Open Access Case Report

Dengue in a Post PCNL Patient – Vigilance and Sucpiscion Matters

Sanjay P. Dhangar, Nayanesh Chavan, Niraj More, Manisha Shengal

Asian Journal of Research and Reports in Urology, Page 1-4

Dengue is a rapidly spreading mosquito-borne viral disease. The spectrum of clinical manifestations ranges from subclinical infections to severe dengue with leaky membranes, haemorrhagic manifestations, shock and organ dysfunction and finally death. Haematuria with fever in a post PCNL setting is a common finding. Severe haematuria require transfusion in around 11.2-17.5% patients and angioembolization in around 0.8% cases. We present a case of haematuria with fever in a young patient who underwent PCNL for partial staghorn calculus. She developed fever on second post-operative day, diagnosed dengue positive on fifth post-operative day, became anuric and went into dengue shock syndrome on sixth post-operative day. She recovered well after haemodialysis and multiple platelet and packed cell transfusion on eleventh post-operative day. We here want to highlight the importance of a multidisciplinary team approach and high level of vigilance and suspicion for dengue when a post-operative PCNL patient develops fever with haematuria.

Open Access Case Report

Repair of Classical Adult Female Exstrophy (Reared as Male) with Management of Surgical and Psychological Issues

Mukesh Chandra Arya, Ankur Singhal, Vivek Vasudeo, Ajay Gandhi, Manoj Kumar Garg, Yogendra Shyoran

Asian Journal of Research and Reports in Urology, Page 10-13

There are very few case reports of classical bladder exstrophy (CBE) presenting at an adult age. A 19 years old male patient was admitted with complaints of urinary incontinence since birth and was found out to be a CBE with female gender genetically. She underwent complete genitourinary reconstruction in stages. She needed multiple psychiatric consultations to accept change in the gender. Genitourinary reconstruction with achieved continence in adult exstrophy warrants this presentation.

Open Access Case Report

Renal Artery Aneurysm Presenting with Ring Shaped Calcification and Microscopic Haematuria

Mukesh Chandra Arya, Ankur Singhal, Gulab C. Bothra, Ajay Gandhi, Yogendra Shyoran

Asian Journal of Research and Reports in Urology, Page 14-17

Calcified renal artery saccular aneurysm produces ring calcification in the renal area which may be mistaken as a renal calculus. Attempting Percutaneous nephrolithotomy or extracorporeal shockwave lithotripsy without prior angiography may result in a life-threatening aneurysmal rupture.

Open Access Case Report

Clear Cell RCC with Lytic Bony Lesions: Metastasis or Multiple Myeloma, A Diagnostic Dilemna

Anuj Mahajan, Prashanth Adiga, Janine Miranda

Asian Journal of Research and Reports in Urology, Page 23-27

Introduction: The existence of two malignancies together is very rare. Multiple myeloma and RCC occurring together is highly uncommon. Possible reason for co-existence may be similar cytokine growth requirements however no etiology has been proven for sure.

Case Presentation: We present a case with a renal lesion and bony lytic lesions suspected of being secondary osseous metastasis. However on further evaluation the bony lesions were found to be due to co-existent multiple myeloma.

Conclusion: The occurrence of RCC and MM together is higher than the expected incidence. The causative etiology may be genetic abnormalities, environmental exposures or immune-related mechanisms that predispose the patient to the second malignancy. These findings are particularly relevant in the management of patients with known RCC and lytic bone lesions.

Open Access Case Study

Experience in Kidney Transplantectomy with Temporary Iliac Arterial Occlusion for Bleeding Control in Patients with High Cardiological Risk – A Case Report

Diego Rodrigo Dametto, Eric Martinez Lino, Thiago da Silveira Antoniassi, Pedro Francisco Ferraz Arruda

Asian Journal of Research and Reports in Urology, Page 18-22

Introduction: Approximately 16% of transplanted kidneys require surgical removal which may occur in cases of graft intolerance syndrome, premature loss, chronic inflammation, recurrent infections and cancer. When indicated, the classic technique is the open nephrectomy that may represent mortality rates at around 6 to 14%, reaching as high as 38% in cases of the procedure. The objective is to report a case of renal transplantectomy with intraoperative use of an iliac intravascular balloon catheter to control bleeding in a high-risk patient. The information was through reviewing the medical record, photographic record during the procedure and reviewing the literature.

Results: In this current case, the temporary occlusion of the iliac artery by a vascular balloon catheter proved to be effective in controlling bleeding during graft removal in a patient at high surgical risk.

Conclusions: Mortality related to transplantectomy is high, especially in cases of acute indication for the procedure and blood loss is an independent factor associated with increased morbidity and mortality and hospital stay. In this sense, the intraoperative use of a transient iliac intravascular balloon catheter in the reported case allowed for the control of bleeding during a graft nephrectomy in a high-risk surgical patient. Thus, there was a shortening of the surgical time, decreased need for transfusion, and safe anesthetic management, showing itself as an alternative in cases where surgical removal of the graft must be performed urgently.

Open Access Original Research Article

Sexual Function and Quality of Life in Penile Cancer Patient after Partial Penectomy

Richman Patandung, Yacobda H. Sigumonrong

Asian Journal of Research and Reports in Urology, Page 5-9

Introduction: Urological cancers are increasing in number, but one of them is quite rare, which is penile cancer. In Indonesia, penile cancer was ranked thirtieth. The management often caused sexual problems for the patients. This study would like to find out the sexual function of the patients after partial penectomy.

Methods: This study was conducted in Haji Adam Malik General Hospital from 2017-2018. Patients underwent partial penectomy patients were included in the study. Data were obtained preoperative and 3 months postoperative by using IIEF and EORTC QLQ-C30 questionnaires.

Results: We found 10 partial penectomy for penile cancer cases in Haji Adam Malik General Hospital Medan. Mean of age is 48 ± 16,26 and smoking was noted in 8 (80%). IIEF questionnaire shows significant correlation in erectile function (9,0±0,94 p<0,05), orgasmic function (2,6±1,17 p<0,05), sexual desire (4,5±0,70 p<0,05), intercourse satisfaction (3,5±0,70 p<0,05), and overall satisfaction (4,6±0,69 p<0,05). EORTC questionnaire stated that quality of life (18,32±6,58 p<0,05), fatigue (17,78±11,94 p<0,05), and sleep (73,36±14,04 p<0,05) significantly affected. Other variable such as physical, role, emotional, cognitive, and social functioning shows no difference.

Conclusion: Penile cancer management, even with organ-sparing technique, still brings drawbacks to the patients, in the whole domain of the IIEF questionnaire and impairs the quality of life of the patients.