Our Multiple Single-step Access Results in Percutaneous Nephrolithotomy

Objective:The aim of this study is to evaluate the success and complication rates of percutaneous nephrolithotomy (PNL) with multiple single step access in patients with staghorn kidney stones.Materials and Methods:A total of 118 patients with staghorn kidney stones, who underwent PNL in our clinic between 2008 and 2015, were included in the study. All patients were examined with non-contrast abdominal computed tomography before the operation. Demographic data of patients, operation details, intra- and postoperative complications and additional interventions were evaluated.Results:The mean age of the patients included in the study was 49.6 years. The mean operative time was 139.4 minutes and the mean fluoroscopy time was 126.9 seconds. Postoperative residual stone was detected in 28% of the patients. Postoperative fever was observed in 19 patients (16.2%), and sepsis developed in 3 (2.5%) of them. Additional postoperative procedures were required in 11 patients (9.3%). No patient was lost due to complications. Operation success and complication rates were compatible with the literature.Conclusion:For staghorn stones, PNL with multiple single step dilatation technique can be used as an effective and safe method in adult patients

Nephrocutaneous Fistula: An Unusual Nephrectomy Indication in Percutaneous Nephrolithotomy

Percutaneous nephrolithotomy (PNL) is recognized as the gold standard treatment method for stones larger than 2 cm due to its high success and acceptably low complication rates. The complications of PNL are well defined. Prolonged urinary leakage is one of them. In this study, a case of post-PNL urine leakage that was eventually treated with nephrectomy is discussed

Cases of a Borderline Pathology That Can Mimic Bladder Cancer: Primary Amyloidosis of Urinary Bladder

Amyloidosis is a disease characterised by accumulation of a fibrillar protein called amyloid in the extracellular space. The kidneys, ureters and the bladder can be affected in the urinary tract. However, primary amyloidosis of bladder is a rare entity. Macroscopic hematuria could be the first and only symptom of primary amyloidosis of the bladder; therefore, it has similar findings with urinary tract malignancies. Histopathological evaluation is mandatory for the diagnosis. Follow-up should always include cystoscopic evaluation as recurrence is expected in the natural course

A Case of Iatrogenic Ureter Injury: Recent Diagnostic and Treatment Methods

The ureters are rarely exposed to trauma. Ureteral injuries are generally in the form of iatrogenic, blunt injuries, and rarely penetrating injuries. Iatrogenic injuries often occur during surgical procedures. They do not present with specific findings and symptoms, therefore, they have late-onset symptoms. Imaging modalities of choice are usually intravenous pyelography and computed tomography. Treatment is tailored to the location of the trauma

Coexistence Between Hodgkin’s Lymphoma and Renal Cell Cancer: Case Report

Renal cell cancer (RCC) is the most common kidney tumor and accounts for 3% of all adult cancers. Hodgkin’s lymphoma (HL) is also constitutes less than 1% of all malignancies with the male predominance. The risk of secondary cancer increases during the treatment period of HL in 15 years of followup. We presented a case indicating co-occurence between HL and RCC and literature review about this rare coincidence

Anomalili Böbreği Olan Hastalarda Perkütan Netrolitotomi Sonuçlanmız

Objective: To evaluate the success and complication rate of percutaneous nephrolithotomy (PNL) performed in patients with congenital anomalies such as horseshoe kidneys, crossed renal ectopia and renal malrotation.Materials and Methods: Data of 1472 patients who underwent PNL operation in our clinic between January 2007 and January 2015 were analyzed retrospectively. PNL was performed in 28 renal units of 26 patients with congenital renal anomalies. Demographic data of the patients, type of congenital renal anomalies, success rate of PNL and complications were evaluated.Results: Out of 28 PNL-performed renal units, 14 were found out to be with fusion and 14 with rotation anomalies. The average age of the patients was 53 (±1.97) years, 19 were male and 7 were female with an average stone size of 515 (±87.4) mm2. The average operating time was 109 (±11.0) minutes and fluoroscopy time was 191 (±48.4) seconds. The stone-free rate detected postoperatively by computed tomography was 55%. Complications included postoperative fever in 3 patients, postoperative arteriovenous fistula in 1 patient, and intraoperative colon injury in 1 patient.Conclusion: PNL is a safe and effective method in the treatment of stones in kidneys with congenital anomaliesAmaç: Atnalı böbrek, crossed renal ektopi ve böbrek malrotasyonu gibi anomalili böbreği olan hastalarda yapılan perkütan nefrolitotomi (PNL) sonuçlarını ve komplikasyonlarını değerlendirmek amaçlandı. Gereç ve Yöntem: Ocak 2007 ve Şubat 2015 yılları arasında kliniğimizde PNL yapılan 1472 hastanın verileri retrospektif olarak incelendi. Böbrek anomalisi olan 26 hasta ve toplamda 28 renal üniteye PNL yapıldı. Hastaların demografik verileri, konjenital anomalinin tipi, PNL başarısı ve komplikasyonlar değerlendirildi. Bulgular: Opere edilen 28 renal ünitenin 14 tanesinde füzyon, 14 tanesinde ise rotasyon anomalisi vardı. Hastaların ortalama yaşı 53 (±1,97) yıldı. Hastaların 19 tanesi erkek, 7 tanesi kadındı ve ortalama taş boyutu 515 (±87,4) mm2 olarak hesaplandı. Ortalama operasyon zamanı 109 (±11,0) dakika ve floroskopi süresi ise 191 (±48,4) saniyeydi. Postoperatif istenen bilgisayarlı tomografide %55 taşsızlık saptandı. Komplikasyon olarak ise 1 hastada intraoperatif kolon yaralanması, 3 hastada ateş yüksekliği ve 1 hastada arteriyovenöz fistül gözlendi. Sonuç: Konjenital anomalili böbrek taşı tedavisinde PNL güvenli ve başarılı bir yöntemdi

Outcomes of Percutaneous Nephrolithotomy in Patients with Anomalous Kidney

Amaç: Atnalı böbrek, crossed renal ektopi ve böbrek malrotasyonu gibi anomalili böbreği olan hastalarda yapılan perkütan nefrolitotomi (PNL) sonuçlarını ve komplikasyonlarını değerlendirmek amaçlandı. Gereç ve Yöntem: Ocak 2007 ve Şubat 2015 yılları arasında kliniğimizde PNL yapılan 1472 hastanın verileri retrospektif olarak incelendi. Böbrek anomalisi olan 26 hasta ve toplamda 28 renal üniteye PNL yapıldı. Hastaların demografik verileri, konjenital anomalinin tipi, PNL başarısı ve komplikasyonlar değerlendirildi. Bulgular: Opere edilen 28 renal ünitenin 14 tanesinde füzyon, 14 tanesinde ise rotasyon anomalisi vardı. Hastaların ortalama yaşı 53 (±1,97) yıldı. Hastaların 19 tanesi erkek, 7 tanesi kadındı ve ortalama taş boyutu 515 (±87,4) mm2 olarak hesaplandı. Ortalama operasyon zamanı 109 (±11,0) dakika ve floroskopi süresi ise 191 (±48,4) saniyeydi. Postoperatif istenen bilgisayarlı tomografide %55 taşsızlık saptandı. Komplikasyon olarak ise 1 hastada intraoperatif kolon yaralanması, 3 hastada ateş yüksekliği ve 1 hastada arteriyovenöz fistül gözlendi. Sonuç: Konjenital anomalili böbrek taşı tedavisinde PNL güvenli ve başarılı bir yöntemdirObjective: To evaluate the success and complication rate of percutaneous nephrolithotomy (PNL) performed in patients with congenital anomalies such as horseshoe kidneys, crossed renal ectopia and renal malrotation.Materials and Methods: Data of 1472 patients who underwent PNL operation in our clinic between January 2007 and January 2015 were analyzed retrospectively. PNL was performed in 28 renal units of 26 patients with congenital renal anomalies. Demographic data of the patients, type of congenital renal anomalies, success rate of PNL and complications were evaluated.Results: Out of 28 PNL-performed renal units, 14 were found out to be with fusion and 14 with rotation anomalies. The average age of the patients was 53 (±1.97) years, 19 were male and 7 were female with an average stone size of 515 (±87.4) mm2. The average operating time was 109 (±11.0) minutes and fluoroscopy time was 191 (±48.4) seconds. The stone-free rate detected postoperatively by computed tomography was 55%. Complications included postoperative fever in 3 patients, postoperative arteriovenous fistula in 1 patient, and intraoperative colon injury in 1 patient.Conclusion: PNL is a safe and effective method in the treatment of stones in kidneys with congenital anomalie

Is it possible to distinguish testicular torsion from other causes of acute scrotum in patients who underwent scrotal exploration? A multi-center clinical trial

INTRODUCTION: To assess the clinical presentation of patients who underwent surgical exploration for acute scrotum and to investigate the potentially related factors for differential dignosis. MATERIAL AND METHODS: We retrospectively analyzed the medical records of 97 patients who underwent surgical exploration for acute scrotum between May 2007 and July 2013. The patients were divided into two groups as follows: Group1 included patients with testicular torsion (TT) and Group 2 contained patients with acute scrotal pathologies other than TT, including torsion of the testicular appendage, epididymo-orchitis, trauma and Henoch-Schönlein purpura. The physical examination findings, colour Doppler ultrasound (CDUS) and laboratory findings for the groups were compared. RESULTS: In total, 97 scrotal explorations were carried out for acute scrotum. Group 1 included 72 patients (74.2%) and Group 2 included 25 patients (25.8%). Group 2 was comprised of patients with torsion of the testicular appendage (n = 13), epididymo-orchitis (n = 8), testicular trauma (n = 2) and Henoch-Schönlein purpura (n = 2). In Group 1, 32 cases (44.4%) presented to a hospital less than 6 hours after onset of pain. More than half (64%) of Group 2's cases presented more than 24 hours after pain onset. Fever and pyuria appeared more frequently in Group 2 than in Group 1 and the results reached statistical significance (p = 0.001 and p = 0.044, respectively). Group 1 had more testicular tenderness than Group 2 (p <0.001). Our testicular salvage rate was 59.7%, and 40.3% of patients underwent orchiectomy. CONCLUSIONS: CDUS predicted the diagnosis of TT (sensitivity 98.6%). Furthermore, clinical findings may also play a substantial role in the differential diagnosis of acute scrotum