ABSTRACT
@#A hernia occurs when an organ or fatty tissue squeezes through a weak spot in surrounding muscle or connective tissue, called fascia. Hernia is classified as inguinal, incisional, femoral, umbilical, or hiatal. The bladder may herniate in 1%–3% of the cases through the inguinal canal. A herniated bladder with calculus is a more unique condition that has only 3 reported cases. Reported here is a case of a 65-year-old male with a known case of left bladder inguinal hernia. He presented with an inguinoscrotal bulge at the left groin and severe lower urinary tract symptoms, associated with a need to squeeze his scrotum to complete his voiding. A Computed Tomography scan revealed inguinoscrotal bladder hernia, left with urinary bladder calculi, and an enlarged prostate gland. The patient underwent cystoscopy, inguinal exploration left, cystolithotomy, hernioplasty left. Inguinoscrotal hernia of the bladder is a rare pathology and often goes unrecognized in during surgical hernia repair. Preoperative identification of bladder hernia is essential to prevent iatrogenic trauma and severe complications. It is mandatory for general surgeons and urologists to keep in mind this rare condition during surgical repair of inguinal hernia.
ABSTRACT
OBJECTIVE@#To provide an overview on the impact of healthcare disruption by the COVID-19 pandemic to urology training programs in the Philippines.@*METHODS@#A survey questionnaire was used in collaboration with the study done by Rosen, et al. last May 2020. Telephone survey of the study population was done determining the status of resident staffing, workload, health/wellness, and didactics. Numerical and categorical data were analyzed and descriptive statistics are provided.@*RESULTS@#All the observations on resident time in the workplace, including assignment to teams (81%), redeployment responses (55-97%), and remote clinical work (65%) were significant. Fifty one percent of residents have decreased research load. Eighty one percent have didactics in small groups. Fifty-five percent have 1 to 2 Video-based learning/conferences per week (p=0.007) followed by those with 3-4 with 98% (p=0.120) and those with >5 with only 6% (p=0.729). For Resident health and wellness, 87% of the residents were exposed to COVID-positive patients, but only 8% of residents were COVID positive (p=0.591). Lastly, 59% of the participants do not have access to wellness programs.@*CONCLUSION@#Data from respondents revealed significant changes in the different aspects of the present study. Urology residents spent more time away from their specialties, and have been re-deployed to COVID-19 floors. Ambulatory services, conferences, educational lectures have mostly shifted to virtual platforms. Resident concerns for COVID-19 exposure have been addressed properly; however, wellness programs have not been widely available for residents. As a first national survey, the present study may give significant insights on program changes and may be used as preliminary data for future studies.