Objective: To evaluate the efficacy and complications of mini-percutaneous nephrolithotomy (PCNL) surgery using 14-20 Fr access sheaths in pediatric patients, as well as the results of postoperative stone analysis and metabolic urine analysis. Material and methods: We retrospectively evaluated the records of 206 pediatric patients (232 kidney units) who underwent mini-PCNL for kidney stones in our clinic between February 2011 and December 2018. We evaluated the demographic characteristics, complications, stone-free rates, and the results of chemical analysis and urinary metabolic analysis. Results: The age ranged from 9 months to 16 years. The mean age was 5.1±3.9 years, and the median age was 3.5 years. The median stone burden was 200 mm2 (min: 100; max: 1600). Kidney stones were most commonly located in the pelvis in 118 (50.9%) patients, followed by lower calyceal stones in 42 (18.1%) and multiple calyceal stones in 38 (16.4%) patients, respectively. While the success of mini-PCNL was 80.6% after the first session, this rate increased to 87.9% after auxiliary treatments. The total complication rate was 12.9% according to modified Clavien classification. A postoperative stone analysis showed that calcium oxalate had the highest frequency with 61.1% of patients, followed by cystine stone with 21.3% of patients. Metabolic urine analysis revealed no abnormalities in 42.8% of patients. The most common metabolic abnormality was hyperoxaluria (32%), followed by hypercalcuria (19.6%). Conclusion: Mini-PCNL is a safe and effective procedure with reasonable complications for the treatment of pediatric kidney stones. All kinds of multidisciplinary efforts are required to remove kidney stones completely in pediatric patients. Cite this article as: Baydilli N, Tosun H, Akınsal EC, Gölbaşı A, Yel S, Demirci D. Effectiveness and complications of mini-percutaneous nephrolithotomy in children: one center experience with 232 kidney units. Turk J Urol 2020; 46(1): 69-75.

Persistent urinary incontinence (UI) in adults may indicate a congenital anomaly. Before initiating medical treatment in these patients, a detailed physical examination is necessary for establishing an accurate diagnosis. In this study, we report on a patient who presented with the complaint of congenital UI associated with ectopic ureter and was detected with a right complete duplex collecting system and a ureter opening into the vulva and the surgical treatment applied to that patient.

Pheochromocytomas are tumors of the embryonic chromaffin cells, originating from the embryonic neural crest. The pheochromocytomas developing at extra-adrenal locations are termed paragangliomas, which are extremely rare and account for almost 0.06% of all bladder tumors. In this report, we present a 23-year-old woman who presented with a one-year history of repeated episodes of dizziness, hypertension, intermittent hematuria, and nausea/vomiting that occurred during urination and was operatively treated due to a diagnosis of paraganglioma of the urinary bladder.

It has been more than a decade since fusion prostate biopsy (FPB) has been used in the diagnosis of prostate cancer (PCa). Therefore, patients with a previous history of negative FPB and ongoing suspicion of PCa are beginning to emerge. This study investigated whether the first biopsy type (standard or fusion) should be effective in deciding on a second biopsy. Male patients aged 40–75, with a serum prostate-specific antigen (PSA) value of less than 10 ng/mL and a negative biopsy history within the last 24 months, who underwent FPB in our clinic due to persistent PSA elevation and/or suspicious multiparametric prostate magnetic resonance imaging (MpMRI) findings were included to the study. Patients were divided into groups according to the type of first biopsy (Group 1; those whose first biopsy was FPB, Group 2; those whose first biopsy was standard prostate biopsy). Some demographic and clinical data of the groups, as well as PCa detection rates, were compared. A p value of less than 0.05 was considered statistically significant. A total of 275 patients (Group 1: 84, Group 2: 191) were included in this study. The groups were similar in terms of age, PSA values before the first biopsy, PSA values before the second biopsy, family history of PCa, and prostate volume. PCa was detected at a higher rate in Group 2 than Group 1 (23% vs 15.5%, p = 0.044). The data obtained from this study indicate that the type of initial biopsy should be taken into account when deciding on FPB in secondary patients with a previous negative biopsy history.

Aim: This study aimed to present the short- and long-term results of Demirtas two-step treatment model in patients with obstructed-hydronephrotic kidneys functioning below 10%, and before deciding on nephrectomy, to evaluate whether this method can contribute to the accurate assessment. Material and methods: This prospective study included patients with unilateral renal obstruction and renal parenchymal loss assessed by computed tomography and whose renal function was found to be below 10% in Tc-99m-dimercaptosuccinic acid. In the first step, percutaneous nephrostomy (PCN) was performed. Two weeks later, the second step was performed, in which patients were offered nephrectomy (if renal function was <10%) or etiology-based treatment (if renal function was ≥10%). Results: Thirty-eight patients were included in the study, comprising 20 (52.6%) men and 18 (47.4%) women with a mean age of 51.3±16.8 years. Mean baseline renal function was 6.0%, which increased to 10.8% two weeks after PCN (p=0.001). Renal function increased to above 10% in 20 (52.6%) out of 38 patients. Of these, 17 patients underwent etiology-based treatment and baseline, two-week, and 12-month renal function levels were 7.0%, 17.5%, and 18.8%, respectively (p<0.001). Conclusion: Demirtas two-step treatment model introduced in the present study can be recommended as a standard treatment modality in unilaterally obstructed kidneys functioning below 10% ability.