Bilateral single-session retrograde intrarenal surgery for the treatment of bilateral renal stones

Atis, G. | Koyuncu, H. | Gurbuz, C. | Yencilek, F. | Arikan, O. | Caskurlu, T.

Article | 2013 | International Braz J Urol39 ( 3 ) , pp.387 - 392

The aim of the study was to evaluate the efficacy and safety of bilateral single- -session retrograde intrarenal surgery in the treatment of bilateral renal stones. Materials and Methods: From December 2008 to February 2012, 42 patients who had undergone bilateral single-session retrograde intrarenal surgery (RIRS) and laser lithotripsy were included in the study. The procedures were performed in the lithotomy position on an endoscopy table under general anesthesia, beginning on the side in which the stone size was smaller. Plain abdominal radiography, intravenous urograms (IVU), renal ultrasonography (USG) and/or non-contrast tomog . . .raphy (CT) scans were conducted for all patients. The success rate was defined as patients who were stone-free or only had residual fragment less than 4 mm. A total of 42 patients (28 male, 14 female) with a mean age 39.2 ± 14.2 were included in the present study. The mean stone size was 24.09 ± 6.37 mm with a mean operative time of 51.08 ± 15.22 minutes. The stone-free rates (SFR) were 92.8% and 97.6% after the first and second procedures, respectively. The average hospital stay was 1.37 ± 0.72 days. In two patients (4.7%), minor complications (Clavien I or II) were observed, whereas no major complications (Clavien III-V) or blood transfusions were noted in the studied group. Bilateral single-session RIRS and laser lithotripsy can be performed safely and effectively with a high success rate and low complication rate in patients with bilateral renal stones Daha fazlası Daha az

Effect of morphine on lower urinary tract discomfort after transurethral resection of prostate under general anesthesia: A randomised clinical study

Menda, F. | Temur, S. | Bilgen, S. | Yencilek, F. | Koyuncu, H. | Sancar, N. | Koner, O.

Article | 2013 | Journal of Anesthesia27 ( 5 ) , pp.720 - 724

Background: Lower urinary tract (LUT) discomfort is a common complaint after transurethral resection of the prostate (TURP), and it may lead to agitation and restlessnes. We have evaluated the efficacy of morphine for preventing TURP-related LUT discomfort symptoms. Methods: This was a prospective randomised study including 60 patients (American Society of Anesthesiologists class I and II) who were scheduled to undergo TURP. The patients were divided into two equally sized groups (group M: morphine, group C: control). A standartized anesthesia method was used. Group M patients received morphine 0.04 mg/kg intravenous (iv) in 100 ml . . .of normal saline followed by an infusion of morphine for 24 h (0.01 mg/kg/h); group C patients received 100 ml normal saline 20 min before the expected extubation time, followed by a normal saline infusion which looked identical to that of the morphine infusion. The incidences and severity of LUT discomfort, postoperative pain, sedation level, postoperative nausea and vomiting (PONV) and respiratory depression were recorded at 0, 1, 2, 6, 12 and 24 h postoperatively. Results: The incidence of LUT discomfort was lower in group M patients at all time points during the study (p < 0.05) except for 2 h postoperatively, and the severity of LUT discomfort was also lower this group at 0, 12 and 24 h postoperatively (p = 0.001, p = 0.04 and p = 0.02, respectively). Pain (numeric rating scale) scores were lower in group M patients at 0 (p = 0.003) and 6 h (p < 0.001). The need for rescue analgesic was lower in group M patients (19 patients in group C, 10 patients in group M; p = 0.04). The incidence of PONV was higher in group M patients (p = 0.03). The incidence of pruritus, respiratory depression and over-sedation were similar among the groups. Conclusion: Based on these results, we conclude that morphine effectively reduces LUT discomfort after TURP at a cost of postoperative nausea and vomiting. © 2013 Japanese Society of Anesthesiologists Daha fazlası Daha az

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