Yazar "Tepeler, Abdulkadir" seçeneğine göre listele

Listeleniyor 1 - 20 / 25
  • [ X ]
    Öğe
    The All-Seeing Needle Instead of the Veress Needle in Pediatric Urologic Laparoscopy
    (Mary Ann Liebert, Inc, 2013) Silay, Mesrur Selcuk; Tepeler, Abdulkadir; Sancaktutar, Ahmet Ali; Kilincaslan, Huseyin; Altay, Bulent; Erdem, Mehmet Remzi; Hatipoglu, Namik Kemal
    Purpose: To investigate the feasibility of the all-seeing needle for safe entry and creation of pneumoperitoneum in pediatric urologic laparoscopy. Patients and Methods: A total of 14 children underwent various transperitoneal urologic laparoscopic procedures. The all-seeing needle, which is 4.85F in diameter, was used for safe entry into the abdominal cavity at the site of the umblicus in all cases. The microoptic was integrated with the light system and connected via a zoom ocular enabling direct visualization of the layers between the skin and the peritoneal cavity. Once the intraperitoneal access was obtained, CO2 pneumoperitoneum was created from one port of the three-way connector attached to the proximal part of the needle. Then the laparoscopic trocars were placed under vision of the microoptical system. Results: Mean age of the children was 4.52.9 years. In all children, the all-seeing needle was safely introduced into the abdominal cavity under direct vision. Then, CO2 pneumoperitoneum was succesfully performed. The mean time for optical puncture was calculated as 1.1 +/- 0.8 minutes. No complication was encountered during the introduction of the needle, creation of the pneumoperitoneum, and placement of the trocars. Conclusions: The all-seeing needle appears to be beneficial in safe entry and for creating pneumoperitoneum in laparoscopic pediatric urology cases. It eliminates the disadvantages of the Veress needle, which is blunt insertion, and may possibly prevent complications.
  • [ X ]
    Öğe
    Are small residual stone fragments really insignificant in children?
    (W B Saunders Co-Elsevier Inc, 2013) Dincel, Nida; Resorlu, Berkan; Unsal, Ali; Tepeler, Abdulkadir; Silay, Mesrur Selcuk; Armagan, Abdullah; Diri, Akif
    Objectives: To assess the significance of asymptomatic residual stone fragments of less than 4 mm (clinically insignificant residual fragments [CIRFs]) after shock wave lithotripsy (SWL), percutaneous nephrolithotomy (PNL), and retrograde intrarenal surgery (RIRS) in children. Patients and Methods: Eighty-five children were followed up for 6 to 50 months (median 22). Outcomes measured were fragment re-growth, stone events (emergency department visits, hospitalization, or additional interventions) and spontaneous fragment passage. Results: During follow-up, 22 children (25.8%) passed residual fragments spontaneously. Highest spontaneous passage rate was found for renal pelvis stones and the lowest for the lower pole stones (57.1% vs. 16.1%; p<0.001). When the number of the fragments increased, the chance of the spontaneous passage decreased (30% vs 20%; p<0.05). Symptomatic episodes including renal colic, hematuria, or urinary tract infection were documented in 34 (40%) patients, and re-growth of fragments was observed in 18 (21.2%). Stone size had no significant effect on spontaneous passage (p=0.079), stone growth (p=0.528), and symptomatic episodes (p=0.402). Twenty-five patients (29.4%) required secondary intervention for stone re-growth or stone related events and the remaining 20 patients (23.5%) needed medical treatment for bothersome symptoms or complications. Conclusions: Our results suggest that 40% of children with CIRFs will become symptomatic and 20% will develop stone re-growth over the following 6 months. Only one fifth of the fragments will pass spontaneously without any complications. Therefore, the use of the term CIRF is not appropriate for postoperative residual fragments in children. (c) 2013 Elsevier Inc. All rights reserved.
  • [ X ]
    Öğe
    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.
  • [ X ]
    Öğe
    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.
  • [ X ]
    Öğe
    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.
  • [ X ]
    Öğe
    Do the urolithiasis scoring systems predict the success of percutaneous nephrolithotomy in cases with anatomical abnormalities?
    (Springer, 2017) Kocaaslan, Ramazan; Tepeler, Abdulkadir; Buldu, Ibrahim; Tosun, Muhammed; Utangac, Mehmet Mazhar; Karakan, Tolga; Ozyuvali, Ekrem
    The objective of this study is to assess the utility of the Guy, S.T.O.N.E., and CROES nephrolithometry scoring systems (SS), and compare the capability of each system to predict percutaneous nephrolithotomy (PNL) outcome in patients with anatomical abnormalities. We retrospectively collected medical records of patients with anatomical abnormalities who underwent PNL for the treatment of renal calculi by experienced surgical teams in four referral centers. All of the patients were graded by a single observer from each department based on preoperative computed tomography images using each SS. Patient demographics and outcomes were compared according to the complexity of the procedure as graded by each scoring system. A total of 137 cases with anatomical abnormalities [horseshoe kidney (n = 46), malrotation (n = 33), kypho and/or scoliosis (n = 31) and ectopic kidney (n = 27)] were assessed retrospectively. The mean stone burden, number, and density were 708.5 mm(2), 1.7, and 791.8 HU, respectively. The mean procedure, fluoroscopy, and hospitalization times were 75.2 +/- 35.3 min, 133.4 +/- 92.3 s, and 3.5 +/- 2.1 days, respectively. Stone-free status was achieved in 106 cases (77.4 %). A total of 17 (13.6 %) complications occurred postoperatively. The mean scores were 2.7, 7.2, and 219.1, for the Guy, S.T.O.N.E., and CROES systems, respectively. CROES score was the independent predictor of PNL success in cases with anatomical abnormalities [p: 0.001, OR 1.01, (95 % CI 1005-1021)]. The CROES scoring system is well correlated with the success of PNL in cases with anatomical abnormalities; the S.T.O.N.E. and Guy scoring systems failed to predict the outcomes of PNL in this specific patient population.
  • [ X ]
    Öğe
    Does aging affect the outcome of percutaneous nephrolithotomy?
    (Springer, 2015) Buldu, Ibrahim; Tepeler, Abdulkadir; Karatag, Tuna; Bodakci, Mehmet Nuri; Hatipoglu, Namik Kemal; Penbegül, Necmettin; Akman, Tolga
    To investigate whether aging affects surgical outcomes by comparing the results of two patient groups undergoing PNL: those over 60 and those under 60. A retrospective screen was made for patients undergoing conventional PNL surgery for renal stones performed in two separate centers between 2010 and 2013. 520 patients included were classified into age groups: patients aged 18-59 comprised Group-1 and those aged over 60 comprised Group-2. Those between 60-69 years (sexagenarian) were assigned to Group-2a; 70-79 years (septuagenarian) to Group-2b; and 80-89 years (octogenarian) to Group-2c. Patients' demographic characteristics (accompanying comorbidities, ASA scores, body mass indices and stone size) and perioperative values (duration of surgery and hospital stay, success and complication rates) were compared between the groups. Mean stone size was similar in groups (30.1 +/- 15.5 vs. 31.5 +/- 15.4 mm, p = 0.379). The mean ASA value for the patients in Group-1 was 1.61; significantly lower than that in the other groups (p = 0.000). The level of accompanying comorbidities in Group-1 was significantly lower than that of the other groups (p = 0.000). The mean duration of surgery, postoperative hematocrit drop, complication and success rate were statistically similar in Groups 1 and 2 (p = 0.860, p = 0.430, p = 0.7, and p = 0.66, respectively). The duration of hospital stay was significantly shorter in the patients in Group-1 compared to those in Group-2 (p = 0.008). In experienced hands, PNL can be safely and reliably performed in the treatment of renal stones in elderly patients.
  • [ X ]
    Öğe
    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]
  • [ X ]
    Öğe
    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.
  • [ X ]
    Öğe
    The Forgotten Ureteral Stent in Children: From Diagnosis to Treatment
    (Elsevier Science Inc, 2013) Sancaktutar, Ahmet Ali; Adanur, Senol; Resorlu, Berkan; Tepeler, Abdulkadir; Ziypak, Tevfik; Soylemez, Haluk; Atar, Murat
    Purpose: We conducted a multicenter pediatric study of ureteral stents unintentionally left in situ. Materials and Methods: A total of 22 patients with encrusted Double-J (R) ureteral stents unintentionally left in situ were treated at 4 centers between January 2007 and March 2012. Stone burdens were estimated using plain radiography and computerized tomography. Treatment decision was made based on clinical and radiological findings or stone burden. Results: Nine girls and 13 boys with a mean age of 9.5 years (range 2 to 16) were analyzed. Mean indwelling time of ureteral stent was 21.7 months (range 6 to 60). Stents were inserted for the indication of urolithiasis (17 patients) and reconstructive urological intervention (5). In 2 patients stents had been placed bilaterally. Mean stent stone burden was 184 mm(2) on plain radiography and 247 mm(2) on computerized tomography, a difference that was statistically significant (p = 0.002). Shock wave lithotripsy was done in 6 cases. Endoscopic procedures were performed in all patients, including ureteroscopy in 8, simple stent removal in 7, endoscopic cystolithotripsy in 6, percutaneous nephrolithotomy in 5, retrograde intrarenal surgery in 3 and percutaneous cystolithotripsy in 2. Surgical removal of each stent required a mean of 1.5 interventions and a mean hospital stay of 4.4 days. Conclusions: At experienced centers combined endourological techniques can achieve successful and safe management of forgotten stents even in the pediatric age group. Thus, routine preprocedural tomography is a must in children with forgotten ureteral stents.
  • [ X ]
    Öğe
    Initial experience of micro-percutaneous nephrolithotomy in the treatment of renal calculi in 140 renal units
    (Springer, 2014) Hatipoglu, Namik Kemal; Tepeler, Abdulkadir; Buldu, Ibrahim; Atis, Gokhan; Bodakci, Mehmet Nuri; Sancaktutar, Ahmet Ali; Silay, Mesrur Selcuk
    The aim of this study was to investigate the effectiveness and reliability of the micro-percutaneous nephrolithotomy (PNL) method for the management of kidney stones. We performed a retrospective analysis of 136 patients (140 renal units) who underwent micro-PNL for renal stones between September 2011 and February 2013 in four referral hospitals in Turkey. The selection of treatment modality was primarily based on factors such as stone size and location. In this study, we analyzed patient- and procedure-related factors. The mean age of patients in this study was 28.7 +/- A 20.6 (1-69) years, and the mean stone size was 15.1 +/- A 5.15 (6-32) mm. Conversion to mini-PNL was required in 12 patients. All interventions were performed with the patient in the prone position, except for the 3-year-old patient with the pelvic kidney who was placed in the supine position. The mean hospital stay was 1.76 +/- A 0.65 (1-4) days, and the mean drop in the hemoglobin level was 0.87 +/- A 0.84 (0-4.1) mg/dL. One of our patients required transfusion. Ureteral J stent was implanted in nine (6.43 %) patients because of residual stones. Seven (6.43 %) patients complained of postoperative renal colic which was managed conservatively. Abdominal distension related to extravasation of the irrigation fluid was observed in three patients (2.19 %). There were no other postoperative complications. An overall success rate of 82.14 % was achieved. Micro-PNL can be effectively and safely used for small and moderate kidney stones resistant to shock wave lithotripsy or as an alternative to other minimally invasive treatment methods.
  • [ X ]
    Öğe
    INITIAL REPORT OF 'MICROPERC' IN THE TREATMENT OF PAEDIATRIC KIDNEY STONES
    (Mary Ann Liebert, Inc, 2012) Silay, Mesrur Selcuk; Tepeler, Abdulkadir; Atis, Gokhan; Piskin, Mesut; Sancaktutar, Ahmet Ali; Gurbuz, Cenk; Penbegül, Necmettin
    [Abstract Not Available]
  • [ X ]
    Öğe
    Initial report of microperc in the treatment of pediatric nephrolithiasis
    (W B Saunders Co-Elsevier Inc, 2013) Silay, Mesrur Selcuk; Tepeler, Abdulkadir; Atis, Gokhan; Sancaktutar, Ahmet Ali; Piskin, Mesut; Gurbuz, Cenk; Penbegül, Necmettin
    Background/Purpose: To report the first technical feasibility and safety of microperc in the treatment of pediatric nephrolithiasis. Methods: A multicenter prospective trial was initiated and microperc was performed in 19 children from four different centers. In all cases, 4.85-Fr all-seeing needle was used to access the collecting system under direct vision. Stone fragmentation was performed using a 200-mu m holmium: YAG laser fiber either through the same needle sheath or an 8-Fr microsheath. Patient-and procedure-related factors and perioperative and postoperative parameters were analyzed. Results: The mean age of the children was 7.5 +/- 4.4 years. Mean stone size was 14.8 +/- 6.8 mm. Conversion to Mini-PNL was required in two patients because of optical default in one and the high stone burden in the other. The mean hospital stay was 1.8 +/- 0.8 days and the mean hemoglobin decrease was 0.1 mg/dl. The overall stone-free rate at 1 month was 89.5%. In one patient with obstructed ureteropelvic junction, intravasation of the irrigation fluid has led to abdominal distention and managed with percutaneous drainage intraoperatively. No other postoperative complication was recorded and no ancillary procedure was required. Conclusions: Microperc is a safe and effective procedure in the treatment of pediatric kidney stones. (C) 2013 Elsevier Inc. All rights reserved.
  • [ X ]
    Öğe
    Micro-ureteroscopy for the treatment of distal ureteral calculi in children
    (W B Saunders Co-Elsevier Inc, 2017) Utangac, Mehmet Mazhar; Sancaktutar, Ahmet Ali; Tepeler, Abdulkadir
    Objective: The objective of this study was to demonstrate the efficacy and safety of micro-ureteroscopy (microURS) in the management of distal ureteral stones in the pediatric population. Materials and Methods: A total of 11 children, who had undergone micro-URS between September 2015 and April 2016 with the indication of distal ureteral calculi in two referral centers, were retrospectively evaluated. The procedures were performed with the patient in the lithotomy position under general anesthesia using the standard URS technique with amicro-ureteroscope that has a caliber of 4.85 Fr all along its length. Demographics, perioperative data, and outcomes were assessed. Results: Right (n = 6) and left (n= 8) ureteral stones were detected in the respective number of patients. The mean age of the children was calculated as 55.1 months (range, 6-161 months). The median stone size was 10.5 mm (range, 6-24 mm). The median operative time was 36.8 min (range, 23-68 min). A double 3 stent was implanted in 3 of 11 patients because of severe edema. As a postoperative complication mild hematuria (Clavien grade 1) was observed in one case and resolved spontaneously. Intraoperative minor or major complication did not occur in any of the cases. The mean hospitalization time was determined as 21.4 h (range, 10-28 h). Stone-free status was accomplished in all patients in the final assessment. Conclusion: The outcomes of our series show that micro-URS can be used safely and effectively in the treatment of pediatric distal ureteral stones. Further prospective and comparative studies comparing instruments of different size are warranted. (C) 2017 Elsevier Inc. All rights reserved.
  • [ X ]
    Öğe
    A Mild and Rare Form of Klippel-Trenaunay Syndrome Presenting With Urethral Bleeding Due To Penile Hemangioma
    (Elsevier Science Inc, 2011) Tepeler, Abdulkadir; Yesilolva, Yavuz; Kilinc, Ali; Aktoz, Tevfik; Oenen, Abdurrrahman
    Klippel-Trenaunay syndrome (KTS) is characterized by a triad of cutaneous port-wine capillary malformations, hemihypertrophy, and varicose veins. Intermittent gross painless hematuria is usually the first clinical sign. An 8-year-old boy with multiple hemangiomas, including glans penis, and associated with KTS presented with urethral bleeding. Radiologic and endoscopic evaluation revealed neither intra-abdominal nor intravesical hemangioma. Urethral bleeding was thought to be related to glanular hemangioma extending to the anterior penile urethra. Although we were able to manage the case conservatively, many patients require endoscopic or surgical interventions. Radiologic and endoscopic evaluations and careful follow-up is essential for diagnosis and prompt treatment. UROLOGY 77: 463-465, 2011. (C) 2011 Elsevier Inc.
  • [ X ]
    Öğe
    Multiple Circumferential Urethrocutaneous Fistulae as a Rare Complication of Circumcision and Review of Literature
    (Elsevier Science Inc, 2011) Sancaktutar, Ahmet Ali; Pembegul, Necmettin; Bozkurt, Yasar; Kolcu, Bayram; Tepeler, Abdulkadir
    Circumcision remains the most common surgical procedure performed in boys worldwide. Although circumcision can be associated with numerous major and minor complications, urethrocutaneous fistula is extremely rare and serious. An 18-years-old boy presented with urine passage from 4 fistula orifices. He had been circumcised by nonmedical personnel when he was 2 years old. During the surgery, after degloving the penis, it was observed that the fistulae tracts werecombining. There were only 2 fistulae orifices on the urethra. The fistulae were repaired with simple closure. This is the second case reported in the literature describing multiple urethrocutaneous fistulae. UROLOGY 77: 728-729, 2011. (C) 2011 Elsevier Inc.
  • [ X ]
    Öğe
    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.
  • [ X ]
    Öğe
    Preoperative evaluation of pediatric kidney stone prior to percutaneous nephrolithotomy: is computed tomography really necessary?
    (Springer, 2013) Tepeler, Abdulkadir; Sancaktutar, Ahmet Ali; Taskiran, Mehmet; Silay, Mesrur Selcuk; Bodakci, Mehmet Nuri; Akman, Tolga; Tanriverdi, Orhan
    The objective of the study was to investigate the precise role of computed tomography (CT) in preoperative radiologic evaluation and surgical planning of kidney stone in children prior to percutaneous nephrolithotomy (PNL). A total of 113 pediatric patients (aged a parts per thousand currency sign18 years) undergoing PNL for renal stone(s) in three referral hospitals between March 2010 and August 2012 were retrospectively evaluated. Depending on the preoperative radiologic evaluation, patients were divided into two groups. Those evaluated with CT were classified as group-1 (n = 50) and the remaining cases undergoing intravenous urography (IVU) examination were classified as group-2 (n = 63). Patient- and procedure-related variables and perioperative measures were compared between the groups. The mean age, stone size and localization were similar in both groups (p = 0.07, p = 0.57, p = 0.6, respectively). Although the postoperative hemoglobin drop was found to be significantly higher in group-2 (1.5 +/- A 1.3 vs. 0.9 +/- A 0.6 g/dL, p = 0.005), the mean operation time, fluoroscopic screening time, access number, overall success and complication rates were comparable (p = 0.06, p = 0.94, p = 0.75, p = 041, and p = 0.41, respectively). However, the mean hospitalization time was significantly prolonged in group-2 than in group-1 (p = 0.03). Our findings clearly demonstrate that, despite the key role of preoperative CT in particular patients with anatomically abnormal kidneys, IVU is a valuable alternative imaging modality with comparable radiation doses in children.
  • [ X ]
    Öğe
  • [ X ]
    Öğe
    The Role of Microperc in the Treatment of Symptomatic Lower Pole Renal Calculi
    (Mary Ann Liebert, Inc, 2013) Tepeler, Abdulkadir; Armagan, Abdullah; Sancaktutar, Ahmet Ali; Silay, Mesrur Selcuk; Penbegül, Necmettin; Akman, Tolga; Hatipoglu, Namik Kemal
    Background and Purpose: The treatment of symptomatic lower pole (LP) calculi poses a challenge because of lower clearance rates. We present our experience with microperc in the treatment of LP renal calculi. Patients and Methods: We retrospectively evaluated the symptomatic patients with LP renal calculi who underwent microperc between August 2011 and June 2012 from two referral hospitals. Patients were included only in cases of failure after shockwave lithotripsy (SWL) or retrograde intrarenal surgery (RIRS) and according to patient preference. The percutaneous renal access was performed using the 4.8F all-seeing needle with C-arm fluoroscopy or ultrasonographic guidance with the patient in the prone position. Stone disintegration was established using a 200 mu m holmium: yttrium-aluminum-garnet laser fiber. Results: A total of 21 patients (mean age 37.3 +/- 20.1 years) with LP stone underwent microperc. The mean body mass index was 28.6 +/- 6.0 kg/m(2), and the mean stone size was 17.8 +/- 5.9 (9-29) mm. The duration of surgery and fluoroscopic screening was 62.8 +/- 25.2 minutes and 150.5 +/- 92.8 seconds, respectively. The patients were discharged after a mean 37.5 +/- 14.4 hours of hospitalization time. The mean hemoglobin drop was 0.8 +/- 0.6 (0.1-2.3) g/dL. Conversion to miniperc was necessitated in one patient with loss of vision. Stone-free status was achieved in 18 (85.7%) patients. Clinically insignificant residual fragments were observed in only one (4.8%). The procedure failed in two (9.5%) patients. A total of two minor complications (renal colic necessitating stent insertion and urinary tract infection) were observed postoperatively, none severe. Conclusion: Microperc is a feasible and efficient treatment modality for symptomatic LP calculi. Our results provide that microperc might take a part in case of SWL and RIRS failures or as an alternative to percutaneous nephrolithotomy or RIRS in the management of symptomatic LP calculi.