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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.
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    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.
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    ANTIOXIDANT SIGNAL AND KIM-1 LEVELS IN ESWL INDUCED KIDNEY INJURY
    (Mary Ann Liebert, Inc, 2012) Hatipoglu, Namik Kemal; Evliyaoglu, Osman; Bodakci, Mehmet Nuri; Atar, Murat; Penbegül, Necmettin; Soylemez, Haluk; Sancaktutar, Ahmet Ali
    [Abstract Not Available]
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    The approach of urologists to kidney stones in southeastern Anatolia: a questionnaire survey
    (Aves, 2012) Erturhan, Sakip Mehmet; Bayrak, Omer; Penbegül, Necmettin; Seckiner, Ilker; Soylemez, Haluk; Sancaktar, Ahmet Ali; Yagci, Faruk
    Objective: It is aimed to investigate the possible differences of urologist in the Southeastern Anatolia Region concerning kidney stone disease about treatment selections and processes. We also aimed to provide data to all institutions that perform educational activities in our country, including the Turkish Association of Urology and Endourology. Our study also sought to determine the treatment priorities in our region. Material and methods: A questionnaire consisting of 22 questions was prepared and delivered to urologists by hand or by electronic mail. The responses from 66 urologists were evaluated, and the differences were calculated as percentages. Results: The distribution of the experts participating in the study was as follows: 39% were from a state hospital, 22% were from a private hospital, 7% were from a teaching hospital, and 30% were from a university hospital. Among urologists who opted for surgical treatment, 57% preferred open surgery, 41% preferred percutaneous nephrolithotomy (PNL), and 1% preferred retrograde intrarenal surgery (RIRS). In this study, 78% of the urologists performed PNL, and 55% of them began performing PNL after residency. Among the urologists in this study, 42% chose PNL for renal stone disease in pediatric patients. Support from interventional radiology was available in 40% of the clinics. Only 22% of the urologists were trained for RIRS, and 48% of the urologists have an extracorporeal shock wave lithotripsy (SWL) unit in their clinic. In symptomatic lower calyx stones, the first treatment choice was PNL in 59% of respondents. For coraliform stones, open surgery was preferred by 63%. Conclusion: In the Southeastern Anatolia region where kidney stone disease is endemic, surgical treatment is successfully applied by urologists. However, treatment programs in PNL and RIRC should be emphasized in this area.
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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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    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.
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    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.
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    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
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    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.
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    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.
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    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.
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    Current laparoscopic practice patterns among urologists in Turkey
    (Aves, 2012) Altunoluk, Bulent; Soylemez, Haluk; Ozer, Ali; Efe, Erkan; Sancaktutar, Ahmet Ali; Resim, Sefa
    Objective: Laparoscopic surgery has become increasingly popular in urology over the last decade. This survey was performed to evaluate the current practice patterns in laparoscopy among urologists in Turkey. Material and methods: A detailed questionnaire about urologic laparoscopic practice patterns was distributed to 1242 urologists who were working in Turkey. The questions pertained to age, practice demographics, and the amount and variety of laparoscopy performed. Results: Nearly half of the respondents (48.3%) already performed laparoscopy. Of the urologists in academic settings, including university hospitals and education and research hospitals, 69.6% and 59.4% performed laparoscopy, respectively. In state hospitals, the percentage of those who performed laparoscopy was lower (26.9%). The most important reasons mentioned for performing laparoscopy were shorter hospital stay, patient requests and greater flexibility of possible surgical techniques. The main laparoscopic procedures performed were nephrectomy (benign indication), 91%; renal cyst decortications, 90%; nephrectomy (malign indication), 65%; laparoscopic stone surgery, 47% and pyeloplasty, 38%. A large percentage (77.2%) of respondents intended to attend continuing education and to perform laparoscopy in the future. Conclusions: Our results show that laparoscopic practice steadily increases in frequency and that urologists are willing to substitute open surgery for laparoscopic surgery. The performance of laparoscopic surgery has become a goal for most urologists in Turkey to achieve in the near future.
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    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]
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    Deterioration of renal function in patients operated for lower urinary tract symptoms
    (Aves, 2011) Altunoluk, Bulent; Soylu, Ahmet; Beytur, Ali; Soylemez, Haluk; Baydinc, Can
    Objective: We aimed to investigate the rate of deterioration of the renal function in patients operated for lower urinary tract symptoms, the relation between this rate and patient age, symptom severity, and accompanying diseases. Materials and methods: The data of 369 patients who admitted to our clinic with lower urinary tract symptoms and operated between 01/06/2001 and 31/03/2005 were retrospectively evaluated, and the examination findings and laboratory results have recorded. Results: The preoperative serum creatinin level was <= 1.4 mg/dL in 315 (85.4%) patients and >1.4 mg/dL in 54 (14.6%) patients. The mean age of the patients with serum creatinin level <= 1.4 mg/dL was 68.64 +/- 8.24 years, and that of patients with serum creatinin level >1.4 mg/dL was 72.56 +/- 7.96 years (p<0.05). The level of serum creatinin increased with increasing age, and the renal function was worsened with the increase of symptom score. Also, in the presence of the chronic diseases such as hypertension and diabetes, the rate of renal dysfunction increased by 2.5 times (25.5% vs. 10.9%). There was no correlation between postvoiding residue urine and renal dysfunction. Additionally, the renal dilatation accompanied the increase in the serum creatinin level. Conclusion: In the patients with with lower urinary tract symptoms, the serum creatinin level must be evaluated at the first admission for early diagnosis and treatment of renal dysfunction.
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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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    THE EDUCATION OF PEDIATRIC ENDOUROLOGY: THE STATUS OF TURKISH UROLOGY RESIDENTS
    (Mary Ann Liebert, Inc, 2012) Sancaktutar, Ahmet Ali; Yildirim, Kadir; Bodakci, Mehmet Nuri; Yavuz, Sevgi; Hatipoglu, Namik Kemal; Soylemez, Haluk; Penbegül, Necmettin
    [Abstract Not Available]
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    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.
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    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.
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    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]