Endourology - Grand Journal of Urology

Endourology

Original Article (3) Case Report (1) Letter to the Editor (1)

Original Article

Grand J Urol 2021;1(1):18-21, DOI: 10.5222/GJU.2021.47966

The Effects of Previous Renal Stone Surgery on Percutaneous Nephrolithotomy Outcomes

Joshgun Huseynov, Nadir Kalfazade, Ekrem Guner

Objective: We aimed to compare outcomes of percutaneous nephrolithotomy (PNL) surgery in patients who had and had not undergone renal stone surgery before PNL. Material and Methods: We retrospectively analyzed the medical records of all patients who underwent PNL in our department between 2010 and 2019. Examined parameters consisted of patient demographics, medical and surgical history, stone size, stone density, stone site, estimated intraoperative blood loss, duration of operation, hospital stay and stone-free status. Results: A total of 193 patients were included the study. The mean age of the patients was 45±13 years. The mean duration of surgery was 69±11.5 minutes. The mean stone area was 720.2±600.4 mm2 and the mean stone attenuation was 982.8±327.7 HU. The mean postoperative hemoglobin decrease was 1.8±1.3 g/dL. 66 patients had previous stone surgery including open stone surgery, PNL and retrograde intrarenal surgery (RIRS). There was no statistically significant difference between patients who had and had not previousşy undergone renal stone surgery in terms of age, gender, body mass index and stone area. Operative time, estimated intraoperative blood loss, postoperative hemoglobin decreases and hospital stay were comparable between patients who had, and hed not undergone previous renal stone surgery. Stone-free rate was significantly higher in primary PNL patients compared to patients with a history of renal stone surgery (92.1% vs 77.3%, p=0.006). Conclusion: PNL has a similar complication rate in patients with and without previous kidney stone surgery. However, achieving stone-free status may be challenging in patients with a history of ipsilateral renal stone surgery.

Grand J Urol 2023;3(2):038-041, DOI: 10.5505/GJU.2023.60362

Bipolar vs Monopolar Transurethral Resection of the Prostate in Iraqi Patients: A Prospective Study

Jihad Anad Khalef, Ahmed Hadi Essa

Objective: Bipolar transurethral resection of the prostate (TURP) is a minimally invasive procedure that causes fewer problems, and a faster resection, but requires more expensive equipment. It is the treatment of choice for benign prostatic hyperplasia. In this study, its outcomes will be compared to those of conventional monopolar TURP. Materials and Methods: Twenty-seven patients aged between 52 and 65 years underwent either monopolar TURP (Group 1, n: 15) or bipolar TURP (Group 2, n: 12). Preoperative and perioperative data were recorded and analyzed, including the maximal flow rate (Qmax), prostate volume, intraoperatively resected tissue volume, resection velocity, and operation time. Results: Preoperative mean prostate volumes in Groups 1, and 2 were 82.6 ± 21 ml and 78.8 ± 12 ml, respectively (p=0.117). Preoperative mean serum sodium levels were 140.4 ± 2.3 mmol/l in Group 1 and 139.8 ± 2.2 mmol/l in Group 2. Preoperative mean serum hemoglobin values were 15 ± 0.8 g/dl in Group 1, and 14.5 ± 2.2 g/dl in Group 2. Postoperative mean serum sodium levels were 130.6 and 136.7 mmol/l, in Groups 1, and 2, respectively. Eight patients from the monopolar TURP group exhibited a notable drop in serum sodium levels. In the monopolar TURP group, there were 5 occurrences of TUR syndrome and 2 patients needed blood transfusions due to a mean decrease of 5 g/dl in hemoglobin levels. Complications were identified in 7 cases. Conclusion: Compared to monopolar TURP, bipolar TURP is associated with a shorter hospital stay, and lower transfusion and complication rates.

Grand J Urol 2023;3(3):085-089, DOI: 10.5505/GJU.2023.85047

Comparison of Intrarenal Retrograde Surgery Results Between Different Age Groups

Ferhat Yakup Suceken, Murat Beyatli, Resul Sobay, Eyup Veli Kucuk, Abdurrahman Inkaya

Objective: In this study, we aimed to investigate whether there is a difference in the reliability and efficacy of the method according to age in patients divided into 3 different age groups who underwent RIRS due to kidney stones. Materials and Methods: Patients who underwent Retrograde Intra Renal Surgery (RIRS) for kidney or ureteral stone disease at the Urology Clinic of Health Sciences University Umraniye Health Application and Research Hospital between May 2017 and January 2021 were retrospectively screened, and those aged 20-80 years were included in the study. The demographic and clinical data of the patients and stone-related data were recorded. Patients aged 20-40 years were classified as Group 1, those aged 41- 60 years as Group 2, and those aged 61-80 years as Group 3. Results: After the inclusion and exclusion criteria were applied, the sample consisted of a total of 320 patients, of whom 121 (37.8%) were in Group 1, 133 (41.5%) were in Group 2, and 66 (20.6%) were in Group 3. The mean operative times and stone-free rates were similar between the groups. However, the mean hospital stay was significantly longer in Groups 3 compared to Groups 1 and 2. The minor complication rates were 2.4% in Group 1, 3% in Group 2, and 13.6% in Group 3, indicating a statistically significantly higher value in Group 3 compared to the remaining two groups (p=0.03). The major complication rates of Groups 1, 2, and 3 were 0.8%, 0.7%, and 7.5%, respectively. Accordingly, Group 3 had a significantly higher rate than Groups 1 and 2 (p=0.04). Conclusion: RIRS can be performed on the elderly with success rates comparable to other age groups. However, the elderly, who represent a higher-risk patient population with more comorbidities, have increased rates of minor and major complications both in the perioperative and postoperative periods.

Case Report

Grand J Urol 2023;0(0):, DOI: 10.5505/GJU.2024.39200

First Successful Endoscopic Removal of a Pen from the Male Urinary Bladder

Somanatha Prathyangira Sharma, Javangula Venkata Surya Prakash, Vetrivel Natarajan

Self-inflicted foreign bodies in the urinary bladder are very rarely reported. Insertion of a wide variety of objects into bladder due to autoerotic stimulation, psychiatric disturbances, and senility etc. have been reported in the medical literature. This case report discusses an exceptional incident where a young male patient self-inserted a ball-point pen into his urinary bladder via the urethra. Notably, the pen negotiated the curvatures of the urethra without causing significant lower urinary tract injury. The report underscores the challenges and successful endoscopic removal of the pen, marking the first documented instance of such an extraction in a male patient.