Fleksibl üreterorenoskopi ile kronik unilateral hematürinin tanı ve tedavisi

Amaç: Kronik unilateral hematüri intermittant veya devamlı olarak makroskopik hematüri ile karekterizedir ve standart görüntüleme yöntemleri, idrar sitolojisi yada hematolojik testler ile tanı konamaz. Sistoskopide unilateral hematürik idrar jeti görülür. Bu çalışmada kronik unilateral hematüri tanı ve tedavisinde fleksibl üreterorenoskopi ile Holmiyum lazerin etkinliği araştırılmıştır.Gereç ve yöntemler: Radyolojik görüntüleme yöntemleri, idrar sitolojisi ve hematolojik testleri normal olan ve sistoskopide unilateral hematüri saptanarak fleksibl üreterorenoskopi yapılan yaş ortalaması 29.2 olan 4 hastanın verileri retrospektif olarak değerlendirildi.Bulgular: Hastaların tümünde bütün kalikslere ulaşılarak kanama odağı bulundu ve Holmiyum lazer ile hemostaz uygulandı. Tüm hastalarda makroskopik hematüri kesildi. Ortalama 3.2 ay takip edilen hastalarda makroskopik hematürik nüks görülmedi.Sonuç: Kronik unilateral hematürinin tanı ve tedavisinde fleksibl üreterorenoskopi ile Holmiyum lazer etkin bir yöntem olup ilk seçenek olarak düşünülmelidir.

Anahtar Kelimeler:

böbrek, hematüri, lazer, üreterorenoskopi

Flexible ureterorenoscopy in the diagnosis and treatment of chronic unilateral hematuria

Aim: Chronic unilateral hematuria is characterized by intermittent or persistent macroscopic hematuria and can not be diagnosed with standart imaging modalities, urine cytology or hematologic tests. On cystoscopic examination unilateral hematuric urine jet is seen. In this study, the effectivity of flexible ureterorenoscopy with Holmium laser in the diagnosis and treatment of chronic unilateral hematuria was evaluated.Material and methods: The data of 4 patients with a mean age of 29.2 years who underwent flexible ureterorenoscopy with normal radiological imaging, urine cytology and hematological tests and unilateral hematuria on cystoscopy were evaluated retrospectively.Results: In all patients, entire caliceal system was reached and bleeding focus was hemostated with Holmium YAG laser. Hematuria disappeared in all patients. No macroscopic hematuric recurrence was revealed in the mean 3.2 months follow-up.Conclusion: Flexible ureterorenoscopy is an effective method in the diagnosis and treatment of the chronic unilateral hematuria and should be concerned as a procedure of first choice.

Keywords:

kidney, hematuria, lasers, ureterorenoscopy,

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