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    Effect of the Anesthetic Method on the Outcomes of Ureteroscopy for Proximal Ureteral Stones: A Multi-center Study of the Society of Urological Surgery Aegean Study Group
    (Galenos Yayincilik, 2018) Kizilay, Fuat; Irer, Bora; Sen, Volkan; Erbatu, Oguzcan; Ongun, Sakir; Yildiz, Alperen; Cinar, Onder
    Objective: To analyze the effect of the anesthesia method (spinal and general) on the outcome of ureteroscopy (URS) in patients treated for proximal ureteral stones. Materials and Methods: Patients, who underwent URS for proximal ureteral stones at various urology clinics in Turkiye, were included in the study. The patients were divided into two groups according to the anesthesia method performed; the procedure was performed under spinal anesthesia (SA) in group 1 and general anesthesia (GA) in group 2. Patients' demographic, perioperative data and complication rates were compared between the two groups in a retrospective manner. Results: There were 309 and 329 patients in groups 1 and 2, respectively. The mean stone area and Hounsfield unit in GA group were higher (p<0.001 and p=0.007, respectively). In the GA group, the need for double J stent was more frequent (p<0.001). In the SA group, the rate of push-back of stone into the collecting system was higher (13=0.017). According to the Clavien classification system and the others, complication rates were similar between the two groups (p>0.05). The rate of success of URS, which is accepted as complete stone-free status, was higher in the SA group (p=0.041). Conclusion: URS, which is used in the treatment of proximal ureteral stones, has a high success rate, independent of the anesthesia method used. It is important to keep in mind the patient's comorbidities prior to selecting the anesthesia method and that the stone area and the Hounsfield unit are the important factors affecting the outcomes.
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    Mechanisms and grading of nocturia: Results from a multicentre prospective study
    (Wiley, 2021) Bozkurt, Ozan; Irer, Bora; Kizilay, Fuat; Erbatu, Oguzcan; Sen, Volkan; Cinar, Onder; Ongun, Sakir
    Objective To identify the pathophysiological mechanisms of nocturia and the correlation of these mechanisms with nocturia severity. Methodology After approval by the local ethics committee, all patients with nocturia (>= 1 nocturnal void/night) were included and filled the Overactive Bladder questionnaire, Nocturia Quality of Life, Incontinence Questionnaire - Male Lower Urinary Tract Symptoms (male), International Consultation on Incontinence Questionnaire - Female Lower Urinary Tract Symptoms (female) and 3-day frequency-volume chart. Patients were divided into three groups according to the severity of nocturia: group 1 consisted of patients with mild (1-2 voids/night), group 2 with moderate (3-4 voids/night) and group 3 with severe nocturia (>4 voids/night). Comparative analysis was performed between groups, andP About 68.1%, 64.1% and 8.7% of the patients had nocturnal polyuria (NP), reduced bladder capacity and global polyuria, respectively. 42.7% of the patients had mixed nocturia. 6.1% of the patients did not comply with the aforementioned subtypes and defined as isolated nocturia. Regarding the severity of nocturia, 155 (41%) patients had mild, 167 (45%) patients had moderate and 57 (15%) patients had severe nocturia. Increased nocturia severity was related with decreased quality of life; higher age, urinary tract symptom scores, nocturnal urine volume, evening fluid consumption and beta-blocker medication rates. Increased nocturia severity was also associated with higher NP, global polyuria and reduced bladder capacity rates. Conclusions Nocturia mechanisms may vary between mild and moderate to severe nocturia groups according to the present study. Nocturia grading with identification of subtypes may help for better standardisation of the diagnostic and treatment approaches as well as for the design of future clinical trials.