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LAPORAN KASUS UROLOGILAPORAN KASUS UROLOGI
VARIKOKELVARIKOKEL
Oleh :
Ib. Udayana Hanggara Yulia trisna Wijaya
I Md adi saputra w
Pt. Dyah widyaningsih
PANDE PUTU PATRIA DEWI
LAB/SMF ILMU BEDAH FK UNUD/RSUP
DENPASAR
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I. IDENTITAS◦ Nama : ING
◦ Jenis Kelamin : Laki-laki
◦ Umur : ! "ahun
◦ Tem#a" Lahir : $an%li
◦ $an%sa : In&'nesia
◦ A%ama : (in&u
◦ Suku : $ali
◦ Peker)aan : PNS
◦ Alama" : $an)ar Ka*an+ $an%li
◦ S"a"us : Pasien P'li
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ANA,NESISANA,NESIS
Keluhan U"ama:
$elum #una anak
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Anamnesa Khusus:
Pasien mr#kn ru)ukan &ari a%ian '%n
RSUP San%lah &en%an Varik'kel %r. I-II.
Pasien men%eluhkan elum #una anak #&hl"elah // "hn menikah. (uun%an seks 0-kali semin%%u. Os men%a"akan s#erma an%keluar "i&ak ermasalah+"i&ak en1er a"ause&iki". Neri saa" erhuun%an2-3. $AK&ika"akan n'rmal+ -4 kali #er hari.
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Ri*aa" #enaki" &ahulu:Penaki" )an"un%2-3+ (TN2-3+ D,2-3+Asma 253 s)k ke1il+ a"uk5#en%'a"an "&k "era"ur.
Ri*aa" #en%'a"an: 2-3Ri*aa" s'sial:
Pasien eker)a s% PNS &i RSJ $an%li+mer'k'k253 s)k umur /6 "hn 7 /0
"%8hari+ minum minumaneralk'h'l2-3.
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PE,ERIKSAAN 9ISIK PE,ERIKSAAN 9ISIK
S"a"us Presen"
KU : aik
TD : /08; mm(%
Na&i : ;< =8meni"
Res#irasi : 0 =8meni"
Tem#era"ur: >+4 :?
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tatus !"n"ral
#"pala
,a"a : k'n)un%"i@a #u1a" -8-+ sklera "i&ak "am#akkekunin%an +
reeks #u#il 585 is'k'r
T(T : T'nsil T/8T/+ (i#eremis 2-3
$"h"r
Kel limBe : I : *arna kuli" N+ a"r'C kuli" 2-3 P : Pemesaran KG$ 2-3 massa 2-3+
Dada
- Paru-Paru
Ins# : #er%erakan naBas sime"ris+ re"raksi "i&ak a&a+ naBas
1u#in% hi&un%2-3Pal# : @'kal Bremi"us n'rmal
Per : s'n'r8s'n'r
Aus : Ves 585 + rh -8- + *h -8-
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- Jan"un%
Ins# : i1"us 1'r&is "ak "am#akPal# : i1"us 1'r&is "eraa &i I?S V ,?L sinis"raPer : a"as )an"un% : Kanan : PSL D Kiri : ,?L SAus : S/S0 "un%%al+ re%ular+ mur-mur "i&ak a&a
Abd%&"nIns : s1ar 2-3
Aus : $U 253 N
Pal : Neri "ekan 2-3+ ha"i &an lim#a "ak "eraa+&is"ensi 2-3
Per : "im#ani
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Pemeriksaan Csik umumPemeriksaan Csik umum
E'tr"&itas :(an%a" 253+ e&ema 2-3Eks" A"as :Tena%a 4448444
T'nus N8N R.Csi'l'%is 585 R.#a"'l'%is 2('Bman
Tr'nmer3-8-Eks" $a*ah :Tena%a 4448444
T'nus N8N R.Csi'l'%is 585 R.#a"'l'%is 2$ainski3 -8-
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tatus l%'alis
R"gi% (an' D)
Ins# : "erliha" massa -8-+ "an&a ra&an% -8-
Pal : neri "ekan -8-+ all'"emen" -8-
Per: neri ke"'k ?VA -8-
R"gi% upra Pubi'
Ins# : massa 2-3
Pal : Vesika ""+ neri "ekan 2-3
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R"gi% !E
skr'"um sinis"ra2's melakukanmanu@er @alsa@a3
Ins#eksi : en)'lan2-3
Pal#asi : en)'lan253 se#er"i1a1in%+ neri "ekan2-3
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P"&"ri'saan *isi' Ta&bahan+%l%' Dubur
Seki"ar anus massa 2-3
,uk'sa rek"um li1in
Am#ula rek"i "i&ak k'la#s
T'nus sCn%"er ani 5 N
Pr's"a" : "&k
k'nsis"ensi #a&a" kenal+n'&ul 2-3
Sul1us me&ianus &a"ar
P'le a"as : "eraa(an& s1h'en : Beses - + &arah -
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Dia#h'n's1'#8"ransilluminasi :"i&ak &ilakukan
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RESU,ERESU,E
Pasien laki-laki+ ! "hn+ (in&u+ $ali+ru)ukan &ari a%ian O%n RSUPSan%lah &%n Varik'kel Gr.I-II. Pasienmen%eluhkan "&k s #una anak s"lh// "hn menikah. Dari #m= Csik: &lma"as n'rmal. Re%i' skr'"um sinis"ra:"eraa en)'lan #a&a &aerah a"as
"es"is saa" 's men%e&an+"eraase#er"i 1a1in% neri2-3.
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Dia%n'sis8Dia%n'sis $an&in%Dia%n'sis8Dia%n'sis $an&in%
Dia%n'sis 2klinis3: InBer"ili"as
Dia%n'sis 1ausa : Varik'kel
Dia%n'sis K'm#likasi : -
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USUL PE,ERIKSAANUSUL PE,ERIKSAAN
Pemeriksaan La'ra"'rium
Darah Len%ka#+ $T8?T+ analisiss#erma
Pemeriksaan Ra&i'l'%is
9'"' R'n%"en Th'rak PA
K'nsul: Pulm'n'l'%i Anes"esi
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?r'ss se1"i'n sh'*in% "he #am#iniB'rm #le=us
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AnalisisAnalisis
A= &an P= : Os men%eluh "i&akmemiliki anak se)ak // "ahunmenikah. Di"emukan en)'lan
eren"uk se#er"i 1a1in% #a&askr'"um kiri+ hilan% "imul mun1ul"eru"ama saa" 's men%e&an. Neri2-3 Tan&a-"an&a ke%anasan "i&ak&i"emukan+ hema"uri 2-3
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Kesim#ulanKesim#ulan
,'&era"e Varik'kel
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Diagnosis kerjaDiagnosis kerja
Diagnosis utama: Moderate Varikokel
Diagnosis penyulit: Infertilitas
Diagnosis penyerta: -
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Usulan Tera#iUsulan Tera#i
Tera#i U"ama 2Varik'kel3:
- Tera#i e"i'l'%i:/. Li%asi "in%%i @ena s#erma"ika in"ernase1ara #al'm' #r'se&ur
0.@arik'kelek"'mi- Tera#i sim"'ma"ik: -
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K'm#likasi "an#a "era#i- #a&a "es"is: a"r'C "es"is
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K'm#likasiK'm#likasi
K'm#likasi "era#i 2Varik'kelek"'mi3- Selama '#erasi: #er&arahan
- Pas1a e&ah &ini: #er&arahan+ inBeksi
l'kal8sis"emik+ hema"'m.- Pas1a e&ah lan)u": hi&r'kel+ neri
an% mene"a#+ rela#s
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Pr'%n'sisPr'%n'sis
Duius a& 'nam
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