OBJECTIVE: To compare the effectiveness of abdominal placement of indwelling Foley catheter (IFC)versus thigh traction in the prevention of bleeding and pain after transurethral resection of the prostate(TURP). PATIENTS AND METHODS: This randomized, controlled trial involves 91 patients who underwent TURP atJRRMMC. After TURP, 46 patients were inserted with a urethral catheter which was then anchoredto the thigh and placed on traction, while the catheter was anchored to the abdomen without applicationof any traction in the remaining 45. A simple dipstick test was used to check for the presence of bloodin urine on the 12th and 24th hour after the surgery. Intensity of pain from the catheter was assessedprior to discharge using a visual analogue score (VAS). RESULTS: There were no significant differences between the two groups in terms of the amount of bloodin the urine at the 12th hour (p=1.00) and 24th hour (p=0.427) after TURP. The mean VAS score wassignificantly higher for the thigh traction group (5.17 vs 1.51, p=0.0001). Additionally, there weremore patients in the IFC thigh traction group who complained of moderate (65% vs 4.4%, p= 0.0001)and severe (20% vs 4.4%, p= 0.0001) pain. CONCLUSION Abdominal placement of IFC post TURP is an effective, safe and comfortable way incontrolling post-operative bleeding post-TURP. This method can provide better pain control.

This case report discusses penile strangulation caused by a ball bearing of a fidget spinner in a 9 year - old child. Initial examination revealed a 2 cm x 2 cm metallic ball bearing encircling the base of the penis with gross edema of the distal penile shaft and erythematous penile skin. To release the bearing, a modified string method was used. After removal, skin erosion was treated with debridement and applied with hydrocolloid dressing. Analysis and cross referencing of the case with literature suggest that successful extraction of a constricting object and treatment of penile strangulation, due to the varied nature, causes and effects of penile strangulation, greatly depends on immediate diagnosis and treatment. This spares one from immediate and long term complications, or necrosis with subsequent auto-amputation.

OBJECTIVE: National prostatic digital rectal examination (DRE) advocated by the Philippine Urological Association (PUA) started 2 decades ago in the advent of prostate specific antigen (PSA) screening. It is an effective campaign in promoting prostate health awareness among Filipinos. The aim of this research was to describe and correlate the demographics, clinical profile and prostatic physical findings examined by urologists in over 60 centers in the country.
METHODS: This study was an analytical cross-sectional study involving the participants of the 2013-2015 National DRE campaign. The data were retrieved from the PUA secretariat using a convenience-sampling method on completed forms. The data were correlated using a non-parametric measure of statistical dependence between two variables.
RESULTS: The total number of participants was continuously rising [n=978 (2013), n=2052 (2017) and n=2792 (2015)] having 60-70% newly diagnosed cases annually. Participants were mostly on their 6th decade of life, mostly employed, married and an educational attainment of secondary level. The most predominant symptom was nocturia followed by frequency, incomplete emptying and weak stream. The usual prostate size was between 21-30 grams mostly with doughy consistency, nodular and tender. The mean age of having clinically benign prostate enlargement was noted to be consistent at the age of 61 while that of a prostate cancer suspect ranged from 63-69 years old.
CONCLUSION: Filipinos have similar predominant signs and symptoms of prostate disease as compared to Malays, Chinese and Indians. Clinical findings of prostate diseases correlated well with age, prostate size and consistency.

Human ; Male ; Prostate-specific Antigen ; Digital Rectal Examination ; Nocturia ; Urologists ; Malaysia ; Philippines ; Rivers ; Prostatic Neoplasms ; Prostatic Hyperplasia ; Demography

INTRODUCTION

Testicular torsion is a true urologic emergency. It occurs when the blood supply to the testis is compromised as the vessels twist along the spermatic cord. Early diagnosis and prompt treatment are critical to prevent prolonged ischemia time which is crucial to its prognosis. This paper aimed to present cases of testicular torsion who underwent testis sparing surgery for torsion.

METHODS

Cases of testicular torsion admitted at the institution from January 2023 to July 2024 were reviewed. Demographic data, scrotal ultrasound findings, intraoperative findings and ischemia time were documented. Patients who underwent tunica albuginea fasciotomy with tunica vaginalis flap were monitored post-surgery via scrotal ultrasound, documenting testicular size.

RESULTS

Twenty seven (27) cases of testicular torsion were reviewed. Of these cases, 4 improved after detorsion and orchidopexy, 12 cases with > 72 hours ischemia time and failed detorsion underwent orchiectomy, 11 cases with < 72 hours of ischemia time, tunica albuginea fasciotomy were performed. Five (5) of these 11 cases showed no improvement in appearance and no bleeding was observed and subsequent orchiectomy was performed. Six cases demonstrated improvement in appearance and bleeding after tunica albuginea fasciotomy, tunica vaginalis flap used to cover the resulting defect. Of these 6 cases, 2 cases showed intact testicular size, 1 case had testicular atrophy on monitoring and 3 cases were lost to follow-up.

CONCLUSION

Testicular torsion remains to be a critical urologic emergency. Prompt diagnosis and immediate surgery required to improve salvage rates. Tunica albuginea incision, with subsequent tunica vaginalis flap may be an option for the urologist to improve salvage, although not consistently prevent testicular atrophy.

Human ; Male ; Testicular Torsion ; Spermatic Cord Torsion