ABSTRACT
@#Introduction: Testicular torsion is a urological emergency causing spermatic cord twisting. Delayed management can cause poor outcome, i.e. orchiectomy. Here, we investigated several prognostic factors, including age, onset, clinical symptoms, leukocyte count, for testicular torsion outcomes (orchiectomy vs. orchiopexy) in children in Indonesia. Methods: A retrospective review of 23 patients with testicular torsion who underwent scrotal exploration from July 2013 to November 2018 at our institution was done. Results: The age at testicular torsion diagnosis was 12.8 (interquartile range, 4.6-15.1) years. Only fever showed strong significant prognostic factor for orchiectomy (OR=20; 95% CI=1.6 – 248; p=0.017), while other factors were not, with p-value of 0.54, 1.0, 1.0, 0.19, 1.0, 0.62, 0.62, 0.58, and 0.62, for age, onset, scrotal pain, abdominal pain, hyperemia, edema, nausea, vomitus and white blood cells count, respectively. Furthermore, logistic regression test also revealed that fever is a strong prognostic factor for orchiectomy (OR=22.6; 95% Cl=1.3 – 394.2; p=0.033). Conclusion: The patient with testicular torsion with fever tends to undergo orchiectomy. Further multicenter studies with a larger sample size are necessary to confirm our findings.
ABSTRACT
Sigmoid vaginoplasty has been popular for neovagina reconstruction in vaginal aplasia. The most common surgical complication was vaginal stenosis caused by inadequate vascularization and tension because of graft length. Therefore, ischemia ensued and disrupted wound healing. The selection of double pedicle artery rotation sigmoid vaginoplasty is expected to reduce this problem. Five patients from April to December 2016 were diagnosed with vaginal aplasia; 4 had history of neovagina stenosis. These patients underwent sigmoid vaginoplasty with double pedicle artery rotation. No complications occurred during or after the procedure. Assessment postsurgery was conducted at 1 year. These results suggest that double pedicle artery rotation sigmoid vaginoplasty is a safe and acceptable technique for management of vaginal aplasia. The procedure decreased tension inside vascular pedicles as a result of maintaining abundant vascularization supply. Consequently, this procedure could avert graft necrosis, leakage, and severe stenosis. All of the patients exhibited regular menstrual cycle and satisfactory sexual activity. The outcomes were excellent with remarkable anatomical and functional results.