Correlation between Motorcycle Riding and Erectile Dysfunction on Online Motorcycle Taxi Drivers.

OBJECTIVE: Erectile dysfunction is a condition in which the patient is unable to achieve or maintain a sufficient erection for sexual intercourse. Transportation usage was believed to have a higher risk of erectile dysfunction. This study aimed to assess the correlation between activity and severity of erectile dysfunction among online motorcycle taxi drivers who use motorbikes. MATERIALS AND METHODS: This research uses an observational analytic method with a cross-sectional approach with primary data collection from the respondents who work as online motorcycle drivers from January 2021 to March 2021. Data analyses were conducted using Mann-Whitney and Spearman statistical test. RESULTS: A total of 149 respondents met the inclusion and exclusion criteria contained in this study. It was found that the prevalence of erectile dysfunction in this study was 57.7%. There was a significant difference in the distance covered (km) by online motorcycle taxi drivers who experienced erectile dysfunction compared to those who did not have erectile dysfunction (P=.050). In addition, there was a significant difference in length of work (year) among online motorcycle taxi drivers who experienced erectile dysfunction (P=.045). CONCLUSION: There was a significant difference in erectile dysfunction incidence based on the distance covered per day and length of work in online motorcycle taxi driver. No significant difference was found in the incidence of erectile dysfunction based on the length of motorbike drive per day. The more distance covered (km) and length of work (year) and the more severe the erectile dysfunction are based on international index of erectile function-5 score.

The role of quick Sepsis-related Organ Failure Assessment score as simple scoring system to predict Fournier gangrene mortality and the correlation with Fournier's Gangrene Severity Index: Analysis of 69 patients.

Objective: Fournier's gangrene is a rare but life-threatening infection disease with high mortality rate. The quick Sepsis-related Organ Failure Assessment (qSOFA) is a new and simpler scoring system that may identify patients with suspected infection who are at greater risk for a poor outcome. The purpose of this study was to find out role of qSOFA in determining prognosis of Fournier's gangrene patients. Methods: This study is a case control with retrospective review of Fournier's gangrene patients treated at Hasan Sadikin Hospital from January 2013 to December 2017 who met inclusion criteria. Participants were divided into two groups according to qSOFA score as high qSOFA (2-3) and low qSOFA (0-1). Results: From 69 patients, the mortality rate was 24.6%. The sensitivity of qSOFA score to predict mortality was 88.2%; the specificity was 94.2%; positive predictive value was 83.3%; negative predictive value was 96.1%; positive likelihood ratio was 15.2; negative likelihood ratio was 0.12; and the area under the receiver operating characteristic curve of qSOFA was 94.2%. There was significant association between qSOFA scale and mortality with p-value of 0.0001. The qSOFA score has strong positive correlation with Fournier's Gangrene Severity Index (p<0.0001, r=0.704). Conclusion: qSOFA scoring system has a high prognostic value and can be used to determine prognosis of Fournier's gangrene patients.

Blunt renal trauma in ureteropelvic junction obstruction kidney: A case report.

INTRODUCTION: Kidneys are one of the most commonly affected retroperitoneal organ in trauma cases despite its relatively well-protected location. Renal trauma occurs in 80-95% of urogenital trauma cases and 8-10% of abdominal blunt trauma. Renal trauma in hydronephrotic kidney due to ureteropelvic junction obstruction (UPJO) is a rare entity, despite of high risk of trauma urogenital due to large size and thin parenchyma. In this case we reported blunt renal injury with a congenital abnormality of the kidney. CASE PRESENTATION: We present a case of abdominal blunt trauma due to motor-vehicle accident in a 23 year old male patient. The patient complaint of visible hematuria since 1 day after falling from motorcycle with right flank hit the road, accompanied with right flank pain. Vital signs were within normal limits. Physical examinations reveal distention of right flank with no sign of peritonitis. Supporting examination with FAST ultrasound revealed grade 4 hydronephrosis with internal echo, suspected blood accumulation inside the kidney. Abdominal CT scan revealed grade IV hydronephrosis of right kidney with thin parenchyma. We performed laparotomy and renal exploration, intraoperatively we found multiple laceration of the kidney into pelvicalyceal system (AAST grade IV) with hematoma inside the right kidney and UPJ stenosis (about 5 cm). We decided to perform right nephrectomy despite of grade IV injury with consideration of poor renal function, long stenosis segment and thin renal parenchyma will cause many complications in the future for the patient. CONCLUSION: Renal injury in UPJO kidney is a rare entity despite of high risk of injury in this population. Management of renal injury in this population might be not consistent with guideline for renal trauma, and clinical judgement from the physician plays an important role to provide the best treatment for this patient.

Herlyn-Werner-Wunderlich syndrome with urethrovaginal fistula: A rare case report.

Herlyn-Werner-Wunderlich (HWW) syndrome is difficult to diagnose. We report our first experience of fistula repair in HWW syndrome in Hasan Sadikin General Hospital Indonesia. A 12 years old girl presented with urinary retention, and was consulted to urology because the urethral meatus could not be found. MRI showed two separate uteri, cervices, and vaginas. Complete separation of vagina and urethra was done. After 2 years follow up, the patient had no complaint. HWW syndrome should be suspected in cases with pelvic pain or urinary retention during menarche period among teenagers and neonatal cases with any renal malformation.

Traumatic penile partial amputation caused by rubber band a case report.

INTRODUCTION AND IMPORTANCE: Traumatic amputation of the penis is a rare surgical emergency. Penile amputation is usually caused by self-mutilation, accidents, circumcision, assault and animal attacks. Accidental injury covers a large portion of external genitalia trauma because of its high prevalence and severity of this disease. Here, we report the case of a 21-year-old man who underwent replantation of his self-inflicted partial amputated penis. CASE PRESENTATION: We report a case of traumatic penile partial amputation in a 21-year-old man with a history of mental retardation that presented with a one-day history of pain on the penile shaft due to tied penile shaft with a rubber band ten days prior. Genitalia examination showed a partial amputation at the penis shaft region. Reconstruction microsurgery and debridement on the penile shaft and urethral anastomosis were performed. This case highlights the management of traumatic penile partial amputation. The urethral anastomosis and penile replantation were successfully done. CLINICAL DISCUSSION: Penile amputation is a rare urological emergency. Most of the cases reported with self-mutilation are a result of severe substance-induced psychosis or underlying psychiatric disorder. Factors that contribute to the successful penile replantation include the severity of the penile injury or amputation, type and mechanism of injury, team expertise available, duration of ischemia time, and use of a microscope at the time of neurovascular bundle repair. CONCLUSION: A traumatic penile partial amputation is a rare urologic emergency. Self-inflicted amputation is often found in a patient with a history of psychological or mental illness. The limited data on detailed best surgical measures and outcomes is still a concern.

Reno-duodenal fistula as a rare complication of percutaneous nephrostomy: A case report.

Renoduodenal fistula is a rare condition where a pathological tract is formed between the kidney and duodenum. This condition is caused by various etiologies, such as tuberculosis, malignancy, percutaneous nephrostomy procedure, cryoablation procedure in malignancy, and chronic infection. In this case, we report a case renoduodenal fistula caused by large staghorn calculus, precipitated by a previous history of trauma. Renoduodenal fistula is a rare condition that often presents without symptoms. This condition can be caused by chronic infection of the kidney, and one of the etiology is an infected large staghorn calculus.

Giant vaginal stone as a complication of long-term urethrovaginal fistula: A case report.

CASE PRESENTATION: A case of a 57 years old woman came with the chief complaint of urinary incontinence since 20 years ago. After labor, she complained of urinary incontinence and left untreated. Physical examination and urethrocystoscopy revealed vaginal stone sized 90 × 70 mm and urethrovaginal fistula. We performed hysterectomy and vaginal stone removal, continued with fistula closure and vaginal repair. Up to 2 months follow up, no sign of urinary leakage and incontinence was found. CONCLUSION: Vaginal stone is a rare Case that might be present in a case of long term urethrovaginal fistula with neglected contraceptive device.

Phalloplasty and urethroplasty in adult with disorder of sex developments.

This case report presents our experience on the first phalloplasty and urethroplasty in adult with Development Sex Disorder (DSD) in Indonesia. A 25 years old male with DSD 46 XY planned undergo phalloplasty and urethroplasty with radial forearm free flap (RFFF). Eight months later, there was fistulas repairment due to urethrocutaneus fistulas. Cartilage insertion also was done to make a semi-rigid neophallus. At last, there was no new fistula or stricture developed. Qmax and Qmean were 33,8 ml/s and 14,0ml/s. RFFF only causes minimal complication. The neophallus and neourethra also function properly.

AT1 expression in human urethral stricture tissue.

BACKGROUND: Urethral stricture has a high recurrence rate. There is a common doctrine stating that "once a stricture, always a stricture". This fibrotic disease pathophysiology, pathologically characterized by excessive production, deposition and contraction of extracellular matrix is unknown. Angiotensin II type 1 (AT1) receptor primarily induces angiogenesis, cellular proliferation and inflammatory responses. AT1 receptors are also expressed in the fibroblasts of hypertrophic scars, whereas angiotensin II (AngII) regulates DNA synthesis in hypertrophic scar fibroblasts through a negative cross talk between AT1 and angiotensin II type 2 (AT2) receptors, which might contribute to the formation and maturation of human hypertrophic scars. OBJECTIVE: This study was conducted to determine the expression of AT1 receptors in urethral stricture tissues. METHODS: Urethral stricture tissues were collected from patients during anastomotic urethroplasty surgery. There were 24 tissue samples collected in this study with 2 samples of normal urethra for the control group. Immunohistochemistry study was performed to detect the presence of AT1 receptor expression. Data were analyzed using Mann-Whitney U test, and statistical analysis was performed with SPSS version 20. RESULTS: This study showed that positive staining of AT1 receptor was found in all urethral stricture tissues (n=24). A total of 8.33% patients had low intensity, 41.67% had moderate intensity and 50% had high intensity of AT1 receptors, while in the control group, 100% patients had no intensity of AT1 receptors. Using the Mann-Whitney U test, it was found that urethral stricture tissue had a higher intensity of AT1 receptors than normal urethral tissue with a p-value = 0.012. CONCLUSION: The results showed that AT1 receptor had a higher intensity in the urethral stricture tissue and that AT1 receptor may play an important role in the development of urethral stricture.