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All Journal Indonesian Journal of Urology Jurnal Health Sains
Taufik Rakhman Taher
Department of Urology, Faculty of Medicine/Indonesia University, Cipto Mangunkusumo Hospital, Jakarta, Indonesia.
Dentistry Health Professions Medicine & Pharmacology Nursing Public Health Veterinary

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VESICO-VAGINAL FISTULA: EXPERIENCE OF 11 YEARS Taher, Taufik Rakhman; Zulfikar, Zulfikar; Wahyudi, Irfan; Rodjani, Arry
Indonesian Journal of Urology Vol 20 No 1 (2013)
Publisher : Indonesian Urological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32421/juri.v20i1.39

Abstract

Objective: To evaluate the outcome of surgical repair in patients with vesico-vaginal fistula at Cipto Mangunkusumo Hospital. Material & Method: A retrospective study of 30 patients with vesico-vaginal fistula, who underwent surgical repair of the fistula at Urology Department Cipto Mangunkusumo Hospital between the period of 1998-2008, were reviewed. Patients were analyzed with regard to age, location of fistula, etiology, size of fistula, and surgical approach. The outcome of the surgery was analyzed. Results: This study included 30 patients who underwent surgery with age between 18-69 years old. The most common etiology was due to obstetrical trauma and hysterectomy. Bladder trigone was the most common location of fistulae (40%). During the surgery the transvesical (43%) approach was commonly used. However, the most excellent outcome was surgery by transvesical-transvaginal approach (100%). Success rate of fistula repair was 73%. Conclusion: This disease is a medically and psychosocially devastating condition for the patient. The diagnosis was easy but complicated in decision of treatment. Best results were observed by transvesical-transvaginal approach. Keywords: Vesico-vaginal fistulae, surgical approach, surgical outcome.
Case Report Penile Fracture With Corpus Cavernosum Rupture Without Urethral Disruption Due to Sexual Intercourse Pratama, Dio Rancha; Taher, Taufik Rakhman; Jouwena, Davis Roland Gustav
Jurnal Health Sains Vol. 4 No. 12 (2023): Journal Health Sains
Publisher : Syntax Corporation Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.46799/jhs.v4i12.1119

Abstract

Objective: We reported a case of penile fracture with unilateral corpus cavernosum rupture that underwent penile exploration and reconstruction measures. Case presentation: We reported a 45-year-old male patient complaining of penile pain, swelling, loss of erectile ability and a "pop" sound after bumping during sexual intercourse. The patient can still urinate. Physical examination found a swollen penis, hematom, eggplant-like deformity, and angulation to the right accompanied by tenderness. Routine blood support examination within normal limits. Based on data obtained from the anamnesis, physical examination, diagnosis of penile fracture was established and the patient was treated with exploration and reconstruction of the penis <24 hours. Discussion: Patients carried out exploratory actions carried out with circumferential and degloving subcoronal incisions, 4 cc blood clots were evacuated and ruptures were seen in the tunica albuginea corpus cavernosum sinistra along 4 cm. Reconstruction is carried out with primary sutures on the torn corpus cavernosum. The patient is carried out treatment for 5 days. At the postoperative 7-day evaluation, the surgical wound was good and urination was good. At the evaluation of 1 month the patient can have a painless erection with an erection hardness score of 4, there is no penile deformity. Conclusion: Penile fracture is a urological emergency that shows a good prognosis if you get surgical intervention immediately (<24 hours) and can reduce the number of complications
Priapism Case Report on Chronic Myelocytic Leukemia With Winter Procedure Management Pratama, Dio Rancha; Jouwena, Davis Roland Gustav; Taher, Taufik Rakhman
Jurnal Health Sains Vol. 4 No. 12 (2023): Journal Health Sains
Publisher : Syntax Corporation Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.46799/jhs.v4i12.1120

Abstract

Objective: We reported a case of priapism fracture in chronic myelocytic leukemia performed winter procedure Case presentation: We reported a 22-year-old male patient with complaints of erect penis continuously for 3 days without being affected by sexual stimulation. The patient feels pain in his penis and can still urinate. The patient denied any previous history of penile trauma, drug use, and similar complaints. Physical examination found an erect penis with EHS 4 and palpable corpus cavernosum stiff and soft. Routine blood support tests show an increase in leukocytes up to 367,000/μL. Examination of peripheral blood images shows an increase in the number of all types of granulocytes from young cells to blast cells with the effect of a chronic leukemia. Intracavernous blood gas analysis showed pH 7.2, pO2 25 mmHg, and pCO2 75 mmHg. Based on data obtained from the anamnesis, physical examination, and supporting examinations, a diagnosis of ischemic or low flow priapism was established. The patient was treated with cavernous blood aspiration using the winter procedure and combined with intracavernous irrigation using the α phenyleprine agonist. Discussion: The patient performed a winter procedure using two 18G needles for cavernous blood aspiration and combined with intracaevernose irrigation using phenylephrine 1 mg diluted saline. Intracavernous blood aspiration gets 40 mL of blood. The action was performed in the operating room for 2 hours with the result of the penis being detumescence with EHS 2. The patient is observed for 2 days and then referred to a hospital with internal medicine specialist facilities, hemato-oncology consultants for further management related to CML. Conclusion: Ischemic type priapism or low flow is a urological emergency that can be managed with winter procedures and shows good outcomes.
Co-Authors Arry Rodjani Davis Roland Gustav Jouwena, Davis Roland Gustav Irfan Wahyudi Pratama, Dio Rancha