Muhammed Arif İbiş, Adem Sancı, Muammer Babayiğit, Eralp Kubilay, Khaled Obaid, Mehmet İlker Gökçe, Çağatay Göğüş, Yaşar Bedük

Birden Fazla Taşı Olan Hastalarda İki Taraflı Aynı Seans Üreteroskopi: Güvenli ve Etkili Bir Alternatif midir?

Amaç: Çalışmamızın amacı, bilateral üreter taşı olgularında eş zamanlı bilateral aynı seans üreteroskopi (BSSU) yapılan hastaların sonuçlarını değerlendirmektir. Gereç ve Yöntem: Mart 2014-Ağustos 2018 tarihleri arasında kurumumuzda üreteroskopi yapılan 721 hastanın verileri retrospektif olarak incelendi. Toplam 46 olguya (%6,4) BSSU uygulandığı görüldü. Hasta ve taş özellikleri, taşsızlık oranı ve komplikasyon oranları kaydedildi. Değişkenler taşsızlık sağlanan ve sağlanamayan hasta grupları arasında karşılaştırıldı. Bulgular: Otuz altı (%78,2) hastada ilk seanstan sonra tam taşsızlık sağlandı ve toplam taşsızlık oranı %95,7 (44/46) idi. Hastaların 18’inde en az bir tarafında empakte taş vardı. Başarısız olgularda empakte taş oranı istatistiksel olarak daha yüksekti (p=0,033). Hastaların 40’ına postoperatif bilateral JJ stent yerleştirilirken, 6 hastada JJ stent tek taraflı yerleştirildi. Toplamda 6 (%13) hastada komplikasyonlar görüldü. Bu komplikasyonların tümü düşük dereceli olup, 3 hastada ateş, 3 hastada kateterizasyonun uzamasına neden olan hematüri vardı. Hastaların ortanca hastanede kalış süresi 1 (1-6) gündü. Sonuç: Bilateral üreter taşı olan olgularda aynı seansta bilateral üreteroskopi yapılması düşük komplikasyon ve yüksek başarı oranları ile etkili ve güvenli bir alternatiftir. Ancak JJ kateteri yerleştirme olasılığının daha yüksek olduğu ve özellikle empakte taş olgularında ek müdahale gerekebileceği konusunda hastalar bilgilendirilmelidir.

Bilateral Same Session Ureteroscopy in Patients with Multiple Stones: Is It a Safe and Effective Alternative?

Objectives: The aim of our study was to evaluate the results of patients who underwent simultaneous bilateral same session ureteroscopy (BSSU) in cases of bilateral ureteral stones. Materials and Methods:The medical records of 721 patients who underwent ureteroscopy at our institution, between March 2014 and August 2018, were reviewed retrospectively. BSSU was performed in 46 cases (6.4%) in total. Patient and stone characteristics, stone-free rate, and complication rates were recorded eventually. Variables were compared between successful and unsuccessful cases. Results: Complete stone-free was achieved in 36 (78.2%) patients after the first session and the overall SFR was 95.7% (44/46). In 18 of the patients, at least one of the two sides had an impacted stone. The rate of stone impaction was statistically higher in unsuccessful cases (p=0.033). While postoperative bilateral JJ stent was placed in 40 of the patients, it was unilateral in 6 patients. Complications were encountered in 6 patients in total (13%). All of these complications were low grade, and 3 patients had fever and 3 patients had hematuria causing prolonged catheterization. The median hospital stay of patients was 1 (1-6) day. Conclusion: Performing BSSU in the same session in cases with bilateral ureteral stones is an effective and safe alternative with low complication and high success rates. However, patients should be informed that the possibility of inserting a JJ catheter is higher and that additional intervention may be required, especially in cases with impacted stones.

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