Brawijaya Journal of Urology

A Rare Case: Vesicholithiasis with Dermoid Cyst of Bladder

2025-01-30T08:59:08+07:00

Introduction. Ovarian dermoid cyst, also known as mature cystic teratoma (MCT), is the most common ovarian germ cell tumor in young women. Teratomas have been reported to occur in various sites and organs. Bladder teratoma is a very rare extragonadal tumor, moreover in adults. Although teratomas are known as benign lesions in childhood, they may act as malignant tumors when detected during adulthood.

Case. A 64-year-old woman presented with left side low back pain and dysuria over a 6-month period. Kidney, ureter, and bladder (KUB) X-ray showed a large stone in the bladder with calcification on the left side of the abdomen. An ultrasonography revealed 4.1 cm x 3.1 cm ill-defined echogenic mass in the urinary bladder lumen. Cystoscopy revealed hair on the back of the stone. The diagnosis was made on cystoscopy and confirmed histopathologically. Complete excision was possible. The histopathology report showed a benign mature teratoma with ectodermal, mesodermal, and endodermal elements. The histopathological findings confirmed skin, adnexal structures (sweat glands, hair follicles), adipose, and fibroblastic tissue, which were consistent with those of a dermoid cyst.

Conclusion. A bladder teratoma mimics the presentation of a bladder stone, clinically and radiologically. A dermoid cyst should be considered as a differential diagnosis, especially when the stone appears to be confined to the bladder wall during examination.

Keywords: bladder, dermoid cys, vesicolithiasis

Correlation Between Gender, Age, and Body Mass Index with Length of Stay in Nephrolithiasis Patients

2024-11-11T14:41:35+07:00

Introduction. The increasing prevalence of nephrolithiasis in several countries in recent years has made it a serious public health concern. Three days is the typical duration of stay for nephrolithiasis treatment, so longer length of stay will burden society in various ways, especially in terms of expensive costs. This study aims to determine the relationship between the length of stay patients with nephrolithiasis at RSU PKU Muhammadiyah Mojoagung and gender, age, and body mass index.

Methods. Descriptive analytic with a cross-sectional design is used in this research, applying the method of consecutive sampling. The chi-square statistical test will be used to assess the data in both univariate and bivariate formats. This research was carried out at RSU PKU Muhammadiyah Mojoagung on inpatients diagnosed with nephrolithiasis within 2023.

Results. In this study, 111 patients were included, including 61 men and 50 women. Of the patients, 46.8% were between the ages of 45-65 years old, and the major criteria is non-obesity (64,9%). The patients had a stay of at least 4 days. According to Chi Square Test analysis, body mass index and length of stay have a significant correlation (p=0.012). Meanwhile, there was no correlation between age (p = 0.548) and gender (p = 0.089) with length of stay.

Conclusion. Body mass index has correlation with length of stay in nephrolithiasis patients at RSU PKU Muhammadiyah Mojoagung, while gender and age has no correlation with length of stay of nephrolithiasis patients.

Keywords: age, body mass index, gender, length of stay, nephrolithiasis patients

Advances in Urology: A Comprehensive Literature Review on Urolithiasis Management and Innovations

2025-03-26T09:24:30+07:00

Introduction. Urolithiasis is a prevalent condition, affecting approximately 12% of the global population at some point in their lives, with higher incidence rates reported in industrialized nations. This condition poses significant health challenges worldwide due to its recurrence and the associated healthcare burden. Recent innovations in imaging, minimally invasive techniques, and pharmacotherapy have revolutionized the field. This review aims to explore recent updates and innovations in the management of urolithiasis, from diagnosis to therapy.

Methods. A systematic search using predefined keywords in multiple databases was done. Peer-reviewed articles, clinical trials, meta-analyses, and systematic reviews focused on urolithiasis management, diagnostic techniques, therapeutic innovations, and preventive strategies were analyzed. Articles from January 2015—December 2023 were included, reviewed for its eligibility, and extracted.

Results. Emerging pharmacological agents (eg. empagliflozin, thiosulfate) offer new avenues for prevention and recurrence reduction, particularly for patients with recurrent urolithiasis, although not as primary therapy. Additionally, the integration of artificial intelligence and machine learning is beginning to play a role in predicting stone recurrence and optimizing treatment plans.

Conclusion. This review highlights the importance of a personalized, patient-centered approach in managing urolithiasis, emphasizing the need for ongoing research and clinical trials to further refine these innovations.

Keywords: artificial intelligence, disease management, urinary stone disease, urolithiasis

Prevalence, Parental Knowledge, and Factors Associated with Delayed Treatment of Testicular Hydrocele in Toddlers at Wagir Community Health Center

2025-06-24T08:31:15+07:00

Introduction. Testicular hydrocele is a genitourinary defect that can occur in males, either due to a lymphatic infection or congenital cause. Congenital testicular hydrocele is rarely reported in epidemiological data, both nationally and internationally. Additionally, if a hydrocele does not resolve naturally, it must be treated after the age of 1 year to prevent complications. This study aims to identify the incidence of congenital testicular hydrocele in several toddler health posts within the working area of the Wagir Community Health Centre, Malang Regency, East Java, Indonesia, assess parental knowledge, and analyze factors associated with delayed treatment.

Methods. This descriptive and observational analytic study involved 248 male toddlers in 11 villages in Wagir, Malang Regency, East Java, Indonesia, utilizing questionnaires and physical examinations. Data was obtained passively through screening of villagers who came to the study site. Analysis was then conducted using the SPSS software by Pearson’s Chi-Square and Binary Logistic Regression.

Results. From a total of 248 children, 4.44% were found with testicular hydrocele, with 1.21% cases experiencing delayed treatment. Poor knowledge about this condition was found in 81.82% of the sample. No relationship was found significant between the sociodemographic factors and health factors analyzed and the delay in hydrocele treatment (GLM, Wald Chi-Square, p = 1.000 > 0.05).

Conclusion. The incidence rate of testicular hydroceles in toddlers under five years old at the integrative service post within the working area of Wagir Health Center of Malang Regency was 4.44%, of which 1.21% of cases experienced delays in treatment. Parents' knowledge of the incidence of testicular hydroceles in toddlers under five years old is still lacking. There was no significant relationship between the factors analyzed and the delay in testicular hydroceles management.

Keywords: delay in treatment, epidemiology, sociodemographic factors, testicular hydrocele

Potential of Preoperative Testosterone Stimulation Therapy to Reduce Complication in Hypospadias Repair: A Systematic Review and Meta-Analysis

2025-06-12T13:01:42+07:00

Introduction. The pre-operative hormone stimulation is recommended for hypospadias patients, especially those with small penis, to improve the results and outcomes of hypospadias repair. We conducted a systematic review and meta-analysis to evaluate the effectiveness of pre-operative testosterone stimulations before hypospadias repair.

Methods. We performed a comprehensive search for relevant studies from PubMed, Medline, Cochrane, Proquest, and Embase from August 2000 until August 2023 . The phrases "hypospadias" and "testosterone treatment" were utilized. Only studies focusing on patients diagnosed with hypospadias were considered. This analysis exclusively included English-language papers, randomized control trials, cohort studies, and case-control studies. Case studies without comparable groups were excluded. Editorials, comments, and review articles were excluded from the study. We used the PRISMA guidelines for this systematic review and meta-analysis report. RevMan version 5.4.1 was used to analyze and evaluate the data.

Results. A total of 832 patients undergoing urethroplasty were evaluated in 7 studies. A total of 372 patients were categorized into the intervention group, which received testosterone hormone therapy (parenteral, intramuscular, and topical). Patients who receive preoperative testosterone therapy have a 0.68 reduced risk of complications rate compared to those who did not (P = 0.03, I2 = 28%, CI: 0.68, OR: 0.48 - 0.96), reduced meatal stenosis (P = 0.04, OR: 0.66, 95% CI: 0.44 - 0.98, I2 = 28), reduced the risk of postoperative glans dehiscence (P = 0.0004, OR: 0.46, 95% CI (0.30-0.71), I2 = 57%), and reduced risk of fistula urethrocutaneous (P = 0.03, OR: 0.58, 95% CI: 0.36 - 0.94, I2 = 22%).

Conclusion. Pre-operative testosterone stimulation can improve surgical outcomes. Complication rates, such as meatal stenosis, glans dehiscence, and fistula, showed a significant effect in patients who intervened with testosterone stimulation pre-hypospadias repair.

Keywords: hypospadia, improve, outcome, repair, testosterone