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    Comparison of Retrograde Intrarenal Surgery and Percutaneous Nephrolithotomy in the Treatment of 2-3 cm Multicalyceal Kidney Stones
    (Galenos Yayincilik, 2018) Cakici, Mehmet Caglar; Sari, Sercan; Ozok, Hakki Ligur; Karakoyunlu, Nihat; Hepsen, Emre; Sagnak, Levent; Topaloglu, Hikmet
    Objective: To demonstrate the feasibility of retrograde intrarenal surgery (RIRS) in the treatment of 2-3 cm multicalyceal kidney stones considering the possible complications and unsuitable situations. Multiple kidney stones are observed among 20-25% of patients seen in urology clinics. Percutaneous nephrolithotomy (PNL) is the primary method for treating kidney stones larger than 2 cm. Despite the high success rate achieved, life-threatening complications associated with PNL may arise. Multiple accesses may be required for multiple stones. RIRS has become increasingly widely used. In our study, we aimed to compare these two methods in the treatment of 2-3 cm multicalyceal stones. Materials and Methods: We retrospectively evaluated data of patients who presented with multicalyceal kidney stones measuring 2-3 cm between 2012 and 2016. A total of 64 patients who underwent surgery (36 RIRS, 28 PNL) were included in the study. Results: Major complications were more common, operative time, fluoroscopy time and length of hospital stay time were longer in PNL group than in RIRS group. The number of stones was statistically higher in RIRS group. There was no statistically significant difference in other parameters. No statistically significant difference was found between the two groups in operation success rates. Conclusion: In the literature, the primary treatment option for 2-3 cm multicalyceal stones has been reported to be PNL RIRS should be used in appropriate patients who have risks of complications related to anesthesia, bleeding disorder and patients with anatomic abnormalities who are not suitable for PNL This method is also used to reduce the potential complications and it is more reliable.
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    Nation-wide analysis of the impact of Covid-19 pandemic on daily urology practice in Turkey
    (Wiley-Hindawi, 2021) Bozkurt, Ozan; Sen, Volkan; Irer, Bora; Sagnak, Levent; Onal, Bulent; Tanidir, Yiloren; Karabay, Emre
    Objective To present a nation-wide analysis of the workload of urology departments in Turkey week-by-week during Covid-19 pandemic. Methodology The centres participating in the study were divided into three groups as tertiary referral centres, state hospitals and private practice hospitals. The number of outpatients, inpatients, daily interventions and urological surgeries were recorded prospectively between 9-March-2020 and 31-May-2020. All these variables were recorded for the same time interval of 2019 as well. The weekly change of the workload of urology during pandemic period was evaluated, also the workload of urology and the distributions of certain urological surgeries were compared between the pandemic period and the same time interval of the year 2019. Results A total of 51 centres participated in the study. The number of outpatients, inpatients, urological surgeries and daily interventions were found to be dramatically decreased by the 3rd week of pandemics in state hospitals and tertiary referral centres; however, the daily urological practice were similar in private practice hospitals throughout the pandemic period. When the workload of urology in pandemic period and the same time interval of the year 2019 were compared, a huge decrease was observed in all variables during pandemic period. However, temporary measures like ureteral stenting, nephrostomy placement and percutaneous cystostomy have been found to increase during Covid-19 pandemic compared with normal life. Conclusions Covid-19 pandemic significantly affected the routine daily urological practice likewise other subspecialties and priority was given to emergent and non-deferrable surgeries by urologists in concordance with published clinical guidelines.