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Öğe Comparison of complications associated with standard and totally tubeless percutaneous nephrolithotomy according to modified Clavien grading: A multicenter retrospective study(Elsevier Taiwan LLC., 2014) Karakoyunlu, Ahmet Nihat; Ekici, Musa; Yeşil, Süleyman; Zengin, Kürşad; Göktuğ, Göksel; Özok, Hakkı UğurThe aim of this study was to compare the complications of standard and totally tubeless percutaneous nephrolithotomy (PCNL) based on the modified Clavien complication grading system. We retrospectively evaluated the complications of 290 consecutive patients who had undergone standard or totally tubeless PCNL at four institutes between January 2010 and August 2012 based on the modified Clavien scale. The totally tubeless cases were classified as Group 1 and the cases to which a Malecot re-entry catheter was applied were classified as Group 2. The postoperative complications were recorded according to the modified Clavien complication grading system. Statistically significant differences were observed only in the first-degree injury class between the two groups based on the modified Clavien classification. The requirement for blood transfusion and prolonged percutaneous access site leakage were more frequent in Group 2, but these differences were not statistically significant. We also performed a pain evaluation by monitoring postoperative analgesia demands. In Group 1, the analgesic demand rates in the 1st and 6th postoperative hours were 64.6% and 31.5%, respectively. In Group 2, the analgesic demand rates were 87.5% and 58.75% in the 1st and 6th postoperative hours, respectively. The mean ± standard deviation of analgesic doses in the first 6 hours was 0.96 ± 0.7 and 1.46 ± 0.6 in Groups 1 and 2, respectively. These differences were statistically significant. Based on our results, we can conclude that the tubeless technique has fewer complications, improved postoperative patient comfort, shorter hospitalization times, and a reduced need for analgesics, suggesting that tubeless PCNL should be the standard approach. For suitable cases, this technique may be used safely as the standard PCNL approach. Copyright © 2014, Kaohsiung Medical University. Published by Elsevier Taiwan LLC. All rights reserved.Öğe Comparison of dilation methods in percutaneous nephrolithotomy: Which one is more successful?(Mary Ann Liebert Inc., 2016) Nalbant, İsmail; Karakoyunlu, Ahmet Nihat; Yeşil, Süleyman; Ekici, Musa; Zengin, Kürşad; Öztürk, Ufuk; İmamoğlu, Muhammed AbdurrahimObjective: Creation of the access tract is an important step in percutaneous nephrolithotomy (PNL). In this study, we compared the efficiency and safety of Amplatz, Alken, and balloon dilation methods in the creation of the access tract. Materials and Methods: Data from 487 PNL patients admitted to 517 renal units in 3 centers were analyzed. The Amplatz (280 patients), Alken (142 patients), and balloon (95 patients) dilation methods were compared for their success, duration of the dilation, injury to the collecting system, durations of fluoroscopy and surgery, stone-free and complication rates, pre- and postoperative hematocrit levels, and need for blood transfusion. Results: The dilation methods did not significantly differ with respect to patient demographic data, mean stone area, decrease in hematocrit, need for blood transfusion, unsuccessful tract dilation, injury to the collecting system, stone-free rate, and rate of postoperative complications. The mean fluoroscopy times during Amplatz, Alken, and balloon dilation were 288.52 ± 164.67, 287.34 ± 164.99, and 169.23 ± 21 seconds, respectively. The mean duration of surgery was 96.48 ± 46.07, 94.72 ± 42.25, and 78 ± 25.96 minutes, respectively. The duration of tract creation was 328.67 ± 172.99, 325.14 ± 175.70, and 203.50 ± 32.76 seconds, respectively. The durations of surgery and tract creation were significantly shorter in the balloon dilation group. Conclusion: None of the dilation methods was significantly superior in terms of surgical success, efficiency, or safety. Although balloon dilation was advantageous with respect to time parameters, the role of surgical experience should not be ignored. © Copyright 2016, Mary Ann Liebert, Inc. 2016.Öğe Relationship between anxiety and lower urinary tract symptoms(Derman Medical Publishing, 2016) Çevik, Rıza; Bal, Ufuk; Albayrak, Sebahattin; Tanık, Serhat; Zengin, Kürşad; Atar, Muhittin; Gül, Ali İrfanAim: Lower urinary tract symptoms (LUTS) secondary to benign prostatic hyperplasia (BPH) are prevalent and interfere with the quality of life (QoL) of older men. According to observa¬tional, 22.6% of LUTS/BPH patients reported anxiety or depression. The aim of our study was to investigate the potential influences of anxiety and QoL to LUTS/BPH. Material and Method: We examined consecutive 42 patients admitted to our outpatient clinic with LUTS at Bor State Hospital. We examined and recorded maximum urinary flow rate (Qmax) and International Prostate Symptom Score (IPSS) also Hamilton anxiety rating scale for anxiety and IPSS QoL were utilized in the study. Patients according to IPSS were divided into two groups as moderate (group 1, IPSS ?19) and severe (group 2, IPSS >19) LUTS. Patients according to Qmax were divided into two groups as moderate (group 3, Qmax >9) and severe (group 4, Qmax ?9) LUTS. Results: The mean Hamilton anxiety rating scale score of group 1 and 2 were 15.4 ± 3.3 and 21.4 ± 4.5, respectively (P=0.03); of group 3 and 4 were 13.5 ± 2.8 and 17.9 ± 3.5, respectively (P=0.04). The mean QoL score of group 1 and 2 were 3.2 ± 0.6 and 4.2 ± 0.9, respectively (P=0.02); of group 3 and 4 were 3 ± 0.5 and 3.7 ± 0.6, respectively (P=0.02). Discussion: We found relationship between clinical status, anxiety and QoL in patients with BPH. These psychiatric parame¬ters may help identify individuals to benefit from treatment interventions in daily routine practice. © 2016, Journal of Clinical and Analytical Medicine. All rights Reserved.
