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Öğe A comparison of antegrade percutaneous and laparoscopic approaches in the treatment of proximal ureteral stones(Hindawi Publishing Corporation, 2014) Topaloğlu, Hikmet; Karakoyunlu, Ahmet Nihat; Sarı, Sercan; Özok, Hakkı Uğur; Sağnak, Levent; Ersoy, HamitPurpose. To compare the effectiveness and safety of retroperitoneal laparoscopic ureterolithotomy (RLU) and percutaneous antegrade ureteroscopy (PAU) in which we use semirigid ureteroscopy in the treatment of proximal ureteral stones. Methods. Fifty-eight patients with large, impacted stones who had a history of failed shock wave lithotripsy (SWL) and, retrograde ureterorenoscopy (URS) were included in the study between April 2007 and April 2014. Thirty-seven PAU and twenty-one RLU procedures were applied. Stone-free rates, operation times, duration of hospital stay, and follow-up duration were analyzed. Results. Overall stone-free rate was 100% for both groups. There was no significant difference between both groups with respect to postoperative duration of hospital stay and urinary leakage of more than 2 days. PAU group had a greater amount of blood loss (mean hemoglobin drops for PAU group and RLU group were 1.6 ± 1.1 g/dL versus 0.5 ± 0.3 g/dL, resp.; P=0.022). RLU group had longer operation time (for PAU group and RLU group 80.1 ± 44.6 min versus 102.1 ± 45.5 min, resp.; P=0.039). Conclusions. Both PAU and RLU appear to be comparable in the treatment of proximal ureteral stones when the history is notable for a failed retrograde approach or SWL. The decision should be based on surgical expertise and availability of surgical equipment. © 2014 Hikmet Topaloglu et al.Öğe A comparison of retrograde intrarenal surgery and percutaneous nephrolithotomy for management of renal stones>= 2 CM(Urology and Nephrology Research Centre, 2017) Sarı, Sercan; Özok, Hakkı Uğur; Çakıcı, Mehmet Çağlar; Özdemir, Harun; Baş, Okan; Karakoyunlu, Ahmet Nihat; Sağnak, Levent; Şentürk, Aykut Buğra; Ersoy, HamitPurpose: In this retrospective study, we aimed to compare the outcomes in patients who have been treated with percutaneous nephrolithotomy (PNL) and retrograde intrarenal surgery (RIRS) on renal stones ? 2 cm size. Materials and Methods: We evaluated patients who underwent PNL or RIRS for renal stones ? 2 cm size between November 2011 and November 2014. Stone size, operation, fluoroscopy and hospitalization time, success rates, stone-free rates and complication rates were compared in both groups. Patients were followed for three months. Results: 254 patients were in the PNL Group. 185 patients were in the RIRS Group. The mean age was 46.88 and 48.04 years in PNL and RIRS groups, respectively. The patient and stone characteristics (age, gender, Body Mass Index, kidney anomaly, SWL history and stone radioopacity) were similar between two groups. The mean stone size preoperatively was significantly larger in patients who were treated with PNL (26.33mm.vs 24.04 mm.; P = .006). In the RIRS group, the mean stone number was significantly higher than PNL group (P < .001). The mean operative, fluoroscopy and hospitalization time were significantly higher in PNL group (P < .001). The stone-free rate was 93.3% for the PNL group and 73.5% for the RIRS group after first procedure (P < .001). No major complication (Clavien III-V) occurred in the RIRS group. Conclusion: Although the primary treatment method for renal stones ? 2cm size is PNL, serious complications can be seen. Therefore, RIRS can be an alternative treatment option in the management of renal stones ? 2 cm size.Öğe A new method for fragmented ureteral stent extraction: flexible renoscopy(Elsevier Inc., 2015) Topaloğlu, Hikmet; Sarı, Sercan; Özok, Hakkı Uğur; Baylan, Burhan; Özdemir, Harun; Bıkırov, Muslim; Çakıcı, Mehmet Çağlar; Ersoy, HamitUsage of ureteral DJ stent is very common in urology practise. There are some complications according to the increased usage of ureteral DJ stent in the literature. Stent fragmentation is a rare complication of ureteral DJ stent. In this study we present a 53-year-old male patient who had previous stone surgery and a ureteral DJ stent applied to our polyclinic with complaint of 3-months-long right side pain. In the radiologic examination we observed that DJ stent was fragmented from the upper end on the right kidney. We extracted the fragmentated part of ureteral DJ stent with flexible ureterorenoscopy.Öğe Çocuk hastalarda böbrek taşı tedavisinde retrograd intrarenal cerrahi – mini-perkütan nefrolitotomi yöntemlerinin karşılaştırılması: tek merkezli retropektif çalışma(Kafkas Üniversitesi Tıp Fakültesi, 2016) Karakoyunlu, Ahmet Nihat; Özok, Hakkı Uğur; Sarı, Sercan; Çakıcı, Mehmet Çağlar; Hepşen, Emre; Topaloğlu, Hikmet; Şentürk, Aykut Buğra; Ersoy, HamitAIM: Management of kidney stone in pediatric patients is an important problem. Shock Wave Lithotripsy (SWL), mini-percutaneous nephrolithotomy (mini-PNL), micro PNL and recently developing Retrograde Intrarenal Surgery (RIRS) are the methods used in stone management.METHODS: Among from the 1047 patients who had undergone RIRS and mini-PNL in Dıskapı Yıldırım Beyazıt Training and Research Hospital, 27 patients who are younger than 17 years were included our study. The demographic, intraoperative and postoperative data of these patients and complications were evaluated retrospectively.RESULTS: For 1-2 cm diameter stones, the success for RIRS and mini-PNL were %70 and %100, respectively. For 2-3 cm diameter stones, the success for RIRS and mini-PNL were %50 and %100, respectively. There was no major complication in both groups. Scopy time, operation time, stone burden, hospital stay were different between two groups. And the difference was statistically significant.CONCLUSION: As a result RIRS and mini-PNL are effective and safe methods and they are feasible in treatment of pediatric patientsÖğe Comparison of Retrograde Intrarenal Surgery and Percutaneous Nephrolithotomy Methods For Management of Big- Sized Kidney Stones(>= 4 cm): Single Center Retrospective Study(Urol & Nephrol Res Ctr-Unrc, 2019) Karakoyunlu, Ahmet Nihat; Cakici, Mehmet Caglar; Sari, Sercan; Hepsen, Emre; Ozok, Hakki Ugur; Sagnak, Azmi Levent; Ersoy, HamitPurpose: Management of >= 4 cm sized kidney stone is a rarely seen problem in urology. Few studies are present about this issue. Percutaneous nephrolithotomy(PNL), Retrograde Intrarenal Surgery(RIRS) and open surgery are the methods used in stone management. In our study we aimed to compare RIRS and PNL in the management of >= 4 cm sized kidney stones. Materials and methods: Among patients who had undergone RIRS and PNL in Diskapi Yildirim Beyazit Training and Research Hospital, 94 patients who had >= 4 cm sized kidney stones were included our study. The demographic, intraoperative and postoperative data of these patients and complications were evaluated retrospectively. Results: 94 patients (67 PNL, 27 RIRS) were in the study. Stone laterality, urinary anomaly and gender were similar in two groups.(Group PNL(P) and Group RIRS(R)) Stone number were 2.55 +/- 1.44 and 2.78 +/- 1.42 in Group P and R, respectively. Stone size were 47.06 7.02 and 46.41 6.00 mm. in Group P and R, respectively. The differences between two groups were not statistically significant.(P >.05) In Group P scopy time, hospital stay and stone free rate were higher and operation time was lower than Group R. And the difference was statistically significant(P <.05). Conclusions: As a result, PNL is an effective method and operation time is lower than RIRS. Also a second operation for JJ stent taking is lower in PNL. RIRS is a safe method. RIRS has less complications and hospitalization time. They are feasible in treatment of >= 4 cm sized kidney stones.Öğe Endovascular treatment of a blunt trauma which caused massive perineoscrotal haematoma in a child(Kare Publishing, 2015) Karakoyunlu, Ahmet Nihat; Yıldırım, Mahir; Topaloğlu, Hikmet; Özok, Hakkı Uğur; Sağnak, Levent; Ersoy, HamitUrethral injuries are primarily suggested in patients who are presented at the emergency service with straddle trauma. In addition, perineal vascular injuries are rarely observed in such traumas. In the literature, perineal, vascular injuries have been reported with high-flow priapism in many cases. We will present a treatment for a pure pudendal artery that disturbs hemodynamics. This technique is based on endovascular technique with minimal invasion in pediatric male patients who have followed a fall accompanied neither with urethral injury nor with priapism and those who could not have been controlled with conservative treatment but have a massive hemorrhage, which cannot be controlled with conservative treatment. © 2015 by Erciyes University School of Medicine.Öğe Koitus sırasında penisin süperfisial dorsal veninin rüptürü(Avrasya Üroonkoloji Derneği, 2017) Ekici, Musa; Şentürk, Aykut Buğra; Nalbant, İsmail; Ersoy, Hamit42 yaşında erkek hasta ilişki sonrası penil şişlik ve hematom nedeni ile acil servise başvurdu.Hasta opere edildi. Tunika albüginea bütünlüğü tam idi. Rüptüre süperfisial dorsal ven bulundu ve ligate edildi.Postoperatif seksüel fonksiyon ve ereksiyon tamamen normal idi.Penisin süperfisial dorsal ven ruptürü nadir görülür ancak ağrısız şişlik ve hematom olması, ani detümesans olmaması gibi klinik durumlarda penil fraktür ayırıcı tanısında akılda tutulması gerekirÖğe Malfunctioned and fractured penile prosthesis caused by cross placement: case report(Elsevier Inc., 2015) Karakoyunlu, Ahmet Nihat; Sarı, Sercan; Özdemir, Harun; Topaloğlu, Hikmet; Özok, Hakkı Uğur; Sağnak, Levent; Ersoy, HamitPenile prosthesis is a functional option for patients who have erectile dysfunction after failed medical and intracavernosal treatments. Malleable penile prosthesis is a good alternative. Penile prosthesis implantation is a surgical process. Seldomly complications occur. In this study we presented a 61 y old man who has malfunctioned and broken penile prosthesis due to cross implantation.Öğe Migration of an forgotten intrauterine device into the urinary bladder(Gulhane Medical School, University of Health Sciences, 2013) Sağnak, Levent; Ersoy, Hamit; Aksun, Fuat; Özok, Hakkı Uğur; Karakoyunlu, Ahmet Nihat; Topaloğlu, HikmetSpontaneus migration of the intrauterine devices(IUD) into the bladder is a rare complication. We report and describe the clinical outcome and management of one such case of intravesical IUD. The diagnosis was confirmed after cystoscopic visualization. Endoscopic examination allowed removal of the IUD.Öğe Percutaneous nephrolithotomy performed on the kidney stone in a patient with ankylosing spondylitis: a case study(Elsevier Inc., 2015) Sarı, Sercan; Baylan, Burhan; Sezer, Evginar; Çataroğlu, Cem Koray; Özok, Hakkı Uğur; Ersoy, HamitA 68-year-old man with serious cervical kyphosis and dorsolumbar scoliosis due to ankylosing spondylitis was admitted with a stone 17mm in size in left kidney lower calyx. A percutaneous nephrolithotomy operation was decided considering the size and location of stone and the anatomical deformities of patient. The kidney was accessed through monoplaner triangulation method by giving a special position of the patient's spinal deformity and stone was successfully removed. Percutaneous nephrolithotomy is a feasible method in ankylosing spondylitis patients in case that the right position is achieved. Each patient should be assessed individually deciding on treatment methods. © 2015 The Authors.Öğe Primary Testicular B-cell Lymphoma(Galenos Yayincilik, 2015) Sentuk, Aykut Bugra; Ekici, Musa; Ersoy, HamitPrimary testicular lymphoma constitutes only 1-7% of all testicular neoplasms and less than 1% of all non-Hodgkin lymphoma. We report a 69-year-old man who presented with a painful right testicular mass. Treatment modalities consist of surgical excision, chemotherapy and radiation therapy, however there are no standardized treatment options.Öğe The association of a number of anatomical factors with the success of retrograde intrarenal surgery in lower calyceal stones(Urology and Nephrology Research Centre, 2017) Sarı, Sercan; Özok, Hakkı Uğur; Topaloğlu, Hikmet; Çakıcı, Mehmet Çağlar; Özdemir, Harun; Karakoyunlu, Ahmet Nihat; Şentürk, Aykut Buğra; Ersoy, HamitPurpose: To determine anatomical factors affecting Retrograde Intrarenal Surgery (RIRS) success in the treatment of renal lower calyx stones. Materials and methods: The results of patients were evaluated retrospectively. The patients who have preoperative intravenous urography (IVU) and computed tomography (CT) were divided into two groups as successful (S)(N=103) and unsuccessful(U) (N=29). The anatomic characteristics such as infundibulopelvic angle (IPA), infundibular length (IL), infundibular width (IW) and pelvicaliceal height (PCH) values were compared among two groups. Results: Mean patient age was 47±13.6 years in group S and 49.5 ±11.9 years in group U. The mean stone size was 10mm (6-54mm) in group S and 19mm (8-45mm) in group U (P < .001) Mean IPA was 85.8 ±16.9 degree in group S versus 54.7 ± 11.5 degree in group U. The mean PCH was 1.9cm (0.5-4cm) in group S versus 2.3cm (0.7-3.9cm) in group U. The mean IL were 2.7 ± 0.8 cm and 3.2±0.7cm in group S and group U, respectively. The mean IWs were 0.7 cm (0.2-2.3cm) and 0.7cm (0.3-2) in group S and group U, respectively. The differences were statistically significant for IPA, PCH, IL (P < .05) while was not statistically significant for IW (P > .05). After multivariate analyses, PCH, IPA and stone size were statistically significant factors. Conclusion: In our study we found that IPA, PCH and stone size were significant anatomical factors affecting RIRS success in the treatment of renal lower calyx stones. The patients whose IPA, PCH and stone size valuables are unsuitable, may need multiple RIRS sessions or additional treatment modalities.
