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    Comparison of Non Enhanced Computed Tomography with Ultrasound in Patients with Renal Colic
    (Aves, 2013) Çakıroğlu, Basri; Eyupoğlu, S. Erkan; Hazar, A. Ismet; Balci, M. B. Can; Sinanoğlu, Orhun; Aksoy, Şuleyman Hilmi
    Objective: The aim of the study is to compare the efficacy of non enhanced computed tomography (NECT) with ultrasound (US) imaging in the assessment of ureteral stone in patients admitted to emergency department with flank pain. Methods: Between January 2012 and June 2012, the data of patients admitted to the urology outpatient clinic or emergency department with uni or bilateral flank and/or groin pain were included in the study. The data of US, NECT and urinanalysis were retrospectively reviewed. Patients whose stones were not detected on US examination and refered to NECT examination were included in the study. Results: The mean age and stone size of the 138 patients included in the study were 35.3 +/- 10.8 (7-68), 6.12 +/- 2.68 (3-17), respectively. The patients were distributed according to stone size; the mean age, stone size of 63 patients in group I and group II were 33.1 +/- 10.7, 3.93 +/- 0.98 mm and 37.1 +/- 10.9, 7.96 +/- 2.24 mm respectively. NECT, US sensitivities in Group 1 and Group 2 were 96% (72/75), 56% (76) and 97% (63), 56% (76). The patients were also distributed according to stone location in the urinary tract; the mean age and stone size of 47 patients in group A (kidney stones) were 36.0 +/- 9.47, 5.52 +/- 0.3 mm respectively. the mean age and stone size of 23 patients in group B (renal pelvis and upper ureteral stones) were 38.10 +/- 11.1 and 7.87 +/- 1.98 mm, the mean age and stone size of 25 patients in C group (mid ureteral Stones) were 34.5 +/- 10.2 and 6.02 +/- 1.33 mm, the mean age and stone size of 43 patients in D group (lower ureteral stones) were 33.4 +/- 11.9 and 5.86 +/- 2.33 mm, respectively. Conclusion: NECT is more efficient than US in the detection urinary stones in patients admitted to the emergency department. However, the non invasive US on bedside examination in the emergency department can be useful in the detection of urinary stones. Computed tomography can be useful in cases with negative stone findings in US.
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    Comparison of plasmakinetic transurethral resection of the prostate with monopolar transurethral resection of the prostate in terms of urethral stricture rates in patients with comorbidities
    (Elsevier Inc, 2014) Sinanoğlu, Orhun; Ekici, Sinan; Balci, M. B. Can; Hazar, A. Ismet; Nuhoğlu, Baris
    Purpose: To compare urethral stricture rates in comorbid patients undergoing plasmakinetic transurethral resection of the prostate (PK-TURP) and monopolar transurethral resection of the prostate (M-TURP) for benign prostatic hyperplasia. Methods: The data of 317 patients with comorbidities undergoing either PK-TURP or M-TURP from September 2008 to December 2012 were retrospectively evaluated. Preoperative and postoperative 12-month International Prostate Symptom Score, maximal flow rate, postoperative International Index of Erectile Function scores, and urethral stricture rates were evaluated. Results: A total of 154 patients underwent M-TURP and 163 patients underwent PK-TURP. Urethral stricture rates were 6/154 in the M-TURP treatment arm and 17/163 in the PK-TURP treatment arm (P= 0.000). In the presence of hypertension and/or coronary artery disease and/or diabetes mellitus, the risk of urethral stricture complication was significantly higher in the PK-TURP group than in the M-TURP group (P= 0.000). Conclusions: The risk of urethral stricture increases with PK-TURP in elderly patients with a large prostate and concomitant hypertension and/or coronary artery disease and/or diabetes mellitus. Therefore, PK-TURP should be performed cautiously in this group of benign prostatic hyperplasia patients.
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    Effectiveness of Shock Wave Lithotripsy (SWL) Treatment of Kidney Stones Larger than Two Centimeter
    (Aves, 2012) Çakıroğlu, Basri; Hazar, A. Ismet; Balci, Mustafa Bahadir Can; Sinanoğlu, Orhun; Özkan, Arif; Nuhoğlu, Baris
    Objective: We aimed to investigate the effectiveness of SWL in the treatment of renal stones over 2 cm retrospectively. Methods: One hundred and nine patients (80 men and 29 women), who had been treated with ESWL because of 2cm or greater renal stones between January 2007 and January 2011, were enrolled to the study. Participants with a renal stone sized between 2 and 2.5 cm were grouped as group 1 and the others with a renal stone over 2.5 cm were grouped as group 2. We comapared the quantity of shock wave, analgesia requirement, efficacy and side effects between groups. A new generation ESWL device, Storz Medical Modulith SLK, was used for treatment. Data of the patients was analysed retrospectively. ESWL was considered successful if residual stone pieces smaller than 3 mm were detected in a 3 months period. Results: Renal stones were cleaned successfully in 100 (91.7%) patients who had been followed up for three months. There was no significant difference between group 1 and 2 in terms of residual stones. A patient required additional treatment (1.69%) in group 1, while 4 patients (8%) required additional treatment in group 2. Development rate of stone street in group 1 and 2 was 3.38% (2 patients) and 10% (5 patients), respectively. Five patients in both 2 groups required flexible uroterorenoscopy due to residual stones. Analgesic requirement rates were similar in both groups. 82 (75.2%) patients had not required anlgesic, but 27 participants had been administered intramuscular diclofenac or Tradamol. Neither general, spinal or epidural anestesia nor sedation and narcotic analgesia was administered. Haematuria rates in group 1 and 2 were 15.2% and 36%, respectively. There was also no significant difference between groups in terms of skin rash rates. Conclusion: New generation electromagnetic ESWL provides effective and reliable treatment with minimal complications in patients with renal stones over 2 cm.
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    Infravesical Obstruction Index in Patients with Benign Prostatic Hyperplasia is the Best?
    (Aves, 2012) Çakıroğlu, Basri; Sinanoğlu, Orhun; Hazar, A. Ismet; Balci, M. B. Can; Nuhoğlu, Baris; Aksoy, S. Hilmi
    Objective: The aim of the study is to evaluate the correlation among the factors such as the International prostate symptom score (IPSS), uroflowmetry (Qmax), prostate volume and postvoiding residue (PVR) in predicting infravesical obstruction in patients with benign prostate hyperplasia. Methods: The data of 134 patients referred to the urology outpatient clinic between January 2010 and December 2010 were retrospectively reviewed. The patients were distributed in three groups according to IPSS values; 1st, lower IPSS group (n=35), 2nd, moderate IPSS group (n=67) and 3rd, higher IPSS group (n=32). IPSS, prostate volume, postvoiding residue (PVR), and maximum urine flow (Qmax) values were compared. Prostate volumes and PVR were evaluated with suprapubic ultrasound. The patients with comorbidities which may affect voiding function were excluded from the study. Results: The mean age and IPSS of study patients were 55.6 (43-88) and 13.5 (0-35) respectively. Mean prostate volume and PVR of the 3rd group were significantly higher compared to the 1st and 2nd groups. Conclusion: Although IPSS is a subjective finding of infravesical obstruction, a higher score in patients with lower urinary tract symptoms is in parallel with the objective parameters such as Qmax and PVR.