Brawijaya Journal of Urology

Nephrolithiasis Treated With Rirs On Single Kidney Patient A Case Report

Fransiska Roslinda Dua Neang — 2023-10-07

Urinary stones is a common disorder and affects a con-siderable number of people worldwide. Nephrolithiasis (kidney stones) is one of the kidney diseases, where the discovery of stones containing crystal components and organic matrix is the biggest cause of urinary tract disorders. The case of this left Kidney Stone was reported at WZ Johannes General Hospital, Kupang, East Nusa Tenggara, Indonesia. The patient is a 31 year old female with single kidney, renal stone with the size measured -+ 1.2 cm (HU = 1078) at the lower calyx pole. The patient came to the ER with complaints of left flank pain and patient complains of left lower back pain, lower left abdomen and radiating to the groin. The patient also complains of the most pain at night and often wakes up to urinate and can't hold urine so that the patient sometimes starts urinating before arriving at the bathroom, the patient's urine output is also small. The patient often complains of gritty urine and foam at the end of the urine and has time to urinate blood. RIRS surgical procedure was performed to release the stone. Conclusion : The cause of the Renal stone should be considered prior to treatment as eliminating the cause and the underlying factor will reduce the complications and recurrence rates.

Case Report: Staghorn Stone Successfully Treated With Open Nephrolithotomy

Ezra Harun Florentino Nababan — 2023-10-07

Introduction: Staghorn stones are large branching stones that fill part of all of the renal pelvis and renal calyces and they can be complete or partial depending on the level of occupancy of the collecting system. The case of this Staghorn Kidney Stone stone was reported at Leona hospital, Kupang, East Nusa Tenggara, Indonesia.

Case: The patient is a 22 year old male with Staghorn renal stone with the size measured 14 x 11 cm. The patient came to the ER with complaints of low back pain and patient complains of difficulty urinating first. nephrolithotomy surgical procedure was performed to release the stone.

Conclusion: The cause of the Renal staghorn stone should be considered prior to treatment as eliminating the cause and the underlying factor will reduce the complications and recurrence rates.

Intrauterine Device in The Bladder: A Rare Case Report

Muhammad Edy Haeruddin — 2023-10-07

Introduction: Uterine perforation and migration of intrauterine device (IUD) are rare complications but serious. There are several risk factors, such as consistency and thickness of the uterine wall, length of time of insertion, pelvic surgery history, and installer experience and knowledge. The IUD can migrate to the peritoneal cavity and then cause perforation of the rectum, appendix, or stones in the bladder. Although the migration of the IUD to the bladder can be asymptomatic, removing procedure should be taken as soon as possible.

Case: A 74-year-old woman came to the hospital with a complaint of painful urination two years prior to admission. The patient was diagnosed with a recurrent urinary tract infection (rUTI) over the past two years. For the last two months, the patient complained of lower abdominal pain and occasional hematuria. The patient has a 50-year history of IUD insertion. On ultrasound imaging examination, stones were obtained in the bladder by 2.7cm, in cystoscopy procedures confirmed the diagnosis of IUD migration to the bladder with stone formation. Cystolasertripsy was performed to destroy stones and evacuate stones and IUDs from the bladder. The procedure went off without a hitch. After a postoperative evaluation revealed no complications.

Conclusion: Migration of IUD can be found in the bladder and evaluation of the condition of the patient by radiological examination is necessary. An endoscopic approach could be performed to evacuate the IUD from the bladder.

Routine Preoperative Frailty Assessment Predicts Postoperative Complication in PCNL Surgery

Alfryan Janardhana — 2023-10-07

ABSTRAK:

Introduction: Frailty is an assessment of functional status related to postoperative outcome. This observational study aims to determine differences in the frailty status of patients undergoing Percutaneous Nephrolithotomy (PCNL) with the incidence of postoperative complications.

Methods: This is a retrospective cohort study design conducted at a tertiary referral hospital in Jember with the patient's medical record as the source of data. The frailty status is evaluated using Clinical Frailty Scale (CFS) which are categorized into frailty and non-frailty. The outcomes of this study were perioperative and the incidence of postoperative complications which included estimated blood loss, fever, sepsis, Intensive Care Unit (ICU) admission, Deep Vein Thrombosis (DVT), and postoperative.

Results: Of the 24 patients who were screened, 7 patients with frailty status and 17 patients with non-frailty status before PCNL were performed. Patients with frailty status occur at an older age with a significance value of 0.001 and have a risk of postoperative complications such as fever, length of stay (LOS), sepsis, ICU admission and higher blood transfusion compared to non-frailty patients. The result of the comparison test from length of stay showed a significance of <0.001 (p<0.05). The perioperative events did not have a significant relationship with frailty status.

Conclusion: Assessment of frailty status prior to PCNL is very useful for predicting the incidence of postoperative complications. Risks include fever, sepsis, length of stay, ICU care and blood transfusion are higher in patients with frailty status.

Efficacy and Safety of Combination therapy compared to Monotherapy for Overactive Bladder: A Meta-Analysis

Fauzan Kurniawan Dhani — 2023-10-07

Introduction & Objectives

Overactive Bladder (OAB) Syndrome is urinary urgency often accompanied by increased daytime frequency and nocturia, with or without urgency incontinence. Individuals with OAB report significant impairment to quality of life. Antimuscarinic become first line therapy of OAB patients with dose escalation or change of antimuscarinic if symptom improvement is inadequate. Increasing the antimuscarinic dose often exacerbates anticholinergic Adverse Events (AEs) that can lead to treatment discontinuation. The aim of this meta-analysis to find out the efficacy and safety of combination therapy compared to solifenacin alone.

Materials and Methods

We searched for data’s of Randomized clinical trials in PUBMED, EMBASE, and the Cochrane Library. There was no year restriction and only English is allowed. The outcomes were Micturition Episode/24h , Incontinence Episode/24h , AEs and Discontinue medication due to AEs. The data’s were carried out using PRISMA guideline and statistically analysed by using RevMan 5.3.0.

Result

Three RCTs studies, including 7007 patients were assessed for efficacy and safety of combination therapy compared solifenacin alone. It is revealed Micturation [HR -0.46; 95%CI: -0.63, -0.29; I²13%; p<0.00], Incontinence [HR -0.27; 95%CI: -0.42, -0.13; I²13%; p<0.00], Adverse Events [HR 1.09; 95%CI: 0.94, 1.27; I² 0%; p=0.27] and Discontinue Medication due to AEs [HR 1.26; 95%CI: 0.70, 2.24; I² 0%; p=0.44].
Conclusion

The efficacy of combination therapy of mirabegron plus solifenacin significantly improved storage symptoms regarding micturition and incontinence episode, compared to solifenacin monotherapy. Combination therapy provides better therapeutic benefits for patients with overactive bladder syndrome.