Person: KILIÇARSLAN, HAKAN
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KILIÇARSLAN
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HAKAN
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Publication A cut-off value for the operation time and other risk factors in terms of the infection risk for flexible ureterorenoscopy(Wiley, 2020-12-01) Demir, Aslan; Celen, Sinan; Gunseren, Kadir Omur; GÜNSEREN, KADİR ÖMÜR; Cicek, Mehmet Cagatay; ÇİÇEK, MEHMET ÇAĞATAY; Kilicarslan, Hakan; KILIÇARSLAN, HAKAN; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Üroloji Anabilim Dalı.; 0000-0001-8673-3093; 0000-0002-0471-5404; AAO-8934-2021; ABC-9924-2020Objectives To investigate the operation time (OT) and ureteral access sheath (UAS) usage with the infection rates and to determine a cut-off value for OT.Methods We retrospectively analysed the data of the patients who underwent flexible ureterorenoscopy (FURS) for renal stones larger than 20 mm between 2010 and 2019. The investigated parameters were OT, UAS using, and infection status. The data were analysed by forming two groups according to whether the OT was less than 60 minutes and more, whether the UAS was used and whether an infection occurred. In addition, independent risk factors that may affect postoperative urinary infection development were also investigated by logistic regression analysis. And, a Receiver Operating Characteristic (ROC) curve analysis was applied to determine a cut-off value in OT terms, where infection rates increase more.Results A total of 575 patients were enrolled in the study. The rates of the usage of UAS and infection were greater statistically in the group for longer than 60 minutes. OT was longer statistically in the infection group than in the group without infection (94.1 +/- 14.2 and 68.01 +/- 23.1, for groups 1 and 2, respectively, P < .05, Table 2). OT was statistically longer in the UAS group than the unused one (79.3 +/- 24.4 and 66.7 +/- 22.4, for groups 1 and 2, respectively, P < .05, Table 3). ROC analyses revealed a cut-off point of 87.5 min for OT in terms of infection rate.Conclusion While the infection risk increases when OT exceeds 60 minutes, FURS can be safely performed up to 87.5 minutes with 89% sensitivity and 69% specificity infection risk.Publication Comparison of laparoscopic pyelolithotomy and retrograde intrarenal surgery in the management of large renal pelvic stones(Wiley, 2021-03-02) Çiçek, Mehmet Çağatay; Asi, Tariq; Günseren, Kadir Ömür; Kılıçarslan, Hakan; ÇİÇEK, MEHMET ÇAĞATAY; GÜNSEREN, KADİR ÖMÜR; KILIÇARSLAN, HAKAN; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Üroloji Anabilim Dalı; 0000-0002-0471-5404; 0000-0001-8673-3093; ABC-9924-2020; HGM-5995-2022; FGY-3115-2022Background To compare the clinical outcomes of laparoscopic pyelolithotomy (LP) and retrograde intrarenal surgery (RIRS) in the management of large renal pelvic stones.Patients and methods This study included patients who presented with a single renal pelvic stone sized >= 20 mm and who were treated primarily by LP or RIRS. The patients were grouped based on the surgical procedure they underwent. We retrospectively examined and compared the age, the longest axis, and the surface area of the stone, operation time, hospitalization time, complications, and stone-free rates of the two groups.Results Of the 156 patients included in the study, 44 had LP, and 112 had RIRS. Patients who received LP (13 males, 31 females) had a median age of 54 (18-79) years, while those who underwent RIRS (46 males, 66 females) had a median age of 54.5 (18-79). Patients who received LP were found to have larger median stone size (30 mm vs 24 mm, P = .003), longer operation time (100 minutes vs 70 minutes, P = .007), lower complication rate (2% vs 8.9%, P = .063), longer median hospital stay (3 days vs 1 day, P < .001) and better stone-free rate at the third month (90.9% vs 67.9%, P < .001).Conclusion LP is a safe and efficient procedure that could be used as an alternative to RIRS in managing large renal pelvic stones.Publication Which frequency is better for pediatric shock wave lithotripsy? Intermediate or low: A prospective randomized study(Springer, 2021-04-22) Kaygısız, Onur; Çiçek, Mehmet Çağatay; Mert, Ahmet; Akesen, Selcan; Sarandöl, Emre; Kılıçarslan, Hakan; KAYGISIZ, ONUR; ÇİÇEK, MEHMET ÇAĞATAY; AKESEN, SELCAN; SARANDÖL, EMRE; KILIÇARSLAN, HAKAN; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Üroloji Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Anesteziyoloji Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Biyokimya Anabilim Dalı.; 0000-0002-9790-7295; 0000-0002-0471-5404; 0000-0003-4236-3646; 0000-0002-2593-7196; L-9439-2019; HGM-5995-2022; ELR-9087-2022; DXM-3644-2022; FGY-3115-2022Purpose Shock wave lithotripsy (SWL) is the first option in the treatment of pediatric kidney stones; however, optimal frequency is still uncertain. The aim of this study was to compare low frequency [60 shocks per minute (SWs/min)] and intermediate frequency [90 SWs/min] in terms of lithotripsy success, complications, cardiac arrhythmia, anesthesia time, secondary procedures, and efficiency quotient (EQ) in children. Methods Seventy-eight consecutive children who received SWL for radiopaque renal stones between July 2016 and January 2020 were randomly divided into two groups: Group 60 (SWL frequency: 60 SWs/min) and Group 90 (SWL frequency: 90 SWs/min). After exclusion (remaining 71 children), Group 60 (n = 38) and Group 90 (n = 33) were compared using univariate analysis. Results The median age of children (37 girls, 34 boys) was 5 (1-16) years. Patient demographics and stone features were similar between the groups. Success rate after the last SWL session was 81.6% (n = 31) for Group 60 and 87.9% (n = 29) for Group 90 (p = 0.527). Stone-free rate after the first, second, and third sessions was 42.1%, 18.4%, and 21.1% for Group 60 and 48.5%, 27.3%, and 12.1% for Group 90, respectively. Additional treatment rate was similar between the groups. In Group 60, the EQ was 57.83, and it was 64.07 in Group 90. Median total anesthesia time was significantly longer in Group 60 (74.5 min) than in Group 90 (32 min; p < 0.001). Conclusion Intermediate frequency and low-frequency pediatric SWL have similar success rates; however, intermediate-frequency SWL has a shorter anesthesia time.Publication 15 and 30 w holmium: Yag laser lithotriptor in ureteroscopic lithotripsy: Which one is more effective and safe?(Mary Ann Liebert, 2021-05-05) Kaygısız, Onur; Aydın, Yavuz Mert; Çicek, Mehmet Çağatay; Çelen, Sinan; Coşkun, Burhan; Kılıçarslan, Hakan; Kaygısız, Onur; KAYGISIZ, ONUR; Aydın, Yavuz Mert; AYDIN, YAVUZ MERT; Çicek, Mehmet Çağatay; ÇİÇEK, MEHMET ÇAĞATAY; Coşkun, Burhan; COŞKUN, BURHAN; Kılıçarslan, Hakan; KILIÇARSLAN, HAKAN; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Üroloji Anabilim Dalı.; 0000-0002-9790-7295; 0000-0002-6287-6767; 0000-0002-0471-5404; 0000-0002-8242-9921; JCO-5169-2023; AFP-3055-2022; L-9439-2019Background: Holmium:yttrium-aluminium-garnet (Ho:YAG) laser lithotripsy with ureteroscopy (URS) was a safe and successful treatment option for pediatric ureteral stones. We aimed to comparatively evaluate the outcomes of 15 and 30 W Ho:YAG laser lithotriptors in pediatric ureter stones.Materials and Methods: We retrospectively evaluated 55 children who underwent ureteroscopic laser lithotripsy to treat ureter stone size up to 15 mm between September 2009 and March 2020. Groups were formed according to the laser lithotriptor power 15 W (Group 15: n = 32), 30 W (Group 30: n = 23). The efficiency of laser lithotriptors was compared between the groups.Results: The age, gender, and stone characteristics (longest stone diameter, density, location and multiple stones) were similar between the groups. In the postop first month, stone-free status was achieved in all cases except one child in Group 15. The median operative time was significantly shorter in Group 30 (40 minutes) than in Group 15 (52.5 minutes) (P = .010). Clavien-Dindo class (CDC) 2 complications occurred in 2 children in both groups (P = .597). Although ureteric stenosis was observed in 1 patient in Group 15, no ureteric stenosis was seen in Group 30 during follow-up (median 16.1 months). Length of hospital stay (LoHS) and stone-free rates were similar between groups.Conclusion: URS with 15 and 30 W Ho:YAG laser lithotriptors is an effective treatment option for pediatric ureteral stones with a high success rate and low complication rates. In brief, 30 W Ho:YAG laser lithotriptors should be preferred over 15 W lithotriptors due to their shorter operative time with similar success rate.Publication Comparison of ureteroscopic laser lithotripsy with laparoscopic ureterolithotomy for large proximal and mid-ureter stones(Karger, 2015-01-01) Kaygısız, Onur; Coşkun, Burhan; Kılıçarslan, Hakan; Kordan, Yakup; Vuruşkan, Hakan; Özmerdiven, Gökhun; Yavacaoğlu, İsmet; KAYGISIZ, ONUR; COŞKUN, BURHAN; KILIÇARSLAN, HAKAN; Kordan, Yakup; VURUŞKAN, HAKAN; Özmerdiven, Gökhun; Yavacaoğlu, İsmet; Uludağ Üniversitesi/Tıp Fakültesi/Üroloji Bölümü; 0000-0002-9790-7295; 0000-0002-8242-9921; 0000-0002-9947-848X; AAH-9704-2021; L-9439-2019; JCO-5169-2023; AAM-9726-2020; JIT-9412-2023; GAF-0095-2022; EFH-9523-2022; JIF-9579-2023; EIN-0828-2022Objectives: To compare the effectiveness and complications of ureteroscopic laser lithotripsy with laparoscopic ureter laparoscopic ureterolithotomy in mid- or proximal portion of large ureteral stones. Material and Methods: We reviewed patients with large (>15 mm) ureteral stone and those who underwent ureteroscopic laser lithotripsy CURS group) or laparoscopic ureterolithotomy (LU group). The first attempt was considered successful in patients who had residual fragments smaller than 2 mm and no conversion of the primary procedure to another. Results: Sixty patients (URS group 29, LU group 31) met inclusion criteria. FURS was used as an adjunctive procedure in one patient for URS group and in two patients for LU group in the same season. LU had a higher success rate and the first-day stone-free rate when compared with URS. Number of procedures was also significantly higher in URS group. There was no difference in stone-free rates at the first and third months, and length of hospitalization and operation were higher in the LU group. Only two patients in the LU group and one patient in the URS group had major complications. Conclusions: Laparoscopy is an effective option of large proximal and mid-ureter stone treatment; however, URS provides similar stone-free rates at three months as a minimal invasive procedure.Publication Factors affecting complication rates of percutaneous nephrolithotomy in children: Results of a multi-institutional retrospective analysis by the Turkish pediatric urology society(Lippincott Williams & Wilkins, 2014-03-01) Önal, Bülent; Doğan, Hasan Serkan; Satar, Nihat; Bilen, Cenk Y.; Güneş, Ali; Özden, Ender; Öztürk, Ahmet; Demirci, Deniz; İstanbulluoğlu, Okan; Gürocak, Serhat; Nazlı, Oktay; Tanrıverdi, Orhan; Kefi, Aykut; Korgalı, Esat; Silay, Mesrur Selçuk; İnci, Kubilay; İzol, Volkan; Altıntaş, Ramazan; Kılıçarslan, Hakan; Sarıkaya, Şaban; Yalçın, Veli; Aygün, Cem; Gevher, Fetullah; Arıdoğan, İbrahim Atilla; Tekgül, Serdar; Doğan, Hasan Serkan; KILIÇARSLAN, HAKAN; Uludağ Üniversitesi/Tıp Fakültesi/Üroloji Anabilim Dalı.; ABH-5513-2020; FGY-3115-2022Purpose: We assessed factors affecting complication rates of percutaneous nephrolithotomy in children.Materials and Methods: We retrospectively evaluated data on 1,205 renal units in 1,157 children treated with percutaneous nephrolithotomy at 16 Turkish centers between 1991 and 2012. Of the patients 28.3% had a history of urolithiasis. Complications were evaluated according to the Satava classification system and modified Clavien grading system. Univariate and multivariate analyses were done to determine predictive factors affecting complication rates.Results: A total of 515 females and 642 males were studied. Mean +/- SD patient age was 8.8 +/- 4.7 years (range 4 months to 17 years). Mean +/- SD stone size, operative time and postoperative hospital stay were 4.09 +/- 4.06 cm 2, 93.5 +/- 48.6 minutes and 5.1 +/- 3.3 days, respectively. Postoperative stone-free rate was 81.6%. A total of 359 complications occurred in 334 renal units (27.7%). Complications were intraoperative in 118 cases and postoperative in 241. While univariate analysis revealed that stone history, positive urine culture, operative time, length of hospitalization, treatment success, punctured calyx and location of the stone significantly affected the complication rates (p <0.05), operative time, sheath size, mid calyceal puncture and partial staghorn formation were the statistically significant parameters affecting complication rates on multivariate logistic regression analysis.Conclusions: Percutaneous nephrolithotomy is the treatment of choice for most renal calculi in children. The technique is effective and safe in children, with a high success rate and a low rate of major complications. The significant factors identified should be considered by clinicians to decrease associated complication rates.Publication Ureterorenoscopic lithotripsy for pediatric kidney stones using holmium: Yttrium-aluminum-garnet laser devices: 15 W vs 30 W(Mary Ann Liebert, Inc, 2022-03-07) KAYGISIZ, ONUR; ÇİÇEK, MEHMET ÇAĞATAY; YENİ, SEZGİN; Yeni, Sezgin; Çicek, Mehmet Çağatay; Coşkun, Burhan; COŞKUN, BURHAN; Kılıçarslan, Hakan; KILIÇARSLAN, HAKAN; Turan, Levent; TURAN, LEVENT; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Üroloji Anabilim Dalı.; 0000-0002-9790-7295; 0000-0001-5143-6507; 0000-0002-0471-5404; 0000-0002-8242-9921; L-9439-2019; AAH-9704-2021; JCO-5169-2023Introduction: We aimed to compare the effectiveness of 15- and 30-W holmium: yttrium-aluminum-garnet (Ho:YAG) laser devices used in the treatment of pediatric kidney stones.Methods: Eighty-six consecutive pediatric patients who underwent retrograde intrarenal surgery (RIRS) between February 2010 and August 2020 were enrolled in the study. After exclusion criteria were applied, the data of 79 children were evaluated retrospectively. Patients were divided into two groups according to the laser device power of 15 W (Group 15: N = 30) and 30 W (Group 30: N = 49). The groups were compared according to demographic characteristics, stone feature, and clinical efficacy.Results: The age, gender, height, weight, and stone characteristics were similar between the groups. The mean operation time was shorter in Group 30. The stone-free rate after the first RIRS session (SF1) was 66.7% in Group 15 and 83.3% in Group 30. The SF1 for 20-mm or larger kidney stones was found to be 0% in Group 15 and 62.5% in Group 30. However, there was no statistically significant difference between the two groups in terms of stone-free rate.Conclusions: In pediatric kidney stone treatment, 30-W Ho:YAG laser devices should be preferred as they shorten the operation time compared with 15-W devices and provide the final stone-free status with fewer procedures, especially in large kidney stones.Publication Diode laser in the treatment of benign prostatic enlargement: A preliminary study(Aves, 2011-03-01) Oktay, Bülent; Kılıçarslan, Hakan; Doğan, Hasan Serkan; Kordan, Yakup; Yavaşcaoğlu, İsmet; Vuruşkan, Hakan; Oktay, Bülent; KILIÇARSLAN, HAKAN; Doğan, Hasan Serkan; Kordan, Yakup; YAVAŞCAOĞLU, İSMET; VURUŞKAN, HAKAN; Uludağ Üniversitesi/Tıp Fakültesi/Üroloji Anabilim Dalı.; 0000-0002-9947-848X; ABH-5513-2020; DKK-2716-2022; JIT-9412-2023; GAF-0095-2022; EIN-0828-2022; EFH-9523-2022Objective: To evaluate the efficacy of a novel treatment diode laser, in treatment of benign prostatic enlargement.Materials and methods: We evaluated the surgical and functional outcomes of 85 patients who underwent diode laser treatment for benign prostatic enlargement between September 2007 and April 2009. Preoperative and postoperative the International Prostate Symptom Score (IPSS), the International Index of Erectile Function (IIEF), maximum flow rate, postvoiding residual urine, and prostate volumes were analyzed.Results: All the patients were considered clinically as having benign prostatic enlargement. Mean age was 70.8 +/- 8.6 years and follow-up period was 12.6 +/- 6 months. In all patients, the power used was 120 W, the mean applied energy was 190 +/- 70 kJ and the total laser time was 21.9 +/- 7.2 min. Improvement in functional outcomes began in the third postoperative month and was sustained through 12 months postoperatively. Compared to preoperative data, at postoperative 12 months, we detected a significant decrease in prostate volumes (55.5 +/- 27.6 mL vs. 42.8 +/- 21.7 mL), IPSS (21.6 +/- 4.75 vs. 4.6 +/- 3.3) and residual urine volume (89.5 +/- 85.6 mL vs. 30.4 +/- 22.4 mL), and a significant increase in maximum flow rates (18.7 +/- 6.9 mL/sec vs. 9.6 +/- 5.6 mL/sec). No difference was detected in IIEF scores (36.8 +/- 21.2 vs. 37.8 +/- 23.7). Re-treatment was required in 5.8% of patients, and retrograde ejaculation was reported in 17% of patients.Conclusion: The early results of diode laser treatment for benign prostatic enlargement were equivalent to other endoscopic and minimally invasive treatments.Publication Determination of urinary stone composition using biochemical analysis of fluid samples taken during ureterorenoscopic laser lithotripsy(Springer, 2019-11-01) Arslan, İ. Ethem; Kılıçarslan, Hakan; KILIÇARSLAN, HAKAN; Çiçek, M. Çağatay; Günseren, K. Omur; Ocakoğlu, Gökhan; OCAKOĞLU, GÖKHAN; Kaygısız, Onur; KAYGISIZ, ONUR; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Üroloji Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Biyoistatistik Anabilim Dalı.; 0000-0002-9245-1241; 0000-0002-0471-5404; 0000-0001-8673-3093; 0000-0002-1114-6051; 0000-0002-9790-7295; ABC-9924-2020; AAM-9726-2020; ABD-3885-2020; L-9439-2019; AAH-5180-2021; HLG-6346-2023Purpose The present study aims to biochemically analyze the fluid samples containing stone dust taken during the perioperative period to determine the role of fluid in the prediction of stones in patients treated with ureterorenoscopic procedures. Our secondary aim is to investigate the role of both fluid analysis and stone analysis in predicting the results of the metabolic analysis.Methods Comparative analyses were performed using fluid samples containing stone dust from 93 patients. Biochemical analysis of fluid containing stone dust was conducted; stone fragments were examined at a separate location using X-ray diffractometry(XRD). Metabolic analysis was performed to patients who provided stone-free status 1 month later. The results of chemical analysis were compared with the results of the XRD analysis.Results Patients' stone type was determined with high accuracy using biochemical analysis. Differences were noted in ten patients following biochemical analysis and XRD analysis. Biochemical analysis predicted metabolic disorders in more patients than XRD analysis, particularly for those patients with multiple stone compositions. However, no significant differences between the results of biochemical and XRD analysis methods were found (kappa = 0.27; p = 0.002). Moreover, biochemical analysis results revealed metabolic disorders in five patients; these findings were missed by XRD analysis.Conclusion Biochemical analysis of fluid taken perioperatively during ureterorenoscopic laser lithotripsy to treat urinary system stone disease was found to determine stone composition with high accuracy. Biochemical analysis of fluid samples taken during the perioperative period is, thus, an easy, reliable and cost-effective test to assess stone composition in patients undergoing ureterorenoscopic procedures.Publication Comparison of patient satisfaction rates for the malleable and two piece-inflatable penile prostheses(Aves, 2014-12-01) Kılıçarslan, Hakan; Kaynak, Yurdaer; Gökçen, Kaan; Coşkun, Burhan; Kaygısız, Onur; KILIÇARSLAN, HAKAN; COŞKUN, BURHAN; KAYGISIZ, ONUR; Uludağ Üniversitesi/Tıp Fakültesi/Üroloji Anabilim Dalı.; 0000-0002-9790-7295 ; JIT-9412-2023; AAH-9704-2021; AAM-9726-2020Objective: To compare patient/partner satisfaction with AMS 600-650 and AMS Ambicore penile implants (American Medical Systems, Minneapolis, USA) in patients with erectile dysfunction.Material and methods: The modified Erectile Dysfunction Inventory of Treatment Satisfaction (EDITS) questionnaires at six months after implantation of 46 patients who underwent AMS 600-650 (n=23) or Ambicore placement (n=23) between 1/1/2008 and 1/1/2013 were analyzed.Results: The percentages of patients with AMS 600-650 who reported to be satisfied, very satisfied and neither satisfied nor dissatisfied with their prostheses were 34.78% (n=8), 30.43% (n=7) and 34.78% (n=8), respectively. For patients with AMS Ambicore, these percentages were 73.91% (n=17), 13.04% (n=3) and 13.04% (n=3), respectively. These overall satisfaction rates were significantly different between patients with AMS 600-650 and Ambicore (p=0.013). For patients with AMS 600-650, the percentages of patients who reported to be very likely, neither likely nor unlikely, or very unlikely to continue using their prosthesis were 30.43% (n=7), 34.78% (n=8), and 34.78% (n=8) while for patients with AMS Ambicore, these percentages were 65.21%, 21.33%, and 13.04%, respectively. These percentages were different between patients with AMS 600-650 and Ambicore (p=0.018).Conclusion: The two-piece inflatable penile prosthesis was found to be more successful in overall satisfaction and more likely for continued use when compared to the malleable penile prosthesis.