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    Is abdominal wall hemorrhage an avoidable complication of robotic radical prostatectomy?
    (2020) Koc, Erdem; Gok, Bahri
    Aim: We presented the diagnosis and treatment of patients with abdominal wall hemorrhage after robot-assisted laparoscopic radical prostatectomy (RALRP) in a high volume center. Materials and Methods: We retrospectively screened the data of 1950 patient RALRP series performed between June 2010 and December 2019 in our clinic. Patients who developed postoperative abdominal wall hemorrhage were included in the current study. The diagnosis of abdominal wall hemorrhage was established by ultrasonographic and physical examination findings. Results: In our 1950 patient RALRP series, 15 (0.7%) patients developed abdominal wall hemorrhage. The mean decrease in hemoglobin values was 3.9 (2.8-4.7) g/dl at postoperative 6th hour. On the postoperative 2nd day, areas of ecchymosis were observed on the abdominal wall skin. On the postoperative 4th day, hemoglobin level was stabilized. Blood transfusion was required for 8 of 15 patients. None of the patients required surgical exploration. At the postoperative 1st month control visits, we observed that the ecchymosis was completely disappeared. Conclusion: RALRP is a surgical technique that has been increasingly preferred in the treatment of localized prostate cancer. Abdominal wall hemorrhage is a rarely seen complication of RALRP that may be avoided by paying attention to some anatomical landmarks and optimizing the blood level of muscle relaxant medications at an effective dose. As a rerely seen complication of RALRP, abdominal wall hemorrhage can be successfully managed without the need for explorative surgery.
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    Is retrograde intrarenal surgery successful in the treatment of stones in kidneys with anomalies?
    (2020) Gok, Bahri; Kamaci, Davut; Koc, Erdem; Asil, Erem; Atmaca, Ali Fuat; Odabas, Oner
    Aim: To evaluate the results of retrograde intrarenal surgery (RIRS) in stones with anomaly in the kidney.Material and Methods: Between April 2016 and November 2018, the data of 350 patients undergoing retrograde intrarenal surgery due to kidney stones were retrospectively examined.Patients with stones in the kidney with anomalies were recorded. Demographic data, localization of the stone, size, and success and complication rates were reviewed.In the post-operative controls, stones that were 2 mm and below were accepted as stone-free.Postoperative success was evaluated as stone-free at the 1st and 3rd months.Results: The mean age of the patients was 50.9 ± 15.8 (20-78).RIRS was performed in 29 kidneys with anomalies.Ten patients had horseshoe kidneys, 2 patients had ectopic pelvic kidneys, 13 patients had double collecting system and 4 patients had rotation anomalies.The mean stone size was 16.3 ± 6.1 (8-30) mm. The postoperative 1st and 3rd month stone-free rate was 48.2% and 51.7%, respectively.The complication developed in 4 (13.7%) patients. All of these were minor complications.Second procedure was applied to 14 of the remaining patients. Conclusion: In the treatment of kidney stones with anomalies, RIRS is reliable with low complication rates, but the patient should be informed about the need for additional procedures due to low stone-free rates.