Diphallia or penile duplication is an extremely rare congenital anomaly. It occurs once in every 5.5 million live births. The extent of penile duplication and the number of associated anomalies vary greatly, ranging from a double glans from a penis with no associated anomaly up to complete penile duplication associated with multiple anomalies. Here, we report a 12-year-old boy with complete bifid diphallia associated with bifid scrotum, epispadia, and pubic symphysis diastasis along with a review of the articles pertaining to this anomaly.
Tujuan: untuk mengetahui perbandingan lama operasi, lama perawatan paska operasi, jumlah perdarahan, komplikasi, angka bebas batu, dan hubungan antara komponen tersebut pada operasi percutaneous nephrolithotomy (PCNL) dan operasi terbuka baik, pyelolithotomy maupun extended pyelolithotomy sebagai penatalaksanaan batu ginjal dengan stone burden lebih dari 2 cm. Metode: pengumpulan data dilakukan secara retrospektif yang diambil dari rekam medis pasien batu ginjal yang menjalani PCNL dan operasi terbuka di Rumah Sakit Pusat Angkatan Darat (RSPAD) Gatot Soebroto sepanjang tahun 2011 hingga tahun 2014. Hasil: dari 116 pasien dengan usia antara 22-73 tahun, mayoritas laki-laki, didapatkan hasil perbedaan yang bermakna secara statistik pada lama operasi (p=0,001), lama rawat paska operasi (p=0,011), dan komplikasi demam paska operasi (p=0,048), antara PCNL dan operasi terbuka. Sedangkan untuk parameter angka bebas batu dan jumlah perdarahan, tidak didapatkan perbedaan yang bermakna secara statistik (p=0,245 dan p=0,154). Pada kelompok PCNL dan operasi terbuka, terdapat hubungan yang bermakna pada lama operasi dengan stone burden (p=0,004 dan p=0,02) maupun letak batu (p<0,001 dan p=0,011). PCNL memerlukan lama operasi dan lama rawat paska operasi yang lebih singkat, serta komplikasi demam paska operasi yang lebih sedikit, dibandingkan operasi terbuka. Namun demikian, untuk angka bebas batu dan jumlah perdarahan, tidak berbeda bermakna pada kedua kelompok. Terdapat hubungan yang bermakna secara statistik pada lama operasi dengan stone burden dan letak batu pada kedua kelompok. Simpulan: PCNL merupakan prosedur minimal invasif yang efektif dan aman dalam tatalaksana batu ginjal lebih besar dari 2 cm atau batu ginjal kompleks.
Objective: Benign prostatic hyperplasia (BPH) is a nonmalignant enlargement of the prostate associated with aging. BPH can cause lower urinary tract syndrome (LUTS). Medical therapy for patients with moderate and severe LUTS symptoms comprises a-1 adrenergic receptor antagonists. This study aimed to determine whether there are differences in the international prostate symptom score (IPSS) and maximal flow rate (Qmax) of patients with BPH receiving either silodosin or tamsulosin over 12 w. Methods: This study was a double-blind randomized clinical trial. Subjects were 50 men aged ³ 50 y diagnosed with BPH with an IPSS ³ 8 at the Gatot Soebroto Indonesian Army Hospital. The participants received either silodosin or tamsulosin. Their IPSS and Qmax were assessed at the initial assessment and after 4, 8, and 12 w of treatment. Results: The initial median IPSS was 15 in the tamsulosin group and 17 in the silodosin group (P = 0.808). After 12 w of therapy, the median IPSS decreased to 9 in the tamsulosin group and 10 in the silodosin group (P = 0.186). The initial median Qmax was 10.1 ml/s in the tamsulosin group and 10.9 ml/s in the silodosin group (P = 0.290). After 12 w of therapy, the median Qmax increased to 12.1 ml/s in the tamsulosin group and 11.9 ml/s in the silodosin group (P = 0.969). Although the differences between groups were not significant, the initial and 12-week IPSS and Qmax values differed significantly within each group. Conclusion: There were no significant between-group differences in the IPSS or Qmax after 12 w of therapy. However, both silodosin and tamsulosin produced significant differences between initial and 12-week assessments of IPSS and Qmax.
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