Etiology and Treatment of Renal Forniceal Rupture: A Single Center Experience

Objective: To evaluate the clinical findings, treatment methods and outcomes of patients treated for renal forniceal rupture (RFR). Materials and Methods: Files and records of the patients treated for RFR between January 2013 and November 2016 were evaluated retrospectively. In primary treatment; ureteroscopy and laser/pneumatic lithotripsy (URL) with stone fragmentation and double J (JJ) stent placement were performed in patients with no finding of sepsis. However, only JJ stent/percutaneous nephrostomy placement was performed in those with sepsis findings. The demographic characteristics, related symptoms, and the results of primary and secondary treatment of the patients were evaluated. Results: We had 43 patients with a mean age of 48.6±16.6 years. No cause was found in 4 patients while a urological cause was identified in 39 of them by using anamnesis, physical examination, laboratory and imaging methods. Out of 43 patients, percutaneous nephrostomy catheterization was performed in 5 of 32 patients under primary treatment. URL and JJ stenting were performed in the remaining 11 patients. Additionally, due to giant retroperitoneal urinoma, a retroperitoneal drain was placed in 2 patients by interventional radiology clinic. Conclusion: URL and stone fragmentation seem to be feasible treatment option in the primary treatment of patients with RFR without sepsis findings.

Anahtar Kelime:

Konular: Üroloji ve Nefroloji Cerrahi

Renal Forniks Rüptürü Etiyolojisi ve Tedavisi: Tek Merkez Deneyimi

Öz:

Amaç: Renal forniks rüptürü (RFR) sebebi ile tedavi ettiğimiz hastaların klinik bulguları, tedavi yöntemleri ve sonuçlarını değerlendirmeyi amaçladık. Gereç ve Yöntem: 2013 Ocak-2016 Kasım tarihleri arasında RFR sebebi ile tedavi ettiğimiz hastaların dosyaları ve bilgisayar kayıtları retrospektif olarak değerlendirildi. Hastaların tamamına öncelikle ampirik tedavi başlandı. İdrar kültürü-antibiyogram sonucuna göre gerekli görülen hastalarda seftriakson uygun olan başka bir antibiyotik ile değiştirildi. Sepsis bulgularının olmaması durumunda tedavi olarak üreteroskopi ve lazer/pnömotik litotriptör (ÜRL) ile taş fragmantasyonu ve double J (DJ) stent yerleştirilmesi ameliyatı yapılmıştı. Ancak; sepsis bulgularının olması durumunda tek başına DJ stent/perkütan nefrostomi yerleştirilmesi yapılmıştı. Hastaların demografik özellikleri, ilişkili semptomları, primer ve sekonder tedavilerinin sonuçları değerlendirildi. Bulgular: Hastalarımız yaş ortalaması 48,6±16,6 (23-82) olan 22’si erkek 21’i kadın olmak üzere 43 hastadan oluşmaktaydı. Hastaların yapılan anamnez, fizik muayene, laboratuvar ve görüntüleme yöntemleri ile 4’ünde sebep bulunamazken, 39’unda ürolojik bir sebep saptandı. Kırk üç hastanın 32’sinde hastaya acil tedavide 5 hastaya perkütan nefrostomi kateteri konulurken, 27 hastaya lokal anestezi altında sistoskopi eşliğinde DJ stent takıldı. Geri kalan 11 hastaya ise ÜRL ile taş fragmantasyonu ve DJ stent yerleştirilmesi yapılmıştı. Ayrıca 2 hastaya dev ürinom sebebi ile retroperitoneal dren yerleştirilmişti. Sonuç: Her iki grup tedavi başarısı ve komplikasyonlar açısından değerlendirildiğinde fark olmadığı düşünülürse, sepsis bulguları olmayan spontan RFR’si olan hastalarda öncelikli tedavide ÜRL ve taş fragmantasyonu uygulanabilir bir tedavi gibi görünmektedir.

Anahtar Kelime:

Konular: Üroloji ve Nefroloji Cerrahi

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık

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APA	erçil H, tümer e, senturk a, ALMA E, ÜNAL U, deniz m, EVLİYAOĞLU Y, gürbüz Z (2018). Etiology and Treatment of Renal Forniceal Rupture: A Single Center Experience. , 68 - 72. 10.4274/jus.1639
Chicago	erçil Hakan,tümer erbay,senturk aykut bugra,ALMA Ergun,ÜNAL UMUT,deniz mehmet eflatun,EVLİYAOĞLU Yalçın Kaya,gürbüz Zafer gökhan Etiology and Treatment of Renal Forniceal Rupture: A Single Center Experience. (2018): 68 - 72. 10.4274/jus.1639
MLA	erçil Hakan,tümer erbay,senturk aykut bugra,ALMA Ergun,ÜNAL UMUT,deniz mehmet eflatun,EVLİYAOĞLU Yalçın Kaya,gürbüz Zafer gökhan Etiology and Treatment of Renal Forniceal Rupture: A Single Center Experience. , 2018, ss.68 - 72. 10.4274/jus.1639
AMA	erçil H,tümer e,senturk a,ALMA E,ÜNAL U,deniz m,EVLİYAOĞLU Y,gürbüz Z Etiology and Treatment of Renal Forniceal Rupture: A Single Center Experience. . 2018; 68 - 72. 10.4274/jus.1639
Vancouver	erçil H,tümer e,senturk a,ALMA E,ÜNAL U,deniz m,EVLİYAOĞLU Y,gürbüz Z Etiology and Treatment of Renal Forniceal Rupture: A Single Center Experience. . 2018; 68 - 72. 10.4274/jus.1639
IEEE	erçil H,tümer e,senturk a,ALMA E,ÜNAL U,deniz m,EVLİYAOĞLU Y,gürbüz Z "Etiology and Treatment of Renal Forniceal Rupture: A Single Center Experience." , ss.68 - 72, 2018. 10.4274/jus.1639
ISNAD	erçil, Hakan vd. "Etiology and Treatment of Renal Forniceal Rupture: A Single Center Experience". (2018), 68-72. https://doi.org/10.4274/jus.1639

APA	erçil H, tümer e, senturk a, ALMA E, ÜNAL U, deniz m, EVLİYAOĞLU Y, gürbüz Z (2018). Etiology and Treatment of Renal Forniceal Rupture: A Single Center Experience. Journal of Urological Surgery, 5(2), 68 - 72. 10.4274/jus.1639
Chicago	erçil Hakan,tümer erbay,senturk aykut bugra,ALMA Ergun,ÜNAL UMUT,deniz mehmet eflatun,EVLİYAOĞLU Yalçın Kaya,gürbüz Zafer gökhan Etiology and Treatment of Renal Forniceal Rupture: A Single Center Experience. Journal of Urological Surgery 5, no.2 (2018): 68 - 72. 10.4274/jus.1639
MLA	erçil Hakan,tümer erbay,senturk aykut bugra,ALMA Ergun,ÜNAL UMUT,deniz mehmet eflatun,EVLİYAOĞLU Yalçın Kaya,gürbüz Zafer gökhan Etiology and Treatment of Renal Forniceal Rupture: A Single Center Experience. Journal of Urological Surgery, vol.5, no.2, 2018, ss.68 - 72. 10.4274/jus.1639
AMA	erçil H,tümer e,senturk a,ALMA E,ÜNAL U,deniz m,EVLİYAOĞLU Y,gürbüz Z Etiology and Treatment of Renal Forniceal Rupture: A Single Center Experience. Journal of Urological Surgery. 2018; 5(2): 68 - 72. 10.4274/jus.1639
Vancouver	erçil H,tümer e,senturk a,ALMA E,ÜNAL U,deniz m,EVLİYAOĞLU Y,gürbüz Z Etiology and Treatment of Renal Forniceal Rupture: A Single Center Experience. Journal of Urological Surgery. 2018; 5(2): 68 - 72. 10.4274/jus.1639
IEEE	erçil H,tümer e,senturk a,ALMA E,ÜNAL U,deniz m,EVLİYAOĞLU Y,gürbüz Z "Etiology and Treatment of Renal Forniceal Rupture: A Single Center Experience." Journal of Urological Surgery, 5, ss.68 - 72, 2018. 10.4274/jus.1639
ISNAD	erçil, Hakan vd. "Etiology and Treatment of Renal Forniceal Rupture: A Single Center Experience". Journal of Urological Surgery 5/2 (2018), 68-72. https://doi.org/10.4274/jus.1639