JuRoLap: A resilient and economical home-made specimen retrieval bag

OBJECTIVE@#Specimen retrieval bags were used to remove cysts and masses in minimally invasiveurologic surgeries for more than 3 decades. This study aims to describe the steps in making a home-made specimen retrieval bag named JuRoLap and its safety and resiliency.@*MATERIALS AND METHODS@#The bag’s name was taken from the initials of the institution combined withthe department's short-name (uro) and laparoscopy (Lap). The bag is composed of a non-toxicpolyvinyl chloride (PVC) urine bag custom fitted according to the expected specimen size. The sideswere sealed using an impulse sealer leaving one side open. The bag ways rolled and introducedintracorporeally via the 12mm port. It was opened followed by specimen placement using standardlaparoscopic instruments. Purse-string suture at the one-side opening was tightened and extractedthrough the umbilical port extending the incision as necessary.@*RESULTS@#JuRoLap was used in 33 cases removing various organs such as adrenals, kidney, ureter,bladder and prostate. It was easily prepared, safe, resilient and economical costing approximatelyUSD 0.68. It was essential to routinely check its durability by doing a leak test prior to sterilization.Proper rolling, transparent plastic component of the bag and the use of two laparoscopic graspersprovided ease in bag deployment and specimen entrapment. It was also observed that smaller incisionon extraction site as compared to the specimen size was needed due to the resiliency of the bag.Despite the required learning curve in organ entrapment and extraction, there were no complicationsand specimen leakage noted.@*CONCLUSION@#JuRoLap specimen retrieval bag is organ size specific, safe, resilient and low cost specimenretrieval bag innovation.

A case of penile strangulation in a nine year old boy

@#This case report discusses penile strangulation caused by a ball bearing of a fidget spinner in a 9 year - old child. Initial examination revealed a 2 cm x 2 cm metallic ball bearing encircling the base of the penis with gross edema of the distal penile shaft and erythematous penile skin. To release the bearing, a modified string method was used. After removal, skin erosion was treated with debridement and applied with hydrocolloid dressing. Analysis and cross referencing of the case with literature suggest that successful extraction of a constricting object and treatment of penile strangulation, due to the varied nature, causes and effects of penile strangulation, greatly depends on immediate diagnosis and treatment. This spares one from immediate and long term complications, or necrosis with subsequent auto-amputation.

Prostate disease correlation on demographics and clinical findings among national annual prostatic digital rectal examination campaign participants

@#<p style="text-align: justify;"><strong>OBJECTIVE:</strong> National prostatic digital rectal examination (DRE) advocated by the Philippine Urological Association (PUA) started 2 decades ago in the advent of prostate specific antigen (PSA) screening. It is an effective campaign in promoting prostate health awareness among Filipinos. The aim of this research was to describe and correlate the demographics, clinical profile and prostatic physical findings examined by urologists in over 60 centers in the country.<br /><strong>METHODS:</strong> This study was an analytical cross-sectional study involving the participants of the 2013-2015 National DRE campaign. The data were retrieved from the PUA secretariat using a convenience-sampling method on completed forms. The data were correlated using a non-parametric measure of statistical dependence between two variables.<br /><strong>RESULTS:</strong> The total number of participants was continuously rising [n=978 (2013), n=2052 (2017) and n=2792 (2015)] having 60-70% newly diagnosed cases annually. Participants were mostly on their 6th decade of life, mostly employed, married and an educational attainment of secondary level. The most predominant symptom was nocturia followed by frequency, incomplete emptying and weak stream. The usual prostate size was between 21-30 grams mostly with doughy consistency, nodular and tender. The mean age of having clinically benign prostate enlargement was noted to be consistent at the age of 61 while that of a prostate cancer suspect ranged from 63-69 years old.<br /><strong>CONCLUSION:</strong> Filipinos have similar predominant signs and symptoms of prostate disease as compared to Malays, Chinese and Indians. Clinical findings of prostate diseases correlated well with age, prostate size and consistency.</p>

Effect of short message service reminders on adherence to follow-up of national annual prostatic digital rectal examination campaign participants: A randomized controlled pilot study

@#<p style="text-align: justify;"><strong>INTRODUCTION:</strong> National annual prostatic digital rectal exam (DRE) campaign advocated by the Philippine Urological Association (PUA) started 2 decades ago in over 60 urological centers in the country. It is being used as a tool to educate Filipinos regarding benign and malignant prostate diseases. However, after each campaign, most patients were lost to follow-up leading to delay in diagnosis and low adherence to medications.<br /><strong>OBJECTIVE:</strong> To evaluate the effect of short message service (SMS) in the adherence to follow-up of participants after a campaign.<br /><strong>METHODS:</strong> The investigators enrolled 126 participants aged 40 years old and above with significant LUTS and/or a prostate cancer suspect, in a two arm, parallel, randomized controlled pilot study at the Jose R. Reyes Memorial Medical Center (center with the most number of participants annually in the Philippines). Participants received daily SMS text messages for 3 days (n = 63) or usual care (n = 63). The primary outcome was follow-up at the outpatient clinic within 1 month after campaign. The investigators used Epi Info version 7 to analyze the data.<br /><strong>RESULTS:</strong> Among participants receiving SMS, 21/63 (33.3%) returned, compared to 5/63 (7.94%) in the control group. The relative risk [RR] = 4.2, odds ratio = 5.8 and uncorrected chi-square (X2) = 12.4, at 95% confidence inetrval; p = 0.000429).<br /><strong>CONCLUSION:</strong> This pilot study illustrated the feasibility of using SMS reminder among Filipino national prostatic DRE participants to improve adherence to follow-up. However, further research needs to be done to investigate the impact on adherence to medications and delay in diagnosis.</p>