Background/aim: The purpose of the present study was to review the complications of ureteroscopy (URS) by using the modified Clavien classification system (MCCS) and to investigate the factors associated with complications.Materials and methods: Data regarding 811 patients who underwent URS for ureteral calculus were analyzed. Peroperative and postoperative complications were recorded. The patients were divided into seven groups depending on the severity of the complications. The association of sex, stone size, number, and localization with each MCCS grade was also evaluated. Results:The average age was 45 years. The success of the procedure after one session was 93.5%. Complications were recorded in 57.9% of the patients. According to the MCCS, grade I, II, IIIa, IIIb, IVa, IVb, and V complications were documented in 29.8%, 7.1%, 8.6%, 11%, 0%, 1.2%, and 0% of the patients, respectively. The factors associated with the complications graded by MCCS were sex, stone size, number of stones, and localization. In addition, in multivariate analysis, history of previous surgeries for urolithiasis, orifice dilatation, and instrument size were associated with complications. Conclusion:According to MCCS, sex, history of previous surgeries for urolithiasis, orifice dilatation, size of the instrument, stone size, number of stones, and localization are associated with different grades of complications in URS.

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In this study, it was detected that the informed consent form readability levels used for urological surgical procedures in our country were rather low. We think that the cooperation of the concerned institutions is required for the revision of the consent information texts available and the improvement of the texts according to the strategies recommended.

Objective: To evaluate the impact of ureteral stent insertion following semirigid ureterorenoscopy (URS) in patients with perirenal fat stranding (PFS) due to ureteral stones. Material and methods: Data of 600 patients who underwent URS were analyzed retrospectively. Seventy-two patients detected to have PFS accompanying ureteral stone were included. Patients who did not undergo double J (DJ) stent insertion following semirigid URS were classified as Group I (n: 52), while those who underwent stent insertion were classified as Group II (n: 20). Side distribution; localization of the stones, stone size, presence of fever, urinary tract infection (UTIs) and urosepsis rates were compared in the two groups. Results: The average age of the patients was 44.4 (20-71) years. Male/female ratio and side of the stone location showed similar distribution in both groups (p > 0.05). Fever occurred in 23 cases (44.2%) in Group I and in 15 cases (75%) in Group II (p = 0.038). UTIs occurred in 15 cases (28.9%) in Group I and in 12 cases (60%) in Group II (p = 0.03). Urosepsis presented in 3 (5.8%) and 5 (25%) of the patients in Group I and II, respectively (p = 0.033). Conclusions: According to our results, ureteral DJ stent insertion following URS in patients with PFS due to ureteral stone caused an increase on postoperative infection related complications.KEY WORDS: Perirenal fat stranding; Ureteral stents; Ureteral stones; Ureterorenoscopy. SummaryNo conflict of interest declared. ureteric stones (3). Extracorporeal Shock Wave Lithotripsy (ESWL), ureterorenoscopy (URS) and endoscopic lithotripsy are the most common treatment modalities currently used in ureteral stones. The ureteral DJ stent insertion indications are the complications that develop secondary to the presence of the stones and the complications that arise during the surgical procedure (4). However, the use of stents can lead to side effects such as pain, urinary infection, and irritable voiding symptoms (5, 6). Thus, we aimed to evaluate the correlation between ureteral DJ stent and infective complications such as fever, UTIs and urosepsis in patients with PFS who develop secondary to ureteral stones. MATERIAL AND METHODSData of 600 patients who underwent URS in two tertiary centers between May 2010 and May 2017 were analyzed retrospectively. Routine laboratory, complete urinalysis, urine cultures, blood cultures and CT scan results were obtained by a comprehensive review of medical records. Vital signs were also reviewed and presence of any UTIs, fever and urosepsis were noted. Urine cultures were obtained from patients with asymptomatic bacteriuria and appropriate empirical treatment was started. Symptomatic urinary infection criteria included fever, costovertebral angle sensitivity, pyuria (≥ 10 white blood cells per high-power field), and positive urine culture (≥ 105 colony-forming units of uropathogen/mL). Urosepsis criteria included at least 2 findings of Systemic Inflammatory Response Syndrome (SIRs) in the presence of infection. SIRs criteria include...

Purpose: To investigate whether or not the age of spontaneous resolution of monosymptomatic nocturnal enuresis (MNE) was familial. Patients and Methods: A questionnaire was administered to more than 1,500 people, and 100 appropriate participants were identified from four referral hospitals. We included the participants who had MNE and whose parents also had MNE with spontaneous resolution. Then the association between the spontaneous resolution time of MNE in parents and that in their children was investigated. Results: The mean ages of spontaneous resolution were 10.7 (10-30 years), 9.4 (6-17 years) and 10.9 (6-18 years) in participants, their mothers and their fathers, respectively. According to the statistical analysis, there was a positive correlation between participants and both their mothers and fathers (p < 0.05). In addition, it was revealed that familial MNE history based on first- and second-degree relatives, in addition to their parents, was also associated with the increased spontaneous resolution age of MNE (p < 0.05). According to our results, gender and parents' education status were not statistically associated with the spontaneous resolution (p > 0.05). Conclusion: As a conclusion, the age of spontaneous resolution of MNE is familial. Although the exact reasons of spontaneous resolution still remain a mystery; further genetic investigations may be able to resolve this mystery.

Background/aim: We aimed to compare the results of unilateral and bilateral varicocele surgery. Materials and methods:In two referral hospitals, the data of 180 patients who were treated with unilateral and bilateral microscopic varicocelectomy were retrospectively analyzed. Sperm parameters and spontaneous pregnancy rates were compared in patients who underwent bilateral and unilateral microscopic varicocelectomy. Results:The mean age was 29.6 (17-46) years. While 82 patients underwent unilateral varicocelectomy (Group I), 98 patients underwent bilaterally varicocelectomy (Group II). Forty (48.8%) spontaneous pregnancies occurred in Group I and 59 (60.2%) in Group II. When we analyzed sperm parameters, the rate of increase in the number of sperm in spermiograms was 17% in Group I and 27.5% in Group II. The rate of increase in sperm mobility was 58.5% and 50% in Group I and II, respectively. The improvement rate in sperm morphology was 46.3% in Group I and 56.1% in Group II. There were no significant differences between all these parameters. Conclusion:In light of our results, although pregnancy rates seemed to be higher in patients who underwent bilateral varicocelectomy, these results were not statistically significant. Improvement rates in sperm parameters were similar between the patients who underwent unilateral and bilateral varicocelectomy.

Objective: Urinoma is a rare entity and mainly occurs due to acute obstruction such as ureteral stone. We aimed to demonstrate factors associated with urinoma accompanied by ureteral calculi. Material and methods: Data of 550 patients who were diagnosed with ureteral stone by computed tomography (CT) were analyzed retrospectively. In 20 patients perirenal urinoma was associated with ureteral calculi (group I), whereas in other 530 patients no urinoma was detected (group II). Gender, age, size, side and localization of the stone, hydronephrosis, fever, sepsis, urinary tract infections (UTIs), hematuria, serum creatinine, blood urea nitrogen (BUN), white blood cell (WBC), C-reactive protein (CRP), presence of diabetes mellitus (DM), hypertension (HT) and cronic kidney disease (CKD) of the two groups were compared. Results: The average age of the patients were 46.2 (20-71) and 44.9 (10-82) years in group I and group II, respectively (p > 0.05). According to our results leukocytosis, microscopic and macroscopic hematuria, UTIs, increase of serum creatinine, BUN and CRP, diagnosis of DM and HT were significantly associated with urinoma (p < 0.05). In addition, patients with distal ureteral stones are more prone to urinoma (p = 0.001). An interesting finding of the study was that the stone size in group I (median 5 mm [range 3-8]) was significantly smaller than in group II (9.3 mm [4-25]; p = 0.001). Conclusions: Small stone size, distal localisation of the stone in ureter, leukocytosis, hematuria, UTIs, increase of serum creatinine, BUN and CRP, presence of DM and HT are associated with perirenal urinoma.

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