Ali Ayranci - Academia.edu (original) (raw)

Papers by Ali Ayranci

We aimed to compare different treatment approaches in patients with failed ureteral access sheath... more We aimed to compare different treatment approaches in patients with failed ureteral access sheath placement during first flexible ureterorenoscopy (f-URS) session. Patients with kidney stones measuring 1-2 cm, presented to our urology clinic between April 2019 and April 2021, were included in the study for evaluation. Patients were randomized into two groups, in case of a failed ureteral access sheath placement during the first f-URS session. In group 1, ureteral JJ stent was placed for dilation and second session of f-URS was planned 4-6 weeks later. In group 2, mini percutaneous nephrolithotomy (mPNL) was performed in the same session. Pre-operative demographic data, operative and post-operative characteristics including complications and success rates were compared. Patients were assessed by Short-Form-36 (SF-36) questionnaires to compare overall life quality after each procedure. Twenty-four patients were included in each group. Pre-operative demographic data and stone character...

International Urology and Nephrology, 2022

Auxiliary nephrolithometric scoring systems (NSSs) have been developed to predict complications a... more Auxiliary nephrolithometric scoring systems (NSSs) have been developed to predict complications and treatment success of conventional percutaneous nephrolithotomy (PCNL). However, to our knowledge, there is no study comparing these NSSs in patients undergoing miniPCNL. This study aimed to compare the NSSs in terms of their ability to predict miniPCNL-related complications and treatment success. The data of patients undergoing PCNL between September 2016 and May 2018 were retrospectively reviewed through the electronic medical record system, and 140 patients were included in our study. Stone-free status was evaluated using non-contrast computed tomography between 1 and 3 months after the procedure. PCNL was considered successful if the patient was completely stone free. The postsurgical complications were classified according to the modified Clavien–Dindo classification system. The Clinical Research Office of the Endourological Society (CROES) and STONE NSSs significantly predicted miniPCNL treatment success (p = 0.043, p = 0.018). However, the Guy’s NSS did not significantly predict the treatment success (p = 0.415). Guy’s, CROES and STONE NSSs were not found to significantly predict postsurgical complications (p = 0.584, p = 0.823, p = 0.189). To the best of our knowledge, our study is the first of its kind to investigate the ability of NSSs to predict treatment success and postsurgical complications in patients undergoing miniPCNL. The study found that STONE and CROES NSSs are independent parameters for predicting stone-free status after miniPCNL. In addition, our study found that none of the NSSs were useful in predicting postsurgical complications in patients undergoing miniPCNL.

Journal of B.U.ON. : official journal of the Balkan Union of Oncology, 2019

PURPOSE To evaluate patients, diagnosed with non-muscle invasive bladder cancer, according to pat... more PURPOSE To evaluate patients, diagnosed with non-muscle invasive bladder cancer, according to patient specific parameters including hemoglobin level, estimated glomerular filtration rate (eGFR), body mass index (BMI) and cigarette smoking and to identify if any of these parameters matters in terms of recurrence prediction. METHODS 231 patients who have undergone transurethral resection of the bladder (TURB) between January 2015 and January 2018 and diagnosed with non-muscle invasive bladder cancer (NMIBC) were included. Patient demographic characteristics including age, sex, BMI and cigarette smoking were assessed. Hemoglobin, creatinine and eGFR values were recorded. Follow-up was performed according to the European Association of Urology (EAU) guidelines' recommendations. Recurrence and progression during follow-up were recorded. RESULTS 231 patients were included in the study. Median patient BMI, Hb levels, and eGFR values were 26.51 kg/m2 (IQR 5.48), 14,2 g/dL (IQR 2.50), an...

Ginekologia Polska, 2020

Objectives: The aim of this study is to evaluate the short-term outcomes of our modified autologo... more Objectives: The aim of this study is to evaluate the short-term outcomes of our modified autologous transobturator tape (aTOT) technique with rectus abdominis muscle fascial graft for the treatment of female stress urinary incontinence (SUI). Material and methods: The data of 22 patients who underwent modified aTOT were recorded. Perioperative data regarding operative time, complications and postoperative visual analogue scores were noted. Patients were assessed 18 months after surgery. The primary endpoints of this study were the improvements in the International Consultation on Incontinence Questionnaire-Female Lower Urinary Tract Symptoms (ICIQ-FLUTS) subscores, one-hour pad test and cough stress test rates as an objective cure as well as the improvements in the PGI-I and ICIQ-FLUTS quality of life scores as a subjective cure. Results: Mean age and the mean follow-up period were 51.7 ± 9.8 years and 20.1 ± 0.9 months, respectively. Urethral hypermobility and a positive cough stress test were detected in all the patients. Mean operative time was 43.8 ± 8.1 min. and the overall complication rate was 9%. Mean VAS scores at postoperative 24 hours were 2.6 ± 1.2. At the postoperative eighteenth month, no patient had a positive cough test and mean PGI-I score was 2 while two patients had moderate urinary incontinence according to the pad test. Pad test results, ICIQ subscores of voiding QoL, incontinence, incontinence QoL, total score and total QoL score at baseline and eighteen months after surgery were 76.

Journal of Reconstructive Urology, 2018

The goal of this study is describe mid-urethral sling surgery without mesh usage to avoid mesh re... more The goal of this study is describe mid-urethral sling surgery without mesh usage to avoid mesh related complications. For this purpose our modified transobturator mid-urethral sling technique with the short-term results was evaluated. M Ma at te er ri ia al l a an nd d M Me et th ho od ds s: : The data of 20 patients performed modified transobturator mid-urethral sling with autologous tissue were recorded. The primary endpoints of this study were improvements in The International Consultation on Incontinence Questionnaire-Female Lower Urinary Tract Symptoms (ICIQ-FLUTS) scores and quality of life scores, one-hour pad test measurements, and cough stress tests rates as an objective cure, and Patients Global Impressions of Improvements (PGI-I) scale as a subjective cure. Categorical variables were compared using a paired Student's t-test. R Re es su ul lt ts s: : Twenty patients with a mean age of 50.5±3.3 years and mean body mass index of 28.9±3.9 kg/m 2 , were enrolled in the study. The mean follow-up time was 3.9±0.8 months. Mean operation time was 42.7±7.5 minutes, and complication rates were 1/20 (5%). The mean PGI-I score was 2 postoperatively which means much better than preoperatively. The positive cough test rate and one-hour pad weight gain were statistically lower postoperatively. The decreases of subscores and quality of life scores of the incontinence section were statistically significant. The total ICIQ-FLUTS score and quality of life scores were significantly reduced in the postoperative period. C Co on nc cl lu us si io on n: : To avoid mesh related complications of mid-urethral sling surgeries, our modified transobturator mid-urethral sling technique is a feasible option for patients and surgeons with its short-term effectiveness and safety profile. K Ke ey yw wo or rd ds s: : Stress urinary incontinence; autograft; midurethral sling surgery; mesh; autologous fascial sling Ö ÖZ ZE ET T A Am ma aç ç: : Bu çalışmada, stres üriner inkontinans tedavisinde sentetik meşlerle ilişkili komplikasyonlardan kaçınabilmek için sentetik meş kullanmadan midüretral askı cerrahisi tanımlanmak istenmiştir. Bu amaçla modifiye otolog transobturator midüretral askı cerrahisi (m-OTOT) tekniğimizin kısa dönem sonuçları sunulmuştur. G Ge er re eç ç v ve e Y Yö ön nt te em ml le er r: : m-OTOT uygulanan 20 hastanın preop ve postop "The International Consultation on Incontinence Questionnaire-Female Lower Urinary Tract Symptoms (ICIQ-FLUTS)" skorları, 1 saatlik ped testi ölçümleri, stres testi sonuçları, yaşam kalitesi ölçeği (QoL) ve postop "Patients Global Impressions of Improvements (PGI-I)" skalasını içeren datalar toplandı. Kategorik değişkenler, eşleştirilmiş bir Student t-testi kullanılarak karşılaştırıldı. B Bu ul lg gu ul la ar r: : Yaş ortalaması 50,5±3,3, beden kitle endeksi 28,9±3,9 kg/m 2 olan 20 hastanın ortalama takip süresi 3,9±0,8 aydır. Ortalama ameliyat süresi 42,7±7,5 dakika ve komplikasyon oranı 1/20 (%5) (lokal tedavi ile iyileşen vajinal erozyon)'dir. PGI-I skoru 2 olarak belirtilmiştir ve ameliyat öncesine göre daha iyi olma durumunun karşılığıdır. Pozitif stres test oranı ve 1 saatlik ped testinde ağrılık artışı oranları postoperatif dönemde anlamlı olarak düşüktü. ICIQ-FLUTS formunda inkontinans bölüm skoru ve inkontinans bölümü yaşam kalitesi skoru postop dönemde anlamlı iyileşme göstermiştir, ayrıca toplam ICIQ-FLUTS skorU ve toplam yaşam kalitesi skoru da anlamlı olarak iyileşmiştir. S So on nu uç ç: : Stres üriner inkontinans cerrahisinde mesh ile ilişkili komplikasyonlarından kaçınmak için, modifiye transobturator orta üretral sling tekniğimiz, kısa süreli etkinliği ve güvenlik profili ile hastalar ve cerrahlar için uygun bir seçenektir.

Türk Üroloji Dergisi/Turkish Journal of Urology, 2018

Objective: The aim of this study is to describe a novel transobturator midurethral sling surgery ... more Objective: The aim of this study is to describe a novel transobturator midurethral sling surgery technique by using rectus abdominis fascia. Material and methods: A 54-year-old woman complaining of urinary leakage during effort was diagnosed as pure stress urinary incontinence after detailed questioning, pelvic examination, uroflowmetry and measurement of residual urine volume. She was anxious about complications related to synthetic meshes. However, she was not interested in relatively morbid surgeries such as colposuspension and pubovaginal sling. Autologous transobturator midurethral sling was discussed with the patient. The patient approved the surgery and the surgery was planned. A 5 cm rectus fascia was harvested via suprapubic incision and nonabsorbable stay sutures were placed on its' both edges. Anterior vaginal incision together with paravaginal dissection was performed, as in classical transobturator sling surgery. Groin puncture and blind dissection of adipose tissue was performed. C-shaped trocars were inserted, and advanced through groin punctures and brought up to midurethral incision by finger guidance. Stay sutures were transported via C-shaped trocars to the groin puncture in both sides. Graft was positioned on the midurethral part without any tension and stay sutures were tied to create a tissue bridge on obturator membrane. Incisions were closed and vaginal tampon was placed. Patient was discharged at the first postoperative day. Results: At postoperative third and sixth months, patient was totally dry and did not have any voiding complaints. Small abdominal and vaginal incisions were clean, as well. Conclusion: Autologous transobturator midurethral sling surgery is a safe, effective and feasible surgical option for stress urinary incontinence in the era which mesh-related concerns are rising. Studies with larger volume and long-term follow up periods are needed.

Urolithiasis, 2018

In the present study, we aimed to clarify predictive factors that may cause postoperative infecti... more In the present study, we aimed to clarify predictive factors that may cause postoperative infectious complications after flexible ureterorenoscopy (f-URS). In a 4-year prospective study, charts of patients who underwent fURS between January 2014 and January 2018 for renal stone(s) in a tertiary academic center were reviewed. A standardized fURS procedure was performed for all patients. Post-operative infectious complications including fever, sepsis and septic shock were categorized into same group. Patients with and without infectious complications were compared in the terms of preoperative, operative and post operative characteristics. In total, 463 patients who did not face infectious complications and 31 patients who faced infectious complications were enrolled into the study. The mean age was significantly lower in patients who did face infectious complications (34.8 vs 44.7 years old, p < 0.001). On the other hand, presence of renal abnormality was significantly more common in patients with infectious complications (12.3% vs 35.5%, p < 0.001). The mean operation time was 65.3 min in patients with infectious complications and significantly longer when compared with patients who did not face infectious complication (47.8 min, p < 0.001). Stone-free rate was significantly higher in patients without infectious complications (85.3% vs 77.5, p = 0.009). Multivariate regression analysis revealed that longer operation time ≥ 60 min, presence of renal abnormality and age ≤ 40 years were predictive factors for infectious complications following fURS. The present study has demonstrated that operation time ≥ 60 min, presence of renal abnormality and patients with ≤ 40 years were significantly associated with infectious complications following fURS .