Study demonstrated that antibiotic resistance in the treatment of uncomplicated urinary tract infections varies by geographical region. We believe this comprehensive, national prospective study will provide valuable insights for clinicians planning empirical treatment for uncomplicated urinary tract infections.

Perkütan nefrolitotomi (PNL), böbrek taşlarının çıkarılması için önemli bir yaklaşımdır. Perkütan nefrostomi drenaj tüpü yerleştirilmesi, PNL ameliyatı sonrası ekstravazasyonu önlemek ve hemostazı sağlama amacıyla yapılır. Bu vakada da tek taraflı PNL ameliyatı sonrasında hemostaz sağlama amacıyla takılan inferior vena kavaya uzanan nefrostomi tüpünün başarılı şekilde konservatif olarak çekilmesini bildireceğiz. Bizim vakamızda olduğu gibi bazen, kateter böbrek parankimini perfore edebilir ve renal vene hatta vena kavaya kadar uzanabilir. Vakamızda nefrostomi tüpü inferior vena cava (İVC) içerisinde yer almaktaydı. Kontrol altına alamadığımız olası masif kanama durumunda Kalp Damar Cerrahisi-Girişimsel Radyoloji ekibinin de bulunduğu vakada floroskopi altında katater çekilmesi uygulandı. Hastanın takiplerinde bir sıkıntı izlenmedi ve başarıyla taburcu edildi.

Objective: Symptomatic hydronephrosis occurs in a small subset of pregnancies and may require temporary drainage when conservative management fails. Ureteral Double-J stenting (DJS) is an effective intervention, yet data on maternal and fetal outcomes remain limited. To evaluate maternal and fetal outcomes following DJS placement for symptomatic hydronephrosis during pregnancy and to identify clinical factors associated with stent revision.Material and Methods: This retrospective, single-center cohort was conducted at Kayseri City Hospital, Departments of Urology and Obstetrics & Gynecology (Turkey) between January 2020 and October 2025. Thirty-one pregnant patients who underwent DJS placement for symptomatic hydronephrosis (without obstructive ureteral calculi) were included. Demographic, clinical, and perinatal data were collected from electronic medical records. The primary outcome was a composite adverse perinatal outcome (preterm delivery <37 weeks and/or neonatal intensive care unit [NICU] admission and/or 5-minute Apgar score <7). Secondary outcomes included stent revision and hospital stay. Descriptive statistics and exploratory comparisons were performed.Results: Mean maternal age was 26.2±6.3 years. The mean maximum anteroposterior (AP) diameter was 21.6±8.4 mm, with AP ≥20 mm in 14 patients (45.2%). Stent revision was required in 4 patients (12.9%). Preterm birth occurred in 5 patients (16.2%), NICU admission in 3 patients (9.7%), and mean birth weight was 2884±324 g. Earlier gestational age at stent insertion was significantly associated with stent revision (p=0.017).Conclusion: DJS placement for symptomatic hydronephrosis during pregnancy is generally safe and effective, with favorable maternal and neonatal outcomes. Early gestational stenting may increase revision risk, emphasizing close follow-up, infection surveillance, and timely reassessment of stent function.

Background/Objectives: Micro-percutaneous nephrolithotomy (micro-PCNL) offers direct access to lower pole stones but has limited fragment evacuation. Vacuum-assisted micro-endoscopic combined intrarenal surgery (micro-ECIRS) adds flexible ureteroscopy and suction. We evaluated outcomes after institutional adoption of this technique for symptomatic 1–2 cm lower pole stones. Methods: This retrospective non-concurrent cohort included 81 consecutive adults treated between January 2016 and July 2025 (micro-ECIRS, n = 42; micro-PCNL, n = 39). Only micro-PCNL procedures (n = 33) preceded January 2021. One-month low-dose noncontrast computed tomography (earlier, pre-intervention, in four patients) classified outcomes as Grade A (no residual fragment), Grade B (none >2 mm), or Grade C (none >4 mm; main outcome). Comparisons were unadjusted. Results: Grade C was attained in 90.5% (micro-ECIRS) versus 64.1% (micro-PCNL) (absolute difference 26.4 percentage points, 95% confidence interval [CI] 8.2–43.1; risk ratio [RR] 1.41, 95% CI 1.09–1.82; p = 0.007) and Grade B in 71.4% versus 46.2% (p = 0.025). Grade A did not differ significantly (42.9% vs. 28.2%; p = 0.246). Secondary puncture (4.8% vs. 28.2%) and auxiliary procedures (4.8% vs. 25.6%) were less frequent after micro-ECIRS (both p < 0.05). Complications did not differ significantly (11.9% vs. 30.8%; p = 0.055). Conclusions: In this retrospective, predominantly non-concurrent cohort, institutional adoption of vacuum-assisted micro-ECIRS was associated with higher rates of no residual fragment larger than 2 mm or 4 mm and fewer additional punctures and subsequent procedures. A difference in complete stone clearance was not demonstrated. Treatment–era confounding, baseline imbalance, and complete-case selection prevent causal attribution to the technique.

This study aimed to evaluate the effect of vacuum-assisted access sheath use during mini-percutaneous nephrolithotomy (mini-PCNL) on early postoperative pain intensity and analgesic requirements in the treatment of renal pelvic stones. A total of 150 patients who underwent mini-PCNL for a single renal pelvic stone ≥ 20 mm were retrospectively included. Patients who underwent standard mini-PCNL were classified as Group 1, while those treated with a vacuum-assisted access sheath were assigned to Group 2. Demographic characteristics, perioperative parameters, pain assessed by visual analog scale (VAS), and analgesic requirements were compared between the groups. The two groups were comparable in terms of mean age, body mass index, comorbidity status, ASA scores, degree of hydronephrosis, distance between skin puncture, fluoroscopy time, stone size, and stone density (p > 0.05). Operative time and length of hospital stay were significantly longer in Group 1 (77.97 ± 15.72 min and 3.28 ± 1.56 days, respectively) compared with Group 2 (p < 0.001). The incidence of high-grade fever and urinary tract infections requiring additional antibiotic therapy was significantly higher in Group 1 (p = 0.044 and p = 0.032, respectively). Hemoglobin decrease was also more pronounced in Group 1 (p < 0.001). Postoperative VAS scores were significantly lower in Group 2 than in Group 1 (p < 0.001). The absolute between-group differences in VAS at rest were 1.37 points at 1 h, 1.68 points at 6 h, and 1.81 points at 24 h. For dynamic VAS, the corresponding absolute differences were 2.38, 2.09, and 2.05 points, respectively. Furthermore, the number of patients requiring rescue analgesia was markedly higher in Group 1 (p < 0.001). In addition, Group 1 demonstrated a shorter mean time to rescue analgesia and higher analgesic dosage compared with Group 2 (p = 0.002 and p = 0.019, respectively). In multivariate analysis, vacuum-assisted access sheath use remained an independent predictor of both lower postoperative pain scores and reduced analgesic requirement, with an approximately 90% reduction in the odds of rescue analgesia use after adjustment for operative time and intraoperative remifentanil consumption. Vacuum-assisted access sheath use was associated with lower early postoperative pain scores and reduced analgesic requirements; however, prospective controlled studies are needed to confirm these findings.