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A prospective randomised comparison of bipolar diathermy versus conventional dorsal slit technique for ritual circumcision: a Malaysian experience

Fariz M. M., Tarmizi M. N., Ainaini M. H., Khairil A. M., Faizal A., Ismail Sagap.
La Clinica terapeutica. 2011; 162(6): 543-545

BACKGROUND AND OBJECTIVES: Ritual circumcision is one of the most common surgical procedures performed in the developing world. Various technique for circumcision has been described to increase patient's safety and to decrease operating time. This study will look at comparing the conventional method of circumcision using scissors and ligatures with bipolar diathermy. To compare the incidence of bleeding and infection in patients who underwent circumcision between using the bipolar diathermy technique with conventional surgery (dorsal slit) technique for circumcision. The operative time between the two techniques were also recorded. MATERIALS AND METHODS: A prospective, randomized study was conducted in all children undergoing ritual circumcision at Raja Perempuan Zainab II Hospital, Malaysia over a 1-year period. Data analysed were the operation time,postoperative bleeding rates and infection rates. RESULTS: A total of 341 patients were included in the study. Randomization resulted in 183 patients in conventional surgery group and 158 patients in bipolar group. The incidence of bleeding were significantly better in the bipolar group compared to conventional group (3.1% vs 19.7%), (p<0.001). There was no significant difference in the infection rate (1.3% vs 2.7%) (p=0.457). Operative times were shorter in the bipolar diathermy group (Mean 8.2 minutes) compared to conventional group (Mean 15.3 minutes) (p<0.01). CONCLUSION: Bipolar diathermy technique for circumcision is safe and quicker than the dorsal slit technique.


Tuberculosis of the prostate presenting as benign prostatic hyperplasia

Fazarina M., Tan G. H., Badrulhisham B., Shiran Md Sidik, Tan Geok Chin.
Medicine & health. 2013; 8(2): 85-88

Genitourinary system is the second most common site of tuberculosis (TB) after pulmonary system. Tuberculosis of the prostate is a rare manifestation of genitourinary tuberculosis. It is even more uncommon if occurring in an immune-competent individual. Prostate TB is usually an incidental finding in transurethral resection of prostate (TURP). Here, we report a case of TB of the prostate in a 70-year-old man who had benign prostatic hyperplasia for two years. TB was diagnosed incidentally post-TURP. In this report, we also discuss additional tests which may help in establishing the diagnosis of genitourinary tuberculosis.


Seven-year review of prostate carcinomas diagnosed by TRUS biopsy in a single Malaysian institution

Goh Eng Hong, Ho Christopher Chee Kong, Praveen Singam, Lee Boon Cheok, Zulkifli Mohd Zainuddin, Md Azri.
Asian Pacific journal of cancer prevention : APJCP. 2010; 11(5): 1351-1353

INTRODUCTION: Analysis of epidemiological as well as survival differences among the multiethnic population of Malaysia with prostate cancer is important. METHODS: Patients confirmed by transrectal-ultrasonographic-guided-biopsy performed from 2002 to 2008 were enrolled and analysed according to ethnicity, age, PSA level, Gleason score, stage of disease and survival. RESULTS: Among 83 patients, there were 38 Malay, 40 Chinese, 3 Indians and 2 others. Median age at diagnosis was 69.9 (range: 59-93), 43 patients (51.8%) being diagnosed before the age of 70. The median PSA level upon diagnosis was 574 ng/ml (range: 1-8632) and the median Gleason score was 7 (range: 2-10). Over half were already in Stage 4 when diagnosed. The most common site of metastasis was the bone. As a result the commonest prescribed treatment was hormonal manipulation. Five patients underwent radical prostatectomy and a further thirteen patients had radical radiotherapy (stage I: 1 patient, stage II: 7 patients and stage III: 5 patients). Ten patients defaulted follow-up. The median disease-specific survival was 21.9 months (range: 1-53). CONCLUSIONS: Prostatic carcinoma is a disease of the elderly and it is frequently diagnosed late in Malaysia. Greater efforts should be made to educate Malaysians regarding prostate cancer.


Concept for circumcision surgery by non-invasive means. [Abstract]

Gurcharan Singh Tara.
Malaysian Journal of Child Health. 1996; 8(): 198

Conventional surgeries, as we know, are all invasive in nature i.e. they all need to cause a break in the continuity of the skin first, before any surgical procedures can be carried out. Although preferably all surgical procedures ought to be done in a surgical theatre or in an aseptic environment, this unfortunately, is not always the norm in circumcision surgery. In some countries, circumcisions are performed by barbers, generally at the roadsides. They use a barber knife with the scantiest regard for aseptic procedures. In Africa, circumcisions are generally performed in the bush by traditional circumcisers. As a result, post-circumcision problems e.g. infections, etc. continue to persist. The common denominator in all these surgeries, is invasive surgery. The open wound, in the absence of the universal aseptic surgical procedures being observed, therefore carries a real risk of pathogenic contamination. A new concept based on a study initiated in Malaysia, showed that a potentially safer and aseptic circumcision is attainable, if the surgery is performed by using the body's ability to reject non-viable tissues by non-invasive means. As there is no knowledge or information in general surgery and certainly not in circumcision surgery, on absolute non-invasive surgical techniques that could be used, a procedure termed as CLINICALLY INDUCED, COMPLETE AND TOTAL NON-INVASIVE ASEPTIC OCCLUSION has been used with great success, in Malaysia. This procedure is dependent on the concomitant use of a number of factors which do not involve the use of any invasive means or substances. These factors are described in this paper. This method enables circumcisions to be performed aseptically irrespective of whether they are performed in a surgical theatre or out there in the wilds or on the roadsides.


Tara KLamp

Gurcharan Singh Tara, Ziad Azhari.
. 2009; 0():


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