Functional and Cosmetic Urethroplasty Outcome, Emotional Stress after Genital Examination, Post Traumatic Stress Disorder, and Ages at the Time of Urethroplasty as Potential Risk Factor Causing Psychosocial Disorder of Hypospadia Children.

BACKGROUND: Children with hypospadias, being born with congenital abnormalities, having repeated genital examination, hospitalization, and undewent genital surgery, experienced psychological stress that may negatively affect their psychosocial life. Choosing the proper time of surgery as recommended is important, since it may have a positive impact on the psychosocial adaptation. AIM: This study aims to find the risk factors causing psychosocial disorders in post-repair surgery on hypospadias children. METHODS: This is a case control study, from 203 hypospadias patients underwent urethroplasty from 2009 to 2018. Subjets were screened for psychosocial disorders by Pediatric Symptoms Questionnaire 17 (PSC-17) questionnaire to find those with psychosocial disorders, score 15 or more (case group) and those without psychosocial disorders (control group), score 0-14. We traced back the data retrospectively from both group (history of utrethrocutaneous fistula and meatal stenosis, age upon urethroplasty) and collecting new ones (cosmetic outcome, emotional stress after genital examination, and the existence of PTSD). Fisher's exact test was performed to see the Odds ratio (OR) for each variable. RESULTS: Some children with hypospadias show impaired on psychocosial. Functional and cosmetic outcome not significantly different as potensial risk factor psychosocial disorders, genital examination doesn't trigger psychological stress and also none children show PTSD symtomp after surgery. Comparison time of age urethroplasty did not differ significantly between two group. CONCLUSIONS: Twenty-nine children post urthroplasty show psychosocial disorders. Functional and cosmetic urethroplasty outcomes, emotional stress after genital examination, post-traumatic stress disorder were not risk factors of pshycosocial disorder of hypospadias patients. Ages at time of surgery did not differ significantly between two group and this is contradict to the previous recommendations.

An unusual case of lymphadenopathy due to Continuous Ambulatory Peritoneal Dialysis becomes a challenge during renal transplantation.

A 31-year-old male was diagnosed with Stage V Chronic Kidney Disease and treated with Continuous Ambulatory Peritoneal Dialysis (CAPD) for five years before agreeing to a renal transplantation. Prior to the procedure he suffered from lymphadenopathy due to peritonitis. This complication became an obstacle as it prevented vascular access to the iliac artery and vein. An extensive lymphadenectomy had to be performed before continuing with the procedure. Nevertheless, the procedure was carried out successfully. Iliac lymphadenopathy as a result of peritonitis due to CAPD could become a challenge during renal transplantation if it hindered vascular access during anastomosis.