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Objective:This study aims to review the parameters affecting tumour recurrence, tumour progression and cancer survival of patients with low-grade non-muscle invasive bladder cancer.Materials and Methods:We retrospectively reviewed 262 patients with primary, low-grade Ta bladder cancer. Recurrence was defined as the occurrence of a new tumour in the prostatic urethra or bladder. Tumour progression was defined as confirmed high-grade Ta, all T1 or carcinoma in situ, upper tract recurrence or progression to T2. The associations between factors that affect recurrence and progression were analysed.Results:Tumour recurrence and progression occurred in 119 (45.4%) and 25 (9.5%) patients during follow-up (median follow-up: 50.9±36.3 months), respectively. Univariate and multivariate analyses demonstrate that smoking, multiple tumours and large tumours (3 cm3 cm) and smoking were risk factors for recurrence and progression. Prevention of smoking and routine cystoscopic examination are essential in bladder cancer.

Objective:This study aimed to investigate the influence of different ischaemia techniques on short-term and one year renal function following laparoscopic partial nephrectomy (LPN).Materials and Methods:Data of 359 patients who underwent LPN between November 2009 and April 2018 were reviewed, retrospectively. A total of 287 patients were included in the study. Patients were divided into 4 groups according to type of ischaemia as follows: group A (n=33) was warm ischaemia time (WIT) >20 minute, group B (n=202) was WIT ≤20 minute, group C (n=16) was selective arterial clamping and group D (n=36) was off-clamp. Demographic data, preoperative and postoperative outcomes were compared. The estimated glomerular filtration rate (eGFR) was calculated using the Chronic Kidney Disease Epidemiology Collaboration equation. Change in eGFR according to group and time was evaluated using two-way analysis of variance. P values 0.05) between groups. Only 4 patients in group B had positive surgical margin. The percentage of relative eGFR (% of ΔeGFR) decline 1 year after LPN was significantly (p=0.001) higher in the ischaemic groups (A and B: 9.3% and 7.5%) compared to the zero-ischaemia groups (C and D: 5% and 3.7%).Conclusion:This study revealed that after LPN, cumulative renal function decreases to a certain extent regardless of the technique. However, it was found that cumulative renal functions are better preserved when ischaemia time is reduced to ≤20 min or eliminated.

Objective:Laparoscopic adrenalectomy (LA) is the treatment of choice for benign tumours of less than 6 cm. However, there is still an ongoing debate regarding the exact cut-off value of the tumour size. The aim of this study was to determine the effect of tumour size on intraoperative and postoperative outcomes in patients undergoing LA and also to estimate the learning curve for large adrenal tumours.Materials and Methods:The data of 102 patients who underwent LA from April 2010 to October 2018 was retrospectively analysed. The patients were allocated to 2 groups according to tumour size

Objective:The aim of this study is to investigate the surgical and functional outcomes of laparoscopic partial nephrectomy (LPN) in patients with renal angiomyolipoma (RAML).Materials and Methods:From April 2014 to February 2018, the data of a total of 346 patients who underwent LPN were retrospectively reviewed. Twenty-one patients with final pathology report indicating RAML were included in the study. Demographic data, operative indications, intraoperative and postoperative outcomes as well as complications were evaluated.Results:Eighteen female (85.7%) and 3 male (14.3%) patients were included in this study. The mean age was 55.14±11.95 years. Of the RAMLs, 52.4% were in the right kidney and 47.6% in the left kidney. The mean tumor size was 31.38±16.72 mm and the mean RENAL Nephrometry score was 5.90±1.51 (4-10). RAML could not be differentiated from RCC in 12 patients (57.1%) by preoperative computer tomography and/or magnetic resonance images. In 4 patients, LPN was implemented by off-clamp technique whereas, in 17 patients it was implemented by global ischemia technique. The mean operation duration was 67.86±20.77 (40-110) minutes (min) and the mean estimated blood loss was 117.14±59.7 (30-220) milliliters. In 17 patients who underwent LPN by global ischemia technique, the mean warm ischemia time was 10.88±5.19 (6-22) min. According to the Modified Clavien-Dindo classification, grade 1 complications were detected in 3 patients, postoperatively. The most considerable renal functional changes were detected between preoperative and postoperative- 1st day levels. However, at the end of the first year, the difference was found to decrease.Conclusion:LPN is a safe and effective treatment option for the treatment of RAMLs that are not able to be distinguished from renal cell carcinoma radiologically. Besides the definitive treatment, the exact pathological diagnosis can be ensured by LPN.

The incidence of renal tumor on the allograft kidney is relatively rare. There is no standard treatment available for the management of such cases. However, if technically feasible nephron-sparing surgical approaches, whether open or minimally invasive, should be preferred for the management of these challenging cases. To our knowledge, there is no pure laparoscopic technique reported in the literature but only 3 cases of robot-assisted partial nephrectomy. In this article, we aimed to present the application of pure transperitoneal laparoscopic partial nephrectomy for the management of a renal mass on the allograft kidney.

Yakupoglu, Yarkin Kamil/0000-0002-4764-0289; Mercimek, Mehmet Necmettin/0000-0002-0680-4451 WOS: 000494962600007 Leiomyomas are rare, benign and solid tumors of the kidney. Although the developments in radiological imaging methods provide early detection of kidney tumors, it is difficult to differentiate leiomyomas radiologically from other malignant renal tumors. Moreover, the definitive diagnosis of leiomyomas can only be achieved by histopathological and also immunohistochemical evaluation after surgical intervention. Immunohistochemically, positive staining with smooth muscle actin and vimentin, whereas negative staining with cytokeratin, S100, Mart1 and HMB45 are the methods used in the differential diagnosis of leiomyomas. In this case series, after preoperative radiological evaluation, two female and two male patients between 45 and 89 years of age underwent laparoscopic treatment with the diagnosis of a malignant mass in the kidney. We aimed to illustrate the clinical, radiological and histopathological relationship of four adult patients who were managed by laparoscopic approach and diagnosed with renal leiomyoma. Renal leiomyomas should be kept in mind in patients with a renal mass before definitive treatment.

Objective:In the present study, we aimed to investigate the short- and long-term protective effects of oral sirolimus therapy on extracorporeal shock wave lithotripsy (ESWL)-induced kidney tissue damage in an experimental rat model.Materials and Methods:Twenty-four male Spraque-Dawley rats were used in the study. A total of 1000 shock waves (SWs) were applied to the left kidney of all rats at 15 kV, 60 SW/min. Two main groups, ESWL (group 1) and ESWL sirolimus (group 2), were formed. Each group was divided into two subgroups as early (E) and late (L). Left nephrectomy was performed on the 15th day in E groups and on the 60th day in L groups. Tubular injury, interstitial changes, as well as scar formation, were scored semi-quantitatively for at least 10 cortical fields in each sample. An average score was calculated for each subject. Independent samples t-test was used for statistical analysis. The statistical significance was accepted as p

Ongün, Şakir (Balikesir Author), Objective To present a nation-wide analysis of the workload of urology departments in Turkey week-by-week during Covid-19 pandemic. Methodology The centres participating in the study were divided into three groups as tertiary referral centres, state hospitals and private practice hospitals. The number of outpatients, inpatients, daily interventions and urological surgeries were recorded prospectively between 9-March-2020 and 31-May-2020. All these variables were recorded for the same time interval of 2019 as well. The weekly change of the workload of urology during pandemic period was evaluated, also the workload of urology and the distributions of certain urological surgeries were compared between the pandemic period and the same time interval of the year 2019. Results A total of 51 centres participated in the study. The number of outpatients, inpatients, urological surgeries and daily interventions were found to be dramatically decreased by the 3rd week of pandemics in state hospitals and tertiary referral centres; however, the daily urological practice were similar in private practice hospitals throughout the pandemic period. When the workload of urology in pandemic period and the same time interval of the year 2019 were compared, a huge decrease was observed in all variables during pandemic period. However, temporary measures like ureteral stenting, nephrostomy placement and percutaneous cystostomy have been found to increase during Covid-19 pandemic compared with normal life. Conclusions Covid-19 pandemic significantly affected the routine daily urological practice likewise other subspecialties and priority was given to emergent and non-deferrable surgeries by urologists in concordance with published clinical guidelines.

Background: Partial nephrectomy (PN) is the standard of treatment in patients with cT1 renal tumors. Current guidelines recommend PN as a standard of treatment in patients with cT1 renal tumors. Ho...

Mercimek, Mehmet Necmettin/0000-0002-0680-4451; Gulsen, Murat/0000-0001-5371-0960; Ozden, Ender/0000-0003-3196-4024 WOS: 000526101600001 PubMed: 32293992 Background: A double-pigtail ureteral stent (DPUS) can cause untoward symptoms, such as urgency, frequency, urinary incontinence, hematuria, and body pain that are bothersome to patient's quality of life (QoL). By reducing the quantity of material in the bladder, it could be reasonable to decrease stent-related symptoms (SRSs). We aimed to evaluate the tolerability of single pigtail suture stent (SPSS) with a validated questionnaire after uncomplicated retrograde semirigid ureteroscopic lithotripsy (URSL). Materials and Methods: A total of 130 patients who underwent ureteral stent placement after URSL for unilateral symptomatic ureteral stones with

Purpose Iatrogenic bladder injury remains a major challenge. We compared the success and reliability of laparoscopic repair of intraperitoneal bladder rupture in patients who had undergone total laparoscopic hysterectomy. Methods This retrospective study included patients who underwent total laparoscopic hysterectomy for benign gynaecological cases at a tertiary academic hospital between January 2018 and June 2019. All patient medical records included in the study were reviewed, and the causes, incidence and management of bladder injuries were assessed. Results There were nine patients. The cause of all the ruptures was iatrogenic, and all were intra-operatively detected. In all patients, bladder injuries occurred in the posterior side of the bladder during vesicouterine dissection. Laparoscopic bladder perforation repair was performed successfully in all patients. No major complications had occurred in any patients after surgery. The foley catheters were removed 6.67 +/- 0.7 (5-7) days after surgery. Conclusions If performed by well-trained laparoscopic surgeons, laparoscopic hysterectomy could be the best option for appropriate patients. Nevertheless, patients should be well aware of the potential complications in endometriosis and caesarean cases before the procedure, and care should be paid during dissection. When a urogenital injury is suspected or detected the condition must be adequately identified and proper treatment must be performed to avoid postoperative complications and long-term morbidity. WOS:000526169600001 2-s2.0-85083427391 PubMed: 32267049

Ozden, Ender/0000-0003-3196-4024; Mercimek, Mehmet Necmettin/0000-0002-0680-4451 WOS: 000525208400001 PubMed: 32208049 Background: Considering the increase in a number of vascular complications, right laparoscopic donor nephrectomy is less preferred due to achieving not only shorter renal vein but also longer renal artery. However, recent studies have indicated that the side of the surgery would not affect the outcomes. Aim: The aim of this study is to evaluate the outcomes and strategies to increase the safety of pure retroperitoneoscopic donor nephrectomy (RDN). Methods: We analyzed the prospectively collected medical records of 158 kidney donors who underwent RDN from January 2010 to August 2018. The patients were divided into two groups based on their side of surgery. Right- and left-sided RDNs were compared in terms of demographics, intraoperative, and postoperative data, including the development of incisional hernia (IH). The outcomes of the recipients were also evaluated. Results: Right RDN was performed in 40 (25.3%) and left RDN was performed in 118 (74.7%) donors. Operation time (P = .593), warm ischemia time (P = .271), blood loss (P = .787), and length of hospital stay (P = .908) were statistically similar in right and left RDN groups. Intraoperative and postoperative complications were statistically showed no difference between right and left RDNs. No IH was observed in any group. One-year and five-year patient survival and graft survival rates were 100% versus 97% (P = .299) and 100% versus 95% (P = .126) on both sides, respectively. Conclusion: Right RDN is an effective and safe method as on the left side. RDN has an additional advantage in the absence of IH. Experience with other retroperitoneoscopic urological interventions may have had a positive effect on the outcomes of pure RDN.

Ganglioneuroma is a rare benign tumor originates from neurol crest and may develop anywhere along the sympathetic nervous system is present. Nearly all patients with ganglioneuroma are older than 10 years old. In most cases ganlioneuromas are detected incidentally during work-up for unrelated conditions. Nevertheless, radiological and differential diagnosis of retroperitoneal masses may be challenging. We present management of a 6-year-old boy with ganglioneuroma that located in left retroperitoneum.

Primary bladder melanoma (PBM) is an extremely rare tumor. Herein, we present a 39-year female evaluated for a history of dysuria and hematuria for one month and a solid mass of 23x15 mm detected on the left lateral wall of the bladder. The transurethral resection (TUR) of the tumor revealed muscle-invasive malignant melanoma. Laparoscopic partial cystectomy (LPC) and bilateral pelvic lymph node dissection (BPLND) were performed since other sites of melanoma were excluded. In this article, the effects of tumor characteristics and minimally invasive treatment options on survival are discussed in a patient with muscle-invasive PBM.

Unilateral synchronous multifocal renal tumors are rare. Due to the limited data in the literature and challenges in the technique, there is still doubt on the application of laparoscopic partial nephrectomy (LPN) for the management of such tumors. Herein, we report a 36-year male patient presenting with right-sided flank pain and microscopic hematuria. Abdominal computed tomography (CT) revealed five solid masses, the largest of which was 27 x 18 mm. The patient underwent LPN and the largest mass was resected with the control of segmental artery of the lower pole of the right kidney. The remaining four masses were resected by zero-ischemia technique. Final pathology revealed renal cell carcinoma in all masses. Postoperative period was uneventful. No recurrence was detected during a 5-year follow-up.

Objective: Infections play an important part in post-transplantation causes of morbidity and mortality. The purpose of this study is to evaluate short-, and long-term infections encountered in after renal transplantations. Material and methods: Two hundred and thirteen cases that consisted of both living and cadaver donors, who suffered from late period renal insufficiency and had renal transplant between June 2011 and January 2016 at the Transplantation Center of Sanko University School of Medicine were included in the study. In this study the short-, and long-term infections seen in post renal transplantation were examined retrospectively. Infection types, frequency and periods of infection, infection agents and predisposing factors were determined as the examination parameters. Results: Of the 213 patients who received renal transplant, 139 were males (65.3%) and 74 were women (34.75%) and the mean age was 42 +/- 11,8 (range, 14-70) years. Twelve (5.6%) patients exited after renal transplantation. Post-transplant infections were seen in 49 patients (23.1%) within 1-6 months; in 13 patients (6.1%) within 6-12 months; and in 5 patients (2.4%) after the 12th month. The most common infections after renal transplantation were associated with urinary tract (70 patients, 34.3%). The most frequently isolated agents were E. coli (n=66; 30.9%), Kebsiella spp. (n=18; 8.4%) and Enterococci (n=18; 8.4%) respectively. The renal transplants from the cadavers were observed to contract infections 1.78 times more frequently compared to the living donors (OR=1.78, 95% CI=1.03-3.09). Conclusion: The most common complication after renal transplantation are infections. The majority of the infections are seen within the first year especially between 1-6 months. Post-transplant infections are often related to urinary system. E. coli is the most frequently isolated agent and it may be responsible for urosepsis in renal transplant patients. Infection more often seen in renal transplantations from cadavers.

Aim: To investigate the effects of using 5 mg/day tadalafil on inflammatory indicators including lymphocyte to monocyte ratio (LMR) and monocyte to high-density lipoprotein ratio (MHR) in patients with erectile dysfunction (ED).Material and Methods: This retrospective study included 62 subjects that 31 patients with ED and 31 healthy controls with a normal erectile function. The patients with ED were given a daily 5 mg dose of tadalafil over eight weeks. Baseline and post-treatment erectile function was evaluated using the International Index of Erectile Function (IIEF-5). Changes in IIEF-5 score and inflammatory indicators including LMR and MHR have compared both in ED patients and with controls.Results: The patients and the controls were statistically comparable with respect to age, Diabetes Mellitus, hypertension, coronary artery disease, CRP, testosterone, serum creatinine, lipid profile, LMR, and MHR. The mean IIEF-5 score was 22.97 vs 14.32 (p=0.001) in control and patients with ED, respectively. Having been used 5 mg of tadalafil per day over 8 weeks, an increase in IIEF-5 score (p=0.001) and a decrease in the number of monocytes (p=0.008) were detected in patients with ED. However, there was no statistically significant difference found in LMR and MHR before and after the treatment.Conclusion: According to the results of this study, no significant effect was found daily use of 5mg tadalafil on inflammatory indicators including LMR and MHR. The decrease in the number of monocytes that play a key role in inflammation may have been considered a response to treatment, however, randomized prospective studies are needed to evaluate the relationship among LMR, MHR and tadalafil treatment.

Early diagnosis and treatment of ureteral obstructions are important in terms of protection of renal function. Ureteral strictures which have benign or malignant etiology, can take place a lot of intrinsic and extrinsic reasons. The primary objective is decompression of existing urinary obstruction. Treatment option should be based on according to general conditon and life expectancy of patient, etiology, length and localisation of stricture and renal function. In benign uretral stricture extensive use of endourologic, laparoscopic and robot-assisted treatment options, aplicability and treatment results were reported in various studies, the preference of minimally invasive methods have increased instead of open surgery. DOI:10.4274/kiud.15

Anterior urethra stones are extremely rare causes of acute urinary retention. The data of 34 adult patients who presented with acute urinary retention between August 2011 and September 2017 and treated with anterior urethra were evaluated retrospectively. Their ages, sizes of stones, locations, etiological factors, physical examination findings, treatment modalities, operation period and complications were analyzed. All the patients were male and the mean age was 46.9 ± 17.88 years. All of the stones evaluated in the study were single and the mean stone size was 12.17 ± 3.23 (6-19) mm. Location of the urethral calculi was fossa navicularis in 12 (35.3%) patients, bulbar urethra in 7 (20.6%) patients and penile urethra in 15 (44.1%) patients. A total of 20 patients had urinary calculi located in the other parts of the urinary system at the time of presentation. Stone of the 7 patients with fossa navicularis localized had been treated by intraurethral instillation of 2% lidocaine gel, the other 5 patients had been treated with ventral meatotomy. Urethral stone of the 7 patients with penile and bulbar urethra located was taken by the help of direct forceps without requiring any fragmentation operation. Other stones were treated with endoscopic holmium laser lithotripsy. As a result of surgery operations, urinary tract infection in 3 patients, urethrorrhagia in 2 patients and hematuria in 5 patients were observed. We consider that it is very important to keep anterior urethral stones in mind among differential diagnosis especially in male patients admitted with acute urinary retention. acute urinary retention. [Med-Science 2019; 8(2.000): 365-9]

Yakupoglu, Yarkin Kamil/0000-0002-4764-0289; Mercimek, Mehmet Necmettin/0000-0002-0680-4451; ozkaya, ozan/0000-0002-0198-1221; Ozden, Ender/0000-0003-3196-4024 WOS: 000285141900098 PubMed: 21074805 Purpose: Although percutaneous nephrolithotomy has been accepted as an effective minimally invasive procedure in children, there is still no consensus on how to define and stratify complications by severity. Materials and Methods: We retrospectively reviewed data of children who underwent percutaneous nephrolithotomy at our center between January 2002 and March 2010. A total of 100 procedures were performed in 94 patients with a mean age of 9.5 years. Complications were recorded according to modified Clavien classification. Results: Average stone burden ranged from 100 to 2,850 mm(2) (mean +/- SD 507.5 +/- 475). Stones were located in the renal pelvis in 32 kidneys, calices in 20, renal pelvis and calices in 31, and upper ureter in 3. Stone-free rate after a single session of percutaneous nephrolithotomy was 85%. After auxiliary procedures in 7 cases stone-free rate increased to 89%. Grade I complications were seen in 7 patients postoperatively, grade II in 19 (hematuria requiring blood transfusion in 13 and nonseptic infection requiring antibiotics in 6) and grade III in 4 (hydro-hemothorax in 2 and urine leakage requiring Double-J (R) stent in 2). No grade IV or V complications were observed. Regression analysis showed that stone burden (OR 1.006, 95% CI 1.001-1.011; p = 0.03) and operative time (OR 1.044, 95% CI 1.011-1.077; p = 0.009) were independent risk factors for complications. Conclusions: Percutaneous nephrolithotomy in children is safe, feasible and effective. Stone burden and operative time are independent risk factors for complications. The modified Clavien system provides a straightforward and validated method to classify postoperative complications.

Epispadias is one of the rarest congenital urological anomalies. In epispadias, prepuce is usually a redundant tissue located on the ventral part of penis. Diagnosis is easily made on physical examination. The presence of a complete prepuce associated with epispadias is rare, and diagnosis can be difficult. A 2.5-year-old male patient was admitted to our center for circumcision. Preputial skin was intact and patient presented with a concealed penis. In this paper, we report an unusual case with epispadias and a concealed penis. The patient was managed with a one-stage reconstruction. © 2013 by Türkiye Klinikleri.

Management of kidney stone disease in pediatric population is a challenging condition in urology practice. While the incidence of kidney stone is increasing in those group, technological innovations have conrtibuted to the development of minimally invasive treatment of urinary stone disease such as mini-percutenous nephrolitotomy (mini-PCNL), micro-PCNL, ultra mini-PCNL. In this review we tried to evaluate the effect of new teratment techniques on pediatric kidney stones.

Yakupoglu, Yarkin Kamil/0000-0002-4764-0289; Mercimek, Mehmet Necmettin/0000-0002-0680-4451; Ozden, Ender/0000-0003-3196-4024 WOS: 000303470600012 PubMed: 22309786 OBJECTIVE To present our long-term follow-up data from patients with kidney stones and chronic kidney disease to identify the factors that could help predict the likelihood of long-term deterioration in renal function. METHODS From January 2002 to July 2010, we performed 1117 percutaneous nephrolithotomy (PNL) procedures in 1051 patients. We retrospectively analyzed 69 PNL procedures for 67 patients (47 men and 20 women) in whom the estimated glomerular filtration rate (eGFR) was 5%; and group 3, an eGFR decrease of

tomy tube insertion (p 0.0002, OR 6.4), and post operative fever (p 0.0001). CONCLUSIONS: For patients undergoing PCNL and URS, factors predisposing the development of sepsis include bladder outlet obstruction, positive pre-operative urine culture, and nephrostomy tube insertion. Treatment of a positive preoperative urine culture did not reduce the risk of sepsis, and cannot be considered a reliable preventative measure. A larger sample size is needed to perform multivariate analysis and logistic regression. This would elucidate relationships found on univariate analysis and enable further risk stratification.

Cystic hydatid disease is an endemic disease caused by the larval form of Echinococcus spp. Isolated renal involvement is extremely rare. The treatment methods for renal hydatid disease require some form of intervention, ranging from traditional open techniques to laparoscopic techniques. Herein, we present a large hydatid cyst in the lower pole of the left kidney in a 43-year-old male patient who was treated by the "closed cyst" method via the retroperitoneal laparoscopic approach to prevent soiling of the peritoneal cavity. To our knowledge, this is the first case of a renal hydatid cyst treated by preserving the renal parenchyma by pericystectomy via the retroperitoneoscopic laparoscopic approach in an adult patient. No complications occurred during the perioperative and postoperative periods. After 9 months of follow up, the patient was asymptomatic with no evidence of clinical recurrence. Retroperitoneoscopic laparoscopic closed cyst pericystectomy can be an alternative minimally invasive treatment technique for the treatment of renal hydatid disease.

Sahin, Ahmet/0000-0003-1354-988X; Mercimek, Mehmet Necmettin/0000-0002-0680-4451; Ozden, Ender/0000-0003-3196-4024 WOS: 000277408800016 PubMed: 19931900 OBJECTIVES To compare the stone-free rate and complications between horseshoe and normal kidneys. METHODS Between December 1997 and June 2008, a total of 2401 patients with 2618 renal units underwent percutaneous nephrolithotomy (PCNL). During this period, we retrospectively reviewed the data of 46 patients with 50 (1.9%) renal units with horseshoe kidneys treated by PCNL. We compared the success and complication rate in horseshoe kidney and normal kidney. RESULTS Fifty PCNL were performed in the above-mentioned 46 patients with a mean age of 41.6 years. The average stone burden ranged from 100 to 4900 mm(2) (mean, 644 +/- 135 mm(2)). The stones were located in the renal pelvis in 13 (26%), calices in 17 (34%), and in both in 11 kidneys (22%). A single tract was used in 42 kidneys (84%), and 2 tracts were created in the remaining 8 (16%). Major complications were seen in 8 PCNL procedures (16%). A detailed comparison between horseshoe and normal kidneys showed that stone burden, operation time, stone-free rates, and auxiliary procedure rates were similar. The only statistically significant difference was detected in the number of access, which is more in normal kidneys. Logistic regression analysis did not reveal that horseshoe kidney did not have any negative effect on success after PCNL. CONCLUSIONS Despite the anatomic abnormalities, PCNL is a safe and effective treatment option for calculi both in the horseshoe kidney and the normal kidney with the similar success and complications rates. UROLOGY 75: 1049-1052, 2010. (C) 2010 Elsevier Inc.

Objective: This study aims to compare renal functional outcomes of access techniques in patients who underwent off-clamp (Off-C) laparoscopic partial nephrectomy (LPN). Materials and Methods: Thirty-four Off-C LPNs in patients with functioning contralateral kidney from March 2011 to June 2018 were included in the study. Twenty-two patients underwent transperitoneal, 12 patients underwent retroperitoneal Off-C LPN. The primary outcome was glomerular filtration rate changes over time, postoperatively. The secondary outcome was the evaluation of trifecta and pentafecta rate. Results: Preoperative demographics, tumor size (26.59 vs. 22.83mm, p=0.790), RENAL score (5.45 vs. 5.33, p=0.990), operation time (79.95 vs. 81.33 min, p=0.157), blood loss (170.23 vs. 150.83mL, p=0.790) were similar in both groups. Although preservation of renal function was better in group 2 in the early period, similar results were found in both groups at the end of the first year, postoperatively. No positive surgical margin and postoperative major complications were detected in any patient. While trifecta goals were achieved in all the patients in the cohort, pentafecta rates were 90.9% and 91.7% in the transperitoneal and retroperitoneal groups, respectively. Conclusions: Transperitoneal and retroperitoneal access were found to have similar outcomes in terms of preservation of renal function at the end of the first year postoperatively. Off-C LPN may be considered as a safe and effective treatment option in patients having non-complex renal tumors.