Retroperitoneal laparoscopic adrenalectomy for a large benign adrenal tumor: A case report

A 19-year old man presented with acute onset of intractable hypertension with associated dizziness and nausea. Abdominal computed tomography revealed a 7.0cm x 6.27cm x 6.0cm suprarenal mass on the right. The patient was diagnosed to have pheochromocytoma and successfully underwent retroperitoneal laparoscopic adrenalectomy.

Relief of renal colic using tramadol, tramadol/hyoscine-N-butylbromide or tramadol/alfuzosine combination therapy

OBJECTIVES: To compare the effect of Tramadol, Tramadol/HNBB combination and Tramadol/Alfuzosine combination in the relief of renal colic. MATERIALS AND METHODS: A total of 82 patients diagnosed with renal colic from May to October 2009 were included in the study. The patients were divided into three groups: Group I (n=27) was given Tramadol (50 mg/capsule orally) only, Group II (n=28) was given Tramadol and Hyoscine-N-Butylbromide (10 mg/tablet orally) and Group III was given Tramadol and Alfuzosine (10 mg/tablet orally). Pain was evaluated using the Visual Analog Scale pre-treatment and post-treatment. RESULTS: The Visual Analog Scale scores for all groups showed improvement after treatment. The average difference in Visual Analog Scale for Group I was 3.148, Group II was 3.444, and Group III was 3.429. A significant difference was seen in all treatment groups. ANOVA was used to compare the differences between the three treatments. All treatments had comparable results, therefore, no significant difference was seen in the effect of the three treatments. CONCLUSION: Relief of renal colic was achieved in all groups as seen in a decrease in the Visual Analog Scale Score after giving of treatment, however, the differences for each treatment group was not statistically significant.

Pocket-sized light source device (PLSD): An alternative light source for endoscopic surgery in urology

OBJECTIVE: Endoscopic surgery is one of the most common minimally invasive surgical techniques applied in the field of urology. The authors developed a mechanical adaptor for commercially available penlight-type LED light that can be used in common endoscopic procedures in urology. MATERIALS AND METHODS: A four-piece light adaptor device made from medical-grade aluminum steel was crafted and functions as an adaptor for penlight-type LED light in one end and an endoscopic telescope on the other end. In order to determine its function and quality, it was compared to the conventional light source machine used in most endoscopic procedures. The specification of both light sources were compared in terms of light intensity and colour temperature through a light meter. This device was applied clinically by using it in a series of endoscopic procedures. RESULTS: Application of the device in the endoscopic surgical procedures showed that it functioned well and appropriately. It was able to complete a full course of each operation undertaken. CONCLUSION: This original an innovative device offers an alternative to the conventional light source equipment available commercially. Based on the authors experience we recommend the use of this adaptor for common endoscopic procedures done in minimally invasive surgery.

Five year biochemical recurrence-free rate following permanent prostate brachytherapy in patients with clinically localized prostate cancer

OBJECTIVE: This Study was designed to determine the five year biochemical progression free rate of patients with clinically localized prostate cancer stratified to low, intermediate and high risks groups who underwent permanent prostate brachytheraphy.METHODS: Thirty six patients with a mean age of 67 years diagnosed with clinically localized prostate cancer were treated with Iodine-125 permanent prostate brachytherapy from November 2001 to December 2003. Prostate specific antigen (PSA) failure was defined as having more than +2 increase of serum PSA from the nadir, with PSA nadir set at 0.4 ng/ml. The biochemical recurrence-free rate for the overall and the stratified groups were then calculated.RESULTS: Twelve patients were lost to follow up leaving twenty-four subjects in the study. The prescribe minimum dose was 145 grays. Median follow-up was 62 months. The over-all 5 year biochemical recurrence-free rate was 58%. Satisfying these patients into low, intermediate, and high group yielded a progression free rate of 80%, 42%, and 5%, respectively.CONCLUSION: Permanent prostate branchytheraphy is an effective treatment for patients with clinically localized prostate cancers. This reported 5-year biochemical recurrence-free rate at East Avenue Medical Center (EAMC) is comparable with that reported by other centers.

Nerve sparing radical prostatectomy in an 18-year-old boy with localized poorly differentiated adenocarcinoma

Prostate cancer is predominantly a disease of the elderly male, with more than 75 percent diagnosed older than 65 years. Occurrence of the disease is uncommon in those less than 50 years of age and very rare in the adolescent. The case presented is an 18 year old male who went into urinary retention with associated significant weight loss and gross hematuria. Patient was diagnosed to have clinically localized prostate adenocarcinoma. He underwent radical prostatectomy. Based on literature search, this is the youngest reported case of prostatic adenocarcinoma in the Philippines, the 3rd youngest case in the world and the youngest case of localized prostate cancer who underwent radical prostatectomy. (Author)

A comparative study between active closed drainage and passive open drainage systems in urologic surgery

OBJECTIVE: To compare the clinical efficacy/significance and incidence of exposure to body fluids between the active closed drainage system and passive open drainage system in patients who underwent urologic surgeryMATERIALS AND METHODS: Patients who underwent elective and emergency open urologic surgery that required wound drainage were included. A daily data collection completed by the medical and the nursing staff was performed. Patients with dirty wounds were excludedRESULTS: Sixty-four patients were entered in the study. After exclusion, 56 patients [Group I (Passive drainage) = 27; Group 2 (Active drainage) = 29)] were evaluated for the performance of wound drainage systems. The drain-related complications of group 1 and group 2 were 26 percent and 10 percent, respectively [P 0.5 (NS)]. Change of dressing was more frequent in group 1 than in group 2 patients [P .000 (S)]. There were 567 (group 1CONCLUSION: The clinical efficacy of passive open drain and active closed drain systems were comparable. The risk of exposure of healthcare personnel to potentially harmful body fluids was less when closed suction drain was used in patients who underwent urologic surgery. (Author)