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    Comparative results of transurethral incision with transurethral resection of the prostate in renal transplant recipients with benign prostate hyperplasia
    (Urol & Nephrol Res Ctr-Unrc, 2018) Sarıer, Mehmet; Duman, İbrahim; Kılıç, Süleyman; Yüksel, Yücel; Demir, Meltem; Aslan, Mesut; Emek, Mestan; Yücetin, Levent; Tekin, Sabri; Yavuz, Asuman Havva
    Purpose: The aim of this study is to compare the results of transurethral incision of the prostate (TUIP) and transurethral resection of the prostate (TURP) for the surgical treatment of benign prostate hyperplasia (BPH) in patients with renal transplantation. Materials and Methods: Between April 2009 and May 2016, BPH patients with renal transplants whose prostate volumes were less than 30 cm(3) were treated surgically. Forty-seven patients received TURP and 32 received TUIP. The patients' age, duration of dialysis, duration between transplant and TURP/TUIP, preoperative and postoperative serum creatinine (SCr), International Prostate Symptom Score (IPSS), maximum flow rate (Qmax) and postvoid residual volume (PVR) were recorded. At 1-,6- and 12-month follow-up, early and long-term complications were assessed. Results were evaluated retrospectively. Results: In both groups, SCr, PVR and IPSS decreased significantly after the operation, while Qmax increased significantly (P < .001). There was no difference between the two groups in terms of increase in Qmax and decrease in IPSS, SCr and PVR (P = .89, P = .27, P = .08, and P = .27). Among postoperative complications, urinary tract infection (UTIs) and retrograde ejaculation (RE) rates were higher in the TURP group than the TUIP group (12.7% versus 6.2% and 68.1% versus 25%,respectively), whereas urethral strictures were more prevalent in the TUIP group (12.5% versus 6.3%). Conclusion: For the treatment of BPH in renal transplant patients with a prostate volume less than 30 cm(3) , both TUIP and TURP are safe and effective.
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    Öğe
    Results of minimally invasive surgical treatment of allograft lithiasis in live-donor renal transplant recipients: a single-center experience of 3758 renal transplantations
    (Springer, 2019) Sarıer, Mehmet; Duman, İbrahim; Yüksel, Yücel; Tekin, Sabri; Demir, Meltem; Arslan, Fatih; Yavuz, Asuman Havva
    Allograft lithiasis is a rare urologic complication of renal transplantation (RT). Our aim is to present our experience with minimally invasive surgical treatment of allograft lithiasis in our series of live-donor renal transplant recipients. In a retrospective analysis of 3758 consecutive live-donor RTs performed in our center between November 2009 and January 2017, the results of minimally invasive surgery for the treatment of renal graft lithiasis diagnosed at follow-up were evaluated. Twenty-two (0.58%) patients underwent minimally invasive surgery for renal graft lithiasis. The mean age was 41.6 years, and duration between RT and surgical intervention was 27.3 months (range 3-67). The mean stone size was 11.6 mm (range 4-29). Stones were located in the urethra in 1, bladder in 2, ureter in 9, renal pelvis in 7 and calices in 3 patients. Surgical treatment included percutaneous nephrolithotomy in 1, cystoscopic lithotripsy in 3, flexible ureteroscopic lithotripsy in 6 and rigid ureteroscopic lithotripsy in 12 patients. No major complications were observed. One patient (4.5%) who underwent flexible ureteroscopy developed postoperative urinary tract infection. All patients were stone-free except two (9%) patients who required a second-look procedure after flexible ureteroscopic lithotripsy for residual stones. Stone recurrence was not observed in any patient during a mean follow-up duration of 30.2 months (range 8-84). Renal transplant lithiasis is uncommon and minimally invasive surgical treatment is rarely performed for its treatment. Endourological surgery may be performed safely, effectively and with a high success rate in these patients.
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    Öğe
    Results of transurethral resection of the prostate in renal transplant recipients: A single center experience
    (Springer, 2018) Sarıer, Mehmet; Tekin, Sabri; Duman, İbrahim; Yüksel, Yücel; Demir, Meltem; Alptekinkaya, Furkan; Koşar, Alim; Yavuz, Asuman Havva; Güler, Mehmet
    The aim of this study was to retrospectively evaluate the early and long-term results of renal transplantation (RT) patients undergoing transurethral resection of the prostate (TURP) due to benign prostate hyperplasia (BPH). Eighty-nine patients with RT performed in our hospital underwent TURP between November 2008 and March 2016. Results were evaluated along with early and long-term complications. Patients were followed up for a minimum of 12 months. The mean age of the patients was 61.4 +/- 7.4 years. The median duration of dialysis was 28 (0-180) months. The median duration between transplantation and TURP was 13 (0-84) months. Before TURP, the mean serum creatinine (sCr) was 1.99 +/- 0.83 mg/dL and the mean prostate volume was 33.3 +/- 14.6 cm(3). The mean Q (max), Q (ave) and PVR values were 9.5 +/- 3.7, 5.2 +/- 2.2 ml/s and 85(5-480) mL, respectively. None of the patients developed perioperative and postoperative major complications. Twelve patients (13.4%) developed urinary tract infections in the postoperative period. The sCr, IPSS and PVR values significantly decreased, while Q (max) and Q (ave) significantly increased at the 1-month follow-up. At the 6-month follow-up, 63 (70.8%) patients had retrograde ejaculation. Patients were followed up for a median of 42 (12-96) months. Three patients (3.3%) were re-operated for bladder neck contracture and eight (8.9%) patients were re-operated for urethral stricture. TURP can be safely and successfully applied for the treatment of BPH after RT. LUTS and renal functions significantly improve after the operation. Patients should be followed up for UTIs in the short term and for urethral stricture in the long term.