroscopy and operation time, hemoglobin drop, and stone-free and complication rates) were retrospectively analyzed. RESULTS A total of 119 patients were evaluated, including group 1 (n = 56) for microperc and group 2 (n = 63) for miniperc. We found mean stone sizes as 13.4 +/- 3.4 and 14.8 +/- 3.7 mm in the groups, respectively (P = .046). Mean operation and fluoroscopy times were 57.1 +/- 31.2 minutes and 132.4 +/- 92.5 seconds in the microperc group and 68.9 +/- 36.7 minutes and 226.2 +/- 166.2 seconds in the miniperc group, respectively (P = .110 and P <. 001). Stone-free rates were similar in both groups (82.1% vs 87.3%; P = .433 and 92.8% vs 93.6%; P = 0673) on postoperative day 1 and at first-month follow-up. The mean hemoglobin drop in group 2 differed from that in group 1 significantly (P <. 001). The difference of average hospitalization times was statistically significant (43.0 +/- 15.4 vs 68.5 +/- 31.7 hours; P <. 001). CONCLUSION Our outcomes show that microperc may be preferred as an alternative to mini-PNL for the treatment of pediatric kidney stones of sizes 10-20mmwith comparable success and complication rates, as well as shorter hospitalization and fluoroscopy times. (C) 2015 Elsevier Inc.
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    Comparison of Monoplanar and Biplanar Access Techniques for Percutaneous Nephrolithotomy
    (Mary Ann Liebert, Inc, 2015) Dede, Onur; Bas, Okan; Sancaktutar, Ahmet Ali; Daggulli, Mansur; Utangac, Mazhar; Penbegül, Necmettin; Hatipoglu, Namik Kemal
    Purpose: The aim of this study was to compare the positive aspects and complications of monoplanar and biplanar access techniques used in percutaneous nephrolithotomy (PCNL) based on the modified Clavien complication grading system. Patients and Methods: The data from patients who underwent PCNL using either monoplanar access (group 1) or biplanar access (group 2) techniques were analyzed retrospectively. For the biplanar technique, puncture is adjusted based on different fluoroscopic projections, including vertical and 30 degree positions. For the monoplanar technique, a C-arm fluoroscope was brought into vertical position, the collecting system was visualized with a contrast agent, and the most appropriate calix was selected to extract the targeted stone. Results: The monoplanar technique was performed for renal access in 310 patients (group 1), and the biplanar technique was used for renal access in 351 patients (group 2). There were no statistically significant differences between the two groups with regard to demographic data. The mean puncture time was significantly lower in group 1 (monoplanar) when compared with that of group 2 (biplanar, P=0.04). The overall success rates of the monoplanar and biplanar groups were 88% and 89% (including clinically insignifican residual fragments in 9% and 7%), respectively (P>0.05), and the complication rates of both groups were similar. Conclusion: The monoplanar access technique, which is safe to use, decreases puncture time, minimizes the surgeon's direct exposure time to radiation, and has similar success rates as the biplanar access technique.
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    Comparison of Scoring Systems in Pediatric Mini-Percutaneous Nephrolithotomy
    (Elsevier Science Inc, 2016) Utangac, Mehmet Mazhar; Tepeler, Abdulkadir; Daggulli, Mansur; Tosun, Muhammed; Dede, Onur; Armagan, Abdullah
    OBJECTIVE To apply urolithiasis scoring systems to the pediatric miniperc procedure and to compare their predictive capability for postoperative outcomes. MATERIALS AND METHODS Records from 2 referral centers of patients under 18 years of age who had the miniperc procedure between 2010 and 2015 were retrospectively investigated. All patients included in the study were graded by the same surgeon according to Guy's and Clinical Research Office of the Endourological Society (CROES) scoring systems using preoperative imaging methods. Patient demographics and outcomes were compared according to the complexity of the procedure as graded by each scoring system. RESULTS The mean age of the 97 patients was 7.1 +/- 5.2 (1-17) years. The mean stone burden and number were 388.4 +/- 233.9 mm(2) and 1.5 +/- 1.3, respectively. The mean procedure, fluoroscopy, and hospitalization times were 78.2 +/- 32.8 minutes, 144.8 +/- 84.3 seconds, and 4.1 +/- 2.8 days, respectively. The mean hematocrit drop was calculated as 2.2 +/- 2.2. The mean scores were 1.7 +/- 1.0 and 259.9 +/- 50.6 for Guy's and CROES scoring systems, respectively. In the multivariate analysis, stone-free status was found to be associated with Guy's (r: -0.464, p: .000) and CROES (r: 0.490, : 0.000) scoring systems and stone burden (r: -0.161, p: .041). In the analysis of factors related to complication, Guy's score was identified as an independent predictor of complication (p: .02, odds ratio: 1.9, 95% confidence interval 1.097-3.319). CONCLUSION According to our results, using Guy's and CROES scoring systems, stone-free ratios after percutaneous nephrolithotomy may be predicted preoperatively. In addition, Guy's system is a predictor of postoperative complication rate. (C) 2016 Elsevier Inc.
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    Determining standard criteria for tubeless PCNL
    (Springer, 2014) Daggulli, Mansur; Soylemez, Haluk; Bodakci, Mehmet Nuri; Hatipoglu, Namik Kemal
    [Abstract Not Available]
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    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.
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    Effects of enuresis nocturna on parents of affected children: Case-control study
    (Wiley, 2014) Tanriverdi, Mehmet Halis; Palanci, Yilmaz; Yilmaz, Ahmet; Penbegül, Necmettin; Bez, Yasin; Daggulli, Mansur
    BackgroundEnuresis nocturna (EN) is a chronic medical disorder that may cause a parent to question their parenting ability and contribute to an inability to perform the parental role. The aim of the study was to investigate the effects of EN on the relationship between parents, and the effect of mood changes in the couples on the children. MethodsForty children with EN (group 1) were enrolled in the study, and 44 consecutive healthy children (group 2) were randomly selected from the same school. The clinical diagnosis for the patient group was based on a careful history. Spielberg's State-Trait Anxiety Inventory (STAI), Beck Depression Inventory (BDI), and Dyadic Adjustment Scale (DAS) were applied to all parents, and the answers were recorded. ResultsSTAI scores differed between the mothers in the two groups in terms of trait anxiety, while significant differences between the fathers in terms of both state and trait anxiety were observed. The BDI scores were similar between the two groups. The scores of dyadic consensus were lower in the mothers, while the affectional expression scores were lower in the EN study group fathers compared with controls. The total DAS scores were significantly lower in the parents of the children with EN. ConclusionThe parents of children with EN seem to experience increased levels of anxiety. Their desire to continue the marital relationship, the overall quality of their marital relationship and their comfort as a family may also be negatively affected by having a child with EN.
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    Flexible Ureterorenoscopy for the Treatment of Kidney Stone Within Pelvic Ectopic Kidney
    (Elsevier Science Inc, 2014) Bozkurt, Omer Faruk; Tepeler, Abdulkadir; Sninsky, Brian; Ozyuvali, Ekrem; Ziypak, Tevfik; Atis, Gokhan; Daggulli, Mansur
    OBJECTIVE To present the outcomes of flexible ureterorenoscopy (F-URS) and laser lithotripsy for the treatment of calculi within pelvic ectopic kidney (PEK). PATIENTS AND METHODS We retrospectively reviewed the medical records of 26 patients with calculi in PEK treated with F-URS in 5 referral hospitals between 2010 and 2013. Patient demographics and stone characteristics (age, sex, body mass index, stone size, location, history of shock wave lithotripsy or kidney surgery), and perioperative measures (duration of operation, fluoroscopic imaging, and hospitalization and success and complication rates) were reviewed. RESULTS A total of 26 patients with mean age of 41.1 +/- 15.8 years (7-72 years) were included in the study. The mean stone size was 17.0 +/- 5.1 mm (10-28 mm). The mean procedure and fluoroscopy times were calculated as 52.1 +/- 27.7 minutes (30-120 minutes) and 54.8 +/- 48.9 seconds (10-180 seconds), respectively. The mean length of hospital stay was 2.7 +/- 1.8 days (1-9 days). Treatment was deemed successful in 22 patients (84.6%). Ureteroscopy failed in 4 patients (15.4%) due to impaired passage of fragments (n = 3) or inability to reach the stone secondary to the location in an isolated lower calyx (n = 1). Minor postoperative complications were observed in 5 patients (19.2%; persistent hematuria [n = 1], fever [n = 1], renal colic [n = 2], and urinary tract infection [n = 1]). No severe complications or mortality occurred. CONCLUSION Our results suggest that F-URS is a safe and effective minimally invasive treatment modality for small-and medium-sized stones in PEK. (C) 2014 Elsevier Inc.
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    Micro-percutaneous nephrolithotomy in the treatment of pediatric nephrolithiasis: A single-center experience
    (W B Saunders Co-Elsevier Inc, 2016) Daggulli, Mansur; Utangac, Mehmet Mazhar; Dede, Onur; Bodakci, Mehmet Nuri; Penbegül, Necmettin; Hatipoglu, Namik Kemal; Atar, Murat
    Objective: We aimed to clarify the applicability and safety of micro-PNL (microperc) in the treatment of pediatric kidney stones. Material and methods: A single center prospective trial was initiated, and microperc was performed in 40 children using the same two methods: the classical all-seeing needle and microsheath method. Stone fragmentation was performed using a 200-mu m holmium: YAG laser fiber. Results: The mean age of the patients was 6.3 +/- 4.4 years (range: 7 months-16 years). Fourteen were less than 3 years old. The average calculous size was 16.5 mm (range: 10-36 mm). In 20 patients, access was achieved through the all-seeing needle method. In the other patients, access was achieved by the microsheath method. Conversion to mini-PNL was required in 2 patients due to intraoperative bleeding in one and a high stone burden in the other. The mean hospital stay was 3.8 +/- 1.2 days (range: 1-10 days), and the mean hemoglobin decrease was 0.7 +/- 0.3 mg/dl (range: 0-1.7 mg/dl). The duration of surgery and fluoroscopic screening was 75 min and 3.7 min, respectively. A DJ stent was placed in 11 patients due to a high stone burden. A ureteral stent was left for 1 day in the rest of the cases. Complete clearance was achieved in the other 32 children. None of the patients required transfusion caused by renal hemorrhage. In 1 patient, extravasation of the irrigation fluid caused abdominal distention. As assessed by KUB and/or an ultrasound, the overall stone-free rate at 6 weeks was 80%. There were residual fragments in 6 patients (15%). Conclusions: Our results show that microperc is a safe and effective procedure for the treatment of pediatric kidney stones. Children with small renal calculi and with nonobstructed collecting systems are suitable for microperc. (c) 2016 Elsevier Inc. All rights reserved.
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    Micropercutaneous Cystolithotomy in Children: Our Experience with the Transillumination Technique
    (Mary Ann Liebert, Inc, 2014) Bodakci, Mehmet Nuri; Sancaktutar, Ahmet Ali; Daggulli, Mansur; Hatipoglu, Namik Kemal; Soylemez, Haluk; Penbegül, Necmettin; Atar, Murat
    Aim: We present our experience with micropercutaneous cystolithotripsy (mPCCL) using transillumination-guided access in children with bladder stones and evaluate the safety and efficacy of this procedure. Methods: Twelve children who underwent mPCCL for bladder stone removal in our department between January 2011 and September 2013 were included in this study. Percutaneous access was performed using the transillumination technique. The chief complaint, age and sex of the patients, stone size, operative time, complications, stone-free rate, and stone composition as determined by radiography diffraction analysis were recorded. Results: The mean age of the patients was 2.6 (1-7) years. One out of 12 patients was a girl. The mean stone size was 14 mm (7-32 mm). The mean mPCCL procedure time was 38.7 (15-65) minutes. The mean hospital stay was 1.4 (0.5-4) days. The stone-free rate after one mPCCL intervention was 91.6% and increased to 100% after two sessions of mPCCL. The notable complications were transient macroscopic hematuria in one patient, acute urinary retention in one patient, and the need for a second session of mPCCL in another patient. The stones were composed of calcium oxalate (3), ammonium acid urate (1), calcium phosphate (1), cystine (1), struvite (1), and unknown (5). Conclusion: Transillumination-guided mPCCL is a safe and effective technique, does not require the use of ionizing radiation, is technically easy, and is a minimally invasive alternative for the management of bladder stones. It has many advantages, especially in pediatric patients, such as decreased urethral injury, no need for postoperative catheter insertion in most cases, and shorter operative time.
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    Minimally invasive percutaneous nephrolithotomy: an effective treatment for kidney stones in infants under 1 year of age. A single-center experience
    (Springer, 2015) Daggulli, Mansur; Sancaktutar, Ahmet Ali; Dede, Onur; Utangac, Mehmet Mazhar; Bodakci, Mehmet Nuri; Penbegül, Necmettin; Hatipoglu, Namik Kemal
    We aimed to present the outcomes of PNL surgery performed in infantile patients with small renal stones who were younger than 1 year of age. A single-center prospective trial was initiated and during the period between Jan 2013 and Jan 2015, PNL was applied to 20 renal units of 16 infants (6 girls and 10 boys), including 4 patients with bilateral kidney stones. PNL was performed in patients with renal stones larger than 2 cm, as well as stones resistant to SWL or renal stones that were undetectable during SWL. The mean age of the patients was 9.55 (5-12) months. Of the 20 renal units, 1 had complete staghorn stones, 3 had partial staghorn stones, 13 had renal pelvic stones, and 3 had lower pole stones. The mean stone size was 18.5 mm (range 12-36 mm). Mean operative time for PNL was 88 (25-135 min). Mean fluoroscopy time was estimated as 3.4 min. Mean hemoglobin loss was 0.72 g/L (0.2-3). The mean hospital stay was 4.1 days (2-8 days). On postoperative day 1, a complete stone-free state was achieved in 70 % of renal units (14 of 20). At the end of the first postoperative week, the remaining two patients had insignificant residual fragments of 3 mm and were followed conservatively without any specific intervention. Thus, the total SFR was 80 % (16 of 20) at discharge. In infants aged less than 1 year, minimal access tract dilation during PNL, the use of smaller caliber pediatric instruments, and the realization of this procedure by surgeons with adequate experience in adults carry utmost importance. In addition, special care should be taken to avoid hypothermia and radiation exposure during PNL.
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    Minipercutaneous nephrolithotomy in infants: a single-center experience in an endemic region in Turkey
    (SPRINGER, 233 SPRING ST, NEW YORK, NY 10013 USA, 2014) Bodakçı, Mehmet Nuri; Daggulli, Mansur; Sancaktutar, Ahmet Ali; Söylemez, Haluk; Hatipoğlu, Namık Kemal; Utangaç, Mehmet Mazhar; Penbegül, Necmettin; Ziypak, Tevfik; Bozkurt, Yaşar
    The objective of the study is to evaluate the effectiveness and safety of miniaturized percutaneous nephrolithotomy (mini-PNL) method in infantile patients < 3 years of age diagnosed with renal stones. We studied 48 renal units in 40 patients of infantile patients < 3 years of age who underwent mini-PCNL at our institute. The mean age of the patients was 24.02 (5-36) months. The mean diameter of the stones was 22.3 mm (11-45 mm). Intrarenal access was achieved under fluoroscopic (n = 43) or ultrasonographic (n = 5) guidance under general anesthesia. A 20 Fr peel-away sheath, a 17 Fr rigid nephroscope and a pneumatic intracorporeal lithotripsy were used. Mean operative time for PNL was 85 (25-135) min. Mean fluoroscopy time was estimated as 3.7 min. The mean hospital stay was 4.3 days (2-10). Mean hemoglobin loss was 0.89 g/L (11.56-10.67) and three of the patients, including one case during the perioperative period, required blood transfusions. Colonic perforation developed in one case. In two patients, urinary drainage persisted for more than 24 h after withdrawal of the nephrostomy tube. Seven patients developed urinary tract infections (UTI). At the end of the postoperative first week, the stone-free rate was estimated to be 81.2 %. In conclusion, for percutaneous management of renal stones in the infantile age group, mini-PNL is an applicable treatment modality that can be applied through small incisions. It has higher stone-free rates, shorter hospital stays, and excellent esthetic outcomes. In this age group especially, surgical exposure to hypothermia and radiation should be avoided.
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    A novel drainage technique during micropercutaneous nephrolithotomy in pediatric patients: double angiocath
    (W B Saunders Co-Elsevier Inc, 2016) Penbegül, Necmettin; Utangac, Mehmet Mazhar; Daggulli, Mansur; Dede, Onur; Bozkurt, Yasar; Bodakci, Mehmet Nuri; Atar, Murat
    Micropercutaneous nephrolithotomy (microperc) is a recently introduced percutaneous nephrolithotomy (PNL) technique that has the smallest tract size. The absence of an amplatz sheath during the microperc technique is a fundamental difference that distinguishes it from all other types of PNL (standard, mini, ultramini). Increasing of the intrarenal pelvic pressure (IPP) was demonstrated by the authors in adult patients but this problem may be even more serious in pediatric patients. Previously, the authors defined the use of a 14 gauge angiocath needle and sheath (microsheath) during microperc surgery for pediatric patient to reduce the IPP. In this novel technique, a second angiocath is used to access the renal collecting system to drain fluid during surgery. This technique is more effective in reducing IPP during microperc, especially in pediatric patients. (C) 2016 Elsevier Inc. All rights reserved.
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    A novel percutaneous nephrolithotomy (PCNL) set: The 'Economical One-shot PCNL Set' (Ecoset)
    (Arab Assoc Urology, 2017) Penbegül, Necmettin; Dede, Onur; Daggulli, Mansur; Hatipoglu, Namik Kemal; Bozkurt, Yasar
    Objectives: To suggest a novel disposable percutaneous nephrolithotomy (PCNL) set that we named the 'Economical One-shot PCNL Set' (Ecoset), which consists of a single 30-F dilator, 30-F sheath, and 8-F polyurethane dilator, as use of a 'one-shot' dilatation technique during PCNL is becoming widespread. Patient and methods: The medical records of 42 patients with kidney stones who had undergone 'one-shot' PCNL from February 2014 to June 2016 were retrospectively reviewed and analysed. Demographic data, as well as the stone size, radiation exposure time, operation time, hospitalisation duration, rate of treatment success and complications, were recorded. Results: The mean (SD, range) age of the patients was 44.43 (16.54, 11-72) years. The mean (SD) stone size was 35.12 (17.53) mm. The mean (SD) operation time was 54.58 (22.24) min. The mean (SD) fluoroscopic screening time was limited to 154.72 (117.48) s. Treatment success was achieved in 32 (76%) patients. The mean (SD) hospital stay was 3.09 (0.75) days. None of the patients had any major complications. Bleeding requiring blood transfusion was required in three patients. The cost of a disposable dilatation set for a single PCNL operation with a balloon set, a standard Amplatz set, or an Ecoset is similar to$137, $120, or $27 (American dollars), respectively. Conclusions: The one-shot dilatation technique using the Ecoset for PCNL can be feasibly, safely, and effectively performed in almost every adult patient. The Amplatz dilator set and balloon dilator set have the disadvantage of relatively high cost, whereas the Ecoset is the cheapest 'disposable set' that can be used during PCNL surgery. (C) 2017 Arab Association of Urology. Production and hosting by Elsevier B.V.
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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.
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    Potential biomarkers for the early detection of acute kidney injury after percutaneous nephrolithotripsy
    (Taylor & Francis Ltd, 2016) Daggulli, Mansur; Utangac, Mehmet M.; Dede, Onur; Bodakci, Mehmet N.; Hatipoglu, Namik K.; Penbegül, Necmettin; Sancaktutar, Ahmet Ali
    This study aims to investigate the role of urinary biomarkers in the determination of the potential risks of renal parenchymal tubular damage in adult patients who underwent percutaneous nephrolithotomy (PNL) with the indication of renal stone. A randomized and prospective controlled study was performed between June and December 2013. We enrolled 29 consecutive patients with renal calculi>2cm and who underwent PNL, as well as 47 healthy control subjects. Urine samples, including 2 h before surgery, 2 and 24 h after surgery were collected from the patient group. Freshly voided urine samples were collected from the control group. Kidney injury molecule-1 (KIM-1), neutrophil gelatinase-associated lipocalin (NGAL), N-acetyl-glucosaminidase (NAG), and liver-type fatty acid binding protein (LFABP) levels were measured from these urine samples. The mean KIM-1/Cr value that measured 24 h after the operation was statistically significant, higher than its preoperative (preop) level (p= 0.045). A significant difference was detected between the mean preop and postoperative (postop) 24 h NAG/Cr values (p< 0.001). Also, postop 24 h NGAL/Cr levels were statistically significant, higher than its preop levels (p= 0.013). According to the comparison of preop and postop levels, an increase in LFABP/Cr values secondary to surgical intervention was observed without any statistically significant difference. Besides the LFABP/Cr levels do not change after percutaneous kidney surgery, KIM-1/Cr, NAG/Cr, and NGAL/Cr levels increase postop period, especially at 24 h. Further studies with a larger series and repeated measurements should be performed to clarify if they can be used to demonstrate renal damage after percutaneous surgery or not.