Practice variations for surgical oncological cases among adult urologists in the Philippines in the management of post-Surgical reconstruction and complications

Objectives@#To identify practice variations among adult urologists in the surgical management of their oncologic cases and postoperative complications. @*Methods@#Beginning March 2022 to October 2022 an internet-based survey was performed among members of the PUA practicing in the Philippines.@*Results@#82 Philippine urologists answered the survey during the study period. Majority have no subspecialty training (n=42) and practice primarily in the NCR (n=49). Open radical prostatectomy is the option of choice (n=58) with reported incidence of complications similar to that of previous studies. Conduit (n=77) is the diversion of choice after radical cystectomy with the majority recommending a two-surgeon approach in the harvest and reconstruction.@*Conclusion@#Practice is focused within the NCR with the majority having no subspecialty training thus preferring open surgical approach and two-surgeon team. Implantable devices are the preferred method in managing erectile dysfunction and urinary incontinence but is still lacking local availability.

Surgical outcomes of laparoscopic adrenalectomy: A 10-year single-center experience in the Philippines

INTRODUCTION AND OBJECTIVES@#Laparoscopic adrenalectomy is the standard treatment for adrenal tumors.Described here is the authors’ 10-year experience with laparoscopic adrenalectomy in a single center.@*METHODS@#A retrospective chart review was done on all patients who underwent laparoscopicadrenalectomy from January 2006 to January 2016 at the National Kidney and Transplant Institute.The authors determined the patient demographics (age and gender), tumor characteristics (size,functionality and laterality) and surgical outcomes (operative time, estimated blood loss, conversionto open and complications according to the Clavien-Dindo classification).@*RESULTS@#A total of 90 patients underwent laparoscopic adrenalectomy. The female to male ratio was1.4:1. Most tumors were left-sided [48/90 (53%)], with a mean size of 3.0 ± 0.75cm. The operativetime was 145 ± 35 minutes. The mean estimated blood loss was 50 ± 100cc. The length of hospitalstay was 3.0 ± 1 days. Forty six percent (42/90) of the adrenals were functioning: Hyperaldosteronism(26), Pheochromocytoma (14), and Cushing's syndrome (2). Ninety eight percent(88/90) were benign. There were 2 (2.2%) conversions to open. There were 8 complications (8.89%)(all Dindo-Clavien Class II), all of which were managed conservatively. There was no mortality.@*CONCLUSION@#The authors’ experience with laparoscopic adrenalectomy shows that it is safe and effectivefor adrenal tumors.