The Interventionalist Journal

OUTCOMES OF SINGLE-STAGE THIERSCH-DUPLAY TECHNIQUE WITH DARTOS FLAP REPAIR FOR MID AND DISTAL HYPOSPADIAS: A SEVEN-YEAR EXPERIENCE IN HOSPITAL PAKAR UNIVERSITI SAINS MALAYSIA (HPUSM)

Muhammad Faeid Othman — 2026-06-30

Background: Outcome data on single-stage Thiersch–Duplay hypospadias repair with dartos flap reinforcement from Malaysian centres are limited. Objective: To evaluate surgical, functional, and cosmetic outcomes of single-stage Thiersch–Duplay repair for mid and distal hypospadias at Hospital Pakar Universiti Sains Malaysia (HPUSM). Methods: This retrospective observational study reviewed hypospadias surgeries performed from January 2019 to December 2025. Among 65 cases, 21 underwent Thiersch–Duplay repair; 2 were excluded due to incomplete data, leaving 19 for analysis. Demographics, operative details, complications, and HOSE outcomes (parental telephone interview) were evaluated. Results: Mean age at surgery was 6.74 ± 4.90 years. Distal hypospadias comprised 13 (68.4%) and midshaft 6 (31.6%); chordee was present in 10 (52.6%). Complications occurred in 5 (26.3%) patients: fistula 2 (10.5%), wound dehiscence 2 (10.5%), and hematoma 1 (5.3%). Revision surgery was required in 3 (15.8%). Mean HOSE score was 14.58 ± 1.50, with 15 (78.9%) achieving HOSE ≥14. Conclusion: Single-stage Thiersch–Duplay repair with dartos flap reinforcement achieved favourable HOSE outcomes with acceptable complication rates at HPUSM.

Key words: Hypospadias; Thiersch–Duplay; dartos flap; HOSE score; Malaysia.

ENDOVASCULAR MANAGEMENT OF TRAUMATIC LUMBAR ARTERY HEMORRHAGE FOLLOWING VERTEBRAL BURST FRACTURE IN NONAGENARIAN.

SHAMINI MANIAM — 2026-06-30

This report describes a case of lumbar artery haemorrhage secondary to vertebral fracture in an elderly patient treated with emergent endovascular embolization. A 91-year-old woman presented after a fall with hypotension and back pain. Initial Focused Assessment with Sonography for Trauma (FAST) was negative. Contrast-enhanced computed tomography revealed multilevel vertebral fractures, active extravasation from the right L3 lumbar artery, and a large retroperitoneal hematoma. Emergency angiography confirmed active bleeding. Super-selective embolization using a Gelfoam-coil sandwich technique achieved complete haemostasis. The patient’s hemodynamic status stabilized, and she recovered without further complications. This case highlights the importance of contrast-enhanced CT and the effectiveness of transcatheter arterial embolization in geriatric trauma.

Key words: Lumbar artery injury, retroperitoneal haemorrhage, geriatric trauma, vertebral fracture, transcatheter arterial embolization

The forgotten sentinel: A comprehensive series of rare spontaneous stent fragmentations in neglected ureteric stents

Selva Raja Palaniappan — 2026-06-30

Spontaneous stent fragmentation with encrustation is a rare complication of neglected ureteric stent offering a unique endourological challenge often requiring complex, staged or concurrent procedure for complete clearance. This study aims to evaluate the clinical presentation, surgical management strategies and outcomes of patients presenting with uncommon neglected and fragmented ureteral stents.