Background: Penile amputation is an emergency urologic condition requiring immediate attention in order to maximize functional outcomes. Unfortunately, there is limited experience and publication of case reports describing the successful replantation of penis after incomplete amputation, especially in facilities without adequate microsurgical tools and means. We hereby present a case of penile amputation caused by a mechanical grass cutter and a discussion of its surgical management. Case description: A 33-year-old Indonesian male presented to the emergency department with incomplete penile amputation six hours post injury. The patient has no prior medical history and presented with penile amputation due to a mechanical grass cutter trauma. He underwent immediate non-microsurgery reconstructive replantation of the penis, reattaching all visible vascular, corporal, and fascia layers. After replantation, the patient recovered well and showed preserved normal appearance and sensitivity of the penis. Subsequent Doppler ultrasound investigation revealed adequate arterial flow at the distal end of the anastomosis. The patient was discharged five days after surgery.  Conclusion: In the absence of microsurgical tools and means, the use of non-microsurgical replantation with an at least 2.5x loupe magnification should be the choice of treatment in the case of incomplete penile amputation. The technique showed good outcomes involving adequate functional and cosmetic restoration.

Objective: This study is assigned to evaluate factors that associated with intracytoplasmic sperm injection (ICSI) outcome. Material & methods: A retrospective study design is used to evaluate couples who seeking help for infertility problems at Permata Hati Infertility Clinic, Sardjito General Hospital Yogyakarta. The outcome measures were fertilization and clinical pregnancies rates. All analyses were performed with SPSS statistical software, version 20.0. Result: Forty-five couples participated in this study with mean age 33.69 ± 5.38 years for men and 30.53 ± 4.79 years for women. Of 56 ICSI cycles, there were 43 successful fertilizations (95.6%) and 14 clinical pregnancies (31.1%). In multivariate analysis, factors associated with successful clinical pregnancies were women’s age (p = 0.034, 95% CI 0.005-0.8), number of ICSI cycle (p = 0.045, 95% CI 0.001-0.93), and sperm morphology (p = 0.019, 95% CI 1.648- 253). In bivariate analysis, only men’s age is significantly associated with successful fertilization (p = 0.006, 95% CI 7.22-16.43). Conclusion: Factors associated with outcome of ICSI are women’s age, number of ICSI cycle, and sperm morphology.

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The outcomes of varicocele repair in non-obstructive azoospermic men remain the subject of controversy. Until now, small studies with small number of patients performed make it difficult to assess the efficacy of varicocele surgery in men with non-obstructive azoospermia. This review is performed to evaluate quality of the sperm among non-obstructive azoospermic men after varicocele repair.

ABSTRAK (262,4±130,8 ml, 289,4±126,2 ml, 359,2±137 ml; p=0,02). Kesimpulan:Volume asupan air 300-500 ml tidak mempengaruhi waktu tunggu sebelum uroflowmetry. Peningkatan asupan air minimal 500 ml menambah volume akhir kandung kemih dan memperpendek waktu tunggu. ABSTRACTBackground: In uroflowmetry examination, patients are usually instructed to intake a large volume of water and wait until the bladder is full. The association between the volume of water intake and the waiting time before uroflowmetry is unknown. The aim of this study is to investigate the relationship between the volume of water intake and the waiting time prior to uroflowmetry.