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Öğe Comparison of Anesthesia Methods in Treatment of Staghorn Kidney Stones with Percutaneous Nephrolithotomy(UROL & NEPHROL RES CTR-UNRC, 2016) Buldu, Ibrahim; Tepeler, Abdulkadir; Kaynar, Mehmet; Karatag, Tuna; Tosun, Muhammed; Umutoglu, Tarik; Tanriover, HakanPurpose: To compare the efficacy and safety of percutaneous nephrolithotomy (PNL) in the treatment of staghorn calculi (SC) under spinal anesthesia (SA) versus general anesthesia (GA). Materials and Methods: Patients with SC who treated with PNL from 2011 to 2014 were retrospectively reviewed. In total, 100 patients mere divided into 2 groups according to anesthesia type: SA (group 1, n = 47) and GA (group 2, n = 53). Demographics, perioperative parameters, and postoperative analgesic requirements were compared between the two groups. Results: There was no significant difference in terms of age, sex, American Society of Anesthesiologists score, body mass index, or stone size between the two groups (P = .40, .30, .18, .20, and .50, respectively). The mean procedure times were 84.7 and 87.5 min in the SA and GA groups, respectively (P = .68). The complication rates were similar in the SA and GA groups (19.1% vs. 13.2%, respectively; P = .421). The stone-free rates were also similar in the SA and GA groups (61.7% vs. 52.8%, respectively; P = .374). No statistically significant difference was found in analgesic requirements. Conclusion: SA is a safe method without the risks of GA and may be used for conditions in which GA is contraindicated or in patients with concerns about GA. Our outcomes indicated that SC can be treated safely and effectively under SA.Öğe Comparison of the efficacy of diclofenac, acupuncture, and acetaminophen in the treatment of renal colic(W B SAUNDERS CO-ELSEVIER INC, 2015) Kaynar, Mehmet; Koyuncu, Ferudun; Buldu, Ibrahim; Tekinarslan, Erdem; Tepeler, Abdulkadir; Karatag, Tuna; Istanbulluoglu, Mustafa OkanObjective: The objective is to compare the analgesic effects of diclofenac, acetaminophen, and acupuncture in urolithiasis-driven renal colic pain relief. Methods: Renal colic patients were divided randomly into 3 groups. Patients in group I (n = 40) were treated with intravenous acetaminophen, those in group II (n = 41) with acupuncture, and those in group III (n = 40) with a 75-mg intramuscular injection diclofenac sodium. Visual analogue scale (VAS) and verbal rating scale (VRS) were used to assess pain intensity after 10, 30, 60, and 120 minutes. Results: No significant differences in baseline VAS or VRS were found with regard to age or sex. After 10 minutes, all 3 groups experienced a significant decrease in VAS and VRS scores, with the most drastic decrease occurring in group II. After 30 minutes, there was a significantly higher decrease in group III than in group I (P=.001). After 60 minutes, mean VAS scores of groups I and III (P=.753) were similar. The mean VAS score of group III was lower than that of group II (P=.013). After 120 minutes, the difference in the VAS scores was (P=.000) between groups I and II and between groups II and III. Yet, the VAS evaluation made after 120 minutes revealed statistically similar outcomes for groups I and III (P=.488). The statistical findings for VRS evaluations made after 10, 30, 60, and 120 were similar to those for VAS. Conclusions: In renal colic patients with a possible nonsteroidal anti-inflammatory drug and acetaminophen side effect risk, acupuncture emerges as an alternative treatment modality. (C) 2015 Elsevier Inc. All rights reserved.Öğe Does the presence of hydronephrosis have effects on micropercutaneous nephrolithotomy?(SPRINGER, 2015) Karatag, Tuna; Buldu, Ibrahim; Kaynar, Mehmet; Inan, Ramazan; Istanbulluoglu, Mustafa OkanTo evaluate the effects of presence of hydronephrosis on micropercutaneous nephrolithotomy (micro-PNL) surgery. A retrospective analysis of 112 patients who underwent microperc surgery between December 2012 and April 2014 was performed. Patients were evaluated in two groups according to whether the presence of hydronephrosis. Stone size and location, fluoroscopy and operation time, stone-free rates and patient-related parameters were prospectively recorded into a centralized computer-generated system. A total of 58 patients in Group 1 with hydronephrosis and 54 patients in Group 2 with no hydronephrosis were analyzed. There was no statistically significant difference in terms of stone sizes and body mass indexes (BMI) in comparison of groups (155.2 +/- A 93.06 vs. 143.70 +/- A 70.77 mm(2), p = 0.856 and 27.6 +/- A 4.2 vs. 26.7 +/- A 3.2 kg/m(2), p = 0.625). The success rates were similar (91.3 vs. 92.5 %, p = 0.341). While the mean operation time and fluoroscopy time in Group 1 were 44.2 +/- A 23.62 min and 105.3 +/- A 47 s, it was 38.8 +/- A 26.4 min and 112.53 +/- A 68.3 s in Group 2, but there was no statistical difference in comparison of both groups. The mean attempts of percutan puncture were 1.35 +/- A 0.47 in Group 1 and 1.76 +/- A 0.31 in Group 2 (p = 0.185). We also found no statistical differences regarding mean hemoglobin change and hospitalization time, respectively (p = 0.685 and p = 0753). In comparison of grades of hydronephrosis, there was no statistically significant difference in subgroups analysis. The presence of hydronephrosis does not affect success rates and operative time in micro-PNL procedures significantly. Micropercutaneous nephrolithotomy is technically feasible and efficacious both in hydronephrotic and non-hydronephrotic kidneys.Öğe Effective radiation exposure evaluation during a one year follow-up of urolithiasis patients after extracorporeal shock wave lithotripsy(POLISH UROLOGICAL ASSOC, 2015) Kaynar, Mehmet; Tekinarslan, Erdem; Keskin, Suat; Buldu, Ibrahim; Soenmez, Mehmet Giray; Karatag, Tuna; Istanbulluoglu, Mustafa OkanIntroduction To determine and evaluate the effective radiation exposure during a one year follow-up of urolithiasis patients following the SWL (extracorporeal shock wave lithotripsy) treatment. Material and methods Total Effective Radiation Exposure (ERE) doses for each of the 129 patients: 44 kidney stone patients, 41 ureter stone patients, and 44 multiple stone location patients were calculated by adding up the radiation doses of each ionizing radiation session including images (IVU, KUB, CT) throughout a one year follow-up period following the SWL. Results Total mean ERE values for the kidney stone group was calculated as 15, 91 mSv (5.10-27.60), for the ureter group as 13.32 mSv (5.10-24.70), and in the multiple stone location group as 27.02 mSv (9.41-54.85). There was no statistically significant differences between the kidney and ureter groups in terms of the ERE dose values (p = 0.221) (p >0.05). In the comparison of the kidney and ureter stone groups with the multiple stone location group; however, there was a statistically significant difference (p = 0.000) (p <0.05). Conclusions ERE doses should be a factor to be considered right at the initiation of any diagnostic and/or therapeutic procedure. Especially in the case of multiple stone locations, due to the high exposure to ionized radiation, different imaging modalities with low dose and/or totally without a dose should be employed in the diagnosis, treatment, and follow-up bearing the aim to optimize diagnosis while minimizing the radiation dose as much as possible.Öğe A Rare Complication of Transurethral Resection of the Prostate: Explosion of the Bladder(GALENOS YAYINCILIK, 2015) Buldu, Ibrahim; Karatag, Tuna; Kaynar, Mehmet; Istanbulluoglu, M. OkanMonopolar and bipolar transurethral resection of the prostate is currently the gold standard modality in the treatment of bladder outlet obstruction due to prostatic enlargement. A rare complication of transurethral resection is the explosion of the bladder as may occur during resection of the prostate. The etiology of explosion is thought to be a result of ignition due to mixture of oxygen and hydrogen gas occurring during the resection under increased pressure of the bladder. To the best of our knowledge, our case is the first report of bladder explosion during transurethral resection with bipolar energy using saline solution.
