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    Conservative/surgical treatment predictors of maternal hydronephrosis: results of a single-center retrospective non-randomized non-controlled observational study
    (Springer Netherlands, 2017) Erçil, Hakan; Arslan, Burak; Ortoğlu, Ferhat; Alma, Ergün; Ünal, Umut; Deniz, Mehmet Eflatun; Şentürk, Aykut Buğra; Gürbüz, Zafer Gökhan
    Purpose: To determine the parameters that may help the clinicians decide the best suitable treatment method for the pregnant women with symptomatic hydronephrosis which will be based on the easily accessible laboratory tests, monitoring methods and clinical symptoms. Methods: Digital data and documents of 246 pregnant women with symptomatic hydronephrosis who were hospitalized in our clinic between the dates of January 2011 and January 2016 were retrospectively evaluated. All patients were statistically evaluated in terms of age, symptomatic maximal anterior–posterior diameter of the renal pelvis (MADP), parity, C-reactive protein (CRP) level, white blood cell count (WBC), presence of pyuria, growth of urine culture, fever, serum urine and creatinine levels, visual analog scale (VAS) score of pre- and post-therapy and threatened preterm labor. Results: The study includes a total of 211 pregnant women with symptomatic hydronephrosis. In the second and third trimester groups, the surgical treatment group statistically provided higher levels of CRP, WBC and VAS. Mean MADP in the second trimester of the conservative and surgical groups where symptomatic hydronephrosis was on the right side was 16.67 ± 4.67 and 28.68 ± 7.70 mm, respectively. Mean MADP in the third trimester group of the conservative and surgical groups where symptomatic hydronephrosis was on the right side was 16.96 ± 5.96 and 28.85 ± 7.64 mm, respectively. Conclusions: In patients with symptomatic pregnancy hydronephrosis, the likelihood of surgical treatment for CRP levels, WBC counts and VAS is high. © 2017, Springer Science+Business Media Dordrecht.
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    Öğe
    Safety and efficacy of pneumatic lithotripters versus holmium laser on multiple ureteral calculi
    (Academy of Medical Sciences of I.R. Iran, 2016) Erçil, Hakan; Alma, Ergün; Baş, Okan; Ünal, Umut; Şener, Nevzat Can; Vuruşkan, Ediz; Şentürk, Aykut Buğra; Gürbüz, Zafer Gökhan
    Background: Different energy sources can be used for ureteroscopic stone fragmentation, such as pneumatic, ultrasonic, laser or electrohydraulic. The aim of this study was to compare the efficacy and safety of pneumatic lithotripters versus Ho: YAG laser in the treatment of multiple stones in the distal ureter. Methods: A retrospective evaluation was done using the data of patients to whom ureteroscopic lithotripsy (URL) was applied for ureter stones in our clinic. From these patients, those with multiple unilateral distal ureter stones were identified, then these patients were separated into 2 groups according to the type of lithotriptor used in stone fragmentation as laser lithotripsy (Group 1) and pneumatic lithotripsy (Group 2). Results: Statistically, the two groups were similar in respect of the number of stones, stone burden and the number of double J stents applied intra-operatively. The mean operating time was similar in the 2 groups as 53. 47 (±17. 3) minutes in Group 1 and 50. 59 (±15. 3) minutes in Group 2. On postoperative day 1 after the URL, the stone free rate (SFR) of Group 1 (78. 7%) was found to be significantly high compared to the SFR of Group 2 (63. 6%), while at postoperative month 1, the SFR of both groups was found to be similar. Binary logistic regression was applied to determine the effect of related independent variables on the 1st month SFR. In this model, age and stone burden were affecting variables. Conclusion: Compared to the pneumatic lithotripter, the Ho: YAG laser seems to have advantages of a higher SFR in the early postoperative period, eventhough there are statistically similar success rates and complication rates. © 2016, Academy of Medical Sciences of I.R. Iran. All rights reserved.