Journal of Reconstructive Urology

.: ORIGINAL RESEARCH
Renal Transplantasyon ve Endoskopik Üreter Taş Ameliyatı Sonrası DJ Üreteral Stent Yerleştirilen Hastaların Semptomlarının Karşılaştırılması
Comparison of the Symptoms of the Patients Who Had DJ Ureteral Stent Procedure After Renal Transplantation and Endoscopic Ureterolithiasis Surgery
Özkan ONUKa
aÜroloji Kliniği, Yeni Yüzyıl Üniversitesi Özel Gaziosmanpaşa Hastanesi, İstanbul, TÜRKİYE
J Reconstr Urol. 2019;9(1):6-10
doi: 10.5336/urology.2019-65209
Article Language: TR
Full Text
ÖZET
 Amaç: Dünyada son dönem böbrek yetmezliği prevalansı giderek artmakta olup, buna bağlı olarak renal transplantasyon operasyonları da artmaktadır. Renal transplantasyon sonrasında bazı hastalara DJ üreteral stent yerleştirilmekte, fakat bu stentlere bağlı semptomlar sorgulanmamaktadır. Bu çalışmada, bu semptomların ve uygun tedavi stratejilerinin ortaya konulması amaçlanmıştır. Gereç ve Yöntemler: Bu çalışmada, renal transplantlı 48 hasta ve endoskopik üreter taş cerrahisi uygulanan 48 hasta prospektif olarak değerlendirildi. Hastaların semptomları Uluslararası Prostat Semptom Skorlaması, Wong-Baker Ağrı Skalası ve aşırı aktif mesane değerlendirme formları ile değerlendirildi. DJ üreteral stent yerleştirilen hastalar postoperatif birinci hafta ve DJ üreteral stent çekileceği dördüncü hafta değerlendirildi. Bulgular: Renal transplantasyon sonrası ve üreter taş cerrahisi sonrası DJ üreteral stent takılan her iki grup hasta arasında Uluslararası Prostat Semptom Skorlaması, ağrı derecelendirme ölçeği ve aşırı aktif mesane semptom skorları açısından istatiksel olarak anlamlı fark saptanmadı. Gruplar kendi içinde ve karşılıklı olarak semptom skorları karşılaştırıldı ve anlamlı fark bulunmadı. Endoskopik üreter taş tedavisi olan üç hasta, semptomların şiddetli olması nedeni ile DJ üreteral stent erken çekildi ve bu hastalar çalışma dışı bırakıldı. Renal transplantasyon sonrası yedi hasta ve endoskopik üreter taş tedavisi sonrası sekiz hastada üriner sistem enfeksiyonu saptandı ve kültür antibiyogramlarına göre tedavi verildi. Sonuç: Endoskopik üreter taşı tedavisi sonrasında DJ üreteral stente bağlı semptomları azaltmak için uygulanan medikal tedavi, renal transplantasyon sonrası DJ üreteral stent uygulanan hastalarda da görülen semptomları azaltmada faydalı olabilmektedir.

Anahtar Kelimeler: Kronik böbrek yetmezliği; üreter taşları; üreterorenoskopi
ABSTRACT
 Objective: The number of the renal transplantation surgeries has been on the rise in recent years due to gradually increasing prevalence of the renal failure in the world. A group of the patients undergo DJ stent procedures afterwards the transplantation, however the symptoms after the procedure are not well questionned by the professionals in usual. In this study it is aimed to evaluate these symptoms and assess the treatment strategies. Materials and Methods: Forty-eight patients underwent renal transplantation while 48 patients had endoscopical ureterolithiasis surgery have been evaluated prospectively. International Prostate Symptom Scoring, Wong-Baker Pain Scale and Overactive Bladder Questionnaire were answered by two groups of patients in the postoperative first week and the fourth week that the DJ ureteral stent was removed. Results: There were no significant differences statistically between two groups that underwent renal transplantation and ureterolithiasis surgery. The scores of both groups were compared between and within each others. In 3 patients, DJ stents had to be removed early than expected, due to the severe symptoms and all had been excluded. 7 patients in renal transplantation group and 8 patients in endoscopical urolithiasis surgery group were diagnosed with urinary infection and treated in accordance with antibiogram tests. Conclusion: The medical treatment regimes given to ease the DJ ureteral stent associated symptoms can be beneficial for the patients who underwent the DJ ureteral stent procedure after renal transplantation.

Keywords: Kidney failure, chronic; ureteral calculi; ureteroscopy
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