Şenol Adanur

The Forgotten Ureteral Stent in Children: From Diagnosis to Treatment

PURPOSE We conducted a multicenter pediatric study of ureteral stents unintentionally left in situ. MATERIALS AND METHODS A total of 22 patients with encrusted Double-J® ureteral stents unintentionally left in situ were treated at 4 centers between January 2007 and March 2012. Stone burdens were estimated using plain radiography and computerized tomography. Treatment decision was made based on clinical and radiological findings or stone burden. RESULTS Nine girls and 13 boys with a mean age of 9.5 years (range 2 to 16) were analyzed. Mean indwelling time of ureteral stent was 21.7 months (range 6 to 60). Stents were inserted for the indication of urolithiasis (17 patients) and reconstructive urological intervention (5). In 2 patients stents had been placed bilaterally. Mean stent stone burden was 184 mm(2) on plain radiography and 247 mm(2) on computerized tomography, a difference that was statistically significant (p = 0.002). Shock wave lithotripsy was done in 6 cases. Endoscopic procedures were performed in all patients, including ureteroscopy in 8, simple stent removal in 7, endoscopic cystolithotripsy in 6, percutaneous nephrolithotomy in 5, retrograde intrarenal surgery in 3 and percutaneous cystolithotripsy in 2. Surgical removal of each stent required a mean of 1.5 interventions and a mean hospital stay of 4.4 days. CONCLUSIONS At experienced centers combined endourological techniques can achieve successful and safe management of forgotten stents even in the pediatric age group. Thus, routine preprocedural tomography is a must in children with forgotten ureteral stents.

The impact of pelvicalyceal anatomy in treatment with shock wave lithotripsy and flexible ureterorenoscopy of lower pole renal stones.

this context, recently, resorlu et al. [2] have reported the effective role of pelvicalyceal anatomy in the success of retrograde intrarenal surgery (rIrS) performed for the treatment of lower pole stones. they reported that stone size and IPA were the most important factors effecting stone-free state after rIrS, however IW, IL and PCh had no influence on elimination of stone fragments following F-UrS. Finally, we think that if abovementioned factors which is proven influence the success rates were analyzed in this investigation, this well-designed prospective randomized trial would make even greater contributions to the literature.

Kontinan diversiyonun nadir komplikasyonu: Neobladder taşı ve endoskopik tedavisi

OZET Uriner sistem taslari kontinan uriner diversiyonlarin gec komplikasyonlarindandir. Gross hematuri, diversiyonda basinc hissi, inkontinans ve rekurren uriner sistem enfek- siyonu gibi semptomlar verebilirler. Diversiyon kalkulleri icin cok cesitli tedavi alternatifleri bulunmaktadir. Bu ya - zida klinigimizde tedavi ettigimiz 46 yasinda olan ve ne- obladder icinde radyolojik muayenede 3x2 cm ebatli tas tespit edilen erkek hastayi rapor ettik. Oykusunde 9 yil once mesane tumoru nedeniyle radikal sistoprostatekto- mi ve neobladder operasyonu vardi. ABSTRACT Urinary tract stones are from rare complications of conti- nent urinary diversions. These symptoms may occur such as gross hematuria, feeling the pressure of diverting, in- continence and recurrent urinary tract infection. There are various treatment alternatives for diversion calculi. We reported a male patient who was 46 years old who had 3x2 cm sized stone which is radiologically detected in neobladder and treated in our clinic. In history, there was a radical cystoprostatectomy and neobladder operation due to bladder tumor before 9 years ago.

Ürologların gonad kalkanı kullanımı hakkında bir anket çalışması

Objectives: Our aim is to reflect routines, awareness, and consciousness level of urologists about usage of gonadal shield (GS) in Turkey. Materials and methods: Because of this objective a questionnaire which includes 15 questions was prepared. The questionnaire was delivered to urologists in a Turkish Urology congress. Data derived from 271 urologists by face to face interview were evaluated. Results: Participant were urologists (n=271), consisted of professors (n=33), associate professors (n= 36), assistant professors (n= 36), specialists (n=94), and residents (n=81). According to the data obtained from the questionnaires, 22% of the participants acquired their first infor mation about GS as a medical student, 44% during their residency training, and 14% of them had no information about GS at all. Besides 64% of them did not read any medical article about this subject until that time, and 54% them practically hadn’t seen any GS during their urology practice. In 82% of the hospitals where participants were working hadn’t had any GS, and 18% of the urologists had indicated that GS was available in their hospitals, and they used them once in a while. Urologists responded favorably (20%) or unfavorably (80 %) to the question of ‘Do you find yourself or your colleagues adequately sensitive, and mindful about GS use? Conclusions: Sensitivity and awareness about use of gonadal shields among Turkish urologists are not at a desired level and for this reason, it is not used widely. The urologists should be informed in urological academic platforms about gonad protecting devices.