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Fulltext Experience from Malaysia During the COVID-19 Movement Control Order

Khor V, Arunasalam A, Azli S, Khairul-Asri MG, Fahmy O

Urology, 2020 07;141:179-180.
PMID: 32339556 DOI: 10.1016/j.urology.2020.04.070
Matched MeSH terms: Urology*
Fulltext To Share or Not to Share: Malaysian Healthcare Professionals' Views on Localized Prostate Cancer Treatment Decision Making Roles

Lee YK, Lee PY, Cheong AT, Ng CJ, Abdullah KL, Ong TA, et al.

PLoS One, 2015;10(11):e0142812.
PMID: 26559947 DOI: 10.1371/journal.pone.0142812

AIM: To explore the views of Malaysian healthcare professionals (HCPs) on stakeholders' decision making roles in localized prostate cancer (PCa) treatment.
METHODS: Qualitative interviews and focus groups were conducted with HCPs treating PCa. Data was analysed using a thematic approach. Four in-depth interviews and three focus group discussions were conducted between December 2012 and March 2013 using a topic guide. Interviews were audio-recorded, transcribed verbatim, and analysed thematically.
FINDINGS: The participants comprised private urologists (n = 4), government urologists (n = 6), urology trainees (n = 6), government policy maker (n = 1) and oncologists (n = 3). HCP perceptions of the roles of the three parties involved (HCPs, patients, family) included: HCP as the main decision maker, HCP as a guide to patients' decision making, HCP as a facilitator to family involvement, patients as main decision maker and patient prefers HCP to decide. HCPs preferred to share the decision with patients due to equipoise between prostate treatment options. Family culture was important as family members often decided on the patient's treatment due to Malaysia's close-knit family culture.
CONCLUSIONS: A range of decision making roles were reported by HCPs. It is thus important that stakeholder roles are clarified during PCa treatment decisions. HCPs need to cultivate an awareness of sociocultural norms and family dynamics when supporting non-Western patients in making decisions about PCa.

Matched MeSH terms: Urology
Fulltext The prevalence of postoperative symptoms within 24 hours after ambulatory surgery in a University Hospital

Adlin Dasima, A.K., Karis, M.

Journal of Surgical Academia, 2013;3(2):32-38.
MyJurnal

Ambulatory surgery has now becoming increasingly popular and it is generally well accepted. Major complications following ambulatory surgery are very rare but certain postoperative symptoms can be very unpleasant and distressing to the patients. Follow-up phone calls regarding their well being at home following the surgery may give us the clue and allow us to identify certain problems that can be sorted out immediately or as a reference for a better service in future. The present study was carried out to determine the prevalence of common postoperative symptoms and their subsequent effects within 24 hours after ambulatory surgery by follow-up phone calls. We prospectively studied 199 ASA I and II patients, but only 187 patients were analyzed. Patients had undergone general surgery, orthopaedic, urology, gynaecology or ear, nose and throat (ENT) surgery. Pain was scored based on Numerical Rating Scale (NRS). Majority of patients (70.8%) had only mild pain prior to discharge home. At 24 hours postoperatively, pain was the commonest symptom reported (92.5%) followed by sleepiness (72.2%), dizziness (49.7%), sore throat (17.1%), nausea and vomiting (7.5%) and headache (7%). Sleep was mildly affected in nearly 50% of the patients. Fifty seven percent of patients did not need assistance in performing daily activities during the 24 hours, post surgery. Majority of patients were satisfied (81.3%) with ambulatory surgery. In conclusion, pain was the commonest postoperative symptom encountered following the surgery. Sleep was mildly affected by the postoperative symptoms. Most of the patients did not need assistance in performing their daily activities following surgery. All patients were able to return to at least more than 50% of their normal daily activities at 24 hours after the surgery. Overall satisfaction towards ambulatory surgery was good.

Matched MeSH terms: Urology
Fulltext Robotic surgery: where are we today?

Obaid, Kadhim Jawad, Sood, Suneet

Medical Health Reviews, 2009;2009(1):59-73.
MyJurnal

Robotic surgery is a technique that uses mechanical, computercontrolled arms to conduct surgical operations. It carries the advantages of minimal access associated with laparoscopic surgery, and of precision associated with open surgery. It is also feasible to conduct robotic surgery with the surgeon far away, by “telerobotics”. The robot is more versatile than the human arm, and less susceptible to tremors. The view is excellent, and it is possible to conduct more intricate procedures than are possible with the human hand. Robotics has been in use for over seven years, and the initial experience shows that the success rate is over 90%, with only about 10% of cases needing to be converted to open surgery. Blood loss is low, and tumour margins in cancer surgery are satisfactory. Surgeons have used robotics for procedures in urology, gastrointestinal surgery, gynecology, cardiac surgery, neurosurgery, orthopedics, and other specialties. Presently, robotics suffers from two major disadvantages: one, that it is very expensive, and two, that robotic procedures take significantly longer than do open or laparoscopic procedures.

Matched MeSH terms: Urology
Intrauterine contraceptive device embedded in bladder wall with calculus formation removed successfully with open surgery

Tan JH, Lip H, Ong W, Omar S

Malays Fam Physician, 2019;14(2):29-31.
PMID: 31827733

An Intrauterine contraceptive devices (IUCD) is commonly inserted by the primary health care physician. It can migrate into pelvic or abdominal organs. When a pregnancy occurs following an insertion of an IUCD, there should be a high suspicion of uterine perforation or possible migration. A radiograph can be done in the primary health care clinic to search for a missing IUCD. Early referral to the urology service is warranted when a patient presents with recurrent urinary tract infections. Removal of an intravesical IUCD can be managed with cystoscopy, laparoscopy or open surgery. Herein, we report a case of IUCD migration into the bladder. This case will highlight the importance of proper technique, careful insertion and the role of ultrasound.

Matched MeSH terms: Urology
Rates of self-reported 'burnout' and causative factors amongst urologists in Ireland and the UK: a comparative cross-sectional study

O'Kelly F, Manecksha RP, Quinlan DM, Reid A, Joyce A, O'Flynn K, et al.

BJU Int, 2016 Feb;117(2):363-72.
PMID: 26178315 DOI: 10.1111/bju.13218

To determine the incidence of 'burnout' among UK and Irish urological consultants and non-consultant hospital doctors (NCHDs). The second objective was to identify possible causative factors and to investigate the impact of various vocational stressors that urologists face in their day-to-day work and to establish whether these correlate with burnout. The third objective was to develop a new questionnaire to complement the Maslach Burnout Inventory (MBI), more specific to urologists as distinct from other surgical/medical specialties, and to use this in addition to the MBI to determine if there is a requirement to develop effective preventative measures for stress in the work place, and develop targeted remedial measures when individuals are affected by burnout.

Matched MeSH terms: Urology*
Fulltext Pneumatic ureterolithotripsy in paediatric and adolescent patients: a ten-year experience at the Hospital Universiti Sains Malaysia

Hussein NS, Gohar MR

Singapore Med J, 2011 Jan;52(1):42-6.
PMID: 21298240

Two to three percent of stone disease cases occur in the paediatric age group. It is common in some parts of the world, such as in Turkey, India and Thailand. More than 50 percent of stones in children are still managed through open surgery. Ureteroscopic intervention for children remains a challenging treatment option. However, in contemporary urology practice, this mode of intervention is becoming more common. In this retrospective study, we reviewed our experiences with ureteroscopy and pneumatic lithotripsy in the paediatric and adolescent age group.

Matched MeSH terms: Urology/methods
Fulltext A Global Survey on the Impact of COVID-19 on Urological Services

Teoh JY, Ong WLK, Gonzalez-Padilla D, Castellani D, Dubin JM, Esperto F, et al.

Eur Urol, 2020 Aug;78(2):265-275.
PMID: 32507625 DOI: 10.1016/j.eururo.2020.05.025

BACKGROUND: The World Health Organization (WHO) declared coronavirus disease-19 (COVID-19) as a pandemic on March 11, 2020. The impact of COVID-19 on urological services in different geographical areas is unknown.
OBJECTIVE: To investigate the global impact of COVID-19 on urological providers and the provision of urological patient care.
DESIGN, SETTING, AND PARTICIPANTS: A cross-sectional, web-based survey was conducted from March 30, 2020 to April 7, 2020. A 55-item questionnaire was developed to investigate the impact of COVID-19 on various aspects of urological services. Target respondents were practising urologists, urology trainees, and urology nurses/advanced practice providers.
OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: The primary outcome was the degree of reduction in urological services, which was further stratified by the geographical location, degree of outbreak, and nature and urgency of urological conditions. The secondary outcome was the duration of delay in urological services.
RESULTS AND LIMITATIONS: A total of 1004 participants responded to our survey, and they were mostly based in Asia, Europe, North America, and South America. Worldwide, 41% of the respondents reported that their hospital staff members had been diagnosed with COVID-19 infection, 27% reported personnel shortage, and 26% had to be deployed to take care of COVID-19 patients. Globally, only 33% of the respondents felt that they were given adequate personal protective equipment, and many providers expressed fear of going to work (47%). It was of concerning that 13% of the respondents were advised not to wear a surgical face mask for the fear of scaring their patients, and 21% of the respondents were advised not to discuss COVID-19 issues or concerns on media. COVID-19 had a global impact on the cut-down of urological services, including outpatient clinic appointments, outpatient investigations and procedures, and urological surgeries. The degree of cut-down of urological services increased with the degree of COVID-19 outbreak. On average, 28% of outpatient clinics, 30% of outpatient investigations and procedures, and 31% of urological surgeries had a delay of >8 wk. Urological services for benign conditions were more affected than those for malignant conditions. Finally, 47% of the respondents believed that the accumulated workload could be dealt with in a timely manner after the COVID-19 outbreak, but 50% thought the postponement of urological services would affect the treatment and survival outcomes of their patients. One of the limitations of this study is that Africa, Australia, and New Zealand were under-represented.
CONCLUSIONS: COVID-19 had a profound global impact on urological care and urology providers. The degree of cut-down of urological services increased with the degree of COVID-19 outbreak and was greater for benign than for malignant conditions. One-fourth of urological providers were deployed to assist with COVID-19 care. Many providers reported insufficient personal protective equipment and support from hospital administration.
PATIENT SUMMARY: Coronavirus disease-19 (COVID-19) has led to significant delay in outpatient care and surgery in urology, particularly in regions with the most COVID-19 cases. A considerable proportion of urology health care professionals have been deployed to assist in COVID-19 care, despite the perception of insufficient training and protective equipment.

Matched MeSH terms: Urology/statistics & numerical data*
The Modified Urdu version of International Prostate Symptom Score: A psychometric validation study

Salman M, Khan AH, Sulaiman SAS, Hughes J, Khan JH, Hussain K

Turk J Urol, 2018 Jul;44(4):335-340.
PMID: 29932403 DOI: 10.5152/tud.2018.44834

OBJECTIVE: The objective of the current study was to develop an Urdu version of the International Prostate Symptom Score (IPSS-U) and validate it for Pakistani patients suffering from lower urinary tract symptoms (LUTS).
MATERIAL AND METHODS: IPSS-U was developed by a two-step forward and back translation and to evaluate its psychometric properties, a prospective study involving patients suffering from LUTS (n=267) was conducted at Outpatient Urology Department, Mayo Hospital, Lahore, Pakistan. Internal consistency and reproducibility were assessed using Cronbach's alpha and the Intra-Class Correlation Coefficient (ICC). Moreover, exploratory, and confirmatory factor analyses were performed to determine dimensionality of IPSS-U items.
RESULTS: Overall reliability of IPSS-U was satisfactory (Cronbach's alpha=0.72, ICC of symptom questions=0.92 and ICC of QOL index=0.75). Exploratory factor analysis revealed that two factors were consistent, which together explained 59.8% of the variance. IPSS-U items 1, 3, 5 and 6 were components of the first factor whereas item 2, 4 and 7 were components of the second factor. All the items loaded high on their factors and there were no cross loadings. Moreover, confirmatory factor analysis also showed two-factor model, with acceptable fitting patterns.
CONCLUSION: IPSS-U is a valid and reliable non-gender specific instrument to assess the frequency and severity of LUTS in Urdu-speaking population.

Matched MeSH terms: Urology
Dentist-Urologist Interplay in the Dental Management of Penile Prosthesis Patient

Ramasamy C

J Coll Physicians Surg Pak, 2015 Aug;25(8):628.
PMID: 26305318 DOI: 08.2015/JCPSP.628628
Matched MeSH terms: Urology