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    Are Hounsfield densities of ureteral stones a predictive factor for effectiveness of extracorporeal shock wave lithotripsy?
    (E-CENTURY PUBLISHING CORP, 2014) Cakiroglu, Basri; Eyyupoglu, S. Erkan; Tas, Tuncay; Balci, M. B. Can; Hazar, Ismet; Aksoy, S. Hilmi; Sinanoglu, Orhun
    Extracorporeal Shock Wave Lithotripsy (SWL) has long been used successfully to dissolve ureteral stones. We researched whether Hounsfield values of ureteral stones is a factor that affects the success of SWL. Methods: Data from 144 patients who had diagnoses of ureteral stones and underwent SWL, were retrospectively reviewed between January 2011 and December 2012. Urinary tomography of patients was processed and classified into 3 groups by Hounsfield units (Group 1, < 500 HU; Group 2, 500-1000 HU; and Group 3, > 1000 HU) and 2 groups by stone size (Group A; < 1 cm, Group B; > 1 cm). SWL success was analyzed for both of these group types. Failure was defined as any fragments of the stone that remained within the ureter. Results were analyzed by evaluating the predictive factors in both groups. Results: The study included 144 patients (100 men, 44 women) who fit the inclusion criteria. In Hounsfield unit Group 1 (12 women and 44 men), the mean age was 37.2 +/- 13.2, stone size was 8.5 +/- 2.5 mm, number of shocks was 3240 +/- 1414 (1200-7500) and number of treatments was 1.4 +/- 0.6. In Group 2 (26 women and 32 men), the mean age was 33.6 +/- 7.6, stone size was 9.6 +/- 3.1 mm, process number was 3375 +/- 2103 (1200-8750) and shock amount was 1.6 +/- 0.8. In Group 3 (6 women and 24 men), the mean age was 42.2 +/- 13.6, stone size was 11.7 +/- 3.0 mm, number of shocks was 4513 +/- 2458 (1300-8700) and number of treatments was 2.1 +/- 1.2. In size Group 1 (28 women and 74 men), the mean age was 35.8 +/- 10.6, stone size was 8.1 +/- 1.4 mm, process number was 3105 +/- 1604, shock amount was 1.4 +/- 0.5 and HU value was 580 +/- 297. In Group 2 (16 women and 26 men), the mean age was 39.9 +/- 14.2, stone size was 13.9 +/- 2.4 mm, number of shocks was 4722 +/- 2467, number of treatments was 2.3 +/- 1.1 and HU value was 912 +/- 270. Conclusion: Although stone density predicted the failure of SWL, size of the stone is more important criterion for successful lithotripsy of ureteral stones.
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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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    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.