Genital lymphedema (GL) is an uncommon and disabling disease that manifests as enlargement of the genital region resulting from the disturbance of lymphatic drainage. Although conservative treatment such as decompression is typically the first-line approach, surgical intervention has been shown to be effective in certain cases. This study aimed to systematically review studies evaluating available surgical alternatives for the treatment of male GL. A systematic search strategy using keyword and subject headings was applied to PubMed, Scopus, EMBASE, and Cochrane Library in May 2019. Studies investigating various surgical techniques to treat penile and scrotal lymphedema were included. The potential risk of bias of included trials was evaluated using the methodological index for non-randomized studies (MINORS). In total, 13 studies met the inclusion criteria, nine of which were determined to be high-quality. The average MINORS score was 12.45 for studies involving excision and 14 for studies involving lymphovenous anastomosis (LVA). The most common reason for a low score was a failure to describe the inclusion criteria. Recurrence of lymphedema during follow-up was reported in four studies involving excision and in no studies involving LVA. In general, the quality of the included literature was considered to be fair. Although surgical intervention might not always prevent the recurrence of lymphedema, all of the studies reported improved quality of life after the procedure. This study could be used as the basis for evidence-based guidelines to be applied in clinical practice for managing male GL.

This scoping review aimed to identify and categorize the available measurement options for vaginal laxity (VL), their indications of use, and whether these measurements can sufficiently provide objective clinical judgment for cases indicated for vaginal rejuvenation with many treatment options nowadays. Systematic searches were conducted on five electronic databases, manually searching articles' bibliographies and predetermined key journals with no date or study design limitations. We included all studies involving VL in their inclusion criteria, treatment indications, and outcome parameters. We used the Arksey and O'Malley frameworks as the guideline in writing this scoping review. Of the 9,464 articles identified, 66 articles and 11,258 subjects were included in the final analysis. The majority of studies were conducted in obstetrics and gynecology (73%), followed by plastic surgery (10%), medical rehabilitation (4.5%), dermatology (4.5%), and others (8%). Most studies originated from the North American region (30%). The following measurement tools were used: (1) interviews, (2) questionnaires, (3) physical/digital examinations, (4) perineometers, and (5) others. Our results suggested that subjective perception of laxity confirmed by directed interview or questionnaire is sufficient to confirm VL. Additional evaluation of pelvic floor muscle through digital examination or perineometer or other preferred tools and evaluation of sexual function through validated questionnaire (Female Sexual Function Index, Female Sexual Distress Scale-Revised, etc.) should follow to ensure holistic care to patients. Future research on the psychometric properties (reliability and validity) of commonly used measurements and the correlation in between subjective and objective measurements should be initiated before their clinical applications.

The procedures for closing a laceration wound vary. The efficacy of the new method using adhesive skin tape and its role in wound healing are unclear. Porcine skin is closely similar to human skin. This study was conducted on seven York Pork pigs in the laboratory of the Veterinary Teaching Hospital, Institut Pertanian, Bogor, Indonesia from August 2016 to September 2016. Three laceration wounds were made on the pig's back and closed using skin suture (group 1), the recommended application (group 2), and a modified application (group 3). Histopathological evaluation was performed on days 7 and 30 by biopsy; tensile strength was evaluated after 6 weeks' treatment. On day 7, there was a significant difference in the collagen deposition between groups 2 and 3, but there was no significant difference to group 1. There were no significant differences among the groups regarding subcutaneous fibroblasts and fibrocytes or tensile strength. The maximum force at rest was 380 ± 68.12 N. A modified application of adhesive skin tapes results in better collagen deposition and wound edge adaptation than the recommended application. However, the results of this method do not differ significantly from those of skin suture. Intradermal suture use increases tensile strength.

Background: Labiaplasty has rapidly gained popularity among women in recent years. However, limited studies are available discussing the motivations influencing their decisions to undergo the procedure and its implications for psychological and sexual satisfaction. This systematic review was conducted to identify the primary motivations for labiaplasty and its effects on patients’ psychological aspects and intimate relationships. Methods: This systematic review was conducted by searching 6 online databases with related keywords. Cohort, cross-sectional studies, clinical trials, and case series that reported patients who underwent labiaplasty in adulthood were included. We excluded studies that had subjects with other operations on the genital area. Results: Sixteen eligible studies involving a total of 1143 participants were analyzed. Among women seeking labiaplasty, functional complaints (52.2%) were the primary motivators, followed by concerns about appearance (46.3%), psychological motivations (26.9%), and sexual reasons (20.5%). Improved self-esteem and confidence were the primary psychological outcomes observed, with 1 study also showing a significant reduction in anxiety (P < 0.05). Most patients reported improvements in sexual function, including relationship satisfaction and intercourse comfort, although these changes were nonsignificant. Psychosexual outcomes showed increased sexual confidence and reduced anxiety, but most findings were nonsignificant. Conclusions: Functional complaints were found to be the primary motivations for women seeking labiaplasty, followed by appearance, psychological, and sexual complaints. The psychological, sexual, and psychosexual outcomes after labiaplasty showed some improvements. However, concluding the overall results was challenging due to the divergent assessment tools. Standardized assessment tools that are acceptable worldwide to assess such outcomes are needed for further study.

Introduction: Hypospadias is a congenital abnormality of the urethral meatus in males. Hypospadias can be corrected by two-stage urethroplasty. Hyperbaric oxygen therapy (HBOT) can accelerate wound healing after surgery by increasing oxygenation, angiogenesis, and collagen synthesis. This study aimed to measure the effectivity of HBOT based on serum vascular endothelial growth factor (VEGF) level and Hypospadias Objective Penile Evaluation (HOPE) score in hypospadias reconstruction patients. Methods: This was a randomized controlled trial study. Hypospadias reconstruction was performed using the Sidik- Chaula and Manset Flap techniques. Each HBOT session ranged from 30-60 minutes, administered at 1-3 atm. Twenty subjects were divided into two groups: the HBOT and control groups. VEGF serum levels were measured 1 hour after the operation and 1 hour after every HBOT session. The HOPE score was assessed at the bedside by the attending physician, consisting of six items: the position of the meatus, the shape of the meatus, the shape of the glans, the shape of the penile skin, and the shape of the penile axis, including penile torsion and penile curvature. The data were analyzed with SPSS version 28, using the Shapiro-Wilk and independent t-test methods. Results: There was a trend of increasing VEGF levels as the number of HBOT sessions increased, with significant increase found in patients who underwent three (p=0.038), four (p=0.002), and five (p=0.008) HBOT sessions. We found a significant increase in the total HOPE score (p=0.028) and penile torsion score (p=0.006) in the HBOT group.Conclusions: HBOT can accelerate wound healing after urethroplasty. Three or more HBOT sessions are recommended after the repair of hypospadias.

Introduction: Charity circumcision is common in Indonesia. It is usually done by general practitioners or medical students under supervision. Procedures are often held on a mass scale and rarely followed with post-monitoring. We developed a telemedicine follow-up protocol to educate and address post-procedure complications. This pilot study evaluates the acceptability of telemedicine follow-up protocol for charity circumcision in Indonesia. Method: Data were collected from operators and caregivers of children attending charity circumcision. The protocol consisted of text interviews (pain, urinary retention) and surgical sites' four-angle photographs (epithelialization, bleeding, infection, edema, and glans excoriation). The protocol was conducted two-way between caregivers and operators on days 1, 3, 7, and 30 after circumcision. The Ethics Committee of the Faculty of Medicine, Universitas Indonesia, has approved this study. Result: Twenty-five boys with a mean age of 8.02±1.53 years old have similar pre-operative, operative, and postoperative protocols. Twenty-one caregivers completed four times follow-ups, one missed two times follow-ups, and three missed the last follow-up. Mild pain was the most reported complication, with 32% (8/25), 12% (3/25), 8% (2/24) incidence on days 1, 3, and 7, respectively. By the end of the follow-up, there were no persisting complications, and 80% (20/25) of boys showed complete epithelialization. All caregivers and most operators were satisfied with telemedicine for post-mass circumcision monitoring. Conclusion: The telemedicine-based follow-up is acceptable and feasible to be applied in mass charity circumcision. This protocol is beneficial for monitoring the results and adverse events, therefore, should be routinely adopted in mass charity circumcision programs.