Person: TANIDIR, YILÖREN
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TANIDIR
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YILÖREN
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Publication Open Access Re: Percutaneous Nephrolithotomy in Horseshoe Kidneys: Results of a Multicentric Study(2022-07-01) ŞENER, TARIK EMRE; TANIDIR, YILÖREN; Vicentini F. C., Mazzucchi E., Gokce M., Sofer M., Tanidir Y., Sener T. E., Melo P. A. d. S., Eisner B., Batter T. H., Chi T., et al.This retrospective, multicenter study of patients with horseshoe kidneyssubjected to percutaneous nephrolithotomy (PCNL) demonstrated some expected findings: those withhigher stone burden less apt to be cleared of stone (stone-freeþresidual fragments<4 mm).Increasing body mass index was shown to negatively impact this parameter which has not beenreported for the generic patient subjected to PCNL. These results also demonstrate that supine PCNLcan be undertaken safely and effectively in this cohort.Publication Open Access Consistency of uroflowmetry analysis in children among observers(2023-01-01) ŞEKERCİ, ÇAĞRI AKIN; TANIDIR, YILÖREN; TARCAN, TUFAN; YÜCEL, SELÇUK; ŞEKERCİ Ç. A., TANIDIR Y., TARCAN T., YÜCEL S.© 2023 Wiley Periodicals LLC.Aim: The aim of the study is to compare the intra- and inter-observer interpretations of the same uroflowmetry study at two different times. Materials and Methods: Two-hundred children with a voided volume of 50% above the expected bladder capacity were included. All traces were asked to be evaluated by 11 observers two times in a time span of 1 month. These observers consist of pediatric urologists (n = 2), pediatric urology fellows (n = 2), urology residents (n = 5), and certified urodynamics nurses (n = 2). Each uroflowmetry was asked to be assessed for three domains: voided volume (VV), detrusor sphincter dyssynergia (DSD), and flow curve pattern (FCP). Results: Of the 200 patients with a median age of 10 (4–18) years, 128 (64%) were girls and 72 (36%) boys. The maximum flow rate and the median voided volume were found to be 20 (4–61) mL/s and 232 (116–781) mL. The Fleiss\" kappa coefficient of VV, DSD, and FCP in the first assessment was 0.510, 0.501, and 0.346. In the second assessment, κ values were 0.530, 0.422, and 0.373. The best-agreed findings were similar at both times. These were found to be low VV (0.602 and 0.626) and intermittent pattern (0.500 and 0.553). Interpreters were found to have a statistically significant difference in agreement with their own interpretation at different times. Conclusion: Both inter- and intra-observer reliability of the agreement point out the problem in the standardization of uroflowmetry. Inter- and intra-observer reliability of uroflowmetry interpretation can be increased by defining precise numbers and numerical algorithms.Publication Open Access Worldwide survey on the current practice of asymptomatic urinary stone management: a survey from eau, young academic urologists (yau), endourology and urolithiasis working party(2022-05-01) ŞENER, TARIK EMRE; TANIDIR, YILÖREN; Sener T. E. , Tailly T., Pietropaolo A., Keller E. X. , Tanidir Y., Gomez Rivas J., Hameed Z., De Coninck V., Tefik T., Sarica K., et al.Publication Open Access The efficacy of retrograde intra-renal surgery (RIRS) for lower pole stones: results from 2946 patients(2023-01-01) TANIDIR, YILÖREN; Giulioni C., Castellani D., Somani B. K., Chew B. H., Tailly T., Keat W. O. L., Teoh J. Y., Emiliani E., Chai C. A., Galosi A. B., et al.Purpose: To evaluate the perioperative outcomes of retrograde intra-renal surgery (RIRS) for lower pole stones (LPS) and factors affecting stone-free rate (SFR). Methods: Data from 20 centers were retrospectively reviewed. Inclusion criteria were adult patients, normal renal anatomy, and LPS. Exclusion criteria were bilateral surgery, concomitant surgery for ureteral stones. SFR was defined as a single residual fragment (RF) ≤ 2 mm and evaluated 3-months after surgery. A multivariable logistic regression analysis was performed to assess factors associated with RF. Statistical significance was set at p value < 0.05. Results: 2946 patients were included. Mean age and stone size were 49.9 years 10.19 mm, with multiple LPS in 61.1% of cases. Total operation and laser time were 63.89 ± 37.65 and 17.34 ± 18.39 min, respectively. Mean hospital stay was 3.55 days. Hematuria requiring blood transfusion and fever/urinary infections requiring prolonged antibiotics occurred in 6.1% and 169 5.7% of cases, while sepsis with intensive-care admission in 1.1% of patients. On multivariate analysis, Multiple stones (OR 1.380), stone size (OR 1.865), and reusable ureteroscopes (OR 1.414) were significantly associated with RF, while Thulium fiber laser (TFL) (OR 0.341) and pre-stenting (OR 0.750) were less likely associated with RF. Conclusions: RIRS showed safety and efficacy for LPS with a mean diameter of 10 mm. This procedure can achieve a satisfactory SFR in pre-stented patients with a single and smaller stone, particularly with TFL use.Publication Open Access Comparison and outcomes of dusting versus stone fragmentation and extraction in retrograde intrarenal surgery: results of a systematic review and meta-analysis(2022-01-01) TANIDIR, YILÖREN; ŞENER, TARIK EMRE; Gauhar V., Teoh J. Y. , Mulawkar P. M. , Tak G. R. , Wroclawski M. L. , Robles-Torres J. I. , Chan V. W. , Rojo E. G. , Silva R. D. d. , TANIDIR Y., et al.Introduction Lithotripsy during retrograde intrarenal surgery (RIRS) can be achieved either by fragmenta -ti on and extraction or dusting with spontaneous passage. We aimed to perform a systematic review on the safety and stone-free rate after RIRS by comparing the techniques of dusting vs fragmentation/extraction.Material and methods This review was performed according to the Preferred Reporting Items for Systemat-ic Reviews and Meta-analyses statement. The inverse variance of the mean difference and 95% Confidence Interval (CI), Categorical variables were assessed using Cochran-Mantel-Haenszel Method with the random effect model and reported as Odds Ratio (OR) and 95% CI. Statistical significance was set at p <0.05.Results There were 1141 patients included in 10 studies. Stone size was up to 2.5 cm All studies used hol-mium laser for lithotripsy. Meta-analysis showed no significant difference in surgical time (MD-5.39 minutes 95% CI-13.92-2.31, p = 0.16), postoperative length of stay (MD-0.19 days 95% CI-0.60 --0.22, p=0.36), overall complications (OR 0.98 95% CI 0.58-1.66, p = 0.95), hematuria (OR 1.01 95% CI 0.30-3.42, p = 0.99), postoperative fever (OR 0.70 95% CI 0.41-1.19, p = 0.19) and sepsis (OR 1.03 95% CI 0.10-10.35, p = 0.98), immediate (OR 0.40 95% CI 0.13-1.24, p = 0.11) and overall stone-free rate (OR 0.76 95% CI 0.43-1.32, p = 0.33), and retreatment rate (OR 1.35 95% CI 0.57-3.20, p = 0.49) between the groups.Conclusions This systematic review infers that urologists can safely use either option of fragmentation and basket extraction or dusting without extraction to achieve similar outcomes as both techniques are similar for efficacy and safety.Publication Open Access The utility and safety of ureteral access sheath during retrograde intrarenal surgery in children(2023-02-01) TANIDIR, YILÖREN; TANIDIR Y., Sekerci C. A., Castellani D., Ferretti S., Gatti C., Campobasso D., Bujons A., Quiroz Y., Teoh J. Y., Pietropaolo A., et al.Objectives: The objectives of this study are to present our experience with retrograde intrarenal surgery for management of renal calculi in children less than 7 years old and to determine its safety and efficacy in this age group. Methods: Patient demographics, stone location and size, use of ureteral access sheath, stone-free status, complication rates, and follow-up were evaluated. Results: A total of 16 patients (9 boys and 7 girls; mean age, 4.2 years) underwent 17 procedures. The mean stone size was 11.5 mm (8-17 mm). Flexible ureteroscopy and laser lithotripsy were performed in all cases regardless of stone location. Dilation of the ureteral orifice was required in 5 cases (29.4%), and ureteral access sheaths were placed in 3 patients (17.6%). With a mean follow-up of 10.3 months, 88% of the children were stone free. The success rate for stones less than 10 mm was 100% and 81.8% for stones 10 mm or more (P b .05). There were no major complications, but there was 1 case of perforation and extravasation at the ureterovesical junction after balloon dilation that was managed with stent placement. Conclusions: Retrograde intrarenal surgery is a safe and effective method for the treatment of intrarenal calculi, and it achieves reasonable results with minimal complications in children less than 7 years old. © 2011 Elsevier Inc. All rights reserved.Publication Open Access Outcomes and lessons learnt from practice of retrograde intrarenal surgery (RIRS) in a paediatric setting of various age groups: a global study across 8 centres(2022-05-01) ŞEKERCİ, ÇAĞRI AKIN; TANIDIR, YILÖREN; Lim E. J., Traxer O., Quiroz Madarriaga Y., Castellani D., Fong K. Y., Chan V. W., Bujons Tur A., Pietropaolo A., Ragoori D., Shrestha A., et al.Purpose To analyse and report the practice, outcomes and lessons learnt from a global series of retrograde intrarenal surgery (RIRS) in a paediatric multicentre series. Methods A retrospective review of anonymized pooled data gathered globally from 8 centres in paediatric patients ( 10 years (Group C). Overall, post-operative complication rate was 13.7%. Chi-square comparisons were used for categorical variables; analysis of variance (ANOVA) or Kruskal-Wallis tests were used for continuous variables. Results 314 patients were analysed. The mean age was 9.54 +/- 4.76 years. Groups A, B and C had 67 (21.3%), 83 (26.4%) and 164 (52.2%) patients, respectively. Mean stone size was 10.7 +/- 4.62 mm. Pre-stenting was performed in 155 (49.4%) of patients, ureteral access sheaths (UAS) was used in 54.5% of patients with majority (71%) utilizing holmium laser for stone fragmentation. All complications were minor (Clavien-Dindo grade 1 and 2). SFR was 75.5%. Conclusions RIRS is acceptable as a first-line intervention in the paediatric population with reasonable efficacy and low morbidity. Complications are slightly higher in patients < 5 years of age, which should be taken into account while counselling patients.Publication Open Access Lessons learnt from a multicenter series of 400 cases on the utility of pre-stenting for pediatric retrograde intra renal surgery (RIRS)(2023-02-01) TANIDIR, YILÖREN; Sinha M. M., Castellani D., Ferretti S., Gatti C., Teoh J. Y. C., TANIDIR Y., Sekerci C. A., Bhatia T. P., Tur A. B., Madarriaga Y., et al.Publication Open Access Outcomes from practice of Retrograde Intrarenal Surgery (RIRS) in a paediatric setting of various age groups: A global study across 8 centres(2022-02-01) TANIDIR, YILÖREN; Lim E., Traxer O., Madarriaga Y., Castellani D., Fong K., Chan V., Tur A., Pietropaolo A., Ragoori D., Shrestha A., et al.Geomagnetic storms are an important aspect of space weather and can result in significant impacts on space- and ground-based assets. The majority of strong storms are associated with the passage of interplanetary coronal mass ejections (ICMEs) in the near-Earth environment. In many cases, these ICMEs can be traced back unambiguously to a specific coronal mass ejection (CME) and solar activity on the frontside of the Sun. Hence, predicting the arrival of ICMEs at Earth from routine observations of CMEs and solar activity currently makes a major contribution to the forecasting of geomagnetic storms. However, it is clear that some ICMEs, which may also cause enhanced geomagnetic activity, cannot be traced back to an observed CME, or, if the CME is identified, its origin may be elusive or ambiguous in coronal images. Such CMEs have been termed \"stealth CMEs.\" In this review, we focus on these \"problem\" geomagnetic storms in the sense that the solar/CME precursors are enigmatic and stealthy. We start by reviewing evidence for stealth CMEs discussed in past studies. We then identify several moderate to strong geomagnetic storms (minimum Dst < -50 nT) in solar cycle 24 for which the related solar sources and/or CMEs are unclear and apparently stealthy. We discuss the solar and in situ circumstances of these events and identify several scenarios that may account for their elusive solar signatures. These range from observational limitations (e.g., a coronagraph near Earth may not detect an incoming CME if it is diffuse and not wide enough) to the possibility that there is a class of mass ejections from the Sun that have only weak or hard-to-observe coronal signatures. In particular, some of these sources are only clearly revealed by considering the evolution of coronal structures over longer time intervals than is usually considered. We also review a variety of numerical modelling approaches...Publication Open Access Perioperative outcomes and risk factors for major complications associated with nephrectomy for Xanthogranulomatous pyelonephritis: a multicenter study(2023-01-01) TANIDIR, YILÖREN; Robles-Torres J. I., García-Chairez L. R., Castellani D., Enrriquez-Ávila J. V., Monzón-Falconi J. F., Esqueda-Mendoza A., Flores-Tapia J. P., Wroclawski M. L., Duarte-Santos H. O., Ragoori D., et al.Purpose: To determine the risk factors associated with major complications in patients with histologically confirmed Xanthogranulomatous pyelonephritis (XGP) who underwent nephrectomy. Methods: A multicenter retrospective study was performed including patients who underwent nephrectomy between 2018 and 2022 with histopathological diagnosis of XGP. Clinical and laboratory parameters at the initial presentation were evaluated. Data on extension of XGP was recorded as per the Malek clinical-radiological classification. Characteristics of nephrectomy and perioperative outcomes were obtained. The primary outcome was major complications, defined as a CD ≥ grade 3 and the need for intensive care unit (ICU) admission. Secondary outcomes included the comparison of complications evaluating the nephrectomy approach (transperitoneal, retroperitoneal, and laparoscopic). A sub-analysis stratifying patients who needed ICU admission and Malek classification was performed. Results: A total of 403 patients from 10 centers were included. Major complications were reported in 98 cases (24.3%), and organ injuries were reported in 58 patients (14.4%), being vascular injuries the most frequent (6.2%). Mortality was reported in 5 cases (1.2%). A quick Sepsis-related Organ Failure Assessment (qSOFA) score ≥ 2, increased creatinine, paranephric extension of disease (Malek stage 3), a positive urine culture, and retroperitoneal approach were independent factors associated with major complications. Conclusion: Counseling patients on factors associated with higher surgical complications is quintessential when managing this disease. Clinical-radiological staging, such as the Malek classification may predict the risk of major complications in patients with XGP who will undergo nephrectomy. A transperitoneal open approach may be the next best option when laparoscopic approach is not feasible.
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