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Background and Aim: Fournier gangrene (FG) is a necrotizing fasciitis of perineal and/or genital regions that may progressively spread; necrotic tissue may cause morbidity and mortality related to sepsis and multi-organ dysfunction. Surgical intervention required for patients with Fournier gangrene may vary according to the severity of the infection. A Fournier Gangrene Severity Index (FGSI) has been devised to assess the risk of mortality in patients with Fournier gangrene. The aim of this study was to validate the implementation of the FGSI in predicting mortality of FG patients in our hospital. Methods: A retrospective study was performed on all patients with Fournier gangrene admitted and treated in Hasan Sadikin General Hospital during 2015-2019. Data were collected from the medical records of the emergency room and outpatient clinics. Sociodemographic variables, preexisting comorbidities, outcome, management, and FGSI score were included as variables. Results: In this study, 83 patients were included from the period 2015-2019, divided into two groups. From the Charlson Comorbidity Index, we found the first group average score was 2.5 (0-9), and the second group this was 2 (1-8). From the FGSI, in the first group, we found the average score was 5.5 (2-15), and the average was 14 (10-19) in the second group, which is significantly higher than the first group (p = 0.001). Conclusion:We find that the FGSI score system is a good tool for predicting severity of the disease and mortality risk of the patients, which is consistent with findings in other studies.

Leiomyoma is a benign tumor of smooth muscle origin. Primary leiomyoma of the adrenal gland is very rare. Adrenal tumors are often diagnosed during the ultrasound or computerized tomography (CT) study as incidentaloma. According to the literature review, up to 2018, the largest size of adrenal leiomyoma which had ever been reported was 12 × 10 × 8 cm in dimension (Maher et al.). Herein, we report the largest adrenal leiomyoma with the tumor mass of 600 g (14,1x11,4x10,1 cm) from a female patient admitted to our hospital.

Introduction Erectile dysfunction is a health problem that arises from various conditions and causes an impaired quality of life with a significant health burden. Regenerative and stem cell therapies are some of the potential treatments for erectile dysfunction. This study aimed to review the available information in the literature regarding the use of stem cells in the treatment of erectile dysfunction. Methods This study is a systematic review conducted based on the PubMed, Google Scholar, Cochrane, and DOAJ databases. Literature searching was conducted in English and included articles from 2000 to 2020. Results The result was a total of 318 articles. Following the elimination process, 9 articles remained in the final analysis. The analyzed studies included 164 patients with erectile dysfunction with various medical conditions. Several stem cell types have been used for treating erectile dysfunction, including mesenchymal stem cell, placental matrix-derived stem cell, mesenchymal stem cell-derived exosome, adipose-derived stem cell, bone marrow-derived mononuclear stem cell, and umbilical cord blood stem cell. Generally, stem cell therapy showed a good efficacy and safety profile, although not enough studies on the protocol, dosage, and mechanism of action. Conclusion Stem cell therapy has a good therapeutic potential in erectile dysfunction, the available data from the literature could be the base of usage of stem cells in the treatment of erectile dysfunction although need more research for broader usage.

Introduction: The ischemic process in priapism can lead to displacement of normal tissue with fibrotic tissue, due to collagen deposition, and eventually leads to erectile dysfunction. Many studies have identified that the supernatant of adipose tissue-derived stem cells (ADSCs) significantly ameliorates fibrosis of different tissue, but limited attention has been paid to its efficacy on fibrosis of the corpora cavernosa. Methods: A total of 22 Wistar rats divided into five groups, with two groups each consisting of five male wistar rats with priapism without human ADSC (hADSC) therapy (group I) and two other groups consisting of five rats with priapism, were given 10 6 cells' intracorporeal hADSC injection after 12 hours of penile clamping (group II) were euthanized after 2 and 4 weeks of observation. The last group consisted of two rats without any treatment or model (group III). Following euthanasia, penises were harvested for TGFβ 1 and collagen type I measurement using ELISA. Statistical analysis using independent-sample t-tests was done with SPSS 21.0. Results: Penile TGFβ 1 concentration in the treatment group was significantly lower in the second and fourth weeks of observation (p 2 =0.004, p 4 =0.003), and collagen type I was significantly lower in the second and fourth weeks (p 2 =0.003, p 4 =0.011). Conclusion: Intracorporeal hADSC injection limited the fibrosis process in a priapism model. Although the mechanism was unclear, it may be related to the potential of hADSCs to produce various growth factors that could limit TGFβ 1 and collagen production.

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Highlights Penila strangulation required emergency management to preserve the organ function. Each case managed individually according to its clinical finding and operative settings. Management depends on the type and size of constricting object, time after incarceration, degree of injury, available instrument, and experience of the physicians. Different methods and tools may arise due to circumstance and individual cases differences. Surprisingly, there is no erection problem after removing the strangulation.

Background: Benign prostatic enlargement (BPE) is a common condition in older men causing lower urinary tract symptoms (LUTS). Numerous studies have shown correlations of obesity and age as risk factors of LUTS due to BPE. However, there are only a few studies showing the increase of interleukin-6 (IL-6) as a risk factor in LUTS. IL-6 expression is regulated in the prostate. IL-6 was found to be increased in several conditions, such as infection, inflammation, and obesity. The aim of this study is to correlate visceral obesity and IL-6 expression in the prostate with BPE and LUTS. Methods: We analyzed the correlation of the Visceral Adiposity Index (VAI) and IL-6 of 52 patients with LUTS due to BPE. Statistical analysis was tested using an independent t-test. Data were analyzed with SPSS ver 20.1. Results: Of 52 BPE subjects, who had not received any therapy, 16 patients presented with severe LUTS (30.77%), while the remaining 69.23% had mild-moderate LUTS complaints. IL-6 examination showed that obese patients and severe LUTS had higher IL-6, with p=0.032 and 0.01, respectively. Correlation analysis showed a weak correlation between IL-6 and obesity (r=0.179, p=0.02). Based on regression study, it was found that the risk for a patient with visceral obesity to develop severe LUTS is 5-times higher than normal (p=0.017). Conclusion:This study found a correlation between the degree of visceral obesity assessed by VAI and IL-6 levels in BPE patients. In addition, there is also a correlation between the degree of visceral obesity and IL-6 levels on LUTS severity in people with BPE.