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Öğe Accuracy of Unenhanced Computerized Tomography Interpretation by Urologists in Patients with Acute Flank Pain(Karger, 2015) Sancak, Eyup Burak; Resorlu, Mustafa; Celik, Orcun; Resorlu, Berkan; Gulpinar, Murat Tolga; Akbas, Alpaslan; Karakan, TolgaPurpose: The aim was to compare the findings of non-contrast computerized tomography (NCCT) evaluated by urology specialists with the findings of experienced radiologists, who are accepted as a standard reference for patients who present with acute flank pain. Materials and Methods: Five hundred patients evaluated with NCCT were included in the study. The NCCT images of these patients were evaluated by both radiologists and urology specialists in terms of the presence of calculus, size of calculus, the location of calculus, the presence of hydronephrosis, and pathologies other than calculus, and the results were compared. Results: The evaluations of urology specialists and standard reference radiology specialists are consistent with each other in terms of the presence of calculus (kappa [K]: 0.904), categorical stone size (K: 0.81), the location of calculus (K: 0.88), and hydronephrosis (K: 0.94). However, the evaluations of urology specialists in detecting pathologies other than calculus, which may cause acute flank pain or accompany renal colic, were found to be inadequate (K: 0.37). The false-negative rate of detecting pathologies outside of the urinary system by the urology specialists is calculated as 0.86. Conclusion: Although the urology specialists can evaluate the findings related to calculus sufficiently with NCCT, they may not discover pathologies outside of the urinary system. (C) 2015 S. Karger AG, BaselÖğe Evaluating Ureteral Wall Injuries with Endoscopic Grading System and Analysis of the Predisposing Factors(Mary Ann Liebert, Inc, 2016) Karakan, Tolga; Kilinc, Muhammet Fatih; Demirbas, Arif; Hascicek, Ahmet Metin; Doluoglu, Omer Gokhan; Yucel, Mehmet Ozgur; Resorlu, BerkanObjective: To analyze the predictive factors for intraoperative ureteral wall injury due to semirigid ureteroscopy (URS) used in the treatment of ureteral calculi. Methods: The data of 437 patients who had URS due to ureteral stones were prospectively analyzed. The ureteral wall injuries that occurred during URS were reviewed endoscopically at the end of surgery and divided into two groups as low grade (grades 0 and 1) and high grade (grades 2, 3, and 4) according to classification of ureteral wall injuries. Those two groups were compared for patient and stone characteristics and perioperative findings. Results: Ureteral wall injury was seen in 133 (30.4%) patients after surgery. According to the endoscopic classification of the lesions after URS, grades 0, 1, 2, and 3 injury were seen in 69.5%, 16.4%, 11.2%, and 2.7% of the patients, respectively. There were no grade 4 injuries in our series. Two groups showed statistically significant differences for the location (prox- vs distal and mid-ureter) and size of the stone (9.9mm vs 14.03mm), presence of preoperatively urinary tract infection (UTI) (12% vs 50.8%), needed balloon dilatation (9.8% vs 36.1%), duration of surgery (33.6min vs 43.3min), and surgical success rate (90% vs 76%) (p=0.01, for all). Stone size, location, duration of surgery, and presence of preoperative infection were determined as independent prognostic factors for mucosal injury. Conclusion: The ureteral wall injury grading system may be used for standardized reporting of ureteral lesions after ureteroscopy. Big, proximal ureteral stone, longer operation time, and presence of UTI are the risk factors for ureteral wall injury during URS.Öğe Histologic Evaluation of Human Benign Prostatic Hyperplasia Treated by Dutasteride: A Study by Xenograft Model With Improved Severe REPLY(Elsevier Science Inc, 2015) Resorlu, Berkan; Karakan, Tolga[Anstract Not Available]Öğe Intraperitoneal stone migration during percutaneos nephrolithotomy(Pagepress Publ, 2014) Diri, Akif; Karakan, Tolga; Resorlu, Mustafa; Kabar, Mucahit; Germiyanoglu, CankonPercutaneos nephrolithotomy (PNL) is the standard care for renal stones larger than 2 cm. The procedure has some major and minor complications. Renal pelvis laceration and stone migration to the retroperitoneum is one of the rare condition. We report the first case of intraperitoneal stone migration during PNL.Öğe Retrograde Intrarenal Surgery in Cross-fused Ectopic Kidney(Elsevier Science Inc, 2015) Resorlu, Mustafa; Kabar, Mucahit; Resorlu, Berkan; Doluoglu, Omer Gokhan; Kilinc, Muhammet Fatih; Karakan, TolgaCross-fused renal ectopia is a rare congenital anomaly in which both kidneys are fused and located on the same side. We report a case of right-to-left cross-fused renal ectopia and nephrolithiasis, in whom retrograde intrarenal surgery was used to treat the stone disease. To our knowledge, this is the first case of retrograde intrarenal surgery of a crossed-fused ectopic kidney. (C) 2015 Elsevier Inc.Öğe The Effect of Intraurethral Dexpanthenol on Healing and Fibrosis in Rats With Experimentally Induced Urethral Trauma(Elsevier Science Inc, 2015) Yardimci, Ibrahim; Karakan, Tolga; Resorlu, Berkan; Doluoglu, Omer Gokhan; Ozcan, Serkan; Aydin, Arif; Demirbas, ArifOBJECTIVE To determine the efficacy of dexpanthenol applied early after urethral trauma for preventing inflammation and spongiofibrosis. MATERIALS AND METHODS Twenty-seven rats were randomized and divided into 3 groups, with 9 rats in each group. The urethras of all rats were traumatized with a pediatric urethrotome knife at 6-o' clock. For 14 days, group I was given 0.9% saline twice a day (control group), group II was given dexpanthenol 500 mg/kg ampules once a day and 0.9% saline once a day, and group III was given dexpanthenol 500 mg/kg ampules twice a day intraurethrally using a 22 ga catheter sheath. On day 15, the penises of the rats were degloved to perform penectomy. RESULTS The mean fibrosis scores were 2.4, 2.2, and 1.4, and mean inflammation scar scores were 2, 1.4, and 1.3 in groups I, II, and III, respectively. There was a significant difference between groups I and II for inflammation (P = .011); however, the difference for fibrosis was not significant (P = .331). The differences between groups I and III were statistically significantly different both for inflammation and fibrosis (P = .004 and P = .003, respectively). Groups II and III were not different significantly for inflammation (P = .638); however, there was less fibrosis in group III, in which high-dose dexpanthenol was administered. CONCLUSION We showed that dexpanthenol applied early after urethral trauma significantly decreased inflammation and spongiofibrosis. We hope that our study will help to decrease strictures after urethral trauma and contribute to pharmaceutical investigations aiming to improve the success of the surgery for urethral strictures. (C) 2015 Elsevier Inc.Öğe The effect of music therapy during shockwave lithotripsy on patient relaxation, anxiety, and pain perception(Taylor & Francis Ltd, 2016) Akbas, Alpaslan; Gulpinar, Murat Tolga; Sancak, Eyup Burak; Karakan, Tolga; Demirbas, Arif; Utangac, Mehmet Mazhar; Dede, OnurObjectives: To research the effect of listening to music during shock wave lithotripsy (SWL) on the patient's pain control, anxiety levels, and satisfaction. Patients and methods: The study comprised 400 patients from three hospitals. Half of patients listened to music during their first SWL session but not during their second session. The other half had no music for the first session but the second session was accompanied by music. During all sessions, with and without music, pulse rates, blood pressure, State-Trait Anxiety Inventory-State Anxiety scores (STAI-SA), Visual Analog Scale (VAS scores for pain), willingness to repeat procedure (0=never to 4 happily), and patient satisfaction rates (0=poor to 4=excellent) were assessed. Results: There was no statistical difference between the two groups in terms of blood pressure and pulse rates. In both groups, the STAI-SA and VAS pain scores were lower in the session when music was listened to (p< 0.001). The patients requested more SWL treatment be completed while listening to music and their satisfaction was greater. Conclusion: Music lowered the anxiety and pain scores of patients during SWL and provided greater satisfaction with treatment. Completing this procedure while the patient listens to music increases patient compliance greatly and reduces analgesic requirements.Öğe The protective effect of Papaverine and Alprostadil in rat testes after ischemia and reperfusion injury(Brazilian Soc Urol, 2018) Karagoz, Mehmet Ali; Doluoglu, Omer Gokhan; Unverdi, Hatice; Resorlu, Berkan; Sunay, Mehmet Melih; Demirbas, Arif; Karakan, TolgaObjective: To investigate the effect of papaverine and alprostadil on testicular torsion-detorsion injury in rats. Materials and Methods: A total of 40 male Wistar-Albino rats were used in this study. Four hours of right testicular torsion was applied to each group, excluding sham operated group. The torsion-detorsion (T/D), T/D + papaverine and T/D + alprostadil groups received saline, papaverine and alprostadil at the same time as surgical detorsion, respectively. At 14 days after the surgical detorsion, ischaemic changes and the degree of damage were evaluated with Cosentino scoring and the Johnson tubular biopsy score (JTBS). Results: JTBS was determined as 8.8 +/- 2.7 in the Sham group, 5.08 +/- 1.9 in the T/D+papaverine group, 5.29 +/- 2.3 in the T/D +alprostadil group and 2.86 +/- 1.9 in the TD group. The JTBS was determined to be statistically significantly high in both the T/D + papaverine group and the T/D + alprostadil group compared to the T/D group (p=0.01, p=0.009). In the T/D + papaverine group, 3 (43 We) testes were classified as Cosentino 2, 3 (43%) as Cosentino 3 and 1 (14 %) as Cosentino 4. In the T/D +alprostadil group, 5 (50 %) testes were classified as Cosentino 2, 3 (30 %) as Cosentino 3 and 2 (20%) as Cosentino 4. Conclusion: The present study indicated that spermatic cord administration of alprostadil and papaverine showed a protective effect against ischemia/reperfusion injury after right-side testes torsion and histological changes were decreased after testicular ischemia reperfusion injury.Öğe Ureteroscopy in proximal ureteral stones after shock wave lithotripsy failure: Is it safe and efficient or dangerous?(Canadian Urological Association, 2015) Kilinc, Muhammet Fatih; Doluoglu, Omer Gokhan; Karakan, Tolga; Dalkilic, Ayhan; Sonmez, Nurettin Cem; Aydogmus, Yasin; Resorlu, BerkanIntroduction: We assessed the effectiveness of ureteroscopy (URS) in proximal ureteral stones performed after shock wave lithotripsy (SWL) failure, and determined outcomes in terms of success rate, complications, and operation time. Methods: We analyzed data of patients with previous unsuccessful SWL (Group I) and the ones that did not have SWL or URS before (Group II) for proximal ureteral stones between December 2007 and August 2014. Group I included 346 patients who underwent complementary URS and Group II 209 patients who underwent primary URS. Success rates, operation time and complications were compared between groups. Results: Success rates of complementary and primary URS were 78.9% and 80.9%, respectively. The difference in success rates was not statistically significant between groups (p = 0.57). The complication rates of complementary URS was 12.1%, and 9.5% in primary URS (p = 0.49). No statistically significant differences were noted in terms of gender, age, stone size and side, or lithotripter type between groups. The mean operation time and need for balloon dilatation were higher in complementary URS group compared to the primary URS group, and the difference was statistically significant (p < 0.05). Conclusions: Complementary URS may be used safely after SWL failure in proximal ureteral stones. Its success rate and morbidities are similar to primary URS, except for longer operation time and an increased need for balloon dilatation.
