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    Flexible Ureterorenoscopy versus Extracorporeal Shock Wave Lithotripsy for the treatment of upper/middle calyx kidney stones of 10-20 mm: a retrospective analysis of 174 patients
    (SPRINGER INTERNATIONAL PUBLISHING AG, 2014-01-01) Cecen, Kursat; Karadag, Mert Ali; Demir, Aslan; Bagcioglu, Murat; Kocaaslan, Ramazan; Sofikerim, Mustafa
    To compare the outcomes of flexible ureterorenoscopy (F-URS) with extracorporeal shock wave lithotripsy (ESWL) for the treatment of upper or mid calyx kidney stones of 10 to 20 mm. A total of 174 patients with radioopaque solitary upper or mid calyx stones who underwent ESWL or F-URS with holmium: YAG laser were enrolled in this study. Each group treated with ESWL and F-URS for upper or mid calyx kidney stones were retrospectively compared in terms of retreatment and stone free rates, and complications. 87\% (n = 94) of patients who underwent ESWL therapy was stone free at the end of 3rd month. This rate was 92\% (n = 61) for patients of F-URS group (p = 0.270 p > 0.05). Retreatment was required in 12.9\% of patients (n = 14) who underwent ESWL and these patients were referred to F-URS procedure after 3rd month radiologic investigations. The retreatment rate of cases who were operated with F-URS was 7.5\% (n = 5) (p = 0.270 p > 0.05). Ureteral perforation (Clavien grade 3B) was occured in 3 patients (4.5\%) who underwent F-URS. Fever (Clavien grade 1) was noted in 7 and 5 patients from ESWL and F-URS group, respectively (6.4\% vs 7.5\%) (p = 0.78 p > 0.05). F-URS and ESWL have similar outcomes for the treatment of upper or mid calyx renal stones of 10-20 mm. ESWL has the superiority of minimal invasiveness and avoiding of general anethesia. F-URS should be kept as the second teratment alternative for patients with upper or mid caliceal stones of 10-20 mm and reserved for cases with failure in ESWL.
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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.