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Bilateral same-session ureterorenoscopy: A feasible approach to treat pan-urinary stone disease
(ARAB ASSOC UROLOGY, 2017-01-01) Ozveren, Bora; Eren, Murat Tugrul; Ozveri, Hakan; Altug, Ugur; Sahin, Ahmet
Objectives: To assess treatment effectiveness and safety of bilateral same-session ureterorenoscopy (BSSU) for the management of stone disease involving the entire urinary system. Patients and methods: We reviewed the records of 64 patients who underwent BSSU for the treatment of bilateral ureteric and/or kidney stones. Size, number, location per side, and the total burden of stones were recorded. Data on stenting, lithotripsy, and stone retrieval, and details of hospital stay and operation times were investigated. Treatment results were assessed using intraoperative findings and postoperative imaging. The outcome was considered successful in patients who were completely stone-free or who had only residual fragments of <= 2 mm. Results: The outcome was successful in 82.8\% of the patients who received BSSU (54.7\% stone-free and 28.1\% insignificant residual fragments). The success rate per renal unit was 89.8\%. There were no adverse events in 73.4\% of the patients. The most common intraoperative complication was mucosal injury (36\%). The complications were Clavien-Dindo Grade I in 9.4\% and Grade II in 7.8\%. Grade IIIa and IIIb (9.4\%) complications required re-treatments. Statistical evaluation showed no association between complication grades and stone, patient, or operation features. Stone burden had no negative impact on BSSU results. The presence of impacted proximal ureteric stones was significantly related to unsuccessful outcomes. Conclusion: BSSU is safe and effective for the management of bilateral urolithiasis. BSSU can prevent recurrent surgeries, reduce overall hospital stay, and achieve a stone-free status and complication rates that are comparable to those of unilateral or staged bilateral procedures. (C) 2017 Production and hosting by Elsevier B.V. on behalf of Arab Association of Urology.
Initial Outcomes and Assessment of the Transperineal Multiparametric-Magnetic Resonance Imaging/Ultrasonography Fusion Biopsy Method in Diagnosing Clinically-significant Prostate Cancer
(GALENOS YAYINCILIK, 2017-01-01) Ozgen, Mahir B.; Ozveren, Bora; Uzel, Sertac; Altug, Ugur; Turkeri, Levent
Objective: In this study, it was aimed to investigate the success of transperineal multiparametric magnetic resonance imaging (mp-MRI)/transrectal ultrasonography (USG) fusion prostate biopsy method in prostate cancer diagnosis and detection of clinically significant cancer. Materials and Methods: All patients signed written informed consent then patients with an indication for prostate cancer, therefore biopsy was planned for the last year underwent 3 Tesla mp-MRI retrospectively. All the lesions of patients with Prostate Imaging, Reporting and Data System (PIRADS) 3, 4 and 5 lesions were marked using MIM (TM) Symphony software by a single radiologist. All patients underwent transperineal MRI/USG fusion biopsy under general anesthesia. In the prostate MRI evaluation of the targeted lesions with a PIRADS score of 3-4-5 were sampled with 2 to 5 cores followed by random biopsies of both of the prostate lobes. Results: Prostate adenocarcinoma was diagnosed in 20 of 59 patients (33.8\%) having fusion biopsy. No difference was observed in prostate-specific antigen levels of patients whose biopsy results were benign and malignant. In 63\% of patients, only PIRADS 3 lesions were found, whereas PIRADS 4 and/or 5 lesions were reported in 22 (37\%) patients. The fusion biopsy of PIRADS 3 lesions revealed cancer in 7 patients (19\%), of which 6 had clinically-insignificant prostate cancer criteria. Adenocarcinoma was diagnosed in 59\% who had PIRADS 4 and/or 5 lesions. All these tumors had clinically-significant cancer characteristics. Lesion-targeted fusion biopsies missed 1 clinically-insignificant adenocarcinoma (1/7

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