Brawijaya Journal of Urology

A Case Report with Rare Complication: Bladder Explosion During Transurethral Resection of Prostate (TURP)

2026-01-22T13:03:22+07:00

Introduction. Transurethral Resection of the Prostate (TURP) remains the gold standard procedure for treating Benign Prostatic Hyperplasia (BPH). Although this procedure has proven to be effective, it carries the risk of complications, including rare complications such as bladder explosion. Bladder explosion can occur due to the accumulation of flammable gases, especially hydrogen during electrocauterization.

Case. A 71-year-old man with a medical history of recurrent urinary retention underwent monopolar TURP. During the procedure, a burst sound was heard followed by a 7 cm bladder perforation on the anterior wall. Urgent bladder repair was performed with exploration and placement of cystotomy and retroperitoneal drain. The patient underwent postoperative recovery and the follow-up showed good results.

Conclusion. Bladder explosion is a rare but serious complication of monopolar TURP that requires immediate surgical intervention. Increased awareness and implementation of preventive strategies can minimize the risk of this complication and reduce patient morbidity.

A Case Report: A Pancreatic Cyst Mask as a Renal Cyst: A Diagnostic Challenge

2026-02-05T11:40:56+07:00

Introduction. Pancreatic cysts are increasingly detected and can mimic renal cystic lesions on imaging, particularly on the left side where the pancreatic tail abuts the upper pole of the kidney. Distinguishing between these entities is a diagnostic challenge, as clinical symptoms and standard imaging can be nonspecific.

Case. A 55-year-old woman presented with left flank pain, abdominal fullness, nausea, and heartburn. An abdominal CT scan identified a cystic lesion superior to the left kidney, leading to an initial diagnosis of a perirenal cyst. After unsuccessful treatment for GERD, diagnostic retroperitoneoscopy was performed. The intraoperative finding revealed the cyst was not renal but pancreatic origin, necessitating a subsequent open distal pancreatectomy.

Conclusion. This case highlights that large pararenal cysts, especially on the left, require pancreatic cysts to be considered in the differential diagnosis. When CT findings are inconclusive, advanced modalities like MRI with tissue-specific contrast or fine-needle aspiration of cyst fluid can be crucial for an accurate preoperative diagnosis and to avoid unnecessary surgical interventions.

Uncommon Presentation of Testicular Anomaly: An Insight into Tuberculous Orchitis Diagnostic Challenges in Rural Settings

2026-01-09T10:34:15+07:00

Introduction. Testicular tuberculosis is very rare, accounting for only 3% of genital tuberculosis cases. Diagnosing testicular tuberculosis is challenging and often only confirmed through post-surgical histopathological findings after an orchiectomy.

Case. A 59-year-old male patient came in complaining of a painless, gradually developing expansion in his left testicle. The patient did not have a history of tuberculosis or any related symptoms, including fever, appetite loss, respiratory issues, or significant weight loss. Physical examination and ultrasound suggested a testicular tumor. Due to the absence of definite preoperative diagnostic methods in our settings, we diagnosed the patient with a testicular tumor. Consequently, a left orchiectomy was performed, and the pathologic examination revealed tuberculous orchitis.

Conclusion. Given the limited diagnostic tools available and the elusiveness of similar cases encountered, surgery followed by histopathological findings for both treatment and diagnosis might be unavoidable in many cases.

Urachal Adenocarcinoma: A Case Report of Rare Tumor in Women

2025-11-04T12:14:16+07:00

Introduction. Urachal adenocarcinoma is an uncommon malignancy that typically presents in older men, and its recognition is often delayed because early symptoms are vague. This report is distinctive because it involves a young female patient with a mucinous colon-type immunophenotype, a presentation that is unusually atypical for urachal tumors and can easily be mistaken for a gastrointestinal primary. This rare combination of demographic and pathological features makes the case clinically significant, as it highlights specific diagnostic pitfalls that are not commonly emphasized in the literature.

Case. A 40-year-old woman experienced recurrent dysuria and visible hematuria for one year. CT imaging revealed a mass at the bladder dome extending toward the umbilicus, raising suspicion for a urachal lesion. Following cystoscopic biopsy suggesting mucinous adenocarcinoma, the patient underwent surgical extirpation with partial cystectomy. Histopathology accompanied by immunohistochemistry demonstrated CK7 negativity with CK20, CDX2, and β-catenin positivity, an immunoprofile characteristic of colon-type urachal adenocarcinoma.

Conclusion. Early cross-sectional imaging for persistent hematuria, close attention to masses located at the midline bladder dome, and the routine use of immunohistochemical markers to differentiate urachal from colorectal adenocarcinoma are essential steps to enhance diagnostic accuracy. Incorporating these strategies may prevent missed or delayed diagnoses in similarly atypical presentations of urachal adenocarcinoma.

Prevalence of Nocturia and Its Association with Sleep Quality Among Medical Students During the Covid-19 Pandemic: A Cross-Sectional Study

2026-02-20T11:28:39+07:00

Introduction. Nocturia is the most common lower urinary tract disease that is characterized by waking up to urinate more than once during the main sleep period and its prevalence increases with age. This study aimed to investigate frequency, bothersome and relation of nocturia with sleep quality during COVID-19 pandemic in medical students.

Methods. This study used a cross-sectional approach and an analytical observation method by distributing questionnaires. Questions include demographic characteristics, frequencies of nocturia, and bother scores related to nocturia.

Results. Data on 90 individuals eligible for statistical analysis. The average age was 19.24 ± 1.08 years. Overall nocturia prevalence was 38.8% medical students had nocturia. The nocturia rate was 42.2% and 35.56% in men and women, respectively (p = 0.642). The frequency of nocturia per night was 24.4%, 13.3% and 0.01% (1, 2, and 4 times, respectively).

Conclusion. Nocturia is common among medical students, especially men and it is not related with sleep quality.