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Extracorporeal shockwave therapy in managing lower urinary tract dysfunction: a scoping review

Tue, 01 Apr 2025 00:00:00 GMT

Title: Extracorporeal shockwave therapy in managing lower urinary tract dysfunction: a scoping review Authors: Handayani, Yoshimi; Yufika, Amanda; Inda Lestari, Lazulfa; Setiono, Steven Abstract: ABSTRACT Extracorporeal shockwave therapy (ESWT) exerts a range of biological effects, including anti-inflammatory, immunomodulatory, angiogenic, proliferative, and differential responses, as well as promoting nerve regeneration, enhancing membrane permeability, inducing stem cell attraction, and triggering the release of exosomes. It facilitates both interstitial and extracellular responses that support tissue regeneration by transferring energy into tissues. It may also reduce pain through hyperstimulation analgesia and attenuate inflammatory responses, making it a promising non invasive approach for various lower urinary tract dysfunction (LUTD) conditions, such as underactive bladder, overactive bladder, chronic pelvic pain syndrome, stress urinary incontinence, and interstitial cystitis. This study aimed to explore the efficacy and mechanisms of ESWT in managing LUTD. KEYWORDS extracorporeal shockwave therapy, neurogenic bladder, urologic diseases

Conservative surgery for stage IC2 mucinous borderline ovarian tumor: a five-year follow-up case report

Tue, 01 Apr 2025 00:00:00 GMT

Title: Conservative surgery for stage IC2 mucinous borderline ovarian tumor: a five-year follow-up case report Authors: Widya Utami, Tofan; Hidaya Danial Nasution, Hiro; Oktalia, Arisda; Kusuma, Fitriyadi; Purwoto, Gatot Abstract: ABSTRACT Mucinous borderline ovarian tumors (MBOTs) represent a significant portion of all borderline ovarian tumors, including variants such as microinvasion and intraepithelial carcinoma, which have a higher recurrence risk. Conservative surgery is recommended for patients with MBOTs seeking fertility preservation, despite remaining a debated option to reduce recurrency. This case highlighted successful MBOT management using conservative surgery with unilateral salpingo-oophorectomy, providing insights into optimal recurrence control. A 30-year-old woman presented with abdominal enlargement, with imaging revealed a large right ovarian mass suspected to be malignant. A left salpingo-oophorectomy was performed, with final histopathology confirming MBOTs with microinvasion and intraepithelial carcinoma. No malignancy was found in the peritoneal fluid, and no adjuvant therapy was given due to fertility preservation reasons. No recurrence after 5 years of follow-up. This report highlights the potential of conservative surgery as a fertility-preserving option for young patients with stage IC2 MBOTs. KEYWORDS fertility preservation, ovarian neoplasms, salpingo-oophorectomy

Perianesthetic management in a teenager with focal cortical dysplasia who underwent an epilepsy surgery

Sat, 01 Mar 2025 00:00:00 GMT

Title: Perianesthetic management in a teenager with focal cortical dysplasia who underwent an epilepsy surgery Authors: Tat Yeap, Boon; Hau Koo, Thai; Yee Ang, Song; Hasyizan Hassan, Mohamad Abstract: ABSTRACT Medically resistant epilepsy (MRE) is defined as the failure of adequate trials of 2 tolerated and appropriately used antiepileptic drugs to achieve sustained seizure freedom, where epilepsy surgery (ES) is indicated in patients with MRE due to complex epileptic syndromes, such as Lennox-Gastaut and Sturge-Weber syndromes, and focal cortical dysplasia (FCD), to disconnect the epileptogenic foci from other cerebral structures. ES demands excruciating perianesthetic considerations due to its complexity and various pharmacological interactions. Our patient is a 15-year-old male with MRE secondary to FCD. He successfully underwent ES in our neurosurgical center. We describe our perianesthetic challenges in addition to a brief overview of MRE and FCD. KEYWORDS anesthesia, epilepsy, focal cortical dysplasia, surgery

Comparison between free and pedicled anterolateral thigh flaps and surgical outcomes in soft tissue reconstruction

Sun, 01 Jun 2025 00:00:00 GMT

Title: Comparison between free and pedicled anterolateral thigh flaps and surgical outcomes in soft tissue reconstruction Authors: Rusly Hariantana Hamid, Agus Roy Abstract: BACKGROUND The anterolateral thigh (ALT) flap, harvested either as a free flap with microsurgical anastomosis or as a pedicled flap with an intact blood supply, is widely used to repair soft tissue defects. This study aimed to evaluate the ALT flap, both free and pedicled variants, as a reliable option for reconstruction, focusing on flap viability and complications. METHODS This cross-sectional study included 30 patients who underwent free or pedicled ALT flap reconstruction at IGNG Ngoerah Hospital, Bali, between 2020 and 2024. Inclusion criteria were complete medical records and confirmed vascular flow on preoperative Doppler ultrasound. Statistical analysis was performed using Fisher’s exact test for bivariate analysis. The primary outcomes evaluated were the incidence of complications and their association with the type of flap. RESULTS ALT flaps were used as free flaps in 60% of cases and as pedicled flaps in 40%. Most patients were adult males, with flap placements mainly in the abdomen (36.7%). Wound dehiscence and necrosis occurred in 13.3% of cases. Wound dehiscence and complications requiring follow-up occurred more frequently in patients undergoing free flap procedures (38.9% versus 8.3%, p<0.001; 22.2% versus 0%, p = 0.001). In contrast, the incidence of necrosis was comparable between the two flaps (16.75% versus 8.3%, p = 0.632). CONCLUSIONS The free ALT flap showed a higher risk of partial flap necrosis and required more intensive monitoring. Pedicled ALT flap demonstrated a lower complication rate and more straightforward postoperative care, suggesting a more favorable option. KEYWORDS necrosis, reconstructive surgical procedures, soft tissue injuries, surgical flaps, thigh, wound dehiscence