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    THE AFFECTS OF INCREASING EXPERIENCE ON THE PERCUTANEOUS NEPHROLITHOTOMY OPERATIONS
    (Aves, 2007) Ugras, Yahya Murat; Gunes, Ali; Soylu, Ahmet; Baydinc, Yasar Can
    Introduction: Importance and priority of minimally invasive methods in treatment of kidney stones are known and accepted by concerned medical doctors. Percutaneous nephrolithotomy is a minimally invasive surgical technique that is being applied for 30 years, and is also continuing its evolution meanwhile. From the first years of establishment to date, indications and surgical technique of this operation is developed as well as surgical results. Application in our country for this operation began at 1990's. Knowing how surgical results are affected by passing time and increasing experience is important for both getting information on how budding young surgeons should be trained on this issue and for developing anticipation on the future of percutaneous nephrolithotomy. In this review, in the light of national and international publications, we tried to summarize the evolution process, investigate the affects of increasing clinical and academical experience on results and give an idea on the surgical training methods of percutaneous nephrolithotomy.
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    Comparison of Venous Blood Gas Levels Between Pampiniform Plexus and Brachial Vein in Patients With Varicocele
    (Aves Yayincilik, Ibrahim Kara, 2010) Beytur, Ali; Soylu, Ahmet; Ugras, Yahya Murat; Gunes, Ali; Baydinc, Yasar Can
    Objectives: In this study, we aimed to determine whether there were some changes in the oxygenation and metabolism of testis tissue in patients with varicocele by comparing blood gas levels in dilated pampiniform plexus and brachial vein. Patients and Methods: Venous blood samples of 52 patients (mean age 24.4 +/- 7 years; range 17 to 49 years) who underwent varicocelectomy were taken from most dilated vein of the pampiniform plexus and simultaneously from brachial vein during varicocelectomy. In these samples, pH, lactate, SO(2), pO(2), pCO(2), HCO(3) values were measured and their means were compared. Results: While there were no significant differences between the pH, pO(2) and SO(2) levels of venous samples from brachial vein and pampiniform plexus, lactate level was significantly higher, pCO(2) and HCO(3) levels were significantly lower. Despite these significant differences, mean values measured were within normal laboratory ranges. Conclusion: Although the results of this study showed that varicocele caused statistically significant decreases in the rate of oxygen consumption and metabolism level in the testis tissue compared with the peripheral tissues, values obtained from the venous sample of pampiniform plexus were normal. Therefore, diminished oxygen consumption and decreased metabolism can not explain the negative effects of varicocele on testis tissue. This topic remains to be elucidated in later studies.
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    EVALUATION OF SYMPTOMS DUE TO URETERAL STENTS
    (Aves, 2007) Soylu, Ahmet; Altunoluk, Bulent; Soylemez, Haluk; Yologlu, Saim; Baydinc, Yasar Can
    Introduction: Double J ureteral stents are being used in urological practice for more than 25 years and in the recent years indications have continued to expand. Thus the complications and side effects of ureteral stents are also more frequent than previously reported. In addition to the severe complications resulting from forgotten or intentionally left stents for longer durations in ureters, they might also cause physical and emotional side effects due to bothering symptoms. The majority of the uncomfortable symptoms are related to urinary tract and these symptoms have severe negative impact on patients' general health status and quality of life. In this study, we evaluated the symptoms bothering the patient and impairing the quality of life due to stents. Materials and Methods: One hundred and twenty eight men and 79 women who were treated with ureteral double J stents were recruited. The patients were followed with a questionnaire consisting of 14 questions concerning urgency, incontinence, painful voiding, incomplete emptying, urethral pain, hematuria, sleep disturbance, need for analgesics, overall weakness, social life enjoyment, sexual dysfunction, getting permission from work/school, urinary tract infection and the need for extra antibiotics at 1 and 4 weeks after stent insertion and 1 week after stent removal. In addition to the presence or absence of a symptom, the frequency of the symptom, when it is present, was also asked based on a subjective classification [occasionally (25%), sometimes (50%), most of the time (75%), all of the time (100%)]. The symptoms of each period are compared by statistical analysis. Results: The mean age was 40.1 (range: 8-80) years. The indications for double J insertion were nephro-ureterolithiasis (n: 184), pregnancy related hydronephrosis (n: 8), malignancy (n: 7), ureteropelvic junction obstruction (n: 5), ureterovesical junction obstruction (n: 2), perforation (n: 1). There was no history of previous double J stent insertion in any patient. Double J stents were inserted to the right, left and both ureters in 92, 100 and 15 patients respectively. All double J stents used in the study were made up of polyethylene and except for 4 patients' stents with 6F diameter and 26 cm length were inserted. In the 4 pediatric patients 4.8 F diameter and 16 cm length double J stents were used. There was no change in the social life enjoyment with stent placement or removal. All other symptoms increased with the increased duration of the stent and decreased with the removal. The most significant two symptoms at the post insertion one week were painful voiding (43%) and urgency (41%) resulting from irritation of the stent. Also these two symptoms were significantly high (73%) at the fourth week. Conclusion: The results of our study indicates that ureteral stents have negative impact on general health status, sexual functions, school/work performance and quality of life in addition to the increased urinary tract related symptoms, and these negative effects increase with the duration of the stent. Therefore, the indications and durations of the ureteral stents must be revisited in the light of the quality of life, and unnecessary insertions and longer durations should be avoided.