Person: TANIDIR, YILÖREN
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TANIDIR
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YILÖREN
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Publication Metadata only Real-world Global Outcomes of Retrograde Intrarenal Surgery in Anomalous Kidneys: A High Volume International Multicenter Study(Elsevier Inc., 2021) TANIDIR, YILÖREN; García Rojo E., Teoh J.Y.-C., Castellani D., Brime Menéndez R., Tanidir Y., Benedetto Galosi A., Bhatia T.P., Soebhali B., Sridharan V., Corrales M., Vaddi C.M., Shrestha A., Singh A., Lakmichi M.A., Ragoori D., Sepulveda F., Hamri S.B., Ganpule A.P., Emiliani E., Somani B., Traxer O., Gauhar V.Objective: To analyze the trends and outcomes of retrograde intrarenal surgery for treatment of urolithiasis in anomalous kidneys in a large international multicenter series. Materials and Methods: We designed a multicentric retrospective study. Nineteen high-volume centers worldwide were included. Pre-, peri- and postoperative data were collected, and a subgroup analysis was performed according to renal anomaly. Results: We analyzed 414 procedures: 119 (28.7%) were horseshoe kidneys, 102 (24.6%) pelvic ectopic kidneys, 69 (16.7%) malrotated kidneys and 50 (12.1%) diverticular calculus. The average size (SD) of the stone was 13.9 (±6) millimeters and 193 (46.6%) patients had a pre-operative stent. In 249 cases (60.1%) a disposable scope was used. A UAS (ureteral access sheath) was used in 373 (90%) patients. A Holmium laser was used in 391 (94.4%) patients. The average (SD) operating time was 65.3 (±24.2) minutes. Hematuria, caliceal perforation and difficulty in stone localisation were mostly seen in diverticular stones and difficulty in UAS placement and lithotripsy in the cases of renal malrotation. The overall complication rate was 12%. Global stone-free rate was 79.2%. Residual fragments (RF) were significantly lesser in the pre-stented group (P <.05). Diverticular calculi was the group with more RF and needed ancillary procedures (P <.05). Conclusion: Retrograde intrarenal surgery in patients with anomalous kidneys is safe and effective with a high single-stage stone-free rate and low complication rate. There is a trend toward using smaller and disposable scopes and smaller UAS. Diverticular stones can still be challenging with higher rates of intraoperative hematuria, caliceal perforation and RF. © 2021 Elsevier Inc.Publication Open Access Nation-wide analysis of the impact of Covid-19 pandemic on daily urology practice in Turkey(WILEY, 2021-04) TANIDIR, YILÖREN; Bozkurt, Ozan; Sen, Volkan; Irer, Bora; Sagnak, Levent; Onal, Bulent; Tanidir, Yiloren; Karabay, Emre; Kaya, Coskun; Ceyhan, Erman; Baser, Aykut; Duran, Mesut Berkan; Suer, Evren; Celen, Ilker; Selvi, Ismail; Ucer, Oktay; Karakoc, Sedat; Sarikaya, Ege; Ozden, Ender; Deger, Dogan; Egriboyun, Sedat; Ongun, Sakir; Gurboga, Ozgur; Asutay, Mehmet Kazim; Kazaz, Ilke Onur; Yilmaz, Ismail Onder; Kisa, Erdem; Demirkiran, Engin Denizhan; Horsanali, Ozan; Akarken, Ilker; Kizer, Onur; Eren, Huseyin; Ucar, Murat; Cebeci, Oguz Ozden; Kizilay, Fuat; Comez, Kaan; Mercimek, Mehmet Necmettin; Ozkent, Mehmet Serkan; Izol, Volkan; Gudeloglu, Ahmet; Ozturk, Bilgin; Akbaba, Kaan Turker; Polat, Salih; Gucuk, Adnan; Ziyan, Avni; Selcuk, Berin; Akdeniz, Firat; Turgut, Hasan; Sabuncu, Kubilay; Kaygisiz, Onur; Ersahin, Veli; Kahraman, Halil Ibrahim; Guzelsoy, Muhammet; Demir, OmerObjective To present a nation-wide analysis of the workload of urology departments in Turkey week-by-week during Covid-19 pandemic. Methodology The centres participating in the study were divided into three groups as tertiary referral centres, state hospitals and private practice hospitals. The number of outpatients, inpatients, daily interventions and urological surgeries were recorded prospectively between 9-March-2020 and 31-May-2020. All these variables were recorded for the same time interval of 2019 as well. The weekly change of the workload of urology during pandemic period was evaluated, also the workload of urology and the distributions of certain urological surgeries were compared between the pandemic period and the same time interval of the year 2019. Results A total of 51 centres participated in the study. The number of outpatients, inpatients, urological surgeries and daily interventions were found to be dramatically decreased by the 3rd week of pandemics in state hospitals and tertiary referral centres; however, the daily urological practice were similar in private practice hospitals throughout the pandemic period. When the workload of urology in pandemic period and the same time interval of the year 2019 were compared, a huge decrease was observed in all variables during pandemic period. However, temporary measures like ureteral stenting, nephrostomy placement and percutaneous cystostomy have been found to increase during Covid-19 pandemic compared with normal life. Conclusions Covid-19 pandemic significantly affected the routine daily urological practice likewise other subspecialties and priority was given to emergent and non-deferrable surgeries by urologists in concordance with published clinical guidelines.Publication Metadata only Supi̇n perkütan nefroli̇totomi sonrası akut faz reaktanlarının postoperati̇f kompli̇kasyonları öngörmedeki̇ başarısı(2022-03-10) SARAÇOĞLU, SERTAÇ; ŞENER, TARIK EMRE; TOPBAŞ, FEVZİ BATUHAN; ÖZKAN, ONUR CAN; TANIDIR, YILÖREN; Saraçoğlu S., Şener T. E., Topbaş F. B., Özkan O. C., Tanıdır Y.Giriş Perkütan nefrolitotomi (PNL), her boyutta üst üriner sistem taşlarının tedavi algoritması içerisinde önerilebilen, yüksek başarı ve düşük komplikasyon oranları ile uygulanan bir ameliyattır. PNL sonrası gelişen idrar yolu enfeksiyonları (İYE), PNL’ye bağlı komorbiditelerin en önemli sebeplerindendir. Postoperatif erken dönemde yükselen akut faz reaktanları, enfektif komplikasyonların erken tanınmasını sağlayabilir. Materyal & Metod Haziran 2018 – Mart 2021 tarihleri arasında PNL ameliyatı endikasyonu konularak opere edilen, CRP ve prokalsitonin değerlerine ulaşılabilen hastalar çalışmaya dahil edildi. Hastalar, güncel kılavuzların önerdiği preoperatif değerlendirmeler ile ameliyata alındı. Ameliyat edilen taşların boyutu ve hacmi, uygulanan PNL işlemine ait veriler ve post-operatif veriler prospektif olarak toplandı. Her hastanın preoperatif, erken postoperatif dönemlerde ve postoperatif 1. günde bakılan hemogram, CRP ve prokalsitonin değerlerinin, postoperatif enfektif komplikasyonlarla ilişkisi araştırıldı. Bulgular Çalışmaya 113 hasta dahil edildi. Hastaların demografik verileri ile ameliyat öncesi özellikleri ve ameliyat edilecek taşa ait bulgular tablo 1’de verildi. 77 hastada multiple (61 multiple simple, 7 staghorn + simple, 9 semi staghorn + simple), 36 hastada tek (7 semistaghorn ,29 single simple) taş saptandı. Taşların lokalizasyonu 40 hastada renal pelvis taşı + diğer kalikslerde taş, 15 hastada birden fazla kaliks içerisinde taş, 26 hastada ise renal pelviste tek taş şeklindeydi. Ortanca taş sayısı 2 (min 1, maks 15), ortanca total taş hacmi 2723,25 mm3 (min 295,07, maks 35797), ortanca taş yüzey alanı 1448,89 mm2 (min 235,16, maks 12400,51) saptandı. Tüm ameliyatlar supin pozisyonda yapıldı. 34 hastada (%30,1) endoskopik kombine girişim (“ECIRS”), 79 hastada (%69,9) supin PNL uygulandı. 77 hastada (%68,1) mini-PNL (16-22 Fr), 27 hastada (%23,9) standart-PNL (24-30 Fr), 9 hastada (%8) ise ultra mini-PNL (10-14 Fr) uygulandı. Ameliyat sonunda 33 hastaya (%29,2) nefrostomi, 62 hastaya (%54,9) DJ stent (“Tubeless”), 18 hastaya (%15,9) hem nefrostomi hem DJ stent takıldı. Clavien Dindo sınıflamasına göre 18 hastada (%15,9) 2. derece, 1 hastada (%0,9) 3. derece, 1 hastada (%0,9) 4. derece komplikasyon gelişti. Gelişen 4. derece komplikasyon 1 hastada kardiyak komplikasyona bağlı yoğun bakım ihtiyacının gelişmesiydi, gelişen 3. derece komplikasyon ise yine 1 hastada kanamaya bağlı anjiyoembolizasyon ihtiyacı olmasıydı. Clavien Dindo 2. Derece komplikasyonlar ise 12 hastada postoperatif ateş, 2 hastada idrar yolu enfeksiyonu ve 5 hastada ES transfüzyonu gerektiren kanamaydı. Postoperatif döneme ait bulgular tablo 2’de verildi. Ameliyat öncesi ve sonrasındaki bakılan akut faz reaktanları değerlendirildiğinde CRP, prokalsitonin ve lökosit değerlerinin postoperatif enfektif komplikasyonlarla korelasyon gösterdiği görüldü. Sonuç Supin PNL ameliyatları yüksek taşsızlık oranları ve düşük komplikasyon yüzdesi ile uygulanmaktadır. Ameliyat öncesinde ve postoperatif dönemde hastaların takibinde bakılacak akut faz reaktanlarının postoperatif enfektif komplikasyonları öngörmede başarılı olduğu görülmüştür. Anahtar Kelimeler : Nefrolitotomi, Perkütan, Akut Faz ReaktanlarıPublication Metadata only Evaluation of urinary neutrophil gelatinase-associated lipocalin as a biomarker in pediatric and adult patients with ureteropelvic junction obstruction(2017-03-01) KAYA, CEVDET; ŞAHİN, BAHADIR; TANIDIR, YILÖREN; ŞEKERCİ, ÇAĞRI AKIN; ŞİMŞEK, FERRUH; Talibzade F., KAYA C., ŞAHİN B., TANIDIR Y., ŞEKERCİ Ç. A., AKBAL C., ŞİMŞEK F.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 Metadata only The effect of intradetrusor botulinum neurotoxin type A on urinary NGF, TGF BETA-1, TIMP-2 levels in children with neurogenic detrusor overactivity due to myelodysplasia(WILEY, 2017) ŞEKERCİ, ÇAĞRI AKIN; Top, Tuncay; Sekerci, Cagri Akin; Isbilen-Basok, Banu; Tanidir, Yiloren; Tinay, Ilker; Isman, Ferruh Kemal; Akbal, Cem; Simsek, Ferruh; Tarcan, TufanAimsThe aim of this study was to determine the value of urine nerve growth factor (NGF), transforming growth factor beta 1 (TGF-Beta-1), tissue inhibitor of matrix metalloproteinase 2 (TIMP-2) levels to predict the urodynamic profile before and after botulinum neurotoxin type A (BoNT-A) treatment in children with myelodysplasia. MethodsThis prospective study included 15 children with myelodysplasia who underwent intradetrusor BoNT-A injections due to neurogenic detrusor overactivity (NDOA). Urine samples of each child were collected before and after BoNT-A injections, specifically at the first and third postoperative months. Urine samples were analyzed with ELISA method and NGF, TGF-Beta-1, and TIMP-2 levels were measured. Urine marker levels and clinical findings were assessed for statistical significance with Wilcoxon Signed Ranks Test and Friedman Test. ResultsA total of 15 children (5 boys and 10 girls) were assigned as the study group. Mean age of the patients was 7.12.5 years (range 2.5-11). A statistically significantly decline was observed in urinary TGF-Beta-1 and NGF levels following BoNT-A injections, compared to the preoperative levels (P<0.05). TIMP-2 levels also tend to decrease following BoNT-A injections but this was not statistically significant compared to the preoperative levels. ConclusionThis preliminary study, suggests urinary TGF-Beta-1 and NGF as a potent marker in children with NDOA, as they decline following BoNT-A injection. Further studies are needed in identifying their special role in assessing treatment success after invasive interventions.Publication Open Access Clinical presentation, microbiological characteristics, and their implications for perioperative outcomes in xanthogranulomatous pyelonephritis: perspectives from a real-world multicenter practice(2023-05-10) TANIDIR, YILÖREN; Gauhar V., Robles-Torres J. I., Wroclawski M. L., Trujillo-Santamaría H., Teoh J. Y. C., Tanidir Y., Mahajan A., Gadzhiev N., Ragoori D., Kumar S., et al.Xanthogranulomatous pyelonephritis (XGP) is an uncommon chronic granulomatous infection of renal parenchyma. XGP is often associated with long-term urinary tract obstruction due to stones and infection. We aimed to analyze the clinical, laboratory, and microbial culture profiles from bladder and kidney urine of patients who were diagnosed with XGP. Databases of patients with histopathological diagnosis of XGP from 10 centers across 5 countries were retrospectively reviewed between 2018 and 2022. Patients with incomplete medical records were excluded. A total of 365 patients were included. There were 228 (62.5%) women. The mean age was 45 ± 14.4 years. The most common comorbidity was chronic kidney disease (71%). Multiple stones were present in 34.5% of cases. Bladder urine culture results were positive in 53.2% of cases. Kidney urine culture was positive in 81.9% of patients. Sepsis and septic shock were present in 13.4% and 6.6% of patients, respectively. Three deaths were reported. Escherichia coli was the most common isolated pathogen in both urine (28.4%) and kidney cultures (42.4%), followed by Proteus mirabilis in bladder urine cultures (6.3%) and Klebsiella pneumoniae (7.6%) in kidney cultures. Extended-spectrum beta-lactamases producing bacteria were reported in 6% of the bladder urine cultures. On multivariable analysis, urosepsis, recurrent urinary tract infections, increased creatinine, and disease extension to perirenal and pararenal space were independent factors associated with positive bladder urine cultures. On multivariable analysis, only the presence of anemia was significantly more frequent in patients with positive kidney cultures. Our results can help urologists counsel XGP patients undergoing nephrectomy.Publication Metadata only Atnalı böbrekte supi̇n perkütan nefroli̇totomi̇(2022-03-10) SARAÇOĞLU, SERTAÇ; TOPBAŞ, FEVZİ BATUHAN; ŞENER, TARIK EMRE; TANIDIR, YILÖREN; Şener T. E., Saraçoğlu S., Topbaş F. B., Tanıdır Y.Atnalı böbrek sık karşılaşılan bir füzyon anomalisidir. Üreter girişlerinin süperolateral yerleşimli olması sebebiyle toplayıcı sistem drenajı normal böbreklere kıyasla daha zordur ve bu durum kliniğe üriner staz, tekrarlayan idrar yolu enfeksiyonları ve tekrarlara böbrek taşı oluşumu ile yansır. Avrupa Üroloji Kılavuzlarına uygun olarak atnalı böbreklerde karşılaşılan >2cm taşlar için Perkütan Nefrolitotomi (PNL) taşsızlık oranları yüksek ve komplikasyon oranları düşük olan uygun bir seçenektir. Bu video-bildiride atnalı böbreğinde 25 mm’ye ulaşan taşı olan bir hastaya uygulanan supin mini-PNL ameliyatının tekniğini paylaşmayı amaçladık. Hasta: Hasta, B.K., ek hastalığı olmayan bir erkek hastadır. Hastanın 2017 tarihinden itibaren tekrarlayan idrar yolu enfeksiyonu ve taş düşürme öyküsü mevcuttur. Şiddetli sol yan ağrısı olması üzerine çekilen kontrastsız tüm batın tomografisinde atnalı böbrek anomalisi, sol böbrekte 25 x 14 x 16 mm renal pelvis taşı (Hounsfield maks 1275, ort 899) ve sağ böbrekte 4 x 4 mm & 3 x 2 mm alt kaliks taşları saptanmıştır. Hastanın sol böbrek taşına yönelik sol supin mini-PNL planlanarak hasta operasyon sonunda taşsız olacak şekilde operasyon komplikasyonsuz olarak tamamlanmıştır. Sonuç: Atnalı böbrekte supin perkütan nefrolitotomi güvenli ve etkili bir tedavi yöntemidir. Anahtar Kelimeler : Kidney, Horseshoe Kidney, Nephrolithotomy, PercutaneousPublication Metadata only Experimental and clinical applications and outcomes of using different forms of suction in retrograde intrarenal surgery. Results from a systematic review(2023-01-01) TANIDIR, YILÖREN; Giulioni C., Castellani D., Traxer O., Gadzhiev N., Pirola G., TANIDIR Y., Da Silva R., Glover X., Giusti G., Proietti S., et al.Objective: To identify the latest advances in suction devices and evaluate their effect in Retrograde intrarenal surgery (RIRS) and ureteroscopy for stones. Basic procedures: A systematic literature search was performed on 4 th January 2023 using Scopus, PubMed, and EMBASE. Only English papers were included; both pediatric and adult studies were accepted. Duplicate studies, case reports, letters to the editor, and meeting abstracts were excluded. Main findings: Twenty-one papers were selected. Several methods have been proposed for suction use in RIRS, such as through the ureteral access sheath or directly to the scope. Artificial intelligence can also regulate this system, monitoring pressure and perfusion flow values. All the proposed techniques showed satisfactory perioperative results for operative time, stone-free rate (SFR), and residual fragments. Moreover, the reduction of intrarenal pressure (induced by aspiration) was also associated with a lower infection rate. Even the studies that considered kidney stones with a diameter of 20 mm or higher reported higher SFR and reduced postoperative complications. However, the lack of well-defined settings for suction pressure and fluid flow prevents the standardization of the procedure. Conclusion: Aspiration device in the surgical treatment of urinary stones favours a higher SFR, reducing infectious complications, as supported by the included studies. RIRS with a suction system provided to be a natural successor to the traditional technique, regulating intrarenal pressure and aspirating fine dust.Publication Metadata only Intradetrusor botulinum neurotoxin A (BoNT-A) injections decrease bladder fibrosis secondary to partial urethral obstruction in the male rat model(WILEY, 2012) TİNAY, İLKER; Tinay, Ilker; Tanidir, Yiloren; Cikler, Esra; Cetinel, Sule; Tarcan, TufanAims We evaluated effects of BoNT-A injections on bladder function and histomorphology in a male-rat-overactive-bladder model, created by partial urethral obstruction.