Clinical course of pediatric urolithiasis: Follow-up data in a long-term basis

Koyuncu, H. | Yencilek, F. | Erturhan, S. | Eryildirım, B. | Sarica, K.

Article | 2011 | International Urology and Nephrology43 ( 1 ) , pp.7 - 13

Objective: To evaluate the natural course of the stone disease in pediatric patients from different perspectives among which the spontaneous passage and stone recurrence rates evaluated during the follow-up. Materials and methods: A total of 142 children referring with primary urinary stone disease were evaluated and followed. All children in the study were divided into two groups with respect to the age (Group 1: 0-5 years and Group 2: 6-15 years). Children were followed with respect to spontaneous passage rates, recurrence-regrowth rates, physical as well as the renal growth rates. Results: Stone recurrence has been noted in 44% o . . .f patients in group 1, this value was 31% in group 2. Children with at least one identifiable metabolic abnormality tended to have higher recurrence rates than the others despite conservative measures. The average stone recurrence rate in children without any metabolic abnormality was 14% and nearly 50% in children with an identifiable metabolic abnormality. Conclusions: We may emphasize that due to the high recurrence and re-growth rates, all children with urinary stone disease should be followed closely with regular visits. The evaluation of metabolic risk factors in children with renal stone disease is the basis of medical treatment aimed at preventing recurrent stone events and the growth of pre-existing calculi. © 2010 Springer Science+Business Media, B.V Daha fazlası Daha az

The effect of indomethacin on hyperoxaluria-induced renal tubular epithelial injury

Yencilek, F. | Erturhan, S. | Cangüven, Ö. | Erol, B. | Koyuncu, H. | Göktaş, C. | Sarica, K.

Article | 2009 | Turk Uroloji Dergisi35 ( 4 ) , pp.298 - 303

Objective: The aim of this study was to determine the effect of indomethacin, an anti-inflammatory agent, on apoptosis and crystal deposition developing as a consequence of tubular cell injury induced by hyperoxaluria in an animal model. Materials and methods: Fifty New Zealand rabbits were divided into 3 groups. The first 2 groups were fed with hyperoxaluric diet and Group 3 was the control group with no supplementary procedure or treatment. While the animals in Group 1 were given only hyperoxaluric diet, Group 2 animals was applied indomethacin in addition to the hyperoxaluric diet. Animals were sacrificed at the early (7th day) a . . .nd late (28th day) periods and renal tis-sue specimens were sent for the pathological analysis of crystal deposition and apoptosis. Results: The presence and degree of crystal deposition were significantly less in the specimens obtained from indomethacin-treated group during both the early and late periods ( Daha fazlası Daha az

Does tamsulosin change the management of proximally located ureteral stones?

Yencilek, F. | Erturhan, S. | Canguven, O. | Koyuncu, H. | Erol, B. | Sarica, K.

Article | 2010 | Urological Research38 ( 3 ) , pp.195 - 199

The objective of this study is to assess the efficacy of an alpha-1 adrenergic receptor blocking agent on the spontaneous passage of proximal ureteral calculi ?10 mm. 92 patients having single radio-opaque proximal ureteral stone ?10 mm were randomized into two groups. Group 1 patients (n = 50) were followed with classical conservative approach and patients in Group 2 (n = 42) additionally received tamsulosin, 0.4 mg/day during 4 weeks follow-up. The stone passage rates, stone expulsion time, VAS score, change in colic episodes, and hospital re-admission rates for colicky pain were compared. The patients were furthermore stratified . . .according to stone diameters Daha fazlası Daha az

Hyperoxaluria-induced tubular ischemia: The effect of verapamil on the limitation of tissue HIF-1 alpha levels in renal parenchyma

Yencilek, F. | Sarica, K. | Eryildirim, B. | Erturhan, S. | Karakok, M. | Kuyumcuoglu, U.

Article | 2010 | International Urology and Nephrology42 ( 2 ) , pp.361 - 367

Objectives The effect of verapamil on tubular ischemia that is demonstrated by HIF-1a positivity in tubular cells following hyperoxaluria was evaluated in a rabbit model. Methods Thirty-six healthy male rabbits were randomly divided into three groups. Animals in the hyperoxaluric group were fed with 0.75% ethylene glycol. The verapamil group was fed identically to the hyperoxaluric group. Additionally, the verapamil group received verapamil orally (0.1 mg/kg). The control group received no special diet. Six animals in each group were killed on the 7th day of the experiment and the remaining six at the 28th day. Kidneys of the rabbit . . .s were examined by histopathologic and immunohistochemical analysis to detect the presence and degree of HIF-1a positivity. Results On the 7th day analysis, severe and moderate degree staining for HIF-1a in hyperoxaluric group were shown in four and two, respectively. In the verapamil group, however, three of six specimens showed nuclear staining (moderate in two and severe in one). Two of six specimens in the control group had minimal staining. The 28th day evaluation showed that two of the hyperoxaluric group had minimal degree nuclear staining but not in the remaining four. No staining was shown in the verapamil and control group animals. Conclusions Hyperoxaluria-related ischemia formation may be responsible for subsequent alterations in renal tubules. As a protective agent, verapamil was found to limit the presence of hypoxic changes as documented by HIF-1 alpha positivity in this study. These data also support the presence ischemic insult after hyperoxaluria induction in animal model. © Springer Science+Business Media, B.V. 2009 Daha fazlası Daha az

Treatment of ureteral calculi with semirigid ureteroscopy: Where should we stop?

Yencilek, F. | Sarica, K. | Erturhan, S. | Yagci, F. | Erbagci, A.

Article | 2010 | Urologia Internationalis84 ( 3 ) , pp.260 - 264

Objectives: To evaluate the efficacy of semirigid ureteroscopy in the management of ureteral stones located in different parts of the ureter. Methods: 1,503 patients were treated with semirigid ureteroscopy. All ureteral stones were either removed only by a basket catheter or disintegrated by pneumatic lithotripsy. Success rates, auxiliary procedures, complication rates and operation time were comparatively evaluated according to stone location. Results: Overall, mean stone size and age were 12.1 ± 3.7 mm and 43.2 ± 9.72 years, respectively. While 1,416 patients (94.2%) were completely stone-free, the procedure was unsuccessful in 8 . . .7 cases (5.8%). The success rate was relatively low in the proximal ureter (71.7%) when compared with the mid (94.8%) and distal ureter (98.9%) (p = 0.021). Mean operation time was 25.4 ± 11.7 min. Longer duration of operation and higher complication rate were found in proximal ureteral calculi. Stone migration to the kidney and hematuria were the main reasons of failure in the proximal ureter and ureteral stenting was needed for 56.4% of patients with upper ureteral stone. Conclusions: Semirigid ureteroscopy can be the treatment of choice in lower and midureteral stones. However, it is an invasive and less successful treatment modality for proximal ureteral stones with relatively high complication rates. © 2010 S. Karger AG, Basel Daha fazlası Daha az

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