Karim, Muhammad Ilhamul
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CHARACTERISTIC OF IATROGENIC BLADDER TRAUMA PATIENT IN HASAN SADIKIN GENERAL HOSPITAL FROM JANUARY 2013 - JANUARY 2018 Karim, Muhammad Ilhamul; Adi, Kuncoro
Indonesian Journal of Urology Vol 27 No 2 (2020)
Publisher : Indonesian Urological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32421/juri.v27i2.612

Abstract

Objective: This study was conducted to determine the characteristics of iatrogenic bladder trauma in Hasan Sadikin General Hospital from January 2013 – January 2018. Material & Methods: The study was conducted by retrospective descriptive methods. We reviewed iatrogenic bladder trauma from medical record at Hasan Sadikin General Hospital from January 2013 to January 2018. The data obtained is subsequently recapitulated and processed using a spreadsheet. Results: Most of the cases were found in female patients. There were 30 cases (73.17%) are recorded. Whilst on male patients, there were only 11 cases (26.83%). The average age was 42.35±2.35 years old. According to AAST grading, a total of 2 patients (4.88%) experienced AAST grade V, 28 patients (68.29%) experienced AAST grade IV, 8 patients (19.51%) experienced AAST grade III, and 3 patients (7.31%) experienced AAST grade I. In addition, there were 31 (75.61%) iatrogenic injuries due to gynecologic surgery, 6 (14.63%) iatrogenic injuries due to digestive surgery, and 4 (9.76%) iatrogenic injuries due to endourology surgery. Of all cases, 30 patients (73.17%) underwent immediate intraoperative reconstruction surgery, whilst the other 11 (26.83%) underwent delayed reconstruction surgery. As for the management, 33 (80.49%) patients underwent bladder repair, 1 (2.44%) patients underwent palliative cystectomy, 2 (4.88%) patients underwent damage control surgery, 3 (7.32%) patients underwent bladder exploration, and 2 (4.88%) patients underwent urethral catheter insertion. From all of 41 cases of patients with iatrogenic bladder injury, there were 3 (7.32%) mortality cases due to prolonged bleeding and sepsis. Conclusion: In this study, iatrogenic bladder trauma mostly affected female patients that underwent gynecologic surgery on the age group of 41-50 years old. Almost all of the cases were treated by bladder repair. By knowing the epidemiology of iatrogenic bladder injury and perform prompt treatment then we can take precautions to reduce the level of morbidity and mortality.
UROVAGINAL FISTULA IN TERTIARY HOSPITAL OF WEST JAVA INDONESIA Karim, Muhammad Ilhamul; Tjahjodjati
Indonesian Journal of Urology Vol 29 No 1 (2022)
Publisher : Indonesian Urological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32421/juri.v29i1.709

Abstract

Objective: This study was conducted to find out the frequency and characteristics of urovaginal fistula patients. Material & Methods: This study design used a retrospective descriptive research design conducted at a tertiary hospital in West Java, Indonesia (Hasan Sadikin General Hospital) from 1 January 2010 to 31 December 2016. Results: Of all 22 urovaginal fistula patients, the majority in the age range of 41-50 years, and there was one patient in the age range of 61-70 years. Fourteen patients (63.6%) had defects in the bladder, and 36.5% of patients had defects in the ureters. There were nine patients (40.9%) who had urovaginal fistula after undergoing a hysterectomy procedure. The other causes were cervical carcinoma (40.9%), difficult labor (9.1%), radiotherapy (4.5%), carcinoma rectum (4.5%), cesarean section procedure (9.1%), and other gynecological procedures such as myomectomy or cystectomy (9.1%). Based on the type and location of the fistula, the majority of patients had vesicovaginal fistula/VVF (59%), ureterovaginal fistula/UVF (36%), and a combination of ureterovesicovaginal fistula (5%). The causes of VVF and UVF are different from each other. In patients with VVF, the most common cause is cervical carcinoma (35.7%). Meanwhile, the most common cause of UVF is hysterectomy (75%). Conclusion: Of the various types of urovaginal fistulas, vesicovaginal fistulas are the most frequently encountered. In general, the characteristics of urovaginal fistula patients in Hasan Sadikin General Hospital is slightly different from the literature, especially the cause of fistula. At Hasan Sadikin General Hospital, vesicovaginal fistulas are mostly caused by cervical cancer, not a hysterectomy. For ureterovaginal etiology, the characteristics of patients in Hasan Sadikin General Hospital are caused mainly by hysterectomy.