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  • I was very emotional and pleased with my surgical results.  Beverly Hills has a great combination of medical staff, US trained Board Certified surgeons, and a medical facility with no equal.



    nanette m

  • "I was extremely satisfied with the outcome of my procedures"

    I was extremely satisfied with the outcome of my procedures as well as the total experience. I didnt know what to expect going into another co...

    United States
  • I was satisfied with the way they answer my questions.

  • I am pleased with my treatment. It was done professionally and neatly. Dr. Del Rosario is very considerate with the patients concerns. I am very satisfied. I will definitely recommend Beverly Hills Medical Group. It is very hard to communicate...

  • The word is out and its such a small world.   I just met an acquaintance who I havent seen in a year and she mentioned how wonderful an experience she had having surgery in Manila.  I told her about my ...

    H. Mangiani, Italy
  • Urine Extravasation

    What is Urine Extravasation?

    Extravasation is the process of exuding or passing out of a vessel into surrounding tissues; said or blood or lymph or urine.

    Effects of Urine Extravasation

    The effects of extravasated urine are dramatic. The combination of urine and infection produces severe oedema of a patient's scrotum and abdominal wall. If this is not treated, the skin over his scrotum, penis, and anterior abdominal wall may slough. He may be very ill, toxic, febrile, dehydrated, anaemic, or uraemic, or all of these things. If his renal function is impaired, as it often is after a long standing stricture, extravasation may kill him.

    Your Consultation

    The spontaneous extravasation of urine can be diagnosed by Intravenous urography or Ultrasound.

    Assess the patient's fluid and electrolyte state before surgery. He will probably benefit from intravenous fluid replacement, which may be life-saving.

    Control infection with antibiotics. Chloramphenicol will probably be suitable.

    The Urine Extravasation Procedure

    Lay him supine, give him a general anaesthetic and perioperative antibiotics (ampicillin, trimethoprim, or gentamicin). Clean his abdomen, penis, and scrotum, and the upper half of his thighs with 1% cetrimide, followed by 1% alcoholic iodine. (1) Make 5 cm incisions on each side of the base of his penis. Insert your index finger, and open up the tissue planes widely towards his abdomen, and down the shaft of his penis. (2) Make 5 cm incisions on the inferolateral aspects of his scrotum, and use your finger to open up the tissue planes as far as possible. Place two long corrugated rubber drains into the depth of each wound in each direction, and suture them in place. Dress the wounds with gauze and cotton wool.


    Bath him in a bowl of salt water each day. The swelling will usually settle in about 5 days. Shorten the drains 5 cm a day. Areas of necrotic skin and subcutaneous tissue will form. These will take a long time to separate spontaneously, so excise them. When infection has subsided, close the skin incisions by secondary suture, and graft the bare areas (57.2). Don't attempt bouginage again until he is much improved, say at 4 to 6 weeks.


    Extravasation of irrigating fluid can be a life threatening complication when it is unrecognized. The operating room personnel must monitor the input of fluid versus the output from bladder drainage and loss at the table. When a difference of 500cc is reached, consideration should be given to terminating the procedure. Aggressive diuresis and careful electrolyte management are required. Absorption of cold irrigation fluid has more of an effect on thermoregulation than warmed solution. Most patients will recover without long term sequela.


    What is extravasation?

    Extravasation refers to the leakage of a fluid out of its container. In the case of inflammation, it refers to the movement of white blood cells from the capillaries to the tissues surrounding it. In the case of malignant cancer metastasis it refers to cancer cells exiting the capillaries and entering organs.

    What causes extravasation?

    Extravasation is usually associated with acute obstruction and occurs as the result of increased hydrostatic pressure in the renal sinus.