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Öğe Risk factors and mortality rate in premature babies with acute kidney injury(WILEY, 111 RIVER ST, HOBOKEN, NJ 07030 USA, 2018) Elmas, Ahmet Taner; Tabel, Yılmaz; Özdemir, RamazanBackgroundAcute kidney injury (AKI) is a common morbidity in neonatal intensive care units and associated with poor outcome. This study aimed to determine the prevalence of AKI and provide a demographic data and risk factors associated with the mortality and morbidity. MethodsThis is a retrospective study included 105 premature babies. Diagnosis of AKI was based on neonatal KDIGO classification criteria. The babies were stratified into two groups according to AKI status during the hospitalization. Clinical and laboratory characteristics of the AKI group were compared to non-AKI group. ResultsAKI occurred in 21 (20.0%) of 105 premature babies, and mortality rate in these babies was 61.9%. Lower gestational weeks, lower Apgar scores at 5minutes, lower systolic blood pressures, and inotropic supports were independent risk factors for the development of AKI in preterm babies (P<.05, for each). Oliguria, preeclampsia/eclampsia, resuscitation at birth, lower diastolic blood pressure, patent ductus arteriosus (PDA), inotropic support, and furosemide treatment were associated with the mortality (P<.05, for each). ConclusionsPrenatal risk factors and medical interventions are associated with AKI, and AKI is associated with increased morbidity and mortality. Therefore, identification of AKI is very important in this vulnerable population and it should be performed as quickly as possible in all babies who are at high risk for developing of AKI.Öğe Effects of renal replacement therapy on fıbromyalgıa syndrome ın patıents wıthchronıc kıdney dısease(CARBONE EDITORE, VIA QUINTINO SELLA, 68, PALERMO, 90139, ITALY, 2018) Şahin, İdris; Bağ, Harika GözükaraIntroduction: Although musculoskeletal disorders are among the major complications of chronic kidney disease (CKD), there are scarce data to investigate fibromyalgia syndrome (FMS) in these patients. We aimed to investigate the prevalence of FMS in the patients with CKD. Material and methods: A total of 289 (119 predialysis (PD), 85 hemodialysis (HD), 85 continuous ambulatory peritoneal dialysis (CAPD)) patients were included. Diagnosis of FMS was based on American College of Rheumatology (ACR) 1990 FMS criteria. Results: Mean age was 52 +/- 16 years (range 18-89 years). One-hundred-sixty-four (56.7%) of them were male. A total of 46 patients (10 male/36 female) (15.9%) were diagnosed FMS. The prevalence of FMS was 28.8% in females and 6.1% in males. Compared to males, females had a significantly higher rate of FMS (p<0.001). The prevalence of FMS was 19.3% in PD group, 17.6% in the CAPD group, and 9.4% in the HD group. Although the frequency of FMS was lower in HD group compared to both the PD and the CAPD groups, the differences were not statistically significant (for HD vs PD, p=0.052; for HD vs CAPD, p=0.113). In PD group, hemoglobin (Hb) levels were significantly higher in patients with FMS than without FMS. Parathormone (PTH) levels were significantly lower in CAPD patients with FMS than without FMS. Although the prevalence of FMS was increased in PD and CAPD patients, this increase did not reach statistical significance. FMS was markedly more prevalent in female patients. While the Hb level was lower in the PD patients with FMS, PTH level was lower in the CAPD patients diagnosed with FMS. Conclusions: Our study demonstrated that the rate of FMS was higher in PD and CAPD patients compared to HD patients, although our results did not reach statistical significance. Among the entire demographic and laboratory parameters, female gender was found to be significant risk factor for development of FMS. Future multicenter studies which have large sample size are clearly needed to determine other factors related to development of FMS in patients with CKD.Öğe Extramucosal pancreaticojejunostomy at laparoscopic pancreaticoduodenectomy(Medknow publıcatıons & medıa pvt ltd, b-9, kanara busıness centre, off lınk rd, ghaktopar-e, mumbaı, 400075, ındıa, 2018) Karagul, Servet; Kayaalp, Cuneyt; Sumer, Fatih; Yagci, Mehmet AliWhile the 'best pancreatic anastomosis technique' debate is going during Whipple procedure, the laparoscopic pancreaticoduodenectomy lately began to appear more and more often in the medical literature. All the popular anastomosis techniques used in open pancreas surgery are being experienced in laparoscopic pancreaticoduodenectomy. However, when they were adapted to laparoscopy, their implementation was not technically easy, and assistance of robotic surgery was sometimes required at the pancreatic anastomosis stage of the procedure. Feasibility and simplicity of a new technique have a vital role in its adaptation to laparoscopic surgery. We frequently use the extra-mucosal single row handsewn anastomosis method in open and laparoscopic surgery of the stomach, small and large bowel and we found it easy and reliable. Here, we defined the adaptation of this technique to the laparoscopic pancreas anastomosis. The outcomes were not inferior to the other previously described techniques and it has the advantage of simplicity.Öğe Comparison of dialysate and plasma NTproBNP in prediction of clinical outcomes of diabetic and nondiabetic peritoneal dialysis patients(DUSTRI-VERLAG DR KARL FEISTLE, BAHNHOFSTRASSE 9 POSTFACH 49, D-82032 DEISENHOFEN-MUENCHEN, GERMANY, 2018) Koz, Süleyman; Şahin, İdris; Kayataş, Mansur; Koz, Sema TülayBackground: Plasma level of N-terminal pro-brain natriuretic peptide (P-NTproBNP) is a useful marker in prediction of mortality in peritoneal dialysis (PD) patients. However, the predictive value of spent dialysate counterpart (D-NTproBNP) of plasma NTproBNP on mortality and dropout is not known. Materials and methods: Simultaneous P-NTproBNP and D-NTproBNP assays were performed after an overnight dwell in 44 scheduled ambulatory PD patients. Patients were followed for similar to 47 months. Deceased patients or patients who were transferred to hemodialysis were regarded as dropouts. Results: 14 patients (31.8%) dropped out at similar to 4 years (9 deaths and 5 transfers to hemodialysis). Diabetics, males, and patients with higher membrane permeability had higher dropout rates. Patients with P-and D-NTproBNP higher than median values had higher mortality and dropout rates (Kaplan-Meier test, log-rank Test p < 0.05). Odds ratios of D-NTproBNP for death and dropouts were (3.807 (0.907-15.971), p = 0.068) and (2.87 (1.009-8.138) p = 0.048), respectively; odds ratios of P-NTproBNP for death and dropouts were (4.652 (0.914-23.693), p = 0.064) and (2.67 (0.924-7.716), p = 0.07), respectively; in ROC analysis for death, AUC for P-and D-NTproBNP were 0.762 (0.578-0.946, p = 0.016) and 0.765 (0.590-0.940, p = 0.015), respectively. Exclusion of diabetic patients from the analyses resulted in significant changes in the predictive value P-and D-NTproBNP. Although death and dropout rates were still higher in nondiabetic patients with higher NTproBNP levels, the differences between groups lost statistical significance. Conclusion: Both P-NTproBNP and D-NTproBNP are significant predictors of outcomes of interest. Predictive value of NTproBNP might be different in diabetics and non-diabetic CAPD patients.Öğe Neurofibromas of the bladder in a child with neurofibromatosis type 1(Internatıonal braz j urol, 2018) Doğan, Güleç Mert; Sigirci, Ahmet; Karaca, LeylaÖğe Severe renal bleeding caused by a ruptured renal sheath case report of a rare complication of percutaneous(BMC Urology, 2002) Uğraş, Murat; Güneş, Ali; Baydinç, CanPercutaneous nephrolithotomy is a minimally invasive intervention for renal stone disease. Complications, which are rare and usually presented as case reports, are diversified as the utilization of the procedure is expanded. The procedure causes less blood loss and less morbidity when compared to open surgical procedures. Yet, there are some reports involving severe bleeding and relevant morbidity during surgery. These are usually related with the surgical technique or experience of the surgeon. Renal sheaths are designed to cause minimal trauma inside the kidney and, to our knowledge, there are no reports presenting the rupture of a sheath causing severe bleeding during the procedure. Case report: We present an adult patient who had severe bleeding during percutaneous nephrolithotomy due to parenchymal injury caused by a ruptured renal sheath. During retrieval, due probably to rough handling of the equipment, a piece of stone with serrated edges ruptured the tip of the sheath, and this tip caused damage inside the kidney. The operation was terminated and measures were taken to control bleeding. The patient was transfused with a total of 1600 ml of blood, and the stones were cleared in a second look operation. Conclusion: Although considered to be a minimally invasive procedure, some unexpected complications may arise during percutaneous nephrolithotomy. After being fragmanted, stone pieces may damage surgical equipment, causing acute and severe harm to the kidney. Surgeons must manipulate the equipment with fine and careful movements in order to prevent this situation.Öğe Eosinophilic cystitis(Urologia Internationalis, 2003) Kılıç, Süleyman; Erguvan, Rezzan; İpek, Deniz; Güneş, Ali; Aydın, Nasuhi Engin; Baydinç, CanÖğe Percutaneous nephrolithotomy for pediatric stone disease(Scandinavian Journal of Urology and Nephrology, 2003) Güneş, Ali; Uğraş, Murat Yahya; Yılmaz, Uğur; Baydinç, Can; Soylu, AhmetObjective: We evaluated the outcomes and complications of percutaneous nephrolithotomy (PNL) operations performed in pediatric patients using adult-sized surgical equipment at our center. Material and Methods: The medical and surgical records of 23 children who underwent a total of 25 PNL operations using 24 or 26 F rigid nephroscopes were evaluated retrospectively. The following aspects were considered: stone burden; duration of surgery and complications; details concerning recovery, success, residual fragments and auxiliary procedures; and follow-up details. Results: The success rate of a single PNL session was 70.8%; with the use of auxiliary procedures this was increased to 91.6%. Perioperative and early postoperative complications were excessive bleeding and transfusion in two patients, hydropneumothorax in one, perforation of the collecting system in three and urinoma in one. Complications were more common in children aged <7 years or with staghorn stones. The mean time to catheter removal was 3.4 days and the mean hospitalization time was 4.8 days. Idiopathic hypercalciuria, hypocitraturia, cystinuria and hyperoxaluria were diagnosed in two, two, one and three patients, respectively. Conclusion: Performing PNL with adult-sized equipment is associated with significant complications in children aged <7 years or with staghorn stones. This treatment should not be considered in routine clinical practice. As all stone-removal methods are associated with complications, PNL should be used only if other methods fail or are unavailable.Öğe Effects of micronised purified flavonoid fraction on pain spermiogram and scrotal color doppler parameters in patients with painful varicocele(Urol Int, 2005) Kılıç, Süleyman; Güneş, Ali; İpek, Deniz; Dusak, Abdurrahim; Güneş, Gülsen; Balbay, Derya Mevlana; Baydinç, CanPurpose: Micronised purifi ed fl avonoid fraction (MPFF) is a phlebotropic drug improving venous tone, elasticity and lymphatic drainage, decreasing venous distensibility, venous emptying times, refl ux time of venous blood and capillary hyperpermeability, and having antioxidant activities. Since varicocele is a venous pathology, we evaluated the effects of MPFF on pain, spermiogram and color Doppler parameters in patients with painful varicocele. Material and Methods: Semen analyses and Doppler sonography were performed in 16 patients (aged 20–62 years, mean 31.2 8 10.9) before and after 1,000 mg/day MPFF treatment. Pain change was assessed with visual analogue scale scored between 0 and 10. Patient satisfaction with outcome and side effects were recorded. Results: Mean pain scores at 1, 3, and 6 months were 1.25 8 1.34, 0.25 8 0.68, and 0.12 8 0.34, respectively, all being signifi cantly lower (p ! 0.001 for each) than baseline (4.93 8 1.77). Mean score at 12 months (0.93 8 1.06) was still lower than baseline (p ! 0.001) but higher than at 6 months (p = 0.019). Respectively, 14 (87.5%) and 2 (12.5%) patients reported complete and very signifi cant resolution of pain at the 6th month. All patients were very satisfi ed with the outcome. While semen volume, total sperm count, sperm concentration and morphology did not change signifi cantly, motility increased signifi cantly (p = 0.009) due to decrease of grade 0 sperms (p = 0.006) and increase of grade 3 + 4 sperms (p ! 0.001). Refl ux time of left spermatic vein during the Valsalva maneuver decreased signifi cantly (p = 0.003). No signifi cant change occurred in refl ux time of the right spermatic vein. No side effect was recorded. Conclusions: Results of this preliminary study suggest the safety and effi cacy of MPFF in the treatment of varicocele-associated pain. However, no recommendation for the use of MPFF in the treatment of pain associated with varicocele can be made before these preliminary results are confi rmed by a randomized pla cebocontrolled trial.Öğe Instillation of skin nephrostomy tract and renal puncture site with ropivacaine decreases pain and improves ventilatory function after percutaneous nephrolithotomy(Journal of Endourology, 2007) Toprak, Hüseyin İlksen; Yücel, Aytaç; Güneş, AliPain after percutaneous nephrolithotomy (PCNL) is well investigated, but no optimal management strategy has yet been defined. Ventilatory changes after uncomplicated PCNL remain obscure. We investigated whether pain can be managed with a combination of a parenteral non-narcotic drug and instillation of a local anesthetic into the operative field. We also measured ventilatory changes early after PCNL to determine whether this analgesic modality improves ventilatory status. PATIENTS AND METHODS: In a randomized blinded study, 34 well-matched patients underwent PCNL with single subcostal access. At the end of the operation, 30 mL of either 0.02% ropivacaine or saline was instilled into the renal puncture site, nephrostomy tract, and skin. Postoperatively, patients received parenteral metamizol (dipyrone) (500 mg/dose) on demand. Pain visual analog score (VAS), peak expiratory flow rate (PEF), and blood-gas analysis were performed at 2, 6, and 24 hours postoperatively. The number of analgesic doses required was recorded. RESULTS: The VAS at 6 hours, time to first analgesic demand, and total analgesic need were significantly lower (P=0.001, 0.008, and 0.001, respectively) in the ropivacaine group, whereas the PEF at 2 and 6 hours was significantly higher (P=0.001 for each). Analgesic use in the first 12 and 24 hours was lower in this group. Blood-gas analysis was within the normal range in both groups. Time of surgery and hemoglobin decrease were not significantly different. CONCLUSIONS: A decrease in PEF indicating restricted ventilation appears early after PCNL. Because these patients were chosen carefully to have normal function preoperatively, this decrease was attributed to nociception. A combination of ropivacaine instillation with metamizol decreases pain and analgesic use and improves PEF more than use of metamizol alone. Such a multimodal pain-management strategy is effective in minimizing postoperative opioid use with proper pain management, resulting in better ventilation.Öğe Some criteria to attempt second side safely in planned bilateral simultaneous percutaneous nephrolithotomy(Urology, 2008) Gedik, Ender; Güneş, Gülsen; Güneş, Ali; Uğraş, Murat Y.; Yanık, Metin; Soylu, Ahmet; Baydinc, CanTo determine the validity of some criteria that could guide in the decision to cancel or proceed with the second side of planned bilateral simultaneous percutaneous nephrolithotomy (bsPCNL). METHODS Patients with an indication for bilateral PCNL were enrolled in this study. The operation was stopped at the end of the initial side if operative time was 180 min, the hemoglobin level was 11 g/dL, the hemoglobin decrease was 3 g/dL, the systolic arterial pressure was 100 mm Hg, the arterial oxygen saturation was 95%, the arterial blood pH was 7.35, or the blood sodium was 128 mg/mL. The success and complication rates were compared in patients who underwent second side PCNL (group 1) and those for whom the procedure was stopped after the initial side (group 2). RESULTS Of 42 planned bsPCNLs, 12 were stopped after the initial side, with the cause being prolonged operative time in 7, hemoglobin decrease in 6, systolic arterial pressure decrease in 2, arterial oxygen saturation decrease in 2, pH decrease in 1, and sodium decrease in 1. Differences in patient characteristics, stone burdens, and overall success and complication rates were insignificant. Transfusion, postoperative urinary infection, and prolonged urine drainage rates were similar, but the total hospitalization time was significantly longer in group 2. One hydrothorax and one renal pelvic perforation occurred in group 2. The need for transfusion correlated positively with the number of nephrostomy tracts in group 2 (r 0.895, P .001). No such correlation was found in group 1. CONCLUSIONS Despite the best of intentions, about 30% of anticipated bsPCNL cases might be limited to single-sided PCNL, depending on the intraoperative events. Our criteria seem reasonable, because similar success and complication rates were obtained with bilateral, separate-session PCNL and bsPCNL. These criteria can be considered in the decision making to omit the advantages of a single session for safety.Öğe The epidemiology and factors associated with nocturnal enuresis among boarding and daytime school children in southeast of Turkey a cross sectional study(BMC Public Health, 2009) Güneş, Ali; Güneş, Gülsen; Açık, Yasemin; Akıllı, AdemNocturnal enuresis can be defined as the involuntary passage of urine during sleep beyond the age of anticipated nightime bladder control, after 4-6 y of age [1,2]. It is well known that nocturnal enuresis is a common, genetically complex and heterogeneous disorder among children [3]. According to International Children's Continence Society (ICCS),intermittent incontinence is urine leakage in discrete amounts. It can occur during the day and/or at night, and it is applicable to children who are at least 5 years old. Enuresis means intermittent incontinence while sleeping. In contrast to the previous terminology, the terms (intermittent) nocturnal incontinence and enuresis are now synonymous[4]. Enuresis can be further categorized into primary nocturnal enuresis or secondary nocturnal enuresis. Primary nocturnal enuresis is therefore bedwetting in a child aged 5 years or more who has never been dry for extended periods, while secondary nocturnal enuresis is the onset of wetting after a continuous dry period of more than 6-12 months[5].Öğe Erectile dysfunction in testicular cancer patients treated with chemotherapy(Andrologia, 2012) Taşdemir, Cemal; Fırdolaş, Fatih; Harputluoğlu, Hakan; Altıntaş, Ramazan; Güneş, AliInformation on male potency in testicular cancer (TC) patients treated with chemotherapy is insufficient. We aimed to assess the levels of depression and anxiety symptoms, sexual function and gonodotrophins. Participants (n = 27) were identified and recruited from the genitourinary services of two medical centres, one in Inonu University and the other in the Firat University. All patients are TC patients treated with chemotherapy after unilateral orchiectomy. Participants completed follow-up assessments after the completion of the chemotherapy regimen. Serum luteinising hormone, follicle-stimulating hormone and testosterone levels were determined after blood samples had been taken in the morning after an overnight fast. International Index of Erectile Function (IIEF-15) was also used to evaluate erectile dysfunction (ED) score. Beck Depression and Beck Anxiety Scale were used to assess psychological symptoms. The findings indicated that men treated with chemotherapy had significantly different IIEF-15 and Beck Anxiety scores compared with men who did not receive chemotherapy. But no statistically significant difference was determined in the serum gonodotrophin levels and depression score between the two groups. It is concluded that patients with TC undergoing chemotherapy have greater risk than normal men for ED, independently of the gonodotrophin’s level.Öğe Assessment of urinary incontinence in the women in eastern Turkey(International Urogynecology Journal, 2013) Altıntaş, Ramazan; Beytur, Ali; Oğuz, Fatih; Taşdemir, Cemal; Güneş, AliIntroduction and hypothesis The aims of the present study were to determine the types of UI among women visiting the urology department, to identify the potential risk factors associated with each type of UI, and to identify healthcare-seeking behaviors of affected women in our region. Methods The data of 617 community-dwelling women, who were at least 18 years of age or older and who presented with a complaint of UI ongoing over a year, and those without UI, who were admitted for any other reason, from June 2010 to April 2012, were evaluated. Results Mean age was 51.29 years (range 18–110 years); median parity was 3.54 (range 0–11) and 88.2 % of the women were married. Mean BMI was 28.01 kg/m2 . Very few women (18.5 %) accepted UI as a disease and searched for medical help by themselves; however, the remaining women (81.5 %) were brought or directed for evaluation by someone else. Stress UI was reported by 43 women (10.5 %), urge UI and mixed UI were noted by 153 (37.5 %) and 212 (52 %) women respectively. Conclusions The most frequent type of UI was mixed UI in our region. Age, BMI, multiparity, and hypertension were identified to have a different importance for each type of UI, but diabetes mellitus, birth trauma, gynecological surgery, lumbar disc hernia (LDH), and multiple sclerosis (MS) were the other important related factors. However, a small number of patients accepted UI as a disease and searched for therapy. This reveals that the public should be informed in detail about female UI in developing countries.Öğe Is there a relationship between chronic periodontitis and erectile dysfunction(The Journal of Sexual Medicine, 2013) Oğuz, Fatih; Eltaş, Abubekir; Beytur, Ali; Akdemir, Ender; Güneş, AliIntroduction. Chronic periodontitis (CP) is characterized with inflammation of the gingival tissues, which causes endothelial dysfunction in different organs. Aim. In this study, we investigated the association of CP with the erectile dysfunction (ED). Methods. The study group included 80 male patients with ED and 82 male patients without ED (control), aged between 30 and 40 years. The International Index of Erectile Function (IIEF) questionnaire was used to assess male sexual function, particularly the presence or absence of ED. Main Outcome Measures. The patients in the study and control groups were statistically compared according to their plaque index (PI), bleeding on probing (BoP), probing depth (PD), and clinical attachment level (CAL). Results. In the non-ED and the ED groups, the mean age was 35.7 4.8 and 34.9 4.9 years, respectively. Patients’ characteristics including body mass index, household income, and education status were similar in both groups (P > 0.05). Nineteen patients (23%) had severe CP in the non-ED group; 42 patients (53%) had severe CP in the ED group. Logistic regression analysis showed a significantly high association between ED and the severity of CP (odds ratio: 3.29, 95% confidence interval: 1.36–9.55, P < 0.01). The mean values of PI, BoP, and the percentages of sites with PD >4 mm and sites with CAL >4 mm were significantly higher in the ED group than in the control group (P < 0.05). The mean values of PD and CAL were not significantly different in the two groups (P > 0.05). The decayed, missing, filled teeth scores were also significantly higher in the ED group than in the non-ED group (P < 0.05). Conclusion. Our results have suggested that CP had a high association with ED in young adults at 30–40 years. We think that it will be of benefit to consider periodontal disease as a causative clinical condition of ED in such patients.Öğe The importance of instrument type in paediatric percutaneous nephrolithotomy(Urolithiasis, 2014) Altıntaş, Ramazan; Oğuz, Fatih; Taşdemir, Cemal; Beytur, Ali; Çimen, Serhan; Güneş, Ali; Çolak, CemilWe reported our experience with percutaneous nephrolithotomy in children and compared the outcomes, including the morbidity and success rates, regarding the instruments of different sizes. One hundred and seventythree paediatric patients, who underwent percutaneous nephrolithotomy in our clinic between 1999 and 2013, were assessed. According to the size of instruments used during surgery, three different groups were formed and the pre- and postopeartive outcomes were compared between the groups. 76 girls and 97 boys with a mean age of 9.24 (B17) years were assessed. Stone-free rates were 75.6 % in group 1 (n = 82) using 17 F nephroscope, 79.4 % in group 2 (n = 73) using 24 F nephroscope and 72.2 % in group 3 (n = 18) using 26 F nephroscope. Postoperative fever was seen in four, five and one patient in group 1, 2 and 3, respectively. Urinary infection was seen in one patient in group 1 and four patients in group 2. Mean haematocrit drop and stone burden were significantly lesser in group 1. No significant difference was seen in the duration of nephrostomy and hospitalization between the groups. The success rates obtained in the groups using different instrument types (paediatric or adult) were similar. However, age, weight, height, stone burden and bleeding were significantly lesser in group 1 that used paediatric type of instrument. As the most frequent complication of PNL, bleeding seems to be associated with stone burden, the diameter of dilatation and the calibre of instrument. To decrease the particular complications, paediatric type of instruments are convenient and do not affect the success.Öğe Factors affecting complication rates of percutaneous nephrolithotomy in children results of a multi institutional retrospective analysis by the Turkish pediatric ürology society(The Journal of Urology, 2014) Önal, Bülent; Doğan, Hasan Serkan; Satar, Nihat; Bilen, Cenk Yücel; Güneş, Ali; Özden, Ender; Öztürk, Ahmet; Demirci, Deniz; İstanbulluoğlu, Mustafa Okan; Gürocak, Özdemir Serhat; Nazlı, Oktay; Tanrıverdi, Orhan; Kefi, Aykut; Korgalı, Esad; İnci, Kubilay; İzol, Volkan; Altıntaş, RamazanWe assessed factors affecting complication rates of percutaneous nephrolithotomy in children. Materials and Methods We retrospectively evaluated data on 1,205 renal units in 1,157 children treated with percutaneous nephrolithotomy at 16 Turkish centers between 1991 and 2012. Of the patients 28.3% had a history of urolithiasis. Complications were evaluated according to the Satava classification system and modified Clavien grading system. Univariate and multivariate analyses were done to determine predictive factors affecting complication rates. Results A total of 515 females and 642 males were studied. Mean ± SD patient age was 8.8 ± 4.7 years (range 4 months to 17 years). Mean ± SD stone size, operative time and postoperative hospital stay were 4.09 ± 4.06 cm2, 93.5 ± 48.6 minutes and 5.1 ± 3.3 days, respectively. Postoperative stone-free rate was 81.6%. A total of 359 complications occurred in 334 renal units (27.7%). Complications were intraoperative in 118 cases and postoperative in 241. While univariate analysis revealed that stone history, positive urine culture, operative time, length of hospitalization, treatment success, punctured calyx and location of the stone significantly affected the complication rates (p <0.05), operative time, sheath size, mid calyceal puncture and partial staghorn formation were the statistically significant parameters affecting complication rates on multivariate logistic regression analysis. Conclusions Percutaneous nephrolithotomy is the treatment of choice for most renal calculi in children. The technique is effective and safe in children, with a high success rate and a low rate of major complications. The significant factors identified should be considered by clinicians to decrease associated complication rates.Öğe Percutaneous nephrolithotomy for pediatric diseases(European medical journal, 2015) Çelik, Hüseyin; Çamtosun, Ahmet; Altıntaş, Ramazan; Taşdemir, Cemal; Topçu, İbrahim; Serhan, Çimen; Güneş, AliÖğe Çocuklarda ESWL(Türkiye Klinikleri J Urology, 2015) Çimen, Serhan; Güneş, AliÇocukluk çağında görülen taş hastalığının sıklığı erişkinlerdekine benzer şekilde ülke ve bölgelere göre değişiklik göstermektedir. Çocuk yaş grubunda tespit edilen taşların genellikle üst üriner sistemde olduğu gösterilmiştir. Çocukluk çağı taş hastalığı erişkinlerden farklı değerlendirme, tedavi ve takip yaklaşımı gerektirmektedir. Günümüzde çocukluk çağı taş hastalığının tedavisinde özellikle böbrek taşlarında ESWL birinci seçenek tedavi yöntemi olarak kabul edilmekte ve uygulanmaktadır.
