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.

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.

Body dysmorphia is a debilitating disorder that centralizes on a preoccupation with one’s physical appearance. Often, these individuals seek surgical correction in an effort to subdue this preoccupation. A majority of complications from feminizing gender reassignment surgery, consists of urethral stricture or stenosis, leading to voiding dysfunction. The patient is 39-year old male who underwent bilateral nipple removal, bilateral orchiectomy, scrotectomy and total penectomy with perineal urethrostomy, one year prior to consult. The patient eventually presented with acute urinary retention secondary to perineal urethrostomy stenosis. Urethroplasty with revision of perineal urethrostomy site using a buccal graft was done; and on follow up, he was noted to have good urine flow on uroflowmetry with mild lower urinary tract symptoms. Complex urethral strictures may be noted in patients with prior reconstructive history and lengthy areas of fibrosis. Although perineal urethrostomy is a valid surgical course of treatment for patients with complex strictures, improper technique, suboptimal patient factors, and, poor healing may lead to stenosis. The study aims to describe the use of a buccal graft as a viable alternative and easily reproducible technique to augment a revision perineal urethrostomy and lessen the recurrence of stenosis.

Human ; Male ; Adult: 25-44 Yrs Old ; Gender Reassignment Surgery ; Sex Reassignment Surgery