Pub Date : 2023-02-27DOI: 10.33719/yud.2023;18-1-1238308
Y. İ. Çömez, M. Balcı, Doğukan Sökmen, K. Seker, V. Tuğcu
Objective: To investigate the learning curve for robot assisted laparoscopic radical perineal prostatectomy (robotic RPP) for surgeons who already perform transperitoneal robot assisted laparoscopic radical prostatectomy. Material and Methods: A total of initial 120 robotic RPP cases were analyzed for perioperative data from single surgeon performing to determine the learning curve. Perioperative all data are collected including operation time, estimated blood loss, postoperative length of stay, complications and positive surgical margin results. The consecutive patients were classified into four groups: cases 1–30 (Group 1), cases 31–60 (Group 2), cases 61–90 (Group 3) and cases 91-120 (Group 4). Results: Median age of 61.4 (46-73) years and PSA level was 8.4 (2-32). Mean operative time was 143.2 minutes, and the length of surgery progressively decreased over time (from group 1 to group 4; P<001). Mean console time was 90.6 minutes and significant differences was found group 3 vs. 4 (p=0.047). The mean length of stay was 1.6 days, and significantly decrease after 60 cases over time (P<0.001). Mean removal of the urethral catheter significantly earlier in group 4 (P1vs4=0.012). There was no statistically significant difference between the groups with respect to pathologic tumor Gleason score, positive surgical margine of the specimen and complications. Conclusions: This study suggests that surgical qualification for robotic RPP can be obtained at least after 90 cases for an experienced robotic surgeon. Keywords: prostatectomy, robot-assisted, perineal, learning curve, prostate cancer
{"title":"Determining the learning curve for robot-assisted radical perineal prostatectomy in surgeons familiar with robotic retropubic prostatectomy","authors":"Y. İ. Çömez, M. Balcı, Doğukan Sökmen, K. Seker, V. Tuğcu","doi":"10.33719/yud.2023;18-1-1238308","DOIUrl":"https://doi.org/10.33719/yud.2023;18-1-1238308","url":null,"abstract":"Objective: To investigate the learning curve for robot assisted laparoscopic radical perineal prostatectomy (robotic RPP) for surgeons who already perform transperitoneal robot assisted laparoscopic radical prostatectomy. Material and Methods: A total of initial 120 robotic RPP cases were analyzed for perioperative data from single surgeon performing to determine the learning curve. Perioperative all data are collected including operation time, estimated blood loss, postoperative length of stay, complications and positive surgical margin results. The consecutive patients were classified into four groups: cases 1–30 (Group 1), cases 31–60 (Group 2), cases 61–90 (Group 3) and cases 91-120 (Group 4). Results: Median age of 61.4 (46-73) years and PSA level was 8.4 (2-32). Mean operative time was 143.2 minutes, and the length of surgery progressively decreased over time (from group 1 to group 4; P<001). Mean console time was 90.6 minutes and significant differences was found group 3 vs. 4 (p=0.047). The mean length of stay was 1.6 days, and significantly decrease after 60 cases over time (P<0.001). Mean removal of the urethral catheter significantly earlier in group 4 (P1vs4=0.012). There was no statistically significant difference between the groups with respect to pathologic tumor Gleason score, positive surgical margine of the specimen and complications. Conclusions: This study suggests that surgical qualification for robotic RPP can be obtained at least after 90 cases for an experienced robotic surgeon. Keywords: prostatectomy, robot-assisted, perineal, learning curve, prostate cancer","PeriodicalId":33828,"journal":{"name":"Yeni Uroloji Dergisi","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47601591","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-02-27DOI: 10.33719/yud.2023;18-1-1222172
Y. İ. Çömez
Objective: Since the laparoscopy education had became widespread, the advance laparoscopic procedures can be performed even at secondary public hospitals. In this study, we aimed to present our experience of the first seven years of laparoscopic transperitoneal adrenalectomy. Material And Methods: the study included 30 patients with laparoscopic transperitoneal adrenalectomy (LA) performed from October 2012 to April 2019. The retrospective assessment investigated age, sex, body mass index, adrenal mass characteristics, hormonal activity, operation duration, hemorrhage status, transfusion requirements, final pathology and complication rates. Results: Mean age was 54.3±11.5 years and mean body mass index was 25.6±2.7 kg/m2. Mean mass size was 48.5±23 mm and mean operation duration was 70.2±21.6 minutes. Mean peroperative hemorrhage amount was 41±48.8 cc, while only 2 patients required transfusion. Mean hospitalization duration was 1.3±0.88 days. None of the laparoscopic cases was converted to open surgery, and no major complications such as death recorded. Conclusion: Transperitoneal laparoscopic adrenalectomy (LA) surgery may be performed safely after adequate training for appropriate patients with low morbidity and mortality. Keywords: laparoscopy, adrenalectomy, experience, open surgery, transperitoneal
{"title":"The applicability of laparoscopic adrenalectomy and our experience at a secondary health institution","authors":"Y. İ. Çömez","doi":"10.33719/yud.2023;18-1-1222172","DOIUrl":"https://doi.org/10.33719/yud.2023;18-1-1222172","url":null,"abstract":"Objective: Since the laparoscopy education had became widespread, the advance laparoscopic procedures can be performed even at secondary public hospitals. In this study, we aimed to present our experience of the first seven years of laparoscopic transperitoneal adrenalectomy. Material And Methods: the study included 30 patients with laparoscopic transperitoneal adrenalectomy (LA) performed from October 2012 to April 2019. The retrospective assessment investigated age, sex, body mass index, adrenal mass characteristics, hormonal activity, operation duration, hemorrhage status, transfusion requirements, final pathology and complication rates. Results: Mean age was 54.3±11.5 years and mean body mass index was 25.6±2.7 kg/m2. Mean mass size was 48.5±23 mm and mean operation duration was 70.2±21.6 minutes. Mean peroperative hemorrhage amount was 41±48.8 cc, while only 2 patients required transfusion. Mean hospitalization duration was 1.3±0.88 days. None of the laparoscopic cases was converted to open surgery, and no major complications such as death recorded. Conclusion: Transperitoneal laparoscopic adrenalectomy (LA) surgery may be performed safely after adequate training for appropriate patients with low morbidity and mortality. Keywords: laparoscopy, adrenalectomy, experience, open surgery, transperitoneal","PeriodicalId":33828,"journal":{"name":"Yeni Uroloji Dergisi","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69671566","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-02-27DOI: 10.33719/yud.2023;18-1-1172380
Erdal Benli
Objective: The definite cause of overactive bladder (OAB), which negatively affects the quality of life of patients, is unknown. This study aims to provide evidence for the inflammatory process in patients with OAB whose etiology has not been fully elucidated. Material and Methods: The study included 154 people with OAB diagnosis and 131 people as controls. This study was conducted retrospectively, cross-sectionally between April 2015 and April 2020. The data were recorded at the first meeting by an expert on this subject. Groups were compared in terms of CRP and ESR measured in serum. Statistical analysis used the chi-square test, independent samples t-test, Mann-Whitney U test, and Pearson and Spearman correlation analyses. P<0.05 was accepted as statistical significance. Results: There were no differences between the groups in terms of comorbid diseases. There were significant differences identified in terms of age and BMI between the groups (p<0.005). When groups are compared according to CRP levels, values were 0.28 [0.54] for the OAB group and 0.17 [0.22] mg/dl for the control group (p=0.047). The distribution according to ESR in the groups was 19 [30.5] and 12.5 [13] mm/h, respectively (p=0.004). Conclusion: This study provides new evidence to the literature showing the relationship between OAB and an inflammatory process. It was determined that CRP and ESR levels were increased in patients with OAB compared to the control group. These results show us that there is an inflammatory process at the onset of this disease. Keywords: inflammation, overactive bladder,
{"title":"An examination of relationship between overactive bladder and C-reactive protein and erythrocyte sedimentation rate","authors":"Erdal Benli","doi":"10.33719/yud.2023;18-1-1172380","DOIUrl":"https://doi.org/10.33719/yud.2023;18-1-1172380","url":null,"abstract":"Objective: The definite cause of overactive bladder (OAB), which negatively affects the quality of life of patients, is unknown. This study aims to provide evidence for the inflammatory process in patients with OAB whose etiology has not been fully elucidated. Material and Methods: The study included 154 people with OAB diagnosis and 131 people as controls. This study was conducted retrospectively, cross-sectionally between April 2015 and April 2020. The data were recorded at the first meeting by an expert on this subject. Groups were compared in terms of CRP and ESR measured in serum. Statistical analysis used the chi-square test, independent samples t-test, Mann-Whitney U test, and Pearson and Spearman correlation analyses. P<0.05 was accepted as statistical significance. Results: There were no differences between the groups in terms of comorbid diseases. There were significant differences identified in terms of age and BMI between the groups (p<0.005). When groups are compared according to CRP levels, values were 0.28 [0.54] for the OAB group and 0.17 [0.22] mg/dl for the control group (p=0.047). The distribution according to ESR in the groups was 19 [30.5] and 12.5 [13] mm/h, respectively (p=0.004). Conclusion: This study provides new evidence to the literature showing the relationship between OAB and an inflammatory process. It was determined that CRP and ESR levels were increased in patients with OAB compared to the control group. These results show us that there is an inflammatory process at the onset of this disease. Keywords: inflammation, overactive bladder,","PeriodicalId":33828,"journal":{"name":"Yeni Uroloji Dergisi","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69671786","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-02-27DOI: 10.33719/yud.2023;18-1-1191867
T. Aydoğan, M. Binbay
Objective: To compare outcomes of single- layer renorrhaphy suturing and hemostatic agent application with double-layer renorrhaphy among complex renal tumors. Material and Methods: 51 patients who underwent robotic partial nephrectomy due to complex renal tumors (PADUA score ≥10) between August 2017 and February 2021 were retrospectively enrolled. A double-layer renorrhaphy was applied in 36 patients (Group 1), and a single-layer renorrhaphy plus hemostatic agent FloSeal® (Baxter Medical, Fremont, CA) was applied in 15 patients (Group 2). Pre- and post-operative serum creatinine, glomerular filtration rate, hemoglobin levels, surgical and warm ischemia time, drainage, hospital stay duration, as well as complications were all evaluated. Results: Group 1 and Group 2 mean PADUA scores were 11 and 10.47, respectively. The mean preoperative, postoperative 1st day and 6th month serum creatinine were 1.02, 1.15 and 1.09 mg/dL in the Group 1 and were 0.93, 1.02 and 0.90 mg/dL in the Group 2, respectively. The mean preoperative, postoperative 1st day and 6th month glomerular filtration rates were 91.47, 77.31 and 81.90 mL/ min/1.73m2 in the Group 1 and were 92.07, 84.93 ve 90.73 mL/min/1.73m2 in the Group 2, respectively. Operation and warm ischemia time were 118min and 23min in the Group 1, and 101min and 13 min in the Group 2, respectively. There was no significant difference between groups in terms of drain removal time and hospital stay. Perioperative only Clavien I and II complications were observed with no recurrence during the follow-up. Conclusion: A single-layer of renorrhaphy plus hemostatic agent application can be safely applied in complex renal tumors with a PADUA score between 10-11 undergoing robotic partial nephrectomy. Keywords: robotic partial nephrectomy, nephron sparing surgery, renorrhaphy, complex renal tumor
{"title":"Can a single-layer of renorrhaphy be applied with hemostatic agent in robotassisted laparoscopic nephron-sparing surgery applied to complex renal tumors?","authors":"T. Aydoğan, M. Binbay","doi":"10.33719/yud.2023;18-1-1191867","DOIUrl":"https://doi.org/10.33719/yud.2023;18-1-1191867","url":null,"abstract":"Objective: To compare outcomes of single- layer renorrhaphy suturing and hemostatic agent application with double-layer renorrhaphy among complex renal tumors. Material and Methods: 51 patients who underwent robotic partial nephrectomy due to complex renal tumors (PADUA score ≥10) between August 2017 and February 2021 were retrospectively enrolled. A double-layer renorrhaphy was applied in 36 patients (Group 1), and a single-layer renorrhaphy plus hemostatic agent FloSeal® (Baxter Medical, Fremont, CA) was applied in 15 patients (Group 2). Pre- and post-operative serum creatinine, glomerular filtration rate, hemoglobin levels, surgical and warm ischemia time, drainage, hospital stay duration, as well as complications were all evaluated. Results: Group 1 and Group 2 mean PADUA scores were 11 and 10.47, respectively. The mean preoperative, postoperative 1st day and 6th month serum creatinine were 1.02, 1.15 and 1.09 mg/dL in the Group 1 and were 0.93, 1.02 and 0.90 mg/dL in the Group 2, respectively. The mean preoperative, postoperative 1st day and 6th month glomerular filtration rates were 91.47, 77.31 and 81.90 mL/ min/1.73m2 in the Group 1 and were 92.07, 84.93 ve 90.73 mL/min/1.73m2 in the Group 2, respectively. Operation and warm ischemia time were 118min and 23min in the Group 1, and 101min and 13 min in the Group 2, respectively. There was no significant difference between groups in terms of drain removal time and hospital stay. Perioperative only Clavien I and II complications were observed with no recurrence during the follow-up. Conclusion: A single-layer of renorrhaphy plus hemostatic agent application can be safely applied in complex renal tumors with a PADUA score between 10-11 undergoing robotic partial nephrectomy. Keywords: robotic partial nephrectomy, nephron sparing surgery, renorrhaphy, complex renal tumor","PeriodicalId":33828,"journal":{"name":"Yeni Uroloji Dergisi","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69671863","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-10-27DOI: 10.33719/yud.2022;17-3-1114575
S. Karadağ, M. Ekşi
Objective: To present our ‘methylene blue-guided retroperitoneoscopy technique’ that we apply in cases where extravasation develops for various reasons and is complicated as a result in Percutaneous Nephrolithotomy surgery (PNL). Material and Methods: A total of 36 patients, who underwent PNL with the ‘methylene blue technique’ at Bakirkoy Dr. Sadi Konuk Training and Research Hospital between 2014 and 2020, were retrospectively evaluated. The study included only cases in which the ‘methylene blue-guided retroperitoneoscopy technique’ was used due to the inability to advance the Amplatz sheath to the targeted calyx due to renal scarring or a staghorn stone filling the targeted calyx, Amplatz sheath was withdrawn from the kidney with the guidewire due to the inattention of the assistant surgical team or contrast material extravasation. The patients’ demographic, preoperative, perioperative, and postoperative data were recorded, and stone-free and complication rates were noted. Results: The mean age of the patients was 45.1 (36-55) years, the mean body mass index was 27.8±4 kg/m2, the mean stone size was 3.4±0.7 cm, and the mean stone volume was 22.3±10.2 cm3. The mean operation time was calculated as 95.8±30.3 minutes. The stone-free rate was 68% on the postoperative first day and 75% on the third month. Eight patients (22.2%) underwent a secondary procedure (extracorporeal shock wave lithotripsy or flexible ureterorenoscopy). Conclusion: The ‘methylene blue-guided retroperitoneoscopy technique’ we apply under retroperitoneoscopic direct vision is a safe and practical option for re-accessing the kidney by locating the calyx, which is first partially or completely dilated. Keywords: methylene blue, retroperitoneoscopy, renal access failure, percutaneous nephrolithotomy
目的:介绍我们的“亚甲基蓝引导下的后腹膜镜技术”，我们应用于因各种原因发生外渗的病例，并导致经皮肾镜取石术(PNL)的复杂性。材料和方法:回顾性评估2014年至2020年间在Bakirkoy Dr. Sadi Konuk培训和研究医院接受“亚甲基蓝技术”PNL的36例患者。本研究仅包括以下病例:由于肾脏瘢痕形成或靶肾盏内有雄角结石，无法将Amplatz鞘推进至靶肾盏，由于辅助手术团队的疏忽或造影剂外溢，导丝将Amplatz鞘从肾脏取出，因此使用“亚甲基蓝引导腹膜后镜技术”。记录患者的人口统计学、术前、围手术期和术后数据，并记录无结石率和并发症发生率。结果:患者平均年龄45.1(36-55)岁，平均体重指数27.8±4 kg/m2，平均结石大小3.4±0.7 cm，平均结石体积22.3±10.2 cm3。平均手术时间为95.8±30.3 min。术后第一天结石清除率为68%，第三个月为75%。8名患者(22.2%)接受了二次手术(体外冲击波碎石术或输尿管镜检查)。结论:我们在腹膜后直视下应用亚甲基蓝引导的后腹膜镜技术是一种安全实用的选择，可以通过定位先部分或完全扩张的肾盏来重新进入肾脏。关键词:亚甲基蓝，腹膜后镜检查，肾通路失败，经皮肾镜取石术
{"title":"Methylene blue-guided retroperitoneoscopy technique: alternative for percutaneous nephrolithotomy in cases with renal access failure","authors":"S. Karadağ, M. Ekşi","doi":"10.33719/yud.2022;17-3-1114575","DOIUrl":"https://doi.org/10.33719/yud.2022;17-3-1114575","url":null,"abstract":"Objective: To present our ‘methylene blue-guided retroperitoneoscopy technique’ that we apply in cases where extravasation develops for various reasons and is complicated as a result in Percutaneous Nephrolithotomy surgery (PNL). Material and Methods: A total of 36 patients, who underwent PNL with the ‘methylene blue technique’ at Bakirkoy Dr. Sadi Konuk Training and Research Hospital between 2014 and 2020, were retrospectively evaluated. The study included only cases in which the ‘methylene blue-guided retroperitoneoscopy technique’ was used due to the inability to advance the Amplatz sheath to the targeted calyx due to renal scarring or a staghorn stone filling the targeted calyx, Amplatz sheath was withdrawn from the kidney with the guidewire due to the inattention of the assistant surgical team or contrast material extravasation. The patients’ demographic, preoperative, perioperative, and postoperative data were recorded, and stone-free and complication rates were noted. Results: The mean age of the patients was 45.1 (36-55) years, the mean body mass index was 27.8±4 kg/m2, the mean stone size was 3.4±0.7 cm, and the mean stone volume was 22.3±10.2 cm3. The mean operation time was calculated as 95.8±30.3 minutes. The stone-free rate was 68% on the postoperative first day and 75% on the third month. Eight patients (22.2%) underwent a secondary procedure (extracorporeal shock wave lithotripsy or flexible ureterorenoscopy). Conclusion: The ‘methylene blue-guided retroperitoneoscopy technique’ we apply under retroperitoneoscopic direct vision is a safe and practical option for re-accessing the kidney by locating the calyx, which is first partially or completely dilated. Keywords: methylene blue, retroperitoneoscopy, renal access failure, percutaneous nephrolithotomy","PeriodicalId":33828,"journal":{"name":"Yeni Uroloji Dergisi","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69671495","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-10-27DOI: 10.33719/yud.2022;17-3-1099157
A. Kalkanlı, N. Çilesiz, C. T. Gezmiş, Ç. Kaya, Onur Fikri, A. Kadıoğlu
Objective: The Covid-19 pandemic, which affects all areas of life, has also deeply affected academic and health services. There has previously been no assessment of the effects of the pandemic on the academic and health services of urology residents in Turkey, for this purpose, a survey was conducted. Material and Methods: The survey consisted of a total of 31 questions under four main topics (education and research activities, working conditions in health services, social-psychological effects, and personal health) and was carried out between July-August 2020. The survey was 89 urology training centers in Turkey; among them, 76 (85.4%; 38 universities and 38 state hospitals) completed and returned the questionnaire. Results: The average weekly education hours decreased (2.43±2.46 hours to 1.3±1.8 hours; p=.00) and 67 centers (88.15%) used new technologies such as webinars and videoconferencing. The time devoted to weekly research activities also decreased during the pandemic (2.15±2.54 hours to 1.8±1.93 hours; p<0.001). However, university hospitals increased their research activities (9.9%), while state hospitals decreased (44%). The average weekly outpatient clinic hours decreased from 86.23±86.54 to 37.22±19.88 (p<0.001) and the regression was higher in state hospitals (63.61%) compared to university hospitals (42.41%) (p <0.05). A significant decrease was observed in the number of operations per week compared to the pre-pandemic period (from 40.7±24.25 to 14.3±16.44; p<0.001). In addition, 74 centers (97.36%) reported that they continued to perform emergency urological cases and 41 centers (53.9%) reported that the total working hours decreased, but 72 centers (94.7%) reported that they were employed in non-urology areas such as Covid outpatient clinics or services. For the residents, 10 centers (13.15%) provided childcare, 55 centers (72.36%) provided accommodation, and 18 centers (23.68%) provided transportation, but 33 centers (43.42%) lacked protective personal equipment and 26 centers (34.21%) gave leave to employees with comorbidity. Residents were concerned about not having enough surgical cases in 57 centers (75%), the transmission of Covid-19 to their family in 73 centers (96.05%), and in 34 centers (44.73%), they had moved away from their homes to protect their families. Furthermore, residents were isolated in 25 centers (32.89%) and swabs were taken in 54 centers (71.85%) due to the query (doubt, suspicion) of illness. Residents were diagnosed with Covid-19 in 14 centers (18.42%). Conclusion: This survey has shown that as the Covid-19 pandemic affects all areas of life, it also causes serious negatives in the academic (educational and research), social, and psychological lives of urology residents. Keywords: COVID-19, residency, pandemic, urology training, surgical training
{"title":"The impact of COVID-19 pandemic on urology residency in Turkey: a nationwide survey","authors":"A. Kalkanlı, N. Çilesiz, C. T. Gezmiş, Ç. Kaya, Onur Fikri, A. Kadıoğlu","doi":"10.33719/yud.2022;17-3-1099157","DOIUrl":"https://doi.org/10.33719/yud.2022;17-3-1099157","url":null,"abstract":"Objective: The Covid-19 pandemic, which affects all areas of life, has also deeply affected academic and health services. There has previously been no assessment of the effects of the pandemic on the academic and health services of urology residents in Turkey, for this purpose, a survey was conducted. Material and Methods: The survey consisted of a total of 31 questions under four main topics (education and research activities, working conditions in health services, social-psychological effects, and personal health) and was carried out between July-August 2020. The survey was 89 urology training centers in Turkey; among them, 76 (85.4%; 38 universities and 38 state hospitals) completed and returned the questionnaire. Results: The average weekly education hours decreased (2.43±2.46 hours to 1.3±1.8 hours; p=.00) and 67 centers (88.15%) used new technologies such as webinars and videoconferencing. The time devoted to weekly research activities also decreased during the pandemic (2.15±2.54 hours to 1.8±1.93 hours; p<0.001). However, university hospitals increased their research activities (9.9%), while state hospitals decreased (44%). The average weekly outpatient clinic hours decreased from 86.23±86.54 to 37.22±19.88 (p<0.001) and the regression was higher in state hospitals (63.61%) compared to university hospitals (42.41%) (p <0.05). A significant decrease was observed in the number of operations per week compared to the pre-pandemic period (from 40.7±24.25 to 14.3±16.44; p<0.001). In addition, 74 centers (97.36%) reported that they continued to perform emergency urological cases and 41 centers (53.9%) reported that the total working hours decreased, but 72 centers (94.7%) reported that they were employed in non-urology areas such as Covid outpatient clinics or services. For the residents, 10 centers (13.15%) provided childcare, 55 centers (72.36%) provided accommodation, and 18 centers (23.68%) provided transportation, but 33 centers (43.42%) lacked protective personal equipment and 26 centers (34.21%) gave leave to employees with comorbidity. Residents were concerned about not having enough surgical cases in 57 centers (75%), the transmission of Covid-19 to their family in 73 centers (96.05%), and in 34 centers (44.73%), they had moved away from their homes to protect their families. Furthermore, residents were isolated in 25 centers (32.89%) and swabs were taken in 54 centers (71.85%) due to the query (doubt, suspicion) of illness. Residents were diagnosed with Covid-19 in 14 centers (18.42%). Conclusion: This survey has shown that as the Covid-19 pandemic affects all areas of life, it also causes serious negatives in the academic (educational and research), social, and psychological lives of urology residents. Keywords: COVID-19, residency, pandemic, urology training, surgical training","PeriodicalId":33828,"journal":{"name":"Yeni Uroloji Dergisi","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69671904","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-10-27DOI: 10.33719/yud.2022;17-3-1115325
T. Kargı, M. Ekşi
Objective: We examined factors predicting metachronous recurrence of bladder cancer in our series of patients who underwent radical nephroureterectomy (RNU) for upper system urothelial carcinoma (UTUC). Material and Methods: Patients with UTUC-induced RNU in our center from September 2009 to March 2020 were included in the study. Patients were classified as having and not having an intravesical recurrence (IVR), and the factors predicting recurrence were evaluated. Results: A total of 50 patients were included in the study. IVR was developed in 19 (38%) of 50 patients, with a mean follow-up of 39.5 ± 25.3 months. There was no significant difference between the two groups in demographic characteristics, admission hemoglobin, glomerular filtration rate, and degree of hydronephrosis in preoperative ureterorenoscopy and cytology positivity history (p>0.05). The IVR (+) group had significantly more previous history of bladder cancer (35.5% vs. 52.6%, p=0.019, respectively). While the number of patients with ureteral tumors was 10 (32.3%) in the IVR (-) group, it was 9 (47.4%) in the IVR (+) group, and it was significantly higher. There are 28 (56%) patients with T2-T4 pathology in the entire patient group, and the rate is significantly greater in the IVR (+) group (63.2% vs. 51.6%, p=0.038, respectively). Conclusion: Caution should be exercised for metachronous bladder cancer recurrence in patients with a previous history of bladder cancer, especially in ureteral and high pathological T-stage UTUCs. Keywords: upper urinary tract urothelial carcinoma, intravesical recurrence, risk factor, nephroureterectomy
目的:研究在接受根治性肾输尿管切除术(RNU)治疗上系统尿路上皮癌(UTUC)的患者中膀胱癌异时性复发的预测因素。材料与方法:本研究纳入2009年9月至2020年3月在我中心收治的utuc致RNU患者。将患者分为有无膀胱内复发(IVR)，并对预测复发的因素进行评估。结果:共纳入50例患者。50例患者中有19例(38%)出现IVR，平均随访39.5±25.3个月。两组患者人口学特征、入院血红蛋白、肾小球滤过率、术前输尿管镜及细胞学阳性史肾积水程度差异无统计学意义(p < 0.05)。IVR(+)组膀胱癌既往病史明显增加(35.5% vs. 52.6%， p=0.019)。输尿管肿瘤患者中，IVR(-)组为10例(32.3%)，IVR(+)组为9例(47.4%)，两者差异有统计学意义。整个患者组中出现T2-T4病理的患者有28例(56%)，其中IVR(+)组出现T2-T4病理的患者比例明显高于IVR(+)组(63.2%比51.6%，p=0.038)。结论:对于既往有膀胱癌病史的患者，尤其是输尿管和高病理t期UTUCs患者，应谨慎对待异时性膀胱癌复发。关键词:上尿路尿路上皮癌，膀胱内复发，危险因素，肾输尿管切除术
{"title":"Risk factors for intravesical recurrence after radical nephrourethrectomy in upper urinary tract urothelial tumors: retrospective single-center study","authors":"T. Kargı, M. Ekşi","doi":"10.33719/yud.2022;17-3-1115325","DOIUrl":"https://doi.org/10.33719/yud.2022;17-3-1115325","url":null,"abstract":"Objective: We examined factors predicting metachronous recurrence of bladder cancer in our series of patients who underwent radical nephroureterectomy (RNU) for upper system urothelial carcinoma (UTUC). Material and Methods: Patients with UTUC-induced RNU in our center from September 2009 to March 2020 were included in the study. Patients were classified as having and not having an intravesical recurrence (IVR), and the factors predicting recurrence were evaluated. Results: A total of 50 patients were included in the study. IVR was developed in 19 (38%) of 50 patients, with a mean follow-up of 39.5 ± 25.3 months. There was no significant difference between the two groups in demographic characteristics, admission hemoglobin, glomerular filtration rate, and degree of hydronephrosis in preoperative ureterorenoscopy and cytology positivity history (p>0.05). The IVR (+) group had significantly more previous history of bladder cancer (35.5% vs. 52.6%, p=0.019, respectively). While the number of patients with ureteral tumors was 10 (32.3%) in the IVR (-) group, it was 9 (47.4%) in the IVR (+) group, and it was significantly higher. There are 28 (56%) patients with T2-T4 pathology in the entire patient group, and the rate is significantly greater in the IVR (+) group (63.2% vs. 51.6%, p=0.038, respectively). Conclusion: Caution should be exercised for metachronous bladder cancer recurrence in patients with a previous history of bladder cancer, especially in ureteral and high pathological T-stage UTUCs. Keywords: upper urinary tract urothelial carcinoma, intravesical recurrence, risk factor, nephroureterectomy","PeriodicalId":33828,"journal":{"name":"Yeni Uroloji Dergisi","volume":"44 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69671606","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-10-27DOI: 10.33719/yud.2022;17-3-1143471
Cevper Ersöz, Abdullah Ilktac, S. Kalkan, Yunus Kayalı, Habib Akbulut, H. Toprak, Bayram Doğan
Objective: This study aims to compare the clinically significant prostate cancer (csPCa) detection rates of cognitive targeted biopsy (CTB) and systematic biopsy (SB) and to reveal the factors affecting csPCa detection rates. Material and Methods: Patients diagnosed with localized prostate cancer between 2016-2019 were evaluated retrospectively. Patients who underwent SB and concomitant CTB were recorded. The number of cores taken from the index lesion in CTB, age, prostate-specific antigen (PSA) level, Gleason score, International Society of Urological Pathology (ISUP) grade, Prostate Imaging and Data Reporting System (PIRADS) score, the diameter of index lesion, and digital rectal examination (DRE) findings was recorded. We also studied whether there was a concordance between the localization of the lesion on MRI (magnetic resonance imaging) and the localization of the nodule detected on DRE. Results: Eighty patients were included in the study. csPCa was detected in 55 (68.7%) patients with SB, whereas CTB alone detected csPCa in 35 (43.7%) patients (p<0,01). SB missed 2 patients with csPCa, but 35% of the men with csPCa would be missed by CTB. Detection rates of csPCa in SB and CTB were significantly higher in patients with a concordance between DRE and mpMRI (p= 0.012 and p<0.01, respectively). In patients who had csPCa in CTB, significant differences were detected in the mean age, prostate volume, PSA, lesion diameter, number of cores, and PIRADS score (p=0.005, p=0.02, p=0.005, p=0.003, p=0.017, and p=0.002, respectively) Conclusion: SB maintains its importance in the diagnosis of csPCa. CTB can be preferred in patients with larger lesions. Keywords: Prostate cancer, prostate biopsy, magnetic resonance imaging, targeted biopsy
{"title":"Systematic versus cognitive targeted biopsy: evaluation of parameters related to clinically significant prostate cancer and comparison of detection rates","authors":"Cevper Ersöz, Abdullah Ilktac, S. Kalkan, Yunus Kayalı, Habib Akbulut, H. Toprak, Bayram Doğan","doi":"10.33719/yud.2022;17-3-1143471","DOIUrl":"https://doi.org/10.33719/yud.2022;17-3-1143471","url":null,"abstract":"Objective: This study aims to compare the clinically significant prostate cancer (csPCa) detection rates of cognitive targeted biopsy (CTB) and systematic biopsy (SB) and to reveal the factors affecting csPCa detection rates. Material and Methods: Patients diagnosed with localized prostate cancer between 2016-2019 were evaluated retrospectively. Patients who underwent SB and concomitant CTB were recorded. The number of cores taken from the index lesion in CTB, age, prostate-specific antigen (PSA) level, Gleason score, International Society of Urological Pathology (ISUP) grade, Prostate Imaging and Data Reporting System (PIRADS) score, the diameter of index lesion, and digital rectal examination (DRE) findings was recorded. We also studied whether there was a concordance between the localization of the lesion on MRI (magnetic resonance imaging) and the localization of the nodule detected on DRE. Results: Eighty patients were included in the study. csPCa was detected in 55 (68.7%) patients with SB, whereas CTB alone detected csPCa in 35 (43.7%) patients (p<0,01). SB missed 2 patients with csPCa, but 35% of the men with csPCa would be missed by CTB. Detection rates of csPCa in SB and CTB were significantly higher in patients with a concordance between DRE and mpMRI (p= 0.012 and p<0.01, respectively). In patients who had csPCa in CTB, significant differences were detected in the mean age, prostate volume, PSA, lesion diameter, number of cores, and PIRADS score (p=0.005, p=0.02, p=0.005, p=0.003, p=0.017, and p=0.002, respectively) Conclusion: SB maintains its importance in the diagnosis of csPCa. CTB can be preferred in patients with larger lesions. Keywords: Prostate cancer, prostate biopsy, magnetic resonance imaging, targeted biopsy","PeriodicalId":33828,"journal":{"name":"Yeni Uroloji Dergisi","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69671621","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-10-27DOI: 10.33719/yud.2022;17-3-1164082
Doğukan Sökmen, Bedriye Koyuncu Sökmen, Zülfü Sertkaya, E. Keskin
Objective: Our objective was to evaluate the accuracy and reliability of YouTube videos about penile doppler ultrasonography (PDU), a diagnostic tool for erectile dysfunction. Material and Methods: Videos on YouTube were searched using the term “Penile Doppler Ultrasonography”. The most related 48 videos were included in to study. For each video, uploader type (physician, patient, or YouTuber), target group (physicians or non-physicians), video duration, upload date, daily view count, the total number of views, and the number of likes and comments were recorded. The reliability and quality of the content of these videos included in the study were evaluated using JAMA, DISCERN, and GQS scores. Results: The physicians uploaded all of the videos used in the study. It was shown that 27 (56%) of the videos were prepared for physicians, and the remaining videos were prepared for non-physicians. All the videos had general information about the PDU, 32 (67%) videos gave theoretical information, and 23 (48%) videos gave information about the application of the PDU. When the videos were examined according to the target group, it was shown that the videos prepared for physicians had a longer duration (p=,001) but had a lower number of comments and views (p=,012 and p=.046, respectively). In addition, when the video content quality and reliability were examined, the average JAMA score was 2.5, the GQS score was 3.44, and the DISCERN score was 52.2. It was found that the quality and reliability scores were statistically higher in the videos prepared for physicians (p<0.05). Conclusion: As a source of knowledge about health care, YouTube is frequently used by doctors and other people (including patients). High-quality information is very important for both physicians and individual patients. In this study, we showed that videos uploaded by physicians had reliable content, but these high-quality videos had longer duration and lower view count. In order to improve the quality of PDU-related videos, physicians should upload high-quality videos, and YouTube algorithms should direct patients to high-quality videos. Keywords: penile, doppler, ultrasonography, YouTube
{"title":"Does YouTube videos have reliable information on Penile Doppler Ultrasonography?","authors":"Doğukan Sökmen, Bedriye Koyuncu Sökmen, Zülfü Sertkaya, E. Keskin","doi":"10.33719/yud.2022;17-3-1164082","DOIUrl":"https://doi.org/10.33719/yud.2022;17-3-1164082","url":null,"abstract":"Objective: Our objective was to evaluate the accuracy and reliability of YouTube videos about penile doppler ultrasonography (PDU), a diagnostic tool for erectile dysfunction. Material and Methods: Videos on YouTube were searched using the term “Penile Doppler Ultrasonography”. The most related 48 videos were included in to study. For each video, uploader type (physician, patient, or YouTuber), target group (physicians or non-physicians), video duration, upload date, daily view count, the total number of views, and the number of likes and comments were recorded. The reliability and quality of the content of these videos included in the study were evaluated using JAMA, DISCERN, and GQS scores. Results: The physicians uploaded all of the videos used in the study. It was shown that 27 (56%) of the videos were prepared for physicians, and the remaining videos were prepared for non-physicians. All the videos had general information about the PDU, 32 (67%) videos gave theoretical information, and 23 (48%) videos gave information about the application of the PDU. When the videos were examined according to the target group, it was shown that the videos prepared for physicians had a longer duration (p=,001) but had a lower number of comments and views (p=,012 and p=.046, respectively). In addition, when the video content quality and reliability were examined, the average JAMA score was 2.5, the GQS score was 3.44, and the DISCERN score was 52.2. It was found that the quality and reliability scores were statistically higher in the videos prepared for physicians (p<0.05). Conclusion: As a source of knowledge about health care, YouTube is frequently used by doctors and other people (including patients). High-quality information is very important for both physicians and individual patients. In this study, we showed that videos uploaded by physicians had reliable content, but these high-quality videos had longer duration and lower view count. In order to improve the quality of PDU-related videos, physicians should upload high-quality videos, and YouTube algorithms should direct patients to high-quality videos. Keywords: penile, doppler, ultrasonography, YouTube","PeriodicalId":33828,"journal":{"name":"Yeni Uroloji Dergisi","volume":"51 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69671661","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-10-27DOI: 10.33719/yud.2022;17-3-1141735
Sami Kaan Coşarcan, A. T. Doğan, M. Kılıç, Ö. Erçelen
Objective: The advantages of robot-assisted surgery include shorter incisions, less postoperative pain, perioperative blood loss, and a faster return to daily functions. Thoracic epidural analgesia (TEA) provides highly satisfactory analgesia in abdominal surgery. However, its hypotensive effect, particularly in minimally invasive procedures, exceeds its contribution to rapid recovery. Fascial plane blocks may be more beneficial in that context. This study evaluated the effects of regional analgesia techniques in robotic prostatectomy, nephrectomy, and cystectomy operations. Material and Methods: Following IRB Ethics Committee approval (2021.467.IRB1.134), the records of patients who had undergone robotic prostatectomy, nephrectomy, and cystectomy surgeries were retrospectively reviewed between January 2018 and January 2022. Results: One hundred and forty patients with full documentation were included in this study. Various regional analgesia methods were used. Fascial plane blocks were seen to be used in addition to epidural analgesia. Transversus abdominis plane (TAP) and rectus sheath blocks exhibited satisfactory results in robotic prostate surgeries and TAP blocks in robotic nephrectomy operations. Conclusion: In robotic prostatectomy and nephrectomy operations, we recommend fascial plane blocks as the first-choice method for postoperative analgesia. Keywords: regional anesthesia, robotic surgery, radical prostatectomy, minimally invasive surgery, fascial plane blocks, recovery after surgery
{"title":"The efficacy of regional analgesia techniques in urological robotic surgeries: a retrospective clinical study","authors":"Sami Kaan Coşarcan, A. T. Doğan, M. Kılıç, Ö. Erçelen","doi":"10.33719/yud.2022;17-3-1141735","DOIUrl":"https://doi.org/10.33719/yud.2022;17-3-1141735","url":null,"abstract":"Objective: The advantages of robot-assisted surgery include shorter incisions, less postoperative pain, perioperative blood loss, and a faster return to daily functions. Thoracic epidural analgesia (TEA) provides highly satisfactory analgesia in abdominal surgery. However, its hypotensive effect, particularly in minimally invasive procedures, exceeds its contribution to rapid recovery. Fascial plane blocks may be more beneficial in that context. This study evaluated the effects of regional analgesia techniques in robotic prostatectomy, nephrectomy, and cystectomy operations. Material and Methods: Following IRB Ethics Committee approval (2021.467.IRB1.134), the records of patients who had undergone robotic prostatectomy, nephrectomy, and cystectomy surgeries were retrospectively reviewed between January 2018 and January 2022. Results: One hundred and forty patients with full documentation were included in this study. Various regional analgesia methods were used. Fascial plane blocks were seen to be used in addition to epidural analgesia. Transversus abdominis plane (TAP) and rectus sheath blocks exhibited satisfactory results in robotic prostate surgeries and TAP blocks in robotic nephrectomy operations. Conclusion: In robotic prostatectomy and nephrectomy operations, we recommend fascial plane blocks as the first-choice method for postoperative analgesia. Keywords: regional anesthesia, robotic surgery, radical prostatectomy, minimally invasive surgery, fascial plane blocks, recovery after surgery","PeriodicalId":33828,"journal":{"name":"Yeni Uroloji Dergisi","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47466512","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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