Objective: This study aimed to evaluate the impact of obesity on the outcomes of supine percutaneous nephrolithotomy (PCNL) in a tertiary care center. Understanding surgical outcomes in obese patients, given their rising prevalence and urolithiasis risk, is crucial for optimizing treatment strategies. Materials and Methods: This retrospective study included data from 256 patients aged 18 and older who underwent PCNL in the Galdakao-Valdivia position between July 2021 and July 2024 at a tertiary care hospital. Patients were categorized into three groups based on their body mass index (BMI): normal weight (BMI: 18-24.9 kg/m²), overweight (BMI: 25-29.9 kg/m²), and obese (BMI: 30-34.9 kg/m²). Demographic data, stone characteristics, operative time, fluoroscopy time, hospital stay, nephrostomy duration, stone-free rates (SFR), and complications were analyzed and compared across the three groups. Results: There was no significant difference between the groups regarding age, sex, stone laterality, location, or size (p>0.05). Median BMI values were significantly different between the groups (p0.05). No significant differences were found in operative time, fluoroscopy time, hospital stay, or nephrostomy time among the groups (p>0.05). Minor and major complication rates were similar across all groups (p>0.05). Conclusion: Obesity does not appear to significantly impact the outcomes of supine PCNL, including operative time, stone-free rates, or complication rates. These findings suggest that with experienced surgeons, supine PCNL is a safe and effective treatment option for obese patients, though further prospective studies are needed to confirm these results.

Background and Objectives: In the surgical treatment of benign prostatic hyperplasia (BPH), laser enucleation of the prostate is recommended as an alternative to transurethral resection (TURP) and open prostatectomy (OP). The thulium fiber laser, with its superficial penetration depth, can offer a rapid learning process by causing less heat injury and capsule damage. This study compares the first 60 cases of an endourologist performing thulium fiber enucleation of the prostate (ThuFLEP) without a mentor to the results of OP and TURP performed by experienced surgeons. It also identifies the case number at which the operation time for ThuFLEP starts to plateau. Materials and Methods: Between 1 November 2021 and 1 November 2023, the initial 60 ThuFLEP cases of an endourologist with no prior enucleation experience were compared with TURP and OP operations performed by experienced surgeons. Since the first 60 ThuFLEP cases involved 80–120 cc prostates, TURP and OP operations within this size range performed during the same period were included in the study. The groups were assessed for age, preoperative and postoperative prostate volume, PSA levels, the IPSS, the IPSS Quality of Life (QoL), and maximum urinary flow (Q_max). The 60 consecutive ThuFLEP cases were divided into three groups of 20 (Groups 1, 2, and 3) and compared for operation time, IPSS, and Q_max. Results: The operation time for TURP was shorter than for ThuFLEP and OP (p < 0.001). There was no significant difference between ThuFLEP and OP in postoperative Q_max and IPSS, while TURP had lower values than the other two methods. For ThuFLEP, the operation time was longer in the first 20 cases but plateaued in groups 2 and 3 (p < 0.001). Postoperative Q_max and IPSS values showed no significant differences among the three ThuFLEP groups (p > 0.05). Conclusions: For large prostates, ThuFLEP provides better postoperative results than TURP and offers shorter catheterization and hospital stay times than OP. Its short learning curve makes it a preferable method for treating BPH compared to other laser techniques.

Impact of Positive Surgical Margins on Renal Cell Carcinoma Recurrence - Bulletin of Urooncology

Aim: The aim of this study was to investigate the factors affecting treatment success in children that got either pyeloplasty or J stent placement in ureteropelvic junction obstruction (UPJO). Patients and Methods: The study... | Find, read and cite all the research you need on Tech Science Press

Üretral darlıkların cerrahi tedavisinde kullanılan üretroplasti, özellikle uzun segmentli veya tekrarlayan darlıklarda etkili sonuçlar vermektedir. Cerrahi başarının sadece teknik beceriyle değil, postoperatif bakımın kalitesiyle de ilişkili olduğu vurgulanmaktadır. Bu bağlamda, üretroplasti sonrası dönemde uygulanacak standart hasta bakım protokolleri; kateter yönetimi, ağrı ve enfeksiyon kontrolü, mobilizasyon, beslenme, psikososyal destek ve izlem gibi alanlarda yapılandırılmıştır. Kateter süresi cerrahi tekniğe göre belirlenmeli; hasta kateterle mobilizasyon ve hijyen açısından eğitilmelidir. Ağrı genellikle basit analjeziklerle kontrol edilebilirken, enfeksiyonların önlenmesi için kısa süreli antibiyotik profilaksisi önerilmektedir. Oral mukoza grefti uygulanan hastalarda özel ağız bakım protokolleri ve beslenme düzeni iyileşme açısından kritik önemdedir. Ayrıca, fiziksel aktivite kısıtlamaları, kabızlığın önlenmesi ve ağız egzersizleri de dikkate alınmalıdır. Psikososyal destek, özellikle genç hastalarda tedaviye uyumu artırabilir. Kateterin çıkarılmasından sonra işeme takibi yapılmalı, gerektiğinde görüntüleme ve endoskopik değerlendirme uygulanmalıdır. Geç komplikasyonlar arasında nüks darlık, fistül, hematom ve erektil disfonksiyon sayılmakta olup, erken tanı ve uygun müdahale önemlidir. Sonuç olarak, üretroplasti sonrası bireyselleştirilmiş ve disiplinler arası planlanan postoperatif bakım, cerrahi başarının sürdürülmesi ve hasta memnuniyetinin artırılması açısından elzemdir.