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 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 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 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 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 Laparoscopic ureterolithotomy; an equally effective and a sensible alternative to flexible ureterorenoscopy in the management of large ureteral stones in terms of effectivity and cost(Iniestares, S.a., 2021-07-01) Demir, Aslan; Günseren, Kadir Ömür; GÜNSEREN, KADİR ÖMÜR; Çicek, Mehmet Çağatay; ÇİÇEK, MEHMET ÇAĞATAY; Yavasçaoğlu, İsmet; YAVAŞCAOĞLU, İSMET; Kılıçarslan, Hakan; KILIÇARSLAN, HAKAN; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Üroloji Anabilim Dalı.; 0000-0001-8673-3093; 0000-0002-0471-5404; 0000-0001-8673-3093; ABC-9924-2020; HGM-5995-2022; JIT-9412-2023; EIN-0828-2022OBJECTIVES: We aimed to understand whether laparoscopic ureterolithotomy (LU) is a good alternative to flexible ureterorenoscopic lithotripsy (FURS) by comparing these techniques concerning cost-effectiveness.METHODS: We analysed 79 patients with upper ureteral stones larger than 1.5 cm underwent FURS or LU concerning cost-effectiveness analysis. The data including age, body mass index (BMI), stone size, operation time, hospitalisation time, complications and stone-free rates of 15th day and 3rd months. We audited the costs of FURS and LU and compared them concerning cost-effectiveness.RESULTS: There was not any statistically significant difference between the two groups with regard to age, BMI, stone size, stone-free rates at the 3rd month, and complication rates, (p>0.05).The operation times were statistically lower in the FURS than in the LU (61.5 +/- 24.3 min and 140.9 +/- 49.1 min, respectively, p<0.05). The stone-free rate at the 15th day was lower in the FURS group than in the LU group (31 (81.6%) and 41 (100%), respectively, p<0.05) (Table I).However, this statistical difference disappears at 3 months (p>0.05). The mean costs of FURS and LU were $194.2 +/- 12.4 and $179.2 +/- 58.5, respectively (p<0.001).CONCLUSION: FURS is equally effective to LU in terms of stone-free rates. The cost of FURS is higher statistically than LU. FURS is shown as the first choice for the upper ureteral stones larger than 10 mm in size, if the laparoscopic experience is in high-level situations in that clinic, LU may be a suitable alternative to FURS, especially for challenging cases.Publication Myxoid liposarcoma of the spermatic cord: A case report(Aves, 2007-12-01) Kılıçarslan, Hakan; Yalçınkaya, Ulviye; Vuruşkan, Hakan; Doğan, Hasan Serkan; Kordan, Yakup; KILIÇARSLAN, HAKAN; YALÇINKAYA, ÜLVİYE; VURUŞKAN, HAKAN; Doğan, Hasan Serkan; Kordan, Yakup; Uludağ Üniversitesi/Tıp Fakültesi/Üroloji Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Patoloji Anabilim Dalı.; 0000-0002-9947-848X; ABH-5513-2020; AAH-8924-2021; FGY-3115-2022; EFH-9523-2022; GAF-0095-2022Introduction: Myxoid liposarcoma is a rare condition and a very little number of cases have been described in the spermatic cord to date. It presents as painless scrotal or inguinal masses that are often confused with hydroceles or inguinal hernias. These lesions tend to recur locally, whereas metastasis is less common than with round cell, pleomorphic, and dedifferentiated liposarcomas. For this reason, high inguinal orchiectomy is the treatment of choice in myxoid liposarcoma of the spermatic cord. Prognostically favorable factors in liposarcomas of the spermatic cord are low tumor grade, small tumor size and superficial depth of invasion, complete resection with negative margins, and the absence of metastases. We present a case of myxoid liposarcoma of spermatic cord which has all these favorable prognostic factors with a brief review of this rare entity.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 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.