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Zulfiqar Yevri
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Biochemistry, Genetics & Molecular Biology Immunology & microbiology Nursing Public Health

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Urologic Morbidity in Surgery of Placenta Accreta Spectrum in Universitas Andalas Hospital Zulfiqar Yevri
Andalas Obstetrics And Gynecology Journal Vol. 8 No. 2 (2024)
Publisher : Universitas Andalas

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.25077/aoj.8.2.823-828.2024

Abstract

Background: Hysterectomy for placenta accreta spectrum disorders is known to be associated with urologic morbidity, including intentional or unintentional cystostomy, ureteral injury, and bladder fistula. Case: A 32year old woman with urine retention post total hysterectomy on indications placenta accreta spectrum Grade 3 type 4 S2 segment- 9 days ago, referred to Universitas Andalas Hospital. The patient complained difficulty to urinate, hematuria and supra pubic pain. Physical examination sign of acute abdomen unclear. A Pelvic abdominal ultrasound was performed, the result were Acites and complex acites, left renal hydronefrosis, cystitis and sludge gallblader. From the laboratory result found anemia, leucocytosis, trombositosis, ureum, creatinine and albumin were in normal limit, hyponatremia, hypokalemia, hypocalsemia. The patient were given antibiotics, blood transfusion and natrium, kalium and calcium correction. Cystoscopy was performed to explore the bladder, the result were found adhesion and ruptured at the posterior wall of the bladder a long 3 cm then proceed with laparotomy to repair the bladder and adhesiolisis. During hospitalization, the patient’s condition was good, hemodynamics was stable with sufficient diuresis. The patient was discharged on day 4 after laparotomy of bladder repair with temporary urine catheter installed. Discussion: This patient diagnose previously is placenta accreta spectrum with percreta graded so had a high risk of urologic morbidity. The bladder ruptured occurred after 9th day of hysterectomy. This can occur because the injury during dissection of the uterine vesicular fold undergoes necrosis and then become opens on the 9th day after hysterectomy. A multidisciplinary team should be made in management of placenta accreta spectrum. A team comprising a consultant maternal fetal medicine with pelvic surgery experienced, a blood bank team, an anesthesiologist, a urologist skilled, an interventional radiologist and an experienced neonatologist is advised. Keywords: urologic complication, placenta accreta, urologic morbidity
Unilateral Renal Cystic Disease Zulfiqar Yevri
Andalas Obstetrics And Gynecology Journal Vol. 8 No. 2 (2024)
Publisher : Universitas Andalas

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.25077/aoj.8.2.829-833.2024

Abstract

Background: Unilateral renal cystic disease of kidney is a non familial and non progressive disorder, characterized by replacement of the renal parenchyma by a cluster of multiple cysts with a normal contralateral kidney. Case: A 2-day-old newborn baby came to the Urology Department of the Perinatology Department of Andalas University Hospital. The baby with prenatal ultrasound results showed unilateral hydronephrosis and multicystic kidneys. From the postnatal ultrasound, it was found: The right kidney was normal in shape and size; clear differentiation of the cortex and medulla; the pelvic calyx system was not dilated; No stones were seen; There were multiple cystic lesions with regular borders in the renal cortex, the largest cyst size was 5.5x4 cm. The left kidney was normal in shape and size; clear differentiation of the cortex and medulla; The pelvic calyx system was not dilated; No stones or sludge were seen. The impression of multiple renal cysts. The patient was followed up for renal function and cyst development. Conclusion : This case highlights the importance of early diagnosis and follow-up in infants with unilateral renal cystic lesions. Differentiating URCD from other cystic renal diseases is essential for appropriate management and counseling. Further studies are needed to elucidate the pathogenesis and long-term outcomes of URCD.    
Urologic Morbidity in Surgery of Placenta Accreta Spectrum in Universitas Andalas Hospital Zulfiqar Yevri
Andalas Obstetrics And Gynecology Journal Vol. 8 No. 2 (2024)
Publisher : Fakultas Kedokteran Universitas Andalas

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.25077/aoj.8.2.823-828.2024

Abstract

Background: Hysterectomy for placenta accreta spectrum disorders is known to be associated with urologic morbidity, including intentional or unintentional cystostomy, ureteral injury, and bladder fistula. Case: A 32year old woman with urine retention post total hysterectomy on indications placenta accreta spectrum Grade 3 type 4 S2 segment- 9 days ago, referred to Universitas Andalas Hospital. The patient complained difficulty to urinate, hematuria and supra pubic pain. Physical examination sign of acute abdomen unclear. A Pelvic abdominal ultrasound was performed, the result were Acites and complex acites, left renal hydronefrosis, cystitis and sludge gallblader. From the laboratory result found anemia, leucocytosis, trombositosis, ureum, creatinine and albumin were in normal limit, hyponatremia, hypokalemia, hypocalsemia. The patient were given antibiotics, blood transfusion and natrium, kalium and calcium correction. Cystoscopy was performed to explore the bladder, the result were found adhesion and ruptured at the posterior wall of the bladder a long 3 cm then proceed with laparotomy to repair the bladder and adhesiolisis. During hospitalization, the patient’s condition was good, hemodynamics was stable with sufficient diuresis. The patient was discharged on day 4 after laparotomy of bladder repair with temporary urine catheter installed. Discussion: This patient diagnose previously is placenta accreta spectrum with percreta graded so had a high risk of urologic morbidity. The bladder ruptured occurred after 9th day of hysterectomy. This can occur because the injury during dissection of the uterine vesicular fold undergoes necrosis and then become opens on the 9th day after hysterectomy. A multidisciplinary team should be made in management of placenta accreta spectrum. A team comprising a consultant maternal fetal medicine with pelvic surgery experienced, a blood bank team, an anesthesiologist, a urologist skilled, an interventional radiologist and an experienced neonatologist is advised. Keywords: urologic complication, placenta accreta, urologic morbidity
Unilateral Renal Cystic Disease Zulfiqar Yevri
Andalas Obstetrics And Gynecology Journal Vol. 8 No. 2 (2024)
Publisher : Fakultas Kedokteran Universitas Andalas

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.25077/aoj.8.2.829-833.2024

Abstract

Background: Unilateral renal cystic disease of kidney is a non familial and non progressive disorder, characterized by replacement of the renal parenchyma by a cluster of multiple cysts with a normal contralateral kidney. Case: A 2-day-old newborn baby came to the Urology Department of the Perinatology Department of Andalas University Hospital. The baby with prenatal ultrasound results showed unilateral hydronephrosis and multicystic kidneys. From the postnatal ultrasound, it was found: The right kidney was normal in shape and size; clear differentiation of the cortex and medulla; the pelvic calyx system was not dilated; No stones were seen; There were multiple cystic lesions with regular borders in the renal cortex, the largest cyst size was 5.5x4 cm. The left kidney was normal in shape and size; clear differentiation of the cortex and medulla; The pelvic calyx system was not dilated; No stones or sludge were seen. The impression of multiple renal cysts. The patient was followed up for renal function and cyst development. Conclusion : This case highlights the importance of early diagnosis and follow-up in infants with unilateral renal cystic lesions. Differentiating URCD from other cystic renal diseases is essential for appropriate management and counseling. Further studies are needed to elucidate the pathogenesis and long-term outcomes of URCD.    
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