Publications by authors named "Sinan L Kirecci"

4 Publications

  • Page 1 of 1

Rare Causes of Hydronephrosis in Adults and Diagnosis Algorithm: Analysis of 100 Cases During 15 Years.

Cureus 2020 May 21;12(5):e8226. Epub 2020 May 21.

Urology, Sisli Hamidiye Etfal Research and Training Hopsital, University of Health Sciences, Istanbul, TUR.

Introduction Hydronephrosis (HN) is a common pathology that is with/without obstruction. HN should be promptly addressed; otherwise, it progresses to cause impaired kidney function. This study was conducted to define the diagnosis algorithm and poor prognostic parameters used to evaluate unknown HN. Materials and Methods This study enrolled 100 patients who were over 20 years of age and were admitted to the center between 2001 and 2015 for the diagnosis and treatment of HN. Although initial diagnostic tests were applied, the HN etiology of the patients could not be found in ambulatory conditions; therefore, they were hospitalized to seek the causes for their HN. Patients who had a malignancy or tuberculosis or any previous ureteral injury were excluded. Results Of these cases, 29 were on both sides, whereas 42 were on the left side. Despite further investigations, the etiology was not determined in five patients. The frequency of malignancy in patients with hematuria (5/15) was two times higher than in patients without hematuria (33% vs. 17.6%; p = 0.01). Additionally, the malignancy rate was significantly higher in patients with weight loss (100%) than those without weight loss (OR: 6.25; p < 0.001). Conclusions Further investigation is recommended to define the precise etiology of HN. Hematuria and weight loss should be considered poor predictive factors during diagnosis.
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http://dx.doi.org/10.7759/cureus.8226DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7306661PMC
May 2020

Prognostic factors for surgical margin status and recurrence in partial nephrectomy.

Int J Clin Pract 2020 Oct 14;74(10):e13587. Epub 2020 Jul 14.

Department of Urology, Sisli Hamidiye Etfal Training & Research Hospital, Medical Sciences University, Istanbul, Turkey.

Purpose: To evaluate the prognostic factors affecting the surgical margin and recurrence in patients who underwent partial nephrectomy (PN) for renal masses.

Materials And Methods: Data of 125 patients who underwent open or laparoscopic PN because of renal mass between January 2006 and January 2019 were analysed retrospectively. Demographic data, habits, additional diseases, clinical and laboratory findings, operational data, the morphology of the tumour in computerised tomography or magnetic-resonance imaging and follow-up data were scanned and acquired via our hospital's system and archive.

Results: Average age was 54.4, male-female ratio was 1.55 and average tumour size was 3.31 cm. One hundred and four patients had malignant pathology and 21 were benign. Positive surgical margin (PSM) rate was 5.6% and recurrence rate was 3.2%. Average follow-up was 47.4 months. Pathological size of the tumour was larger (P = .006), warm-ischemia period was lower (P = .003) and PADUA score was higher (P = .015) in open technique. Tumour size and tumour stage were statistically higher in patients with recurrence (P = .009, P < .001, respectively). There was a significantly higher PSM ratio in mandatory indication group than elective indication group (P = .025). No statistically significant difference was observed between surgical margin positivity and tumour size, Fuhrman grades, PADUA scores, RENAL scores and C-index. (P > .05).

Conclusion: Surgical margin positivity after PN is not significantly associated with tumour characteristics and anatomical scoring systems. Surgical indication for PN has a direct influence on PSM rates. Tumour size and stage after PN are valuable parameters in evaluating the recurrence risk.
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http://dx.doi.org/10.1111/ijcp.13587DOI Listing
October 2020

Radical Cystectomy and Ileal Conduit Diversion for Bladder Urothelial Carcinoma With Sarcomatoid and Squamous Variants After Renal Transplantation.

Cureus 2020 May 2;12(5):e7935. Epub 2020 May 2.

Urology, Sisli Hamidiye Etfal Training and Research Hospital, University of Health Sciences, Istanbul, TUR.

Renal transplantation is the optimal treatment for patients with end-stage renal disease. However, the incidence of malignancies, especially urological malignancies, increases after renal transplantation due to long-term immunosuppressive treatments. We report a case of radical cystectomy and ileal conduit diversion in a 39-year-old female patient who developed invasive bladder carcinoma with extravesical extension three years after renal transplantation. Radical cystectomy and ileal conduit diversion surgery are feasible options for patients who developed invasive bladder cancer after renal transplantation and are effective methods for the protection of renal functions in the short-term follow-up period.
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http://dx.doi.org/10.7759/cureus.7935DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7265775PMC
May 2020

Lower urinary tract dysfunction in pediatric patients after ureteroneocystostomy due to vesicoureteral reflux: Long-term follow-up.

Low Urin Tract Symptoms 2019 Apr 11;11(2):O48-O52. Epub 2018 Jan 11.

Urology Department, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey.

Objective: The aim of the present study was to evaluate long-term lower urinary tract dysfunction (LUTD) in pediatric patients who underwent ureteroneocystostomy due to vesicoureteral reflux.

Methods: The present retrospective study was performed on 61 patients. Patients were divided into 3 groups: Group 1 (n = 26), did not have LUTD; Group 2 (n = 23), had LUTD; and Group 3 (n = 12), was not toilet trained preoperatively. Patients were reassessed regarding de novo LUTD or the persistence of LUTD at least 7 years after the ureteroneocystostomy.

Results: Mean patient age was 7 years (range 1-15) when ureteroneocystostomy was performed and the surgery was associated with a 92% success rate. The mean follow-up period was 10 years (range 7-12 years). Postoperative LUTD was present in 6 (23%), 12 (52%), and 1 (8.3%) patients in Groups 1, 2, and 3, respectively. The presence of LUTD before surgery and bilateral repair in the same setting were predictive risk factors for the presence of LUTD during the long-term follow-up. LUTD occurred at higher rate in Group 2 than in Groups 1 and 3 (52% vs. 23% and 8.3%, respectively; P = .015). The presence of de novo LUTD was significant in Group 1 compared with the presence of preoperative and postoperative LUTD (P = .031, Wilcoxon analysis).

Conclusions: LUTD may not resolve after a ureteroneocystostomy, and additional therapy could be necessary. Due to the probability of damage to the ureterovesical nerve and/or disturbed bladder dynamics, de novo LUTD may occur in patients with bilateral high-grade reflux without LUTD before a ureteroneocystostomy.
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http://dx.doi.org/10.1111/luts.12213DOI Listing
April 2019