Background: Testicular torsion is one of the urological emergencies that require immediate scrotum exploration. Characteristics of testicular torsion patients, variated time exploration, and the findings of the degree of testicular torsion at the time of exploration can affect the outcome of the testicles. The study aimed to determine the characteristics of testicular torsion diagnosed patients and identify the predictors of testicular salvage.Method: The method used in the study was cohort retrospective with inclusion and exclusion criteria. Receiver operator characteristics analysis is performed to determine the probability of orchidectomy based on time to exploration and degrees of twist. Multivariate logistic regression tests are performed to identify the factors that cause the testicles to be retained. P<0.05 was significant.Results: There are 45 patients mostly diagnosed with testicular torsion aged between 12 to 16 years (64.40%). Left testicular torsion was more frequent than the right torsion (82.20%). The etiology of torsion was mostly idiopathic (77.80%). Orchidopexy procedure was performed on 12 testicular torsion patients (26.70%); on follow-up, one patient was found to have testicular atrophy. The time to explore cut-off value 8.5 hours and the 450 degrees of twisting will cause the testis to not survive with the specificity of 83% and 92% and sensitivity of 81% and 82%, respectively. Multivariate analysis shows time to explore and degree of twisting associated with orchidectomy of the affected testis (p<0.05).Conclusion: Patients are relatively young. Not all patients with testicular torsion will manifest typical symptoms of acute, atypical symptoms such as lower abdominal pain, which can be identified as testicular torsion. Mostly affected left testicle. Orchidectomy is the most commonly performed operation on patients. The outcome of testicular torsion can be predicted by observing the time to exploration factor and the degree of testicular torsion in the patient.
Objective: In this report, we describe the case of urethral injuries after circumcision. Case(s) Presentation: A 5-year-old male came to the urology clinic complaining of urine seeping through the gauze-covered wound. The patient had undergone circumcision. Before the procedure, the patient could generally urinate through the external urethral orifice. His parent realized that the urine was flowing out through the circumcision scar instead of the external orifice. Even though the wound was open and wet, he felt painless when urinating. After cleaning the wound, it appeared that there was a sizeable chromic catgut thread knotted on the right corpus cavernosum. The pendular urethra was cut widely; therefore, the urine came out of this spot. A six French Foley catheter was inserted over the external urethral orifice, the cut urethra towards the bladder. The injured urethra was expected to be attached to simplify the next six-month operation by inserting this urinary catheter. Discussion: Urethral injury post circumcision is rarely reported, but this complication is dangerous due to its morbidity and long-term impact. The paradigm shift from two-stage repair to one-stage repair has developed. Mathieu’s modified technique and the Snodgrass technique are recommended. Conclusion: Urethral injury during circumcision can be devastating. The repair technique for urethral trauma depends on the involvement and condition of the surrounding soft tissue, also the size of the tissue damage.
The kidney continues to be the most commonly injured organ in the genitourinary system, with the vast majority of cases being caused by blunt trauma. The majority of individuals with renal trauma are managed conservatively. However, hemodynamic instability, such as shock induced by renal hemorrhage or developing retroperitoneal hematoma (showing grade v renal trauma), renal pelvis or ureteral injury, as well as other renovascular pathologies, may signal the necessity for surgical intervention, which may include renorrhapy. Renorrhaphy in the setting of grade V renal trauma is very uncommon and has only been documented in a few cases in the preceding literature. We discuss a unique and complex case that was successfully managed, and we examine the relevant literature to give useful information for the management of blunt renal trauma patients.
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