Correlation between Motorcycle Riding and Erectile Dysfunction on Online Motorcycle Taxi Drivers.

OBJECTIVE: Erectile dysfunction is a condition in which the patient is unable to achieve or maintain a sufficient erection for sexual intercourse. Transportation usage was believed to have a higher risk of erectile dysfunction. This study aimed to assess the correlation between activity and severity of erectile dysfunction among online motorcycle taxi drivers who use motorbikes. MATERIALS AND METHODS: This research uses an observational analytic method with a cross-sectional approach with primary data collection from the respondents who work as online motorcycle drivers from January 2021 to March 2021. Data analyses were conducted using Mann-Whitney and Spearman statistical test. RESULTS: A total of 149 respondents met the inclusion and exclusion criteria contained in this study. It was found that the prevalence of erectile dysfunction in this study was 57.7%. There was a significant difference in the distance covered (km) by online motorcycle taxi drivers who experienced erectile dysfunction compared to those who did not have erectile dysfunction (P=.050). In addition, there was a significant difference in length of work (year) among online motorcycle taxi drivers who experienced erectile dysfunction (P=.045). CONCLUSION: There was a significant difference in erectile dysfunction incidence based on the distance covered per day and length of work in online motorcycle taxi driver. No significant difference was found in the incidence of erectile dysfunction based on the length of motorbike drive per day. The more distance covered (km) and length of work (year) and the more severe the erectile dysfunction are based on international index of erectile function-5 score.

Mini percutaneous nephrolithotripsy for pediatric kidney stone using 1.5mm probe size shock pulse lithotriptor: A case report.

The recent development of mini-PCNL technique, allows tract formation with minimal damage to the renal parenchyma in pediatric patients. This report describes our preliminary findings with mini-PCNL using a 1.5-mm probe-size shock pulse lithotriptor. A 11-year-old child presented with multiple small inferior calyceal calculi. The patients were placed in Bartz flank-free modified supine position and underwent mini PCNL. The stone was fragmented using a 1.5-mm probe shock pulse lithotripter and fragments were suctioned out through the hollow probe. Our experience suggests that using a shock pulse lithotripter on a mini-PCNL to treat renal stones in children is both safe and effective.

The role of quick Sepsis-related Organ Failure Assessment score as simple scoring system to predict Fournier gangrene mortality and the correlation with Fournier's Gangrene Severity Index: Analysis of 69 patients.

Objective: Fournier's gangrene is a rare but life-threatening infection disease with high mortality rate. The quick Sepsis-related Organ Failure Assessment (qSOFA) is a new and simpler scoring system that may identify patients with suspected infection who are at greater risk for a poor outcome. The purpose of this study was to find out role of qSOFA in determining prognosis of Fournier's gangrene patients. Methods: This study is a case control with retrospective review of Fournier's gangrene patients treated at Hasan Sadikin Hospital from January 2013 to December 2017 who met inclusion criteria. Participants were divided into two groups according to qSOFA score as high qSOFA (2-3) and low qSOFA (0-1). Results: From 69 patients, the mortality rate was 24.6%. The sensitivity of qSOFA score to predict mortality was 88.2%; the specificity was 94.2%; positive predictive value was 83.3%; negative predictive value was 96.1%; positive likelihood ratio was 15.2; negative likelihood ratio was 0.12; and the area under the receiver operating characteristic curve of qSOFA was 94.2%. There was significant association between qSOFA scale and mortality with p-value of 0.0001. The qSOFA score has strong positive correlation with Fournier's Gangrene Severity Index (p<0.0001, r=0.704). Conclusion: qSOFA scoring system has a high prognostic value and can be used to determine prognosis of Fournier's gangrene patients.

Comparison between staged laparoscopic technique in children with high intra-abdominal undescended testis: a systematic review and meta-analysis.

Background: This study performed a systematic review and meta-analysis to compare the outcomes of the staged laparoscopic Fowler-Stephens Laparoscopic Orchiopexy (FSLO) and Staged Laparoscopic Traction Orchiopexy (SLTO) in patients with intra-abdominal testes (IAT). Methods: This study reviewed literature published from 2016 to 2024. A systematic literature search was conducted on three databases: PubMed, ScienceDirect, and Google Scholar, using keywords (High intra abdominal testis) AND (("Fowler Stephens laparoscopic orchiopexy" OR (FSLO)) OR (Staged Laparoscopic traction orchiopexy OR (SLTO)). Non-randomized trials and observational studies comparing staged laparoscopic FSLO and SLTO, without any time range restriction are included. Studies without FLSO orchidopexy as a control, case reports, case studies, duplicate publication, no full text and non-English studies are excluded. This study used the PRISMA protocol, the Jadad Scale, and the Newcastle Ottawa Scale (NOS) to evaluate the included studies. To analyze statistical data, the Review Manager (RevMan) software was used. The Chi-squared test was used to calculate statistical heterogeneity in the meta-analysis. Results: There were 240 patients from 5 studies (109 in the SLTO group and 131 FSLO in group). The primary outcome of this study is testicular descent and atrophy. There were no significant differences in testicular descent (RR:1.08[0.96 - 1.23],p<0.20,I 2:0%) and atrophy rate (RR:0.45[0.19 - 1.09],p<0.08,I 2:0%). Secondary outcomes are the duration of operation in both the first and second stages. Statistical analysis reveals a significantly lower first-stage operation time in the FSLO group (MD:9.31[7.08,11.55], p<0.05;I 2:94%). At the same time, lower second-stage operation times are significantly reported in the SLTO group (MD:-4.05[-7.99,-0.12],p<0.05; I 2:60%). Conclusions: In terms of testicular descent and testicular atrophy the SLTO technique yields similar results to the FSLO technique. Both techniques have advantages and disadvantages, and we recommend SLTO as the first choice in children with a high IAT of <4 cm. PROSPERO registration: CRD42023412407.

Wunderlich syndrome in a COVID-19 patient with poor outcome.

A 42-years-old female presented with loss of consciousness and gross hematuria. Physical and laboratory examination indicated hemorrhagic shock. CT-Scan showed massive retroperitoneal hemorrhage on left kidney. The patient needed selective arterial embolization, but the facility was not available for COVID-19 patients who require a negative-pressure room. The patient underwent renal exploratory laparotomy and right nephrectomy, but did not survive due to multiple organ dysfunction syndromes. Wunderlich syndrome is a severe hemorrhagic complication in COVID-19. The three symptoms are known as Lenk's triad which includes hypovolemic shock, acute flank pain, and flank mass.

Factors Affecting Survival Outcome After Percutaneous Nephrostomy as Palliative Urinary Diversion in Obstructive Uropathy due to Advance Cervical Cancer Patients.

INTRODUCTION: Cervical cancer is the 3rd most common cancer in women. In late stages, obstructive uropathy due to mass infiltration is common and the mainstay of treatment for this condition is palliative urinary diversion through percutaneous nephrostomy. Nevertheless, complications due to nephrostomy may have adverse effects on some patients. Further study is necessary to determine whether nephrostomy is suitable for all cervical cancer patients with obstructive uropathy. This study aims to identify the determinants of survival rate of cervical cancer patients undergoing nephrostomy for obstructive uropathy and determine the group of cervical cancer patients that would benefit the most from nephrostomy. METHODS: Data were obtained from medical records of cervical cancer patients in Hasan Sadikin Central Public Hospital from January 2018 to December 2019. Log-rank analysis was performed to assess the survival rate of patients based on clinical conditions (age, metastasis, and ECOG performance status) and initial laboratory results (hemoglobin, leukocyte, thrombocyte and blood acidity). RESULTS: A total of 163 cases were identified from the medical records, with a median survival of 5(1-17) months. The results of the analysis showed that the survival rates of cervical cancer patients undergoing nephrostomy were significantly affected by age (p = 0.0001), metastasis (p = 0.0001), and ECOG performance status (p = 0.0001), while laboratory findings were not significant factors affecting survival (pHb=0.501; pLeu=0.634; pTr=0.077; pBGA=0.687). CONCLUSION: The survival after nephrostomy in advanced cervical cancer patients is largely affected by age, metastasis, and performance status. The choices of doing nephrostomy in those patients should be considering those factors to maximize the benefit over the risk of complications.
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Intratesticular Human Adipose-Derived Stem Cell (hADSC) Transplantation Decreased Oxidative Stress in Testicular Torsion Model of Wistar Rat.

INTRODUCTION: Testicular torsion is a sudden rotation of the testis towards its axis, which causes the twisting of the spermatic cord. Post-detorsion reperfusion will cause inflammation and trigger oxidative stress, which generates reactive oxygen species (ROS). Malondialdehyde (MDA) is an organic compound formed from ROS frequently used as an oxidative stress biomarker during ischemia and ischemia-reperfusion injury. In some organs, stem cell administration on the damaged organ is essential in preventing cellular damage and death. This study aimed to learn about the effect of hADSC administration on an ischemia-reperfusion injury. MATERIAL AND METHODS: A total of 22 Wistar rats divided into 5 groups, two groups each consist of 5 male Wistar rats with testicular torsion model without hADSC therapy (group I), while 2 other groups consist of 5 rats with testicular torsion model were given 1.0×106 cells intratesticular hADSC injection 30 minutes after testicular detorsion (group II). Both groups were euthanized at 1 and 4 weeks of observation. The last group consists of 2 rats without any treatment or model (negative control group). Following euthanasia, testicular tissue was harvested for MDA expression measurement using ELISA and histopathological examination. Statistical analysis using an one way ANOVA was done with SPSS version 21.0. RESULTS: The result of MDA examination using the ELISA method has shown a concentration difference between group I (control) and group II (hADSC treatment). Testicular MDA concentration in the treatment group was significantly lower on the 1st and 4th week of observation (p2=0.000, p4=0.016). Post hoc analysis showed no statistically different between therapy and healthy group (p=0.972). On histopathological examination, Johnsen score in the treatment group was significantly higher on the 4th week of observation (p=0.044). Post hoc analysis showed no statistically different between therapy and healthy group (p=0.195). CONCLUSION: Intratesticular hADSC administration can inhibit ROS formation due to ischemia-reperfusion injury in testicular tissue after testicular detorsion in Wistar rats.

Successful testicular sperm extraction in infertile male with non-obstructive azoospermia presented with bilateral atrophic testis: A case report.

Approximately 50% of men with NOA have minimal sperm production within their dysfunctional testes. Studies shown poor correlations between testicular size and sperm retrieval rates. A 34 years old man with NOA and bilateral testicular atrophic had a successful sperm extraction using mTESE from his 2.1 cc right testicle. Lower testicular volumes significantly decrease sperm retrieval rate in mTESE. However, we described a successful mTESE in atrophic testis. Therefore, small testicular volume does not affect the successful rate of mTESE and should not be a contraindication.

Urinary bladder neck diverticular stone in patient with multiple congenital anomaly (Jarcho-Levin syndrome).

Urinary bladder stone usually is a manifestation of other pathological process, including foreign object or micturition dysfunction. Urinary bladder diverticula can cause urinary stasis that leads to urinary bladder stone. We present a very rare case which is bladder neck diverticula stone in 36-year-old male with multiple congenital anomaly (Jarcho-Levin syndrome) with stone in urinary bladder neck diverticula and the management in our treatment facility.

Malignant priapismus induced by adenocarcinoma of the prostate.

Penile metastasis of adenocarcinoma of prostate is an extremely rare clinical entity and even less of such cases presenting with malignant priapism. Management of priapism with penile shunting is recommended in this case. No consensus beyond personal recommendation from other studies found in this case due to the relative rarity of the disease and the associated lack of data. In this study, we present a case of malignant priapism due to penile metastasis of adenocarcinoma of the prostate, an extremely rare clinical entity and a more uncommon site of metastasis.

Urinary tract villous adenoma in Indonesia.

This is the first recorded case of urinary tract villous adenoma in Indonesia. A 70-years-old man suffered from a painful left flank mass and jelly like mixed urine. He had undergone percutaneous nephrostomy yielding a jelly like substance, and a previous stone surgery. Left nephrectomy and lymph nodes dissection were performed. Intraoperative finding showed significant mucus fluxed from this enlarged kidney. Histopathological examination revealed columnar epithelium and goblet cells amongst the villiform glands. There is no standard established protocol for follow up and management. We should follow-up for a possibility of recurrence or progression.

Phalloplasty and urethroplasty in adult with disorder of sex developments.

This case report presents our experience on the first phalloplasty and urethroplasty in adult with Development Sex Disorder (DSD) in Indonesia. A 25 years old male with DSD 46 XY planned undergo phalloplasty and urethroplasty with radial forearm free flap (RFFF). Eight months later, there was fistulas repairment due to urethrocutaneus fistulas. Cartilage insertion also was done to make a semi-rigid neophallus. At last, there was no new fistula or stricture developed. Qmax and Qmean were 33,8 ml/s and 14,0ml/s. RFFF only causes minimal complication. The neophallus and neourethra also function properly.