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    Does morbid obesity influence the success and complication rates of extracorporeal shockwave lithotripsy for upper ureteral stones?
    (Aves Yayincilik, Ibrahim Kara, 2015) Dede, Onur; Sener, Nevzat Can; Bas, Okan; Dede, Gulay; Bagbanci, Muhammet Sahin
    Objective: The aim of the current study was to investigate whether obesity influences the outcome of extracorporeal shockwave lithotripsy (ESWL) treatment for upper ureteral stones. Material and methods: This is a retrospective study of 134 patients who underwent ESWL between June 2011 and May 2014. Patients were divided into 2 groups. Group 1 comprised 94 patients of normal weight, and group 2 comprised 40 morbidly obese patients. Patients in both groups had upper ureteral stones. Results: The mean age of groups 1 and 2 was 45.6 +/- 12.1 and 45.3 +/- 15.5 years, respectively (p=0.98). There was no significant difference in demographic variables between the groups. The mean stone size in Groups 1 and 2 was 81.7 +/- 25.7 mm(2) and 86.3 +/- 22.4 mm(2), respectively (p=0.51), the mean body mass index (BMI) was 27.4 +/- 2.9 and 42.9 +/- 2.1, respectively (p<0.01), the mean number of ESWL sessions was 2.4 +/- 0.6 and 2.4 +/- 0.7, respectively (p=0.97), and the mean follow-up time was 7.1 +/- 3.4 and 6.6 +/- 2.8 weeks, respectively (p=0.67). The overall stone-free rate was 82% in group 1 and 67% in group 2 (p=0.01). Conclusion: It is well-known that morbidly obese patients have higher rates of anesthesia-related problems due to the comorbidities commonly observed in this population. In the current study, we found that ESWL is a safe and acceptable treatment option for morbidly obese patients with upper ureteral stones.
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    The Effect of Metabolic Syndrome on the Success and Complications of Percutaneous Nephrolitotomy
    (Mary Ann Liebert, Inc, 2015) Nalbant, Ismail; Dede, Onur; Sener, Nevzat Can; Ozturk, Ufuk; Yesil, Suleyman; Karakoyunlu, A. Nihat; Imamoglu, M. Abdurrahim
    Background: The aim of this study was to investigate the effect of Metabolic syndrome (MetS) on the success and complications of percutaneous nephrolithotomy (PNL). Methods: Two hundred ten patients who had undergone PNL for kidney stones in our clinic between May 2012 and May 2014 were retrospectively analyzed. The patients were divided into two groups based on whether they had diagnostic criteria for MetS. All patients had lower pole kidney stones between 15 and 20mm. Complication rates between groups were evaluated using a modified Clavien grading system. Results: Group1 was a standard PNL group and group 2 consisted of patients with MetS. Mean stone size was 293.25102.4mm(2) for group 1 and 301.10 +/- 169.5mm(2) for group 2 (p<0.05). Mean hospitalization days, fluoroscopy duration, and mean hematocrit loss were significantly higher in group 2. Mean operative time and need for blood transfusions were higher in group 2 but statistically insignificant. One hundred twenty five patients in group 1 (96.1%) and 72 patients in group 2 (90%) obtained stone-free state. Conclusions: Our study results reveal an increase in complications and morbidity for patients with MetS during PNL.
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    Stone Formation and Fragmentation in Forgotten Ureteral Double J stent
    (Derman Medical Publ, 2014) Bas, Okan; Sener, Nevzat Can; Ozgun, Serhat; Dede, Onur; Basar, Halil
    Am: Nowadays, ureteral stents play an essential role in various endourological and open surgical procedures and common procedures performed in daily urological practice. However, stents can cause significant complications such as migration, infection, fragmentation, stone formation and encrustation, especially when forgotten for a long period. Objectives: We present our experience in endoscopic management of forgotten ureteral stents with a brief review of current literature. Case presentation: A total of 2 patients with forgotten ureteral stents were treated with endourological approaches in our department. Indwelling durations were 18 months and 36 months. After treatment both patients were stone and stent free. Conclusion:An endourological approach is effective for stent and stone removal after a single anesthesia session with minimal morbidity and short hospital stay. However, therapeutic strategy is also determined by the technology available. The best treatment would be the prevention of this complication by providing detailed patient education.