1.Back door style: A case report on retroperitoneoscopic donor nephrectomy - a first in the Philippines.
Raul Carlo C. Andutan ; Juvido P. Agatep Jr. ; Mark Jason Y. Dequina
Philippine Journal of Urology 2018;28(2):126-129
The aim of this report is to validate the effectiveness and safety of the retroperitoneoscopic donornephrectomy in kidney transplantation and to document the first Retroperitoneoscopic Left DonorNephrectomy in the Philippines done last July 5, 2018.This is a case of 35-year-old female with no comorbidities but with an infraumibilical scar from aprevious cesarean section underwent the first Retroperitoneoscopic Left Donor Nephrectomy in thePhilippines.The principle was pure retroperitoneoscopic donor nephrectomy, hand-assist using Gelport devicewas applied only during vascular transection and allograft retrieval. Access to the retroperitoneumwas established using a modified trocar placement.Retroperitoneal Donor Nephrectomy is a safe and technically-feasible surgery as more urologistsbecome proficient with this approach. The benefits of this approach are in line with the goals of livingkidney allograft retrieval, to minimize morbidity and to maximize safety of the patient. Literatureshows that it has comparable outcomes with Transperitoneal donor nephrectomy (TDN) and opentraditional allograft kidney retrieval.
2.A case report on a Fossa Navicularis Stricture repaired using a Transurethral Ventral Buccal Mucosal Graft Inlay Urethroplasty technique: A first in the Philippines.
Clarice Condeno ; Oyayi Arellano ; Charles Gaston ; Raul Carlo Andutan ; Mark Joseph Abalajon
Philippine Journal of Urology 2023;33(1):19-22
OBJECTIVE:
To describe the technique and report the first transurethral buccal mucosal graft ventral inlay
(Nikolavsky Technique) urethroplasty done in the Philippines, in a patient who had a fossa navicularis
stricture extending to the distal penile urethra.
METHODS:
Reported here is a case of a twenty-seven-year-old male who had a 40% distal urethral
mucosal tear, as seen on initial cystoscopy, following traumatic catherization. The urethral tear was
initially managed with a foley catheter maintained for a month. However, the patient eventually
developed a 4 cm stricture extending from the fossa navicularis to the distal penile urethra. A ventral
buccal mucosal graft was placed on the denuded urethral plate as an inlay patch via the transurethral
route. No skin incisions nor penile degloving was done
RESULTS:
Total operative time was four hours, including graft harvest time, with approximately 400 ml
blood loss. The patient was sent home on the 3rd postoperative day. The urethral catheter was removed
after 14 days. Post-operative follow-up was performed at 0-, 3- 6- and 12-months. A repeat voiding
cystourethrogram was performed at 4 weeks showing no narrowing at the prior stricture site. On 12
months follow-up, uroflowmetry showed a Q-max of 20ml/sec with minimal residual urine. LUTS
symptom scoring was at 7 and IIEF-5 score of 25
CONCLUSION
Repair of distal urethral strictures can be done using transurethral ventral buccal mucosa
graft inlay urethroplasty. It can be challenging for longer strictures (>4 cm) but easily reproducible for
shorter ones. The technique demonstrated good results on medium term follow-up. To the authors’
knowledge, this is the first reported case that utilized this technique in the Philippines.