Ognyan Gatsev - Academia.edu (original) (raw)
Papers by Ognyan Gatsev
Journal of Endourology and Minimally Invasive Surgery
Introduction: Prostate cancer is the most common malignancy in men in Europe. One of the importan... more Introduction: Prostate cancer is the most common malignancy in men in Europe. One of the important clinical problems is the early detection and visualization of recurrence after radical prostatectomy, radiation therapy or other radical topical treatment, in patients with PSA values above 0.2 ng/ml. With the introduction of molecular highly sensitive imaging methods after administration of radiolabeled prostate-specific membrane antigen (PSMA), it became possible to detect early functional changes associated with the development of a metastatic process in this disease, with a negative CT or MRI result. 99mTc-PSMA is a new radiopharmaceutical and is a small ligand that binds to the active core of PSMA. The aim of our study was to evaluate the clinical role of 99mTc-PSMA in imaging local recurrence and/or loco-regional and distant metastases in patients with recurrent prostate cancer and biochemical disease progression. Material and methods: A cohort of 36 prostate cancer patients was ...
Journal of Endourology and Minimally Invasive Surgery
Introduction and objective: The development of medical technology, the improvement of flexible en... more Introduction and objective: The development of medical technology, the improvement of flexible endoscopes and laser lithotripsy devices have led to an expansion of the indications for retrograde intrarenal surgery (RIRS) in the treatment of kidney stones. RIRS has an increased efficacy compared to extracorporeal shockwave lithotripsy (ESWL) and a lower complication rate compared to percutaneous nephrolithotomy (PCNL). With the increase in world’s population and age, the share of older people is increasing, especially in the Western countries. The aim of this study is to compare the efficacy and safety of RIRS in patients aged ≥ 65 years with those < 65 years. Material and methods: A retrospective study of 240 consecutive patients who underwent retrograde intrarenal surgery for renal stones, was performed. Patients were treated at the Clinic of Endourology and SWL of Military Medical Academy, Sofia, for a period from January 2019 to March 2021. 206 of patients were <65 years ol...
Journal of Endourology and Minimally Invasive Surgery
Objective The aim of the study was to compare the efficacy and safety of magnetic resonance imagi... more Objective The aim of the study was to compare the efficacy and safety of magnetic resonance imaging / ultrasound-targeted transperineal prostate biopsy versus standard transrectal systemic biopsy, in detection of prostate cancer, in patients with evidence of previous negative systematic transrectal ultrasound prostate biopsy. Material and Methods From February 2019 to February 2021 in the Clinic of Endourology and SWL of the Military Medical Academy – Sofia, in 59 patients repeated prostate biopsy was performed after a previous negative systematic transrectal ultrasound-guided biopsy. In 35/59 patients in the group, MRI / ultrasound transperineal prostate biopsy was performed (group A), and in the remaining 24/59 patients a repeat systemic TRUS biopsy was performed (group B). The main indications for repeat prostate biopsy were persistent elevated PSA values, a finding on rectal digital examination, and / or a suspected area of prostate MRI. Results. Preoperative data were comparabl...
Flexible Ureteroscopy, 2022
Journal of Endourology and Minimally Invasive Surgery
Introduction and objective: The application of ESWL in treatment of ureteral calculi is to achiev... more Introduction and objective: The application of ESWL in treatment of ureteral calculi is to achieve kidney desobstruction with minimal pain, aiming to reduce the need of analgesia and hospital stay. In times of Covid-19 pandemic by reducing the hospital stay, patients have less contacts and it is more safe for them from an epidemiological point of view. The objective of our study is to evaluate the efficacy and safety of ESWL as a method of kidney desobstruction caused of ureteral calculi during Covid-19 pandemic. Material and methods: A retrospectively collected database of 77 patients, who underwent ESWL for ureteral stones between February 2020 and January 2022 in the Clinic of Endourology and SWL, Military Medical Academy, Sofia, Bulgaria, was reviewed. Data on patients’ preoperative characteristics, stone-free rates, complications and auxiliary procedures were analyzed. Results: Patients’ mean age was 49.1±12.8 years and male-to-female ratio – 75.3%/24.7%. Mean stone length was ...
Journal of Endourology and Minimally Invasive Surgery
Introduction and objective: Acute renal colic due to ureteral calculi is a common urological emer... more Introduction and objective: Acute renal colic due to ureteral calculi is a common urological emergency that can be managed conservatively, by providing renal drainage and medical management of the pain syndrome followed by planned treatment, or by emergency surgery. With the onset of the COVID-19 pandemic leading to the temporary suspension of elective surgical activity, emergency ureteroscopy has become a valuable modality for the treatment of acute renal obstruction. The objective of this study is to evaluate the efficacy and safety of emergency ureteroscopy as first-line treatment for patients with acute renal obstruction due to ureteral stones during the COVID-19 pandemic. Material and methods: A prospectively collected database of 120 patients with acute renal obstruction due to ureteral stone who underwent emergency ureteroscopy within 24 hours from hospitalization between March 2020 and December 2021, was reviewed. Data on patients’ preoperative characteristics, stone-free ra...
Journal of Endourology and Minimally Invasive Surgery
Introduction: Anatomical features of the lower pole calyces plays an important role in the treatm... more Introduction: Anatomical features of the lower pole calyces plays an important role in the treatment of urolithiasis. The optimal treatment options for lower pole stones with a diameter below 2 cm are controversially discussed. Extracorporeal shock wave lithotripsy (SWL) is non-invasive, but is hampered by low stone-free rates and a significant retreatment rate in patients with unfavourable factors for lithotripsy. Retrograde intrarenal surgery (RIRS) has been demonstrated to have high stone-free rates since the development of modern flexible endoscopes. But the long operative time in the case of a large stone burden, unfavourable anatomy and considerable costs for consumables represent limiting factors for this technique. With the miniaturization of percutaneous approach and decreasing the morbidity, minimally invasive percutaneous nephrolithotomy (miniPCNL) is a promising method for treatment of lower pole stones in one stage procedure. The objective of this study is to investigat...
Journal of Endourology and Minimally Invasive Surgery
Introduction: MRI-Ultrasound (MRI/US) fusion-guided transperineal prostate biopsy (TPB) is gainin... more Introduction: MRI-Ultrasound (MRI/US) fusion-guided transperineal prostate biopsy (TPB) is gaining popularity in the diagnostic algorithm of prostate cancer. It is associated with higher pain score than the other methods of prostate biopsy. Effective analgesia is a key point for providing patient comfort and preventing his movement in response to pain with subsequent mismatch of the fused MRI/ US images. The mismatch could lead to inaccurate targeting of suspected cancer lesions. The preferred method of analgesia in an outpatient setting is topical intrarectal administration of lidocaine and periprostatic nerve block, but the pain and the discomfort from the procedure are not completely eliminated. Hypothetically, saddle block anesthesia has an expected better efficacy in relieving the pain from the MRI/US-TPB. Aim: To evaluate the efficacy and safety of saddle block anesthesia in patients undergoing MRI/US-TPB and сomparative analysis between patients who have received and have not...
Social Work & Christianity, 2021
Over the past few decades, researchers have focused considerable attention on religion, spiritual... more Over the past few decades, researchers have focused considerable attention on religion, spirituality, and faith (RSF) in social work. However, most of this research has been focused on the RSF of clients rather than on RSF of social workers themselves. This study used the Social Worker’s Integration of their Faith – Christian (SWIF-C; Author, 2019) to explore efforts by NACSW members (n = 486) to integrate their Christian faith and social work. Overall, participants reported high levels of faith and social work integration—with both faith and social work influencing the other—and also noted some experience of conflict in their effort to integrate their faith and social work. With a goal of developing sustained ethical and competent professional practice, the paper concludes with recommendations for helping students and supervisees integrate their own faith and social work.
Actas Urológicas Españolas, 2020
INTRODUCTION AND OBJECTIVES To assess the surgeon's ability to evaluate the composition of th... more INTRODUCTION AND OBJECTIVES To assess the surgeon's ability to evaluate the composition of the stone by observation of endoscopic images. MATERIALS AND METHODS A series of 20 video clips of endoscopic treatments of urinary stones of which was also available the result of infrared spectroscopy was uploaded to a YouTube site accessible only to members of the South Eastern Group for Urolithiasis Research (SEGUR) who were asked to identify the composition of the stones. RESULTS A total of 32 clinicians from 9 different countries participated in the study. The average number of correct detections of participants was 7.81 ± 2.68 (range 1-12). Overall accuracy was 39% (250 out of 640 predictions). Calcium oxalate dihydrate stones have been correctly detected in 69.8%, calcium oxalate monohydrate in 41.8%, uric acid in 33.3%, calcium oxalate/uric acid in 34.3% and cystine in 78.1%. Precision rates for struvite (15.6%), calcium phosphate (0%) and mixed calcium oxalate/calcium phosphate (9.3%) were quite low. CONCLUSIONS Observation of the stone during the endoscopic procedure was not reliable to identify the composition of most stones although it gave some information allowing to identify with a good sensitivity calcium oxalate dihydrate and cystine stones. Nevertheless, photo or video reporting of the intact stone and its internal structure could should be encouraged to implement results of still mandatory post-operative stone analysis. Endourologists should improve their ability of visual identification of the different types of stones.
Diagnostics, 2021
Objective: To evaluate spectrum and resistance rates to antibacterial agents in causative pathoge... more Objective: To evaluate spectrum and resistance rates to antibacterial agents in causative pathogens of bacterial prostatitis in patients from Southern Europe, the Middle East, and Africa. Materials: 1027 isolates from cultures of urine or expressed prostatic secretion, post-massage urine or seminal fluid, or urethral samples were considered. Results: Escherichia coli (32%) and Enterococcus spp. (21%) were the most common isolates. Other Gram-negative, Gram-positive, and atypical pathogens accounted for 22%, 20%, and 5%, respectively. Resistance was <15% for piperacillin/tazobactam and carbapenems (both Gram-negative and -positive pathogens); <5% for glycopeptides against Gram-positive; 7%, 14%, and 20% for aminoglycosides, fosfomycin, and macrolides against Gram-negative pathogens, respectively; 10% for amoxicillin/clavulanate against Gram-positive pathogens; <20% for cephalosporins and fluoroquinolones against to Gram-negative pathogens (higher against Gram-positive pathog...
DIAGNOSTICS, 2021
Objective: To evaluate spectrum and resistance rates to antibacterial agents in causative pathoge... more Objective: To evaluate spectrum and resistance rates to antibacterial agents in causative pathogens of bacterial prostatitis in patients from Southern Europe, the Middle East, and Africa. Materials: 1027 isolates from cultures of urine or expressed prostatic secretion, post-massage urine or seminal fluid, or urethral samples were considered. Results: Escherichia coli (32%) and Enterococcus spp. (21%) were the most common isolates. Other Gram-negative, Gram-positive, and atypical pathogens accounted for 22%, 20%, and 5%, respectively. Resistance was <15% for piperacillin/tazobactam and carbapenems (both Gram-negative and -positive pathogens); <5% for glycopeptides against Gram-positive; 7%, 14%, and 20% for aminoglycosides, fosfomycin, and macrolides against Gram-negative pathogens, respectively; 10% for amoxicillin/clavulanate against Gram-positive pathogens; <20% for cephalosporins and fluoroquinolones against to Gram-negative pathogens (higher against Gram-positive pathog...
Journal of Endourology and Minimally Invasive Surgery
Introduction: Prostate cancer is the most common malignancy in men in Europe. One of the importan... more Introduction: Prostate cancer is the most common malignancy in men in Europe. One of the important clinical problems is the early detection and visualization of recurrence after radical prostatectomy, radiation therapy or other radical topical treatment, in patients with PSA values above 0.2 ng/ml. With the introduction of molecular highly sensitive imaging methods after administration of radiolabeled prostate-specific membrane antigen (PSMA), it became possible to detect early functional changes associated with the development of a metastatic process in this disease, with a negative CT or MRI result. 99mTc-PSMA is a new radiopharmaceutical and is a small ligand that binds to the active core of PSMA. The aim of our study was to evaluate the clinical role of 99mTc-PSMA in imaging local recurrence and/or loco-regional and distant metastases in patients with recurrent prostate cancer and biochemical disease progression. Material and methods: A cohort of 36 prostate cancer patients was ...
Journal of Endourology and Minimally Invasive Surgery
Introduction and objective: The development of medical technology, the improvement of flexible en... more Introduction and objective: The development of medical technology, the improvement of flexible endoscopes and laser lithotripsy devices have led to an expansion of the indications for retrograde intrarenal surgery (RIRS) in the treatment of kidney stones. RIRS has an increased efficacy compared to extracorporeal shockwave lithotripsy (ESWL) and a lower complication rate compared to percutaneous nephrolithotomy (PCNL). With the increase in world’s population and age, the share of older people is increasing, especially in the Western countries. The aim of this study is to compare the efficacy and safety of RIRS in patients aged ≥ 65 years with those < 65 years. Material and methods: A retrospective study of 240 consecutive patients who underwent retrograde intrarenal surgery for renal stones, was performed. Patients were treated at the Clinic of Endourology and SWL of Military Medical Academy, Sofia, for a period from January 2019 to March 2021. 206 of patients were <65 years ol...
Journal of Endourology and Minimally Invasive Surgery
Objective The aim of the study was to compare the efficacy and safety of magnetic resonance imagi... more Objective The aim of the study was to compare the efficacy and safety of magnetic resonance imaging / ultrasound-targeted transperineal prostate biopsy versus standard transrectal systemic biopsy, in detection of prostate cancer, in patients with evidence of previous negative systematic transrectal ultrasound prostate biopsy. Material and Methods From February 2019 to February 2021 in the Clinic of Endourology and SWL of the Military Medical Academy – Sofia, in 59 patients repeated prostate biopsy was performed after a previous negative systematic transrectal ultrasound-guided biopsy. In 35/59 patients in the group, MRI / ultrasound transperineal prostate biopsy was performed (group A), and in the remaining 24/59 patients a repeat systemic TRUS biopsy was performed (group B). The main indications for repeat prostate biopsy were persistent elevated PSA values, a finding on rectal digital examination, and / or a suspected area of prostate MRI. Results. Preoperative data were comparabl...
Flexible Ureteroscopy, 2022
Journal of Endourology and Minimally Invasive Surgery
Introduction and objective: The application of ESWL in treatment of ureteral calculi is to achiev... more Introduction and objective: The application of ESWL in treatment of ureteral calculi is to achieve kidney desobstruction with minimal pain, aiming to reduce the need of analgesia and hospital stay. In times of Covid-19 pandemic by reducing the hospital stay, patients have less contacts and it is more safe for them from an epidemiological point of view. The objective of our study is to evaluate the efficacy and safety of ESWL as a method of kidney desobstruction caused of ureteral calculi during Covid-19 pandemic. Material and methods: A retrospectively collected database of 77 patients, who underwent ESWL for ureteral stones between February 2020 and January 2022 in the Clinic of Endourology and SWL, Military Medical Academy, Sofia, Bulgaria, was reviewed. Data on patients’ preoperative characteristics, stone-free rates, complications and auxiliary procedures were analyzed. Results: Patients’ mean age was 49.1±12.8 years and male-to-female ratio – 75.3%/24.7%. Mean stone length was ...
Journal of Endourology and Minimally Invasive Surgery
Introduction and objective: Acute renal colic due to ureteral calculi is a common urological emer... more Introduction and objective: Acute renal colic due to ureteral calculi is a common urological emergency that can be managed conservatively, by providing renal drainage and medical management of the pain syndrome followed by planned treatment, or by emergency surgery. With the onset of the COVID-19 pandemic leading to the temporary suspension of elective surgical activity, emergency ureteroscopy has become a valuable modality for the treatment of acute renal obstruction. The objective of this study is to evaluate the efficacy and safety of emergency ureteroscopy as first-line treatment for patients with acute renal obstruction due to ureteral stones during the COVID-19 pandemic. Material and methods: A prospectively collected database of 120 patients with acute renal obstruction due to ureteral stone who underwent emergency ureteroscopy within 24 hours from hospitalization between March 2020 and December 2021, was reviewed. Data on patients’ preoperative characteristics, stone-free ra...
Journal of Endourology and Minimally Invasive Surgery
Introduction: Anatomical features of the lower pole calyces plays an important role in the treatm... more Introduction: Anatomical features of the lower pole calyces plays an important role in the treatment of urolithiasis. The optimal treatment options for lower pole stones with a diameter below 2 cm are controversially discussed. Extracorporeal shock wave lithotripsy (SWL) is non-invasive, but is hampered by low stone-free rates and a significant retreatment rate in patients with unfavourable factors for lithotripsy. Retrograde intrarenal surgery (RIRS) has been demonstrated to have high stone-free rates since the development of modern flexible endoscopes. But the long operative time in the case of a large stone burden, unfavourable anatomy and considerable costs for consumables represent limiting factors for this technique. With the miniaturization of percutaneous approach and decreasing the morbidity, minimally invasive percutaneous nephrolithotomy (miniPCNL) is a promising method for treatment of lower pole stones in one stage procedure. The objective of this study is to investigat...
Journal of Endourology and Minimally Invasive Surgery
Introduction: MRI-Ultrasound (MRI/US) fusion-guided transperineal prostate biopsy (TPB) is gainin... more Introduction: MRI-Ultrasound (MRI/US) fusion-guided transperineal prostate biopsy (TPB) is gaining popularity in the diagnostic algorithm of prostate cancer. It is associated with higher pain score than the other methods of prostate biopsy. Effective analgesia is a key point for providing patient comfort and preventing his movement in response to pain with subsequent mismatch of the fused MRI/ US images. The mismatch could lead to inaccurate targeting of suspected cancer lesions. The preferred method of analgesia in an outpatient setting is topical intrarectal administration of lidocaine and periprostatic nerve block, but the pain and the discomfort from the procedure are not completely eliminated. Hypothetically, saddle block anesthesia has an expected better efficacy in relieving the pain from the MRI/US-TPB. Aim: To evaluate the efficacy and safety of saddle block anesthesia in patients undergoing MRI/US-TPB and сomparative analysis between patients who have received and have not...
Social Work & Christianity, 2021
Over the past few decades, researchers have focused considerable attention on religion, spiritual... more Over the past few decades, researchers have focused considerable attention on religion, spirituality, and faith (RSF) in social work. However, most of this research has been focused on the RSF of clients rather than on RSF of social workers themselves. This study used the Social Worker’s Integration of their Faith – Christian (SWIF-C; Author, 2019) to explore efforts by NACSW members (n = 486) to integrate their Christian faith and social work. Overall, participants reported high levels of faith and social work integration—with both faith and social work influencing the other—and also noted some experience of conflict in their effort to integrate their faith and social work. With a goal of developing sustained ethical and competent professional practice, the paper concludes with recommendations for helping students and supervisees integrate their own faith and social work.
Actas Urológicas Españolas, 2020
INTRODUCTION AND OBJECTIVES To assess the surgeon's ability to evaluate the composition of th... more INTRODUCTION AND OBJECTIVES To assess the surgeon's ability to evaluate the composition of the stone by observation of endoscopic images. MATERIALS AND METHODS A series of 20 video clips of endoscopic treatments of urinary stones of which was also available the result of infrared spectroscopy was uploaded to a YouTube site accessible only to members of the South Eastern Group for Urolithiasis Research (SEGUR) who were asked to identify the composition of the stones. RESULTS A total of 32 clinicians from 9 different countries participated in the study. The average number of correct detections of participants was 7.81 ± 2.68 (range 1-12). Overall accuracy was 39% (250 out of 640 predictions). Calcium oxalate dihydrate stones have been correctly detected in 69.8%, calcium oxalate monohydrate in 41.8%, uric acid in 33.3%, calcium oxalate/uric acid in 34.3% and cystine in 78.1%. Precision rates for struvite (15.6%), calcium phosphate (0%) and mixed calcium oxalate/calcium phosphate (9.3%) were quite low. CONCLUSIONS Observation of the stone during the endoscopic procedure was not reliable to identify the composition of most stones although it gave some information allowing to identify with a good sensitivity calcium oxalate dihydrate and cystine stones. Nevertheless, photo or video reporting of the intact stone and its internal structure could should be encouraged to implement results of still mandatory post-operative stone analysis. Endourologists should improve their ability of visual identification of the different types of stones.
Diagnostics, 2021
Objective: To evaluate spectrum and resistance rates to antibacterial agents in causative pathoge... more Objective: To evaluate spectrum and resistance rates to antibacterial agents in causative pathogens of bacterial prostatitis in patients from Southern Europe, the Middle East, and Africa. Materials: 1027 isolates from cultures of urine or expressed prostatic secretion, post-massage urine or seminal fluid, or urethral samples were considered. Results: Escherichia coli (32%) and Enterococcus spp. (21%) were the most common isolates. Other Gram-negative, Gram-positive, and atypical pathogens accounted for 22%, 20%, and 5%, respectively. Resistance was <15% for piperacillin/tazobactam and carbapenems (both Gram-negative and -positive pathogens); <5% for glycopeptides against Gram-positive; 7%, 14%, and 20% for aminoglycosides, fosfomycin, and macrolides against Gram-negative pathogens, respectively; 10% for amoxicillin/clavulanate against Gram-positive pathogens; <20% for cephalosporins and fluoroquinolones against to Gram-negative pathogens (higher against Gram-positive pathog...
DIAGNOSTICS, 2021
Objective: To evaluate spectrum and resistance rates to antibacterial agents in causative pathoge... more Objective: To evaluate spectrum and resistance rates to antibacterial agents in causative pathogens of bacterial prostatitis in patients from Southern Europe, the Middle East, and Africa. Materials: 1027 isolates from cultures of urine or expressed prostatic secretion, post-massage urine or seminal fluid, or urethral samples were considered. Results: Escherichia coli (32%) and Enterococcus spp. (21%) were the most common isolates. Other Gram-negative, Gram-positive, and atypical pathogens accounted for 22%, 20%, and 5%, respectively. Resistance was <15% for piperacillin/tazobactam and carbapenems (both Gram-negative and -positive pathogens); <5% for glycopeptides against Gram-positive; 7%, 14%, and 20% for aminoglycosides, fosfomycin, and macrolides against Gram-negative pathogens, respectively; 10% for amoxicillin/clavulanate against Gram-positive pathogens; <20% for cephalosporins and fluoroquinolones against to Gram-negative pathogens (higher against Gram-positive pathog...