ABSTRACT
INTRODUCTION: Penile augmentation with foreign material injection is used to increase penile length, girth, or both. Most of these individuals develop complications due to an abnormal mass formation known as penile paraffinoma. Multiple surgical techniques for restoring penile function and correcting near-normal penile shape have been developed, but prior techniques have some post-operative complications. METHODS: We explained the smile incision-modified technique for penile paraffinoma reconstruction using illustrations to describe step-by-step procedures. This study aimed to describe our modified surgical technique for reconstruction to correct complications due to disastrous consequences of failed penile augmentation. RESULTS: A total of 16 patients aged 28-66 years (mean: 44.25 ± 2.63) were operated with a smile incision-modified technique from January 2017 until December 2020 in Semarang Dr. Kariadi tertiary hospital. There were no intraoperative complications observed. We found hematoma in 3 patients in a 1-week follow-up. After 2 weeks of post-operative surgery, all patients had no skin dehiscence or necrosis. Cosmetic appearance and functional improvement after reconstruction were acceptable by all patients. CONCLUSION: Penile paraffinoma reconstruction using the smile incision-modified technique was a feasible and effective technique to manage penile paraffinoma patients with good esthetic results and minor complications.
Subject(s)
Foreign Bodies , Penile Diseases , Plastic Surgery Procedures , Male , Humans , Penile Diseases/surgery , Penile Diseases/etiology , Paraffin , Penis/surgery , Foreign Bodies/surgeryABSTRACT
Continuous ambulatory peritoneal dialysis (CAPD) is one of the modalities for renal replacement therapy in patients with stage 5 chronic kidney disease. There are various techniques and modifications, but there is no main reference for laparoscopic catheter insertion. One common complication related to CAPD is the malposition of the Tenckhoff catheter. In this study, the authors present a modified laparoscopic technique for insertion that can prevent malposition of the Tenckhoff catheter by using two plus one port. Material and method: A retrospective case series from the medical records at Semarang Tertiary Hospital was identified between 2017 and 2021. Demographic, clinical, intraoperative, and postoperative complication data were collected with a 1-year follow-up after the CAPD procedure. Results: This study included 49 patients with a mean age of 43.2±13.6 years, and diabetes was the main cause (51.02%). This modified technique showed no complications intraoperatively. The postoperative complications were found to include one case of hematoma (2.04%), eight cases of omental adhesion (16.3%), seven cases of exit-site infection (14.28%), and two cases of peritonitis (4.08%). Malposition of the Tenckhoff catheter was not found 1-year after the procedure. Conclusion: The two plus one port modified laparoscopic assisted CAPD technique could prevent malposition of the Teckhoff catheter because it is already fixated in the pelvic. A long-term follow-up of 5 years is necessary to know the long-term survival of the Tenckhoff catheter in the next study.
ABSTRACT
Pelvic fracture urethral injury (PFUI) in pediatrics is rare, may involve the bladder neck, and may lead to obstruction and urinary incontinence as a lifelong disability. A 9-year-old female patient had a bladder neck injury related to PFUI after an accident when she was 6 years old and had urinary incontinence. In the previous hospital, the patient underwent appendicovesicostomy but the surgery failed. Continent ileocaecocystoplasty for a definitive treatment was done in our hospital involving the caecum, ileocaecal valve, and ileum. This procedure was delivered safely and brought a good result to the patient with no significant complications.
ABSTRACT
OBJECTIVE: Indonesia has overcome several barriers to the growth of kidney transplantation within the past decade. Currently, the procedure is increasingly performed in several centers across the country. However there are limited publications on kidney transplantation from Indonesia, especially from centers outside Jakarta. This study aims to give a brief overview on transplantation performed, discuss current efforts and progresses of transplantation in Indonesia and chiefly Semarang. METHODS: Retrospective analysis of 20 transplant cases in Semarang during 2014-2018 was performed. Information from other transplant centers was acquired through formal correspondences with 11 central teaching hospitals in Jakarta, Surabaya, Yogyakarta, Malang, Bali, Solo, Palembang, Aceh, Medan, Bandung, and Padang. RESULTS: There were 629 recorded kidney transplantations performed in 12 centers, and we report on 245 cases with viable data. The average age of kidney recipients were younger (35.4 years old) compared to the donors (41.3 years old). Approximately half of the kidneys were obtained from related donors (49.0%) and there was only one case of cadaveric donor. The three leading etiologies of end-stage renal disease were hypertension (37.4%), diabetes mellitus (26.1%), and autoimmune disease (11.3%). There is only one center that has performed more than 100 kidney transplants in Indonesia. CONCLUSION: Indonesia has successfully overcome several major hurdles that had previously hindered the growth of transplantation. Further improvement should concentrate on the development of integrated organ transplant infrastructure, decentralization of transplant professionals, establishment of National kidney transplant database and changing the Nation's paradigm on cadaveric organ donor through public education.