Browsing by Author "Ozbilen, Mert Hamza"

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Citation - WoS: 1
Citation - Scopus: 2
External Validation and Comparison of Current Scoring Systems in Encrusted Ureteral Stent Management: a Multicenter Study
(Brazilian Soc Urol, 2025) Ozbilen, Mert Hamza; Cakici, Mehmet Caglar; Kisa, Erdem; Tigli, Taylan; Ekenci, Berk Yasin; Tufekci, Burak; Ercil, Hakan
Purpose: To compare the external validation of four existing scoring systems for encrusted ureteral stents (EUS) and their relationship with stent indwelling time, stone-free rates, multiple surgery sessions, multimodal procedures, and prolonged operation times exceeding 120 minutes in total. Materials and Methods: The data of 208 patients who underwent surgery for EUS reviewed. All EUSs were evaluated with 4 scoring systems: ESB (encrusted stone burden), FECal (forgotten, encrusted, calcified), KUB (kidney, ureter and bladder), V-GUES (visual grading for ureteral stone burden). Results: As the duration of stent indwelling time prolonged, a significant increase is observed in the scores of ESB, FECal, KUB and V-GUES systems (p<0.001). In multivariate logistic regression analysis, V-GUES score (p=0.025) and stent indwelling time (p=0.014) in stone- free rate, FECal grade (p<0.001) in multimodal procedure requirement, FECal (p=0.002) and V-GUES (p=0.032) scores in multiple surgery sessions, and stent indwelling time (p=0.019) and KUB score (p<0.001) in prolonged operation time were found to be predictors. When the area under receiver operating characterictic (ROC) curves (AUC) of the nomograms were examined, V-GUES score (AUC=0.685) in stone-free rate, FECal grade (AUC=0.780) in multimodal procedure requirement, FECal grade (AUC=0.845) in multiple surgery sessions, and KUB score (AUC=0.860) in prolonged operation time were found to be superior. Conclusions: The management of EUSs is often challenging for urologists. Although the current scoring systems for EUS differ somewhat, it is important to use scoring systems to guide the management of these patients.
Is Cystolitholapaxy Sufficient in Patients with Bladder Stones Secondary to Benign Prostatic Obstruction
(Wiley, 2026) Ozbilen, Mert Hamza; Karabacak, Mahmut Can; Tigli, Taylan; Yoldas, Mehmet; Uysal, Umit; Keskin, Mehmet Zeynel; Gurbuz, Zafer Gokhan
Background To question the necessity of simultaneous benign prostatic obstruction (BPO) intervention with cystolitholapaxy in patients with bladder stone (BS) due to BPO and to investigate the factors predicting secondary intervention.Methods A total of 235 male patients over 40 years of age who underwent cystolitholapaxy, had a follow-up period longer than 12 months, and were thought to have BS secondary to BPO were included in the study.Results A total of 190 patients who did not require additional intervention were defined as Group 1, and 45 patients who required secondary intervention were defined as Group 2. Secondary surgical intervention was required at a rate of 19.5% with an average follow-up of 49 months. Mean peak urine flow rate (Qmax) was 11 m/s in Group 1 and 8.6 m/s in Group 2 (p < 0.001), postvoid residual urine volume (PVR) was 85.5 mL in Group 1 and 115.3 mL in Group 2 (p < 0.001), International Prostate Symptoms Score (IPSS) was 16.7 in Group 1 and 21.7 in Group 2 (p < 0.001). Total prostate volume (TPV) (p = 0.015) and serum prostate-specific antigen (PSA) (p = 0.005) were also significantly higher in Group 2. In the multivariable Cox proportional hazards regression analysis of factors predicting secondary intervention in patients undergoing cystolitholapaxy, low Qmax (hazard ratio (HR) = 0.905, 95% confidence interval (CI): 0.821-0.997, p = 0.043), high PVR (HR = 1.014, 95% CI: 1.007-1.022, p < 0.001), high IPSS (HR = 1.178, 95% CI: 1.106-1.255, p < 0.001) and high PSA (HR = 1.086, 95% CI: 1.000-1.178, p = 0.05) were found to be predictors.Conclusions In patients with BS secondary to BPO, performing cystolitholapaxy offers a high likelihood of avoiding secondary intervention. Low Qmax, high PVR, high IPSS, and high PSA are indicators of a higher risk of secondary intervention in the preoperative period. Therefore, in a patient-centered approach, these predictors should be taken into account when deciding whether BPO surgery is necessary in addition to cystolitholapaxy.