RESUMO
Background: Bipolar Transurethral Resection of Prostate (TURP) and monopolar TURP has been widely used for surgical management of bladder outlet obstruction due to benign prostatic hyperplasia. The aim of this study is to prove the difference of haemoglobin (Hb), sodium levels (Na⁺), application of urethral catheter traction between two groups.Methods: Prospective cohort study was conducted for 82 patients as eligible sample which divided into two groups, bipolar TURP and Monopolar TURP from September 2018 to August 2019. The patient’s demographics, preoperative, postoperative data, and application of urethral catheter traction were recorded.Results: The result shows basic characteristic data seem comparable. The decline levels of Hb before surgery 14.2(2.6) and after surgery 13.6(2.6) in monopolar group was significant (p=0.01), and also in bipolar group 13.7(2.1) vs 13.4(2.1) was significant (p=0.033), despite decreasing Hb levels between two groups were insignificant (p=0.639) but decline levels of Na between two groups were significant (p=0.013) Na⁺ level in bipolar 0(3) and monopolar 1(4). The application of urethral catheter traction in bipolar (19.5%) lower than monopolar (80.5%) were statistically significant (p<0.001).Conclusions: Based on the results of this study, bipolar TURP surgery can be an optional recommendation in treating Benign Prostate Hyperplasia (BPH) in terms of better preserving blood sodium during surgery and low use of traction without significant bleeding complications.
RESUMO
Midgut malrotation is an incomplete rotation of the intestine which occurs during foetal development and usually presents in the neonatal period. The bowel is not fixed adequately and is thus held by a precariously narrow-based mesentery. The incidence of malrotation has been estimated at 1 in 6000 live births, it is rare for malrotation to present in adulthood. Author report a 40-year-old man presented to emergency department with generalized abdominal pain. His symptoms began 2 days before admission. The patient really weak and his mental state was somnolence. His abdomen was slightly extended, and intestinal peristalsis was obscure. Abdominal X-rays revealed dilatation of gastric, coiled spring appearance without free air and step ladder pattern. The patient then underwent laparotomy exploration. Upon entering the abdomen, ileum was noted to completely mobilized and founded volvulus segment, a clockwise twisting three times, about 30 cm proximal from ICJ, and soon author released it. The ligament of Treitz misplaced, there was in the right lower quadrant, close by ICJ. Then about 110 cm segment of ileum necrotic, the rest of the small bowel was normal, author found internal hernia in the right lower quadrant and there was Ladd's band. Clinicians should be aware of this serious cause of abdominal pain. The diagnosis of malrotation in adulthood is often delayed. Complete resolution of acute obstruction or chronic abdominal pain is the result of a high index of suspicion for malrotation, appropriate diagnostic studies, and aggressive treatment.