Background:The objectives of this prospective study were to evaluate the efficiency, safety and applicability of medium-power (MP) holmium laser devices in the endoscopic enucleation of the enlarged prostate (HoLEP) compared with high-power (HP) laser devices.Methods: From October 2019 to July 2020, a total of 120 consecutive patients planned for HoLEP were divided randomly into two groups formed in terms of the power of the device used. While patients in group 1 were treated with a MP device
We present three patients with Behçet's disease associated with intracardiac thrombus and pulmonary vascular involvement. One of these patients had also Budd-Chiari syndrome. All patients were treated with corticosteroid plus monthly intravenous cyclophosphamide as first line treatment and with no recurrences. Immunosuppressive therapy was successful in the treatment of intracardiac thrombus and also in the regression of pulmonary vascular thromboses in these patients. Intracardiac thrombus in Behçet's disease is rarely seen. Behçet's disease should be remembered in the differential diagnosis of the patients with intracardiac mass, especially in patients from the Mediterranean and Middle East populations.
Objective To evaluate retrograde intrarenal surgery (RIRS) outcomes and to determine the effect of operative time on complications of RIRS. Methods Patients undergoing RIRS for renal stones were evaluated. These patients were divided into two groups according to the operation time (Group 1<60 minutes and Group 2>60 minutes). Peroperative outcomes such as fluoroscopy time, stone-free rates, complications and duration of hospitalization were compared. Results Group 1 consisted of 264 patients and Group 2 consisted of 297 patients. SFR rates, duration of hospitalization, and postoperative urinary tract infection rates were similar in both groups. Fluoroscopy time was 7.8±7.3 (0-49) sec in group 1 and 13.1±9.8 (0-81) sec in group 2. Complications according to modified Clavien–Dindo classification system (MCDCS) were 13 and 32 patients (Grade 1), 31 and 63 patients (Grade 2), 1 and 1 patient (Grade 3) in group 1 and 2, respectively. There was statistical difference between the two groups in terms of duration of fluoroscopy time and the MCDCS. Although duration of hospitalization and UTI rates were higher in group 2, no statistical significance was observed among groups. Conclusion Limiting the operation time to 60 minutes in RIRS seems to be important in reducing postoperative complications.
Background: To characterize the safety and efficacy of Holmium Laser
Enucleation of Prostate (HoLEP) in patients with large prostates
(>100ml) at high risk for thromboembolic events (TE)
resuming antithrombotic treatment (AT) in the early postoperative
period. Methods: Data for 378 men with large prostates treated with
HoLEP for symptomatic benign prostatic hyperplasia between December 2016
and July 2020 were reviewed retrospectively. Of the patients, 134 had
been receiving AT, (anticoagulant (AC), n=51; antiplatelet (AP), n=83).
AT was resumed within 24 hours postoperatively. We determined pre-,
peri-, and postoperative parameters, functional outcome, and adverse
events for the 3-month period postoperatively in patients receiving AC
and AP; and compared results with 203 patients without AT. Results:
Patients receiving AC and AP were older (p=0.015) and had a higher
median ASA score (p<0.001). Objective voiding parameters
(Qmax, PVR) and urinary symptoms (IPSS, QoL) improved in the three
groups (p<0.001). Median enucleation and morcellation
efficiencies were 1.58 (IQR:0.87-3.13) and 5 (IQR:1-8.08), median
catheterization and hospitalization time was 2 days (IQR:2-3) and 3 days
(IQR:3-4), respectively. The perioperative results were similar in the
three groups. Overall, one patient in the AP group required blood
transfusion at 4 days postoperatively due to clot retention and
significant hemoglobin decrease (p=0.216). There was no adverse TE in
any patient within 3-month postoperatively. Conclusion: HoLEP is an
effective and safe method in patients with a high risk of TE whose AT is
discontinued for surgery, as it enables AT to be resumed as soon as
possible.
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