Renal ectopia with stone is a rare case with no specific reported incidence rate. The treatment of kidney stone in ectopic kidneys poses a challenge to urologists. A 48-year-old male presenting with colicky pain on the right flank since one year ago. CT urography revealed an right-crossed renal ectopia and hyperdense lesions (25 × 20 mm and 10 × 10 mm) in the ureteropelvic junction of the right kidney. Under general anesthesia, we performed open pyelolithotomy for the patient and removed two stones completely. Open surgery could be the choice for patients with complex stone burden and associated renal anomalies such as ectopic kidney.

Background: Fournier Gangrene (FG) is a case of emergency urology with high mortality. Early and aggressive intervention can be done with a simple assessment system. Simplified Fournier Gangrene Severity Index (SFGSI) simplifies the Fournier Gangrene Severity Index (FGSI) while remaining sensitive and specific. This study aims to compare the performance of FGSI and SFGSI as predictors of FG patient mortality in H. Adam Malik General Hospital Medan. Materials and Methods:This study is an analytical study with a retrospective cross-sectional design. The research subjects were all patients of Medan Haji Adam Malik General Hospital who were diagnosed with FG in the period January 1, 2013 to December 31, 2017. Then the data that became components of the FGSI and SFGSI were age, body temperature, pulse, respiration, potassium, sodium, creatinine, hematocrit, leukocytes, and bicarbonate are recorded and compared against mortality outcomes. Data were analyzed using the Receiver Operator Curve (ROC). Results: From a total of 34 patients sampled in this study, with an average age of 60.4 (± 6.80) years in the living group and 61.5 (± 7.04) years in the deceased group. The difference in length of stay in living patients was 23.42 (± 3.59) days compared to 6.30 (± 1.95) days in patients who died in which all patients were male. There was a significant relationship between FGSI scores with a cut-off> 9 (P <0.001, sensitivity 90% specificity 95.8%). The SFGSI cut-off value was> 2 (p <0.001, sensitivity 80%, specificity 91.7%). Conclusion: FGSI results> 9 are prognostic factors for determining FG output (sensitivity 90% and specificity 95.8%). SFGSI has good sensitivity and specificity at a lower cost (80% and 91.7%).

BACKGROUND:Bladder cancer is the 9th most frequent cancer worldwide. Ki-67 is immunohistochemistry marker that is predictive of cancer cell proliferation. The expression of Ki-67 is associated with poor prognosis in several types of malignancy, yet the value of Ki-67 as the prognostic factor in bladder cancer remains controversial.AIM:This study is aimed to investigate the association between Ki-67 expression with muscle-invasive bladder cancer (MIBC) and non-muscle invasive bladder cancer (NMIBC).METHODS:This was a case-control study with a retrospective design. The study was conducted at the Department of Pathology, University of Sumatera Utara, Indonesia. Samples were paraffin blocks from patients diagnosed with bladder cancer and agreed to be put in the study. The samples were stained with Immunohistochemistry Staining (IHC), and then we quantitatively counted the number of the Ki-67 stained nucleus on a microscope.RESULTS:A total of 54 samples were obtained in this study. Samples consisted of 27 samples with NMIBC and 27 samples with MIBC. The cut-off point was 20%, we found 17 patients with MIBC and 14 patients with NMIBC presented with biomarker > 20%. Biomarker ≤ 20% was found in 10 patients with MIBC and 13 patients with NMIBC. On statistical analysis with Chi-Square test, no significant association found (p = 0.583) between KI-67 and muscle - invasiveness with OR of 1.579, 95% CI (0.533-4.678).CONCLUSION:There is no association between expression of Ki-67 and muscle invasiveness in bladder cancer.

Purpose To determine the differences in mean scores of erectile dysfunctions (EDs) assessed by the International Index of Erectile Function (IIEF-5) questionnaire between patients with chronic kidney disease (CKD) undergoing hemodialysis and patients undergoing continuous ambulatory peritoneal dialysis (CAPD). Patients and Methods This is an analytic observational study with a cross-sectional design that was conducted from June to December 2022 at the Urology Center of Haji Adam Malik General Hospital and Rasyida Kidney Specialized Hospital. The sample of this study were male CKD-patients who underwent regular hemodialysis (HD) and who underwent CAPD, and met the inclusion and exclusion criteria. Psychological disorders experienced during therapy session are considered as risk factors and assessed via the Hospital Anxiety and Depression Scale (HADS). These disorders assessment was used to evaluate the severity of the patients’ anxiety and depressive symptoms. Statistical data analysis was carried out. Results Both groups had HADS-A and HADS-D scores with an average <7, classified as normal anxiety and depression. Most of the patients in the HD group had mild-to-moderate ED (28.6%), while in the CAPD group had mild severity of ED (38.1%). There were no significant differences in severity of ED between patients undergoing HD and CAPD (p > 0.05). However, there was a significant difference in ED scores (IIEF-5) between patients undergoing HD and those with CAPD (p < 0.05), in which patients in the CAPD group had a higher IIEF-5 score. In addition, there was a significant positive correlation with moderate strength (p<0.001; r =0.494) between anxiety disorders and ED disorders in patients undergoing HD and CAPD, whereas there is no significant correlation between depressive disorders and ED conditions (p > 0.05). Conclusion There was a significant difference in IIEF-5 scores between patients undergoing HD and CAPD.

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