Objective: To compare the successful of the identification of the ureteral orifice at cervical cancer patients who received phenazopyridine orally and to analyze the correlation between hydronephrosis and successful rate for retrograde stenting. Material & Method: This was a comparative experimental study, using phenazopyridine hcl orally prior to cystoscopy to identify the ureteral orifice on cervical cancer patients and to perform retrograde stenting on spotted ureteral orifice. Forty samples provided consent to enroll in this study. Mean age was 49.2 ± 5.16 years. Thirty-four out of 40 samples was confirmed as squamous cell carcinoma type. Results: Chi-square test demonstrated no significant differentiation in finding ureteral orifice between treatment and control group on stage 3B (p = 0.408). However, result shown conversely on stage 4A (p = 0.046). There was no significant disparity in conducting retrograde stenting between treatment and control group on stage 2B and 3B (p = 0.221 and p = 0.197). There was no significant correlation between hydronephrosis gradation and retrograde stenting on control group (p = 0.144). Conclusion: Administration of phenazopyridine HCL orally in cervical cancer patients increase success for ureteral orifice identification and retrograde stenting, but not statistically significant. There is no correlation between hydronephrosis with a success retrograde stenting.Keywords: Cervical cancer, hydronephrosis, phenazopyridine hcl, ureteral orifice, retrograde stenting.
BACKGROUND: The rate of delay in the referral of patients with undescended testis (UDT) to health facilities in Indonesia is still relatively high due to delays in the handling of urological surgery. Hence, it requires rapid and appropriate identification and early detection of patients with UDT in the community. AIM: The study aims to analyze the factors of delay in referral in cases of UDT management. METHODS: This study used a cohort design with a retrospective review approach to analyze various factors that cause delays in referring patients with UDT. Collecting identification was done by tracing UDT case-patient documents from January 2016 to November 2021. Data analysis used the Mann–Whitney and Chi-square comparison test, with significance achieved if the p < 0.05. RESULTS: Delay by doctors/paramedics who were not followed up, ignorance of the risk of delaying surgery, and undiagnosed UDT by parents/health-care providers showed a significant difference where the percentage of patients who were delayed was greater on these factors. In addition, the reference source is also known to have a significant difference with a significant value (p < 0.005). CONCLUSIONS: Factors that played a significant role in the delay in operative procedures for treating UDT were delays in referral from doctors (p < 0.025) (primary care physicians and pediatricians) and undiagnosed UDT conditions in patients (< 0.005).
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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