Indonesian Journal of Urology
Not a member yet
480 research outputs found
Sort by
AN ANALYSIS OF FACTORS ASSOCIATED WITH DELAYED DIAGNOSIS AND TREATMENT OF UNDESCENDED TESTIS
Get PDFObjective: This study aimed to analyze factors contributing to delayed diagnosis and treatment of UDT patients at Saiful Anwar General Hospital in Malang. Material & Methods: This retrospective study was conducted at Saiful Anwar General Hospital focusing on patients who underwent orchiopexy or orchiectomy for UDT between January 2019 to February 2024. Delays in treatment were defined as surgery performed after 18 months of age. Statistical analysis involved a comparative study between delayed and non-delayed cases, with a significance level of p<0.05. Results: This study evaluated 140 patients with UDT, aged 3.7 ± 3.87 years old, with 77.1% experiencing delayed referrals. The most common associated anomaly was hypospadias (29.3%). Factors contributing to delayed referral include undiagnosed UDT, inadequate follow-up, and advice to await spontaneous testicular descent, observed in 62% of delayed cases (p = 0.025). Parental unawareness of the risks associated with delayed surgery and misdiagnosis by healthcare providers were significant contributors, affecting 72% and 74% of delayed cases, respectively (p = 0.032 and p < 0.005). Referral sources differed significantly, with pediatricians accounting for 43% of non-delayed referrals, compared to only 8% for delayed cases. General practitioners were responsible for 70% of delayed referrals, and 22% were self-referred (p < 0.005). Conclusion: Most pediatric patients at Dr. Saiful Anwar General Hospital experienced delayed treatment of UDT, often due to referral delays and undiagnosed conditions. Training for primary health-care providers and routine testicular examinations are essential.
Keywords: Delayed factors, diagnosis and treatment, undescended testis
SCREENING AND FACTOR ANALYSIS OF DELAYED TREATMENT OF UNDESCENDED TESTIS (UDT) IN EARLY CHILDHOOD
Get PDFObjective: To determine the prevalence of undescended testis (UDT) cases in the integrated health service post of the Wagir health center working area, the level of parental knowledge of UDT disorders, and to find out what factors affect the delay in UDT treatment. Materials and Methods: Physical examination by a urology specialist education doctor and distributing questionnaires to parents of toddlers with UDT disorders which were then analyzed with SPSS software using the chi square method followed by the binary logistic regression method. Result : Factors that were found to significantly affect the delay in UDT treatment included antenatal care history (sig. = 0.023) and parental knowledge about UDT (sig.=0.044). Factors found to be less significant in influencing the delay in UDT treatment included affordability of health facilities, insurance ownership, parents' monthly income, latest education, and family history. Conclusion: The prevalence of this with the majority of the population having poor knowledge about UDT. The factors that most influence the delay in treatment are antenatal care history and parental knowledge about UDT
Keywords: Undescended Testis (UDT), Delayed Treatment, Parental Knowledge, Delayed Factors
Objective: This study aims to determine the prevalence of undescended testis (UDT) cases in the integrated health service post of the Wagir health center working area, the level of parental knowledge of UDT disorders, and to find out what factors affect the delay in UDT treatment. Material & Methods: Physical examination by a urology specialist education doctor and distributing questionnaires to parents of toddlers with UDT disorders which were then analyzed with SPSS software using the chi square method followed by the binary logistic regression method. Results: Factors that were found to significantly affect the delay in UDT treatment included antenatal care history (sig. = 0.023) and parental knowledge about UDT (sig.=0.044). Factors found to be less significant in influencing the delay in UDT treatment included affordability of health facilities, insurance ownership, parents' monthly income, latest education, and family history. Conclusion: The prevalence of this with the majority of the population having poor knowledge about UDT. The factors that most influence the delay in treatment are antenatal care history and parental knowledge about UDT.
Keywords: Undescended Testis (UDT), parental knowledge, physical examinatio
FACTORS INFLUENCING POST-CIRCUMCISION WOUND HEALING
Get PDFObjective: This study aims to determine the effect of the penile gland and smegma smear, the expression of collagen and fibroblasts in the preputium, on post-circumcision wound healing. Material & Methods: A cross-sectional study conducted in Malang with samples obtained by purposive sampling on September 17, 2022. Inclusive criteria were uncircumcised males who agreed to be circumcised and had no contraindications to the procedure. Furthermore, the preputium obtained from the circumcision procedure was stained with Hematoxylin-Eosin (HE) and counted under an optical microscope. Post-circumcision evaluation was carried out seven days after the procedure. The data were analyzed using the regression method; p denotes the probability value or significance level, while the b score denotes the degree of influence. Results: There were total of 31 research samples that had a significant difference in the average age between the samples with post-circumcision complaints (11.25 ± 2.75) and those without complaints (8.5 ± 2.73) (p=0.05). The regression test found that bacterial culture, fibroblasts, and collagen had significant effects of 24%, 25%, and 24%, respectively. Conclusions: Skin elasticity decreases with age, as marked by increased fibroblasts and decreased collagen density. Fibroblast factors, collagen, and bacterial culture are significant in wound healing.
Keywords: Circumcision, collagen, fibroblast, wound healing
TUMOR IN HORSESHOE KIDNEYS: A CASE REPORT AND LITERATURE REVIEW
Get PDFObjective: This study aims to report a renal tumor in a horseshoe kidney successfully treated with an open left nephrectomy. Case(s) Presentation: A 3 years old girl with a lump in the left abdomen and intermittent hematuria was referred to our hospital. Whole abdominal contrast CT scan showed the presence of a left renal mass in a horseshoe kidney that infiltrates the left renal artery and is attached to the spleen. The patient underwent preoperative chemotherapy followed by surgical resection. Discussion: In a horseshoe kidney, renal tumors are uncommon. The limited kidney mobilization and access to the renal hilum and the abnormal and highly variable vasculature make surgical treatment of a tumor in a horseshoe kidney extremely difficult. Conclusion: Open surgery continues to be the treatment of choice for horseshoe kidney tumors due to their anatomical complexity, particularly in cases where the tumor is difficult to eradicate.
Keywords: Renal tumor, horseshoe kidney, surgical management
PROGNOSTIC FACTORS FOR ORCHIDECTOMY IN TESTICULAR TORSION PATIENTS AT TERTIARY HOSPITAL
Get PDFObjective: This study was conducted to analyze the prognostic factors for orchidectomy in testicular torsion patients. Material & Methods: From January 2001 to December 2021, 100 cases of testicular torsion cases were retrospectively collected. Data were described and analyzed based on clinical factors (age, duration of symptoms, scrotal swelling, high-riding testis, Prehn test, cremasteric reflex, leukocytosis, degree of twisting) and non-clinical factors (distance from hospital, duration of travel to hospital, education level and employment status) for each surgical procedure. Then logistic regression analysis was performed. Results: There were 88 testicular torsion patients (88%) underwent orchidectomy and 12 patients (12%) underwent orchidopexy. There was no significant relationship between age, duration of symptoms, scrotal swelling, Prehn test, cremasteric reflex, leukocytosis, distance from hospital, duration of travel to hospital, education level and employment status with orchidectomy (p>0.05). Significant prognostic factors for orchidectomy in testicular torsion patients were high-riding testis (OR = 0.06; 95% CI = 0.01-0.37; p = 0.002) and degree of twisting (OR = 0.04; 95% CI = 0.006-0.24; p = 0.000). Conclusion: High-riding testis and degree of twisting are prognostic factors for orchidectomy in testicular torsion patients.
Keywords: Orchidectomy, prognostic factors, testicular torsion
PENILE TORSION OF A TWO-YEAR-OLD BOY: A CASE REPORT
Get PDFObjective: This case report presented Penile Torsion in pediatrics. Case(s) Presentation: A two-year-old boy with a chief complaint of rotated penile to the right side since birth. There were 45º in clockwise torsion, slight chordee, and uncircumcised. Patient underwent penile reconstruction surgery, including penile degloving, urethral mobilization, and plication. After seven days follow-up, parents were satisfied with straight penile erection and no torsion at all. After 3 months follow-up, parents reported satisfaction with the surgical outcome such as cosmetic appearance, straight erection, and normal stream urine. Discussion: Surgical techniques ranging from simple penile degloving with foreskin repositioning to more complex surgical procedure involving corporeal tissue. Surgery by using degloving of penile skin and realignment could be suitable for penile torsion <90°. For the cases of >90°, other techniques should be considered such as corporopexy procedure, rotation flap of dorsal dartos, or diagonal suturing of corporeal folds away from and parallel to the neurovascular bundle. Conclusion: Penile reconstruction surgery using penile degloving, urethral mobilization, and plication for penile torsion showed satisfaction result including cosmetic appearance, penile erection, and normal urine flow.
Keywords: Chordee, penile reconstruction, penile torsion
ACCIDENTAL PENILE FRACTURE CAUSED BY SELF-INVOLVEMENT IN THE ABSENCE OF SEXUAL ACTIVITY: A CASE REPORT
Get PDFObjective: This study aims to present a case of accidental penile fracture without sexual activity. Case(s) Presentation: A 40-year-old guy was sent to our emergency center nine hours prior to admission with oedema and lack of tumescence on the penis. There were no records of sexual activity or masturbation. The patient was treated for a hematoma and a fracture. The patient raised no complaints during his one-week and two-month follow-up visits after the procedure. Discussion: A urological emergency involving penile fracture is uncommon. It is important to avoid unnecessary delays in obtaining medical help. In the current case study, with urgent surgical intervention, corporal tears were repaired. Recent research recommends prompt surgical treatment of penile fractures, as this appears to be associated with fewer complications and better results. Conclusion: A penile fracture that requires immediate surgical treatment can preserve erectile and voiding function.
Keyword: Penile fracture, urological emergency, surgical treatment
SINGLE SESSION BILATERAL PERCUTANEOUS NEPHROLITHOTOMY (PCNL) IN HORSESHOE KIDNEY PATIENT WITH BILATERAL STAGHORN STONES: A CASE REPORT
Get PDFObjective: To analyze the outcomes of single-session bilateral PCNL in a horseshoe kidney patient with bilateral staghorn stones in terms of safety and effectiveness. Case(s) Presentation: A 64-year-old woman with bilateral staghorn stones on HSK. She had an anesthesia status of ASA 2, with type 2 diabetes mellitus (uncontrolled with oral medication), 47% of ejection fraction from echocardiography and her body mass index was 21.7 kg/m2. A single session of bilateral PCNL was performed, with 150 minutes of surgery and total blood loss of ± 50 cc. A 4.7 Fr DJ stent was placed on the right kidney, a 5 Fr ureteral catheter was left in the left kidney, and a 16 Fr foley catheter was placed as a right and left nephrostomy. Control plain abdominal x-ray showed no residual stones. Postoperatively, the patient was hospitalized for 3 days, there were no significant complaints and discharged in good condition. Discussion: The procedure was performed in the prone position for two reasons. First, is to avoid intestinal injury during puncture and dilatation, the second is to simplify the positioning of the C arm, as well as the endourology monitor, and the other instruments. Conclusion: Single-session bilateral PCNL for HSK patients with bilateral staghorn stones, in our experience, is quite safe and effective.
Keywords: Horseshoe kidney, single-session bilateral percutaneous nephrolithotomy (PCNL), staghorn stone
PROFILE OF PROSTATE CANCER PATIENTS AT DR. MOEWARDI HOSPITAL PERIOD JANUARY 2017 – JANUARY 2022: RETROSPECTIVE STUDY
Get PDFObjective: This study aims to know the profile of prostate cancer patients treated at Moewardi General Hospital from January 2017 to January 2022. Material & Methods: A retrospective study was conducted in prostate cancer patients who have or are undergoing therapy at Moewardi General Hospital from January 2017 to January 2022 using purposive sampling techniques. Results: From January 2017 to January 2022, 441 male patients were diagnosed with prostate cancer which is dominated able to go home alive, around 92.97%. The age of study subjects was overlooked of 70-80 years with a total of 182 people, dominated by self-employed as many as 420 people. The breakdown of PSA scores of 1-20 in as many as 247 people, Adeno Ca Prostate as many as 374 people with the majority of prostate Ca cases in subjects in non-metastatic status (359 people). The results of variable Rectal Toucher examination described results dominated by palpable prostate and hard as many as 437 people. Conclusion: The most important prognostic indicators in prostate cancer are the patient's age and general health at the time of diagnosis, the cancer stage, the level of pre-therapeutic PSA, and the Gleason score. A worse prognosis is associated with high levels of the disease, more advanced stages, younger age, and elevated levels of PSA.
Keywords: Prostate cancer, patient’s age, PSA, male
EFFECT OF IPSILATERAL TESTICULAR TORSION ON THE QUALITY OF SPERM IN CONTRALATERAL TESTIS OF RAT (Rattus norvegicus) WISTAR STRAIN
Get PDFObjective: This study aims to identify the effect of testicular torsion on the quality of sperm which include: concentration, morphology, and motility of the contralateral testis Rattus norvegicus. Material & Methods: This study is an experimental laboratory study with a post-test only control and completely randomized design (CRD) and divided into 3 groups: control (KO) and treatment (P1 and P2). The treatment group induced testicular torsion of 360˚ to the left for 4 hours. Each group consisted of 9 rats were observed immediately after detorsi (rapid effects) and 9 rats were observed after 30 days do detorsi (slow effect). Data were analyzed by ANOVA - One way and followed by Tuckey HSD test. Results: The results showed a significant difference ( P < 0.05 ) the concentration and morphology of spermatozoa between the control and treatment groups but there is no real difference between P1 and P2 . As for sperm motility are no significant differences ( P < 0.05 ) for each treatment . Conclusion: Based on this it can be concluded that testicular torsion lead to changes in concentration , motility , and morphology of spermatozoa contralateral testis.
Keywords: Testicular torsion, quality of sperm, Rattus norvegicus