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All Journal Indonesian Journal of Urology Jurnal Health Sains
Davis Roland Gustav Jouwena, Davis Roland Gustav
Department of Urology, Faculty of Medicine/Padjajaran University, Hasan Sadikin General Hospital, Bandung.
Dentistry Health Professions Medicine & Pharmacology Nursing Public Health Veterinary

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LAPAROSCOPIC RADICAL CYSTECTOMY WITH ILEAL CONDUIT URINARY DIVERSION, FIRST EXPERIENCE IN BANDUNG Jouwena, Davis Roland Gustav; Pramod, Sawkar Vijay
Indonesian Journal of Urology Vol 22 No 2 (2015)
Publisher : Indonesian Urological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32421/juri.v22i2.175

Abstract

Objective: To report our experience in performing laparoscopic radical cystectomy with ileal conduit urinary diversion (extracorporeal reconstruction). Material & method: This study was take place in Hasan Sadikin Hospital Bandung. A 54-year-old male with histologically proven transitional cell carcinoma of the bladder cT2bN0M0 underwent a laparoscopic radical cystoprostatectomy and ileum dissection was performed under laparoscopy. Ileal conduit and stoma reconstruction performed extracorporeal through small incision between ports (about 4cm). Results: The surgical margins were free of disease. The operative time was 360 minutes. Estimated blood loss was 600cc. Hospital stay was 5 days. Patient was discharge with no complication of post-op wound, and urine production about 1500cc/24hrs via stoma. Conclusion: Laparoscopic radical cystectomy with ileal conduit extracorporeal reconstructive urinary diversion could be the preferred means in managing bladder tumor on selective case.
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 Pratama, Dio Rancha Sawkar Vijay Pramod Taufik Rakhman Taher