Category: Clinical Stones: Ureteroscopy

MP24-4 - What is Impact of Ureteral Access Sheat Size On Acute Kidney Injury Biomarkers in Retrograde Intrarenal Surgery: A Prospective, Randomized Study

Sun, Sep 23
10:00 AM - 12:00 PM

Introduction & Objective : An uretereal access sheat (UAS) has been developed to facilitate access for Retrograde Intrarenal Surgery (RIRS). There are different UASs available in the market with different characteristics, different sizes, and lengths. In this study, we aimed to evaluate whether use of different sizes of UAS during RIRS due to kidney stone has any effect on protecting the kidney functions by measuring urinary kidney injury molecule-1 (KIM-1), neutrophil gelatinase-associated lipocalin (NGAL) and N-Acetyl Beta- D-Glucosaminidase (NAG) levels.


Methods : Between September 2017 to March 2018, 54 patients were included into the present study.  Patients were randomized into two groups. In group 1 (n=27), and group 2 (n=27) patients underwent RIRS by using 9.5 Fr UAS (Cook™, Dublin, Ireland) and 12 Fr UAS (Re-Trace™, Coloplast, Denmark), respectively. Urine samples were obtained from participants immediately before, 2 and 24 hours after the surgery. In all the samples obtained, KIM-1, NGAL, NAG levels were measured. 


Results : Demographic data were established and found to be similar between group 1 and 2 (Table 1). In group 1, KIM-1, NGAL and NAG levels did not change significantly after the surgery. In group 2, second hour after the surgery, urine KIM-1, NGAL and NAG levels significantly increased compared with preoperative levels (pthhour NGAL and NAG levels decreased, KIM-1 levels significantly higher compared with preoperative levels (Table 2). 


Conclusions :

Our results show that acute kidney injury biomarkers (KIM-1, NGAL and NAG) increased early postoperative period in thick size of UAS group. Except for the KIM-1, the others returned to initial levels after postoperative 24 hours. In light of our results, we may recommend to use thin size of UAS during RIRS.  

Altug Tuncel

University of Health Sciences, Ankara Numune Research and Training Hospital
Department of Urology
Ankara, Ankara, Turkey

Dr. Altug Tuncel received a medical degree from the Gazi University, Ankara, Turkey in 1996 and completed his medical proficiency training at the same university in Urology Department on March 2002. Later he started to work as a chief assistant at the Third Urology Clinic at Ankara Numune Research and Training Hospital of Ministry of Health on July 2002. Then, he got the Scientific and Technological Research Council of Turkey (TUBITAK)’s Postdoctoral Research Scholarship and worked as a research fellow for 9 months at University of Texas (USA), Faculty of Medicine, Southwestern Medical Centre, Department of Urology, Minimally Invasive Surgical Division under the guidance of Prof.Dr.Jeffrey A.Cadeddu and took part in some research projects on endourology and urooncology. At Minimally Invasive Surgical Training Centre of the same Department, he was trained in urologic laparoscopic surgery through practical work at wet laboratory with animal models and at dry laboratory with Virtual Reality Simulator (Lap Mentor®). He also attented laparoscopic operations done by Prof.Dr.Cadeddu as observer. After turning back to Turkey, he has started doing urologic laparoscopic surgeries at the clinic where he is currently working. He got the title of associate professor on December 2008. He was promoted to post of Professor at the University of Health Sciences Faculty of Medicine, Department of Urology, Turkey. Dr.Tuncel who has certificate of Turkish Urology Proficiency Council and Certification of Fellows of the European Board of Urology (FEBU). In his urology practices focuses more on endourology and urooncology.

Can Aykanat

University of Health Sciences, Ankara Numune Research and Training Hospital
Department of Urology
Ankara, Ankara, Turkey

Melih Balci

University of Health Sciences, Ankara Numune Research and Training Hospital
Department of Urology
Ankara, Ankara, Turkey

Kilinckaya Muhammed

University of Health Sciences, Ankara Numune Research and Training Hospital
Department of Biochemistry
Ankara, Ankara, Turkey

Seref Coser

University of Health Sciences, Ankara Numune Research and Training Hospital
Department of Urology
Ankara, Ankara, Turkey

Ali Ozercan

University of Health Sciences, Ankara Numune Research and Training Hospital
Department of Urology
Ankara, Ankara, Turkey

Serkan Akdemir

Izmir Medical Park Hospital
Department of Urology
Izmir, Izmir, Turkey

Ozer Guzel

University of Health Sciences, Ankara Numune Research and Training Hospital
Department of Urology
Ankara, Ankara, Turkey

Murat Arslan

Izmir Medical Park Hospital
Department of Urology
İzmir, Izmir, Turkey

Turan Turhan

University of Health Sciences, Ankara Numune Research and Training Hospital
Department of Biochemistry
Ankara, Ankara, Turkey

Yilmaz Aslan

University of Health Sciences, Ankara Numune Research and Training Hospital
Department of Urology
Ankara, Ankara, Turkey