Comparison of Monopolar Versus Bipolar Repeat Transurethral Resection of Bladder Tumours.

OBJECTIVE: To compare the effects of monopolar and bipolar energy sources on efficacy of both techniques and possible complications in bladder cancer patients undergoing repeat Transurethral resection of bladder tumour (re-TURBT). STUDY DESIGN: Descriptive study. Place and Duration of the Study: University of Health Science, Izmir Bozyaka Research and Training Hospital, Turkiye, from 2019 to 2021. METHODOLOGY: Patients undergoing re-TURBT were inducted. Patients with residual tumour at initial TURBT, recurrent bladder cancer and patients with a non-urothelial pathology report in initial TURBT were excluded. The primary outcome was the complication ratio of the TURBT which were obturator reflex, bladder wall perforation, coagulum retention, fever, and TUR syndrome. The secondary outcome was the efficacy of the TURBT procedure, such as complete tumour resection, adequate sampling of deep muscle tissue, and sampling of qualified tissues without any thermal damage. RESULTS: One hundred and twenty-three patients were enrolled; 75 patients in re-M-TURBT group and 48 patients in re-B-TURBT group were analysed. Demographic and tumour characteristics, and complication rates according to the Clavien classification, were similar between the two groups (p = 0.302). The catheterisation time was shorter significantly in the bipolar re-TURBT group (median 4 vs. 3 days, respectively, p = 0.025). CONCLUSION: Monopolar and Bipolar energy sources are techniques that can be used safely in re-TURBT in terms of both appropriate pathology sampling (adequate muscle tissue sampling, cautery artifact) and complication (obturator reflex, hyponatraemia, haemoglobin decrease, bleeding) rates. KEY WORDS: Bladder Cancer, Monopolar, Bipolar, TURBT, Obtrator reflex, Complications.

The comparison of perioperative outcomes between percutaneous nephrolithotomy and retrograde intrarenal surgery in elderly patients.

OBJECTIVES: In this study, we aimed to compare the outcomes and complication rates of percutaneous nephrolithotomy (PCNL) and retrograde intrarenal surgery (RIRS) in elderly patients. MATERIALS AND METHODS: Between April 2011 and January 2020, patients who underwent PCNL and RIRS for renal stone in elderly patients were retrospectively evaluated. The two groups' perioperative values, stone-free rates and complication rates were compared. Post-operative complications were noted according to the Clavien scoring system. RESULTS: There were 89 and 72 patients in the PCNL and RIRS group respectively. The median age was 67 years in both the groups (P = .192). The stone size were 22.2 ± 3.5 mm and 19.9 ± 7.1 mm in the PCNL and RIRS group, respectively (P = .082). Stone-free rates were significantly higher in PCNL group (P = .021, P = .034). Also we found that overall complication and major complication rates were significantly higher in PCNL group (P = .016, P = .029). CONCLUSION: Despite there was higher stone clearance in PCNL, the complication rates were higher compared with RIRS. So RIRS might be a safe alternative treatment method to PCNL in older patients.

The Influence of Aging on Outcomes in Patients Undergoing Percutaneous Nephrolithotomy for Complete Staghorn Stones: A Retrospective Comparative Study.

Objective In this study, we aimed to evaluate the effect of age on the success and complications of percutaneous nephrolithotomy (PCNL) for complete staghorn renal stones. Materials and methods The files of 182 patients who underwent single-access PCNL for complete staghorn renal stones between 2012 and 2017 were retrospectively analyzed. The patients were divided into two groups according to their age: those aged <65 years were defined as Group-1 and those aged ≥65 years as Group-2. The demographic characteristics and perioperative and postoperative results were compared between the two groups. Results Among the patients with complete staghorn renal stones, 139 were in Group-1 and 43 were in Group-2. The mean age of the patients was 43.9 ±10.6 years in Group-1 and 67.8 ±2.1 years in Group-2 (p=0.001). The rate of hemoglobin drop was significantly higher in Group-1 (p=0.001). However, the blood transfusion rate was higher in Group-2 than in Group-1 (18.6% vs. 7.2%, respectively). The stone-free rate was 54.7% in Group-1 and 67.4% in Group-2 (p=0.139). As for the evaluation of the overall complication rates, 34.5% of the patients in Group-1 and 46.5% of those in Group-2 developed complications (p=0.206). According to the Clavien scoring system, the rate of minor complications was found to be 22.3% in Group-1 and 41.9% in Group-2, and the difference was statistically significant (p=0.012). The major complication rates were determined as 4.7% and 12.2% for Group-1 and Group-2, respectively (p=0.155). The number of patients with Clavien grade-2 complications was significantly higher in the elderly patient group (p=0.019). Conclusions Based on our findings, PCNL is an effective and safe method in the treatment of complete staghorn stones in elderly patients.