We present long-term surgical experience of 102 chordee without hypospadias cases. This retrospec... more We present long-term surgical experience of 102 chordee without hypospadias cases. This retrospective study included 102 chordee without hypospadias cases who were surgically treated between 1999 and 2012. Range of patients' age was from 1 month to 31 years. Seventy-two patients were adult, and 30 were children. Mean duration of follow up was 49.3 months. The patients were categorized into 4 groups including skin tethering (group 1), fibrotic dartos and Buck's fasciae ( group 2), corporeal disproportion ( group 3) and urethral tethering (group 4) with the aid of intraoperative artificial erection, according to the structural defect. Forty patients (group 1) were successfully treated with penile degloving. Except 3 (10%) of 31 (group 2) cases, extensive resection of the fibrotic dartos and Buck's fascia was needed to straighten the penis. Corporeal disproportion was identified in 27 patients of whom 2 cases (7%) had complications. One of them developed urethrocutaneous f...
The micro-percutaneous nephrolithotomy (microperc) is a recently introduced percutaneous nephroli... more The micro-percutaneous nephrolithotomy (microperc) is a recently introduced percutaneous nephrolithotomy (PNL) technique that is performed through a 4.8 Fr all-seeing needle. We aimed to measure the intrarenal pelvic pressure (IPP) during microperc and compare it with the levels of conventional PNL. A total of 20 patients with 1- to 3-cm renal calculi resistant to shock wave lithotripsy were treated either with microperc (Group-1, n: 10) or conventional PNL (Group-2, n: 10) by the same surgical team. The IPP was measured during different stages (entrance into the collecting system, stone fragmentation, and before termination) of the procedures by an urodynamic machine using the 6 Fr ureteral catheter. All the variables were statistically compared between the two groups. The demographic values of the patients were similar. The operation time and duration of hospitalization were significantly prolonged in conventional PNL group (p = 0.034, p = 0.01, respectively). The mean drop in hematocrit levels was significantly lower in microperc group (3.5 ± 1.5 vs. 1.8 ± 0.8; p = 0.004). The IPP was significantly higher in microperc group during all steps of the procedure. The highest level of the IPP was measured as 30.3 ± 3.9 and 20.1 ± 3.1 mmHg in Group 1 and Group 2, respectively (p < 0.0001). However, the complication and success rates were found comparable. In conclusion, we demonstrate that the level of IPP is significantly increased during microperc compared to conventional PNL. Microperc should be used cautiously in cases with impaired drainage of the collecting system.
or GITR + cells. Various immunological parameters (such as in vitro and in vivo cross-presentatio... more or GITR + cells. Various immunological parameters (such as in vitro and in vivo cross-presentation, and in vivo CTL activity), tumor growth, and animal survival were measured after treatment.
The treatment of symptomatic lower pole (LP) calculi poses a challenge because of lower clearance... more The treatment of symptomatic lower pole (LP) calculi poses a challenge because of lower clearance rates. We present our experience with microperc in the treatment of LP renal calculi. We retrospectively evaluated the symptomatic patients with LP renal calculi who underwent microperc between August 2011 and June 2012 from two referral hospitals. Patients were included only in cases of failure after shockwave lithotripsy (SWL) or retrograde intrarenal surgery (RIRS) and according to patient preference. The percutaneous renal access was performed using the 4.8F "all-seeing needle" with C-arm fluoroscopy or ultrasonographic guidance with the patient in the prone position. Stone disintegration was established using a 200 μm holmium:yttrium-aluminum-garnet laser fiber. A total of 21 patients (mean age 37.3 ± 20.1 years) with LP stone underwent microperc. The mean body mass index was 28.6 ± 6.0 kg/m(2), and the mean stone size was 17.8 ± 5.9 (9-29) mm. The duration of surgery and fluoroscopic screening was 62.8 ± 25.2 minutes and 150.5 ± 92.8 seconds, respectively. The patients were discharged after a mean 37.5 ± 14.4 hours of hospitalization time. The mean hemoglobin drop was 0.8 ± 0.6 (0.1-2.3) g/dL. Conversion to miniperc was necessitated in one patient with loss of vision. Stone-free status was achieved in 18 (85.7%) patients. Clinically insignificant residual fragments were observed in only one (4.8%). The procedure failed in two (9.5%) patients. A total of two minor complications (renal colic necessitating stent insertion and urinary tract infection) were observed postoperatively, none severe. Microperc is a feasible and efficient treatment modality for symptomatic LP calculi. Our results provide that microperc might take a part in case of SWL and RIRS failures or as an alternative to percutaneous nephrolithotomy or RIRS in the management of symptomatic LP calculi.
We present long-term surgical experience of 102 chordee without hypospadias cases. This retrospec... more We present long-term surgical experience of 102 chordee without hypospadias cases. This retrospective study included 102 chordee without hypospadias cases who were surgically treated between 1999 and 2012. Range of patients' age was from 1 month to 31 years. Seventy-two patients were adult, and 30 were children. Mean duration of follow up was 49.3 months. The patients were categorized into 4 groups including skin tethering (group 1), fibrotic dartos and Buck's fasciae ( group 2), corporeal disproportion ( group 3) and urethral tethering (group 4) with the aid of intraoperative artificial erection, according to the structural defect. Forty patients (group 1) were successfully treated with penile degloving. Except 3 (10%) of 31 (group 2) cases, extensive resection of the fibrotic dartos and Buck's fascia was needed to straighten the penis. Corporeal disproportion was identified in 27 patients of whom 2 cases (7%) had complications. One of them developed urethrocutaneous f...
The micro-percutaneous nephrolithotomy (microperc) is a recently introduced percutaneous nephroli... more The micro-percutaneous nephrolithotomy (microperc) is a recently introduced percutaneous nephrolithotomy (PNL) technique that is performed through a 4.8 Fr all-seeing needle. We aimed to measure the intrarenal pelvic pressure (IPP) during microperc and compare it with the levels of conventional PNL. A total of 20 patients with 1- to 3-cm renal calculi resistant to shock wave lithotripsy were treated either with microperc (Group-1, n: 10) or conventional PNL (Group-2, n: 10) by the same surgical team. The IPP was measured during different stages (entrance into the collecting system, stone fragmentation, and before termination) of the procedures by an urodynamic machine using the 6 Fr ureteral catheter. All the variables were statistically compared between the two groups. The demographic values of the patients were similar. The operation time and duration of hospitalization were significantly prolonged in conventional PNL group (p = 0.034, p = 0.01, respectively). The mean drop in hematocrit levels was significantly lower in microperc group (3.5 ± 1.5 vs. 1.8 ± 0.8; p = 0.004). The IPP was significantly higher in microperc group during all steps of the procedure. The highest level of the IPP was measured as 30.3 ± 3.9 and 20.1 ± 3.1 mmHg in Group 1 and Group 2, respectively (p < 0.0001). However, the complication and success rates were found comparable. In conclusion, we demonstrate that the level of IPP is significantly increased during microperc compared to conventional PNL. Microperc should be used cautiously in cases with impaired drainage of the collecting system.
or GITR + cells. Various immunological parameters (such as in vitro and in vivo cross-presentatio... more or GITR + cells. Various immunological parameters (such as in vitro and in vivo cross-presentation, and in vivo CTL activity), tumor growth, and animal survival were measured after treatment.
The treatment of symptomatic lower pole (LP) calculi poses a challenge because of lower clearance... more The treatment of symptomatic lower pole (LP) calculi poses a challenge because of lower clearance rates. We present our experience with microperc in the treatment of LP renal calculi. We retrospectively evaluated the symptomatic patients with LP renal calculi who underwent microperc between August 2011 and June 2012 from two referral hospitals. Patients were included only in cases of failure after shockwave lithotripsy (SWL) or retrograde intrarenal surgery (RIRS) and according to patient preference. The percutaneous renal access was performed using the 4.8F "all-seeing needle" with C-arm fluoroscopy or ultrasonographic guidance with the patient in the prone position. Stone disintegration was established using a 200 μm holmium:yttrium-aluminum-garnet laser fiber. A total of 21 patients (mean age 37.3 ± 20.1 years) with LP stone underwent microperc. The mean body mass index was 28.6 ± 6.0 kg/m(2), and the mean stone size was 17.8 ± 5.9 (9-29) mm. The duration of surgery and fluoroscopic screening was 62.8 ± 25.2 minutes and 150.5 ± 92.8 seconds, respectively. The patients were discharged after a mean 37.5 ± 14.4 hours of hospitalization time. The mean hemoglobin drop was 0.8 ± 0.6 (0.1-2.3) g/dL. Conversion to miniperc was necessitated in one patient with loss of vision. Stone-free status was achieved in 18 (85.7%) patients. Clinically insignificant residual fragments were observed in only one (4.8%). The procedure failed in two (9.5%) patients. A total of two minor complications (renal colic necessitating stent insertion and urinary tract infection) were observed postoperatively, none severe. Microperc is a feasible and efficient treatment modality for symptomatic LP calculi. Our results provide that microperc might take a part in case of SWL and RIRS failures or as an alternative to percutaneous nephrolithotomy or RIRS in the management of symptomatic LP calculi.
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