1.Accuracy of ultrasound versus computed tomography urogram in detecting urinary tract calculi
Salinawati Bakin ; Erica Yee Hing ; Fam Xeng Inn ; Zulfiqar Mohd Annuar
The Medical Journal of Malaysia 2015;70(4):238-241
Aim: To determine the (i) sensitivity and specificity of
ultrasound (USG) in the detection of urinary tract calculi, (ii)
size of renal calculi detected on USG, and (iii) size of renal
calculi not seen on USG but detected on computed
tomography urogram (CTU).
Methods: A total of 201 patients’ USG and CTU were
compared retrospectively for the presence of calculi.
Sensitivity, specificity, accuracy, positive predictive value
and negative predictive value of USG were calculated with
CTU as the gold standard.
Results: From the 201 sets of data collected, 59 calculi were
detected on both USG and CTU. The sensitivity and
specificity of renal calculi detection on USG were 53% and
85% respectively. The mean size of the renal calculus
detected on USG was 7.6 mm ± 4.1 mm and the mean size of
the renal calculus not visualised on USG but detected on
CTU was 4 mm ± 2.4 mm. The sensitivity and specificity of
ureteric calculi detection on USG were 12% and 97%
respectively. The sensitivity and specificity of urinary
bladder calculi detection on USG were 20% and 100%
respectively.
Conclusion: This study showed that the accuracy of US in
detecting renal, ureteric and urinary bladder calculi were
67%, 80% and 98% respectively.
Calculi
;
Urinary Calculi
2.Penile Augmentation with Resultant Foreign Material Granuloma and Sequalae
Fam Xeng Inn ; Farrah-Hani Imran ; Mohd Faizal Ali ; Rizuana IH ; Zulkifli Z
Malaysian Journal of Medical Sciences 2012;19(4):82-84
Throughout history, a proportion of men appear to correlate penis size and dimensions directly with physical fitness and sexual prowess. Foreign materials, such as paraffin oil, paraffin balm, mineral oils, and silicone, have been used to promise an improvement in penile shaft contour and dimensions. These materials are injected directly into the penis; inducing granuloma formation to achieve increased penis length and girth. However, the result is a severely disfigured and swollen penis, which cannot achieve erection. Local complications of penile lipogranuloma include infection, ulceration, local migration, and cavernosal invasion; leading to functional impairment. Meanwhile, systemic complications include foreign body embolization, organ infarct, and death. Penile lipogranuloma is best treated surgically. Granulomatous skin needs to be completely excised; wound closure with a scrotal skin flap, Cecil’s inlay operation and split thickness skin graft commonly used options. Our case series has shown that penile lipogranuloma, induced by subcutaneous foreign body injections into the penile shaft, and its subsequent adverse outcomes to patients and their partners.
3.Ureteral stricture formation after ureteroscope treatment of impacted calculi: A prospective study.
Xeng Inn FAM ; Praveen SINGAM ; Christopher Chee Kong HO ; Radhika SRIDHARAN ; Rozita HOD ; Badrulhisham BAHADZOR ; Eng Hong GOH ; Guan Hee TAN ; Zulkifli ZAINUDDIN
Korean Journal of Urology 2015;56(1):63-67
PURPOSE: Urinary calculi is a familiar disease. A well-known complication of endourological treatment for impacted ureteral stones is the formation of ureteral strictures, which has been reported to occur in 14.2% to 24% of cases. MATERIALS AND METHODS: This was a prospective study. Ureterotripsy treatment was used on patients with impacted ureteral stones. Then, after 3 months and 6 months, the condition of these patients was assessed by means of a kidney-ureter-bladder (KUB) ultrasound. If the KUB ultrasound indicated moderate to serious hydronephrosis, the patient was further assessed by means of a computed tomography intravenous urogram or retrograde pyelogram to confirm the occurrence of ureteral strictures. RESULTS: Of the 77 patients who participated in the study, 5 developed ureteral strictures. Thus, the stricture rate was 7.8%. An analysis of the intraoperative risk factors including perforation of the ureter, damage to the mucous membrane, and residual stone impacted within the ureter mucosa revealed that none of these factors contributed significantly to the formation of the ureteric strictures. The stone-related risk factors that were taken into consideration were stone size, stone impaction site, and duration of impaction. These stone factors also did not contribute significantly to the formation of the ureteral strictures. CONCLUSIONS: This prospective study failed to identify any predictable factors for ureteral stricture formation. It is proposed that all patients undergo a simple postoperative KUB ultrasound screening 3 months after undergoing endoscopic treatment for impacted ureteral stones.
Constriction, Pathologic/*diagnosis
;
Humans
;
Hydronephrosis/diagnosis
;
Kidney/ultrasonography
;
Prospective Studies
;
Risk Factors
;
Ureter/*pathology/ultrasonography
;
Ureteral Calculi/*therapy
;
Ureterolithiasis/*surgery
;
Ureteroscopy/*adverse effects
;
Urinary Bladder/ultrasonography
4.Overview of Urethral Reconstruction by Tissue Engineering: Current Strategies, Clinical Status and Future Direction
Zahra RASHIDBENAM ; Mohd Hafidzul JASMAN ; Pezhman HAFEZ ; Guan Hee TAN ; Eng Hong GOH ; Xeng Inn FAM ; Christopher Chee Kong HO ; Zulkifli Md ZAINUDDIN ; Reynu RAJAN ; Fatimah MOHD NOR ; Mohamad Aznan SHUHAILI ; Nik Ritza KOSAI ; Farrah Hani IMRAN ; Min Hwei NG
Tissue Engineering and Regenerative Medicine 2019;16(4):365-384
BACKGROUND: Urinary tract is subjected to a variety of disorders such as urethral stricture, which often develops as a result of scarring process. Urethral stricture can be treated by urethral dilation and urethrotomy; but in cases of long urethral strictures, substitution urethroplasty with genital skin and buccal mucosa grafts is the only option. However a number of complications such as infection as a result of hair growth in neo-urethra, and stone formation restrict the application of those grafts. Therefore, tissue engineering techniques recently emerged as an alternative approach, aiming to overcome those restrictions. The aim of this review is to provide a comprehensive coverage on the strategies employed and the translational status of urethral tissue engineering over the past years and to propose a combinatory strategy for the future of urethral tissue engineering. METHODS: Data collection was based on the key articles published in English language in years between 2006 and 2018 using the searching terms of urethral stricture and tissue engineering on PubMed database. RESULTS: Differentiation of mesenchymal stem cells into urothelial and smooth muscle cells to be used for urologic application does not offer any advantage over autologous urothelial and smooth muscle cells. Among studied scaffolds, synthetic scaffolds with proper porosity and mechanical strength is the best option to be used for urethral tissue engineering. CONCLUSION: Hypoxia-preconditioned mesenchymal stem cells in combination with autologous cells seeded on a prevascularized synthetic and biodegradable scaffold can be said to be the best combinatory strategy in engineering of human urethra.
Cicatrix
;
Data Collection
;
Hair
;
Humans
;
Mesenchymal Stromal Cells
;
Mouth Mucosa
;
Myocytes, Smooth Muscle
;
Porosity
;
Skin
;
Tissue Engineering
;
Transplants
;
Urethra
;
Urethral Stricture
;
Urinary Tract