BACKGROUND: Penile tumour is a rare tumour in the genitourinary system, account for 0.4-0.6%. Although rare, patients are often unaware and come in late stage, so the use of chemotherapy agents is becoming crucial. AIM: This study was conducted to evaluate responses and overall survival rate of Paclitaxel, Ifosfamide, and Cisplatin (TIP) regimen in penile cancer with nodal involvement. METHODS: We included all medical records of penile squamous cell carcinoma patients associated with nodal involvement who acquired TIP regimen in Adam Malik Hospital between 2014 and 2016. We administered 175 mg/m2 of Paclitaxel on day 1, 1200 mg/m2 of Ifosfamide on days 1 to 3, and 25 mg/m2 of Cisplatin on days 1 to 3 as our standard TIP regimen. The regimen was re-administered every 21-28 days. Characteristics of the patient including age, history of circumcision, races, primary lesion of the tumour and TNM staging were noted. Adverse event, clinical responses, and overall survival were assessed and evaluated. RESULTS: We extracted data from 17 patients of penile cancer with nodal involvement who acquired TIP regimen with a mean age of 44.18 ± 11.13 years old from our medical records. Only 10 patients completed the full 4 cycles of the regimen. Four patients died before completion, two patients refused to continue the regimen, and 1 patient is still on the second cycle. Total penectomy was the most frequent procedure had taken, and clinical stage T4 and N3 was the most findings at initial diagnosis. There was no complete response noted. Six patients were noted as partial response, and 1 patient was noted as progressive disease. The Kaplan-Meier curve shows an overall 6 months (95% CI: 4.4-7.6 months) of survival with a median of follow-up time was 7 (1-11) months. In subgroup analysis, we found that the responder group has significantly better overall survival than the non-responder group (log-rank test, p = 0.004). CONCLUSION: Paclitaxel, Ifosfamide, and Cisplatin (TIP) regimen give significant clinical benefit in penile cancer with nodal involvement.

Purpose To investigate the effectiveness and safety of ultrasound-guided and Percutaneous Nephrolithotomy (PCNL) compared to the standard fluoroscopy-guided PCNL. Methods This study is a comparative retrospective study obtained from medical records within the last 5 years of Raden Mattaher Hospital, Jambi. Patients were divided into 2 groups, fluoroscopy- and ultrasonography-guided PCNL with large kidney stone > 20 mm. Patient characteristics were divided into pre- and post-operative procedures and analyzed using SPSS ver. 25.0 (SPSS Inc., Chicago, IL, USA). Data were analyzed using Kolmogorov–Smirnov, chi-square and/ Fischer’s exact test and p value < 0.05 was considered statistically significant. Results Of 201 patients’ data from medical records were divided into ultrasound-guided and fluoroscopy-guided groups. Ultrasound-guided group were consisted of 89 patients and fluoroscopy-guided were of 112 patients. US Guided significantly identifies the severity of hydronephrosis compared to PCNL. The demographic data obtained age, sex, body mass index, and preoperative hemoglobin levels showed a normal distribution. On the post-operative results, significant results occurred in post-PCNL stent placement. Installation of a DJ stent alone is more commonly performed on fluoroscopy-guided PCNL procedures compared to ultrasound-guided PCNL. This had a positive impact on post-procedure outcomes, meaning that the post-operative outcome of ultrasound-guided PCNL was better than that of fluoroscopy-guided PCNL. Conclusion The reported data demonstrate that PCNL and ultrasound-guided has similar efficacy and complication rates with PCNL fluoroscopy-guided. This could be a good alternative in urological centers with no access to fluoroscopy. However, ultrasound-guided group was still associated with higher rate nephrostomy tube placement and longer surgery duration.

Background: The treatment of choice for bladder stones in children remains debatable. This study aimed to compare the outcomes of endourological and open cystolithotomy for the management of bladder stones in children. Methods: The Medline, Embase, Cochrane controlled trial databases and clinicaltrials.gov were searched for relevant English-language publications from 1 to 30 August 2022. Stone-free rate (SFR), complication rate, length of stay, and procedure duration were compared. Children (male and female) <18 years of age of any ethnicity with bladder stones (single/multiple) were included. Patients with a history of bladder augmentation or diversion were excluded. The quality of studies included was assessed using Cochrane’s Risk of Bias Assessment. The meta-analysis was performed using RevMan. Results: Five articles (436 participants) that compared endourological versus open cystolithotomy were included in qualitative and quantitative analyses. Four were non-randomised, retrospective, and single centre studies. While the other one was a randomised controlled trial. Measure outcome characteristics included SFR, complications, procedure duration, and length of hospital stay. There was no significant difference in the SFR between transurethral cystolithotripsy (TUCL) and percutaneous cystolithotomy (PCCL) (p=0.22). There were also no significant differences in complications (TUCL versus PCCL, p=0.18; TUCL versus open cystolithotomy [CL] and PCCL versus CL, p=0.08). PCCL featured a longer procedure duration than TUCL (p<0.00001), while CL was shorter than TUCL and PCCL (both p<0.00001). Finally, in terms of length of stay, TUCL was superior to PCCL and CL, while PCCL was better than CL (all p<0.00001). Conclusions: Endourological and open surgical management of bladder stones in children showed comparable SFR and fewer complications. Open surgery offers a shorter procedure duration than endourological management, but PCCL features a shorter procedure duration than TUCL. In terms of length of stay, TUCL and PCCL were superior to CL, while TUCL was better than PCCL.