Indonesian Journal of Urology
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SUPER SELECTIVE EMBOLIZATION AND ETOPOSIDE ISOFOSFAMIDE CHEMOTHERAPY ON A PEDIATRIC BLADDER EMBRYONAL RHABDOMYOSARCOMA: A CASE REPORT
Full text linkObjective: This study reports our experience in managing pediatric ERMS cases treated with super-selective embolization and chemotherapy. Case(s) Presentation: We present a case report about a 2-year-old boy with urinary retention. The complaint began with a history of urination difficulty that has not improved with urethral catheter insertion, thus percutaneous cystostomy was performed. However, a mass appeared in the cystostomy wound. Discussion: The biopsy result confirmed the diagnosis as a bladder embryonal rhabdomyosarcoma. Afterward, the patient was treated with super-selective embolization in both of internal iliac artery branches and it succeed to omit the bleeding symptom and growth of the suprapubic mass. The chemotherapy regimen (Etoposide, Mesna, and Ifosfamide) was administered subsequently for 2 cycles and it showed a satisfactory result in form of the reduction of obstruction symptoms and mass volume. Conclusion: Our case report shows that super-selective embolization and Etoposide Isofosfamide chemotherapy can provide adequate local control in a pediatric patient with bladder ERMS.
Keywords: Embryonal rhabdomyosarcoma, etoposide, isofosfamide
TESTICULAR TORSION IN AN ADULT: A CASE REPORT OF AN UNCOMMON CLINICAL IN A 43-YEAR-OLD MALE
Full text linkObjective: This report aims to document the occurrence of testicular torsion in adult males, explicitly highlighting a case involving a 43-year-old man. It emphasizes the importance of maintaining awareness of this condition within the productive age group. Case(s) Presentation: We present a rare unilateral late-onset left testicular torsion case in a 43-year-old male. Testicular torsion is predominantly observed in youth and teenagers, making its diagnosis infrequent in mature individuals. The patient experienced acute testicular pain along with atypical symptoms, which are crucial for the accurate diagnosis of adult testicular torsion. Discussion: Testicular torsion is the most prevalent surgical emergency concerning the testis, primarily affecting younger populations. This case underscores that adult males are also susceptible to this condition, necessitating a high index of suspicion among healthcare providers. Notably, acute testicular pain in adults may not always manifest in a typical manner, complicating timely diagnosis and treatment. Conclusion: This case serves as an essential reminder for healthcare professionals to remain vigilant regarding the potential for testicular torsion in adult males, particularly those in the productive age group. Early recognition and intervention are critical to preventing complications associated with ischemia, underscoring the need for heightened awareness and prompt assessment in such scenarios. By doing so, healthcare providers can significantly improve outcomes for affected patients.
Keywords: Adult, testicular torsion, left testicular
EVALUATING THE EFFECTS OF TADALAFIL ON LOWER URINARY TRACT SYMPTOMS DUE TO BENIGN PROSTATIC HYPERPLASIA: A SYSTEMATIC REVIEW AND META-ANALYSIS
Full text linkObjective: This review aims to assess tadalafil's efficacy and safety in managing BPH-LUTS, providing insights for clinical practice. Material & Methods: A systematic search strategy was conducted across several electronic reference databases (PubMed, Google Scholar, Proquest, and Cochrane) and included articles published between 2014-2024. Duplicate publications, review articles, and incomplete articles were excluded. Results: Database search yielded 302 articles, which were systematically eliminated, leaving 10 relevant articles. A total of 1.645 patients were involved in the 10 included studies. Of the 10 included studies, 9 were single-center studies and 1 was a multi-center study. Of all the studies, 7 were randomized controlled trials, 2 were observational trials, and 1 was a cohort study. From the meta-analysis test, it was found that the increase in IPSS 12 weeks after therapy was no different when administering tadalafil and tamsulosin. Conclusion: In conclusion, tadalafil monotherapy demonstrates comparable efficacy to tamsulosin in treating LUTS/BPH, with its approval stemming from its effectiveness in managing ED. The IPSS score between tadalafil and tamsulosin is considered similar statistically. Studies suggest synergistic effects when combined with alpha-blockers, offering promise for patients with concurrent conditions. Safety findings support its utility across diverse populations.
Keywords: BPH, LUTS, tadalafil
CHARACTERISTICS OF PRIAPISM PATIENTS AT ARIFIN ACHMAD HOSPITAL RIAU PERIOD 2017-2021
Full text linkObjective: To find out the description of the characteristics of Priapism patients. Material & Methods: This research used a total priapism patients in Arifin Achmad Hospital, Riau Province from January 2023 to February 2023. Results: From 7 patients with priapism who met the inclusion and exclusion criteria, most age group were from the 36-45 year age group in 3 (42.9%) patients. History of disease in patients with most priapism was leukemia in 3(42.9%) patients. Conclusion: Classification of ischemic priapism were in 4 (57.1%) patients and non-ischemic priapism was 3 (42.9%) patients and all management of priapism patients was carried out by surgery (100%).
Keywords: Priapism, leukemia, management of priapism
THE CORRELATIONS BETWEEN LESION LOCATION AND URINARY DISORDERS WITH QUALITY OF LIFE IN ISCHEMIC STROKE PATIENTS AT HASAN SADIKIN HOSPITAL, BANDUNG
Full text linkObjective: This study examines quality of life outcomes in post-ischemic stroke patients with urinary disorders at Hasan Sadikin Hospital Bandung in 2023. Material & Methods: This retrospective study analyzed medical registry data from a single center. Quality of life was evaluated using EORTC Core Quality of Life Questionnaire-30 (EORTC QLQ C-30). Descriptive statistics and Chi-Square/Fisher's Exact tests (95% CI, P < 0.005) were used for clinical and demographic data. Multilinear regression tested the relationship between urinary symptom severity and quality of life. Results: The study included 79 ischemic stroke patients in Hasan Sadikin General Hospital. Patients with urinary disorders had an average age of 52 years (SD ± 13.42), mostly within the 50-60 age group. Hypertension was strongly associated with urinary disorders (P < 0.001). Quality of life decline was highest in role and physical function within the functional domain, and fatigue and insomnia within the symptom domain. Age showed no significant relationship with patient quality of life (P = 0.847 and P = 0.804), but a statistically significant link existed between IPSS total score and quality of life functional outcomes in stroke-ischemic patients. Conclusion: A notable link between urinary disorder severity and the functional domain of quality of life was observed. Further investigation into specific quality of life risk factors related to stroke lesion types is recommended.
Keywords: Stroke, ischemia, quality of life, urinary disorders
INTRACTABLE HEMATURIA IN BLADDER CANCER WITH UNILATERAL HIGH GRADE VESICOURETERAL REFLUX: A CONSERVATIVE APPROACH USING INTRAVESICAL FORMALDEHYDE INSTILLATION
Full text linkObjective: This study aims to report a case of intractable hematuria in a patient with bladder cancer after radiotherapy. Case(s) Presentation: This case reported a 41-year-old male with urothelial carcinoma of bladder who came to our hospital hematuria symptoms that arised four months after radiotherapy session. The patient was admitted several times with intractable hematuria along with low levels of hemoglobin, and diagnosed with cystitis radiation. Discussion: Voiding cystourethrogram (VCUG) showed unilateral high grade vesicoureteral reflux (VUR). The patient showed no sign of improvement after transarterial embolization (TAE), radiation, and high-dose of steroids. However, the symptoms finally resoluted after formaldehyde instillation. Conclusion: Patients with a history of bladder cancer who develop hematuria after radiotherapy should be evaluated promptly to exclude the possibility of recurrent disease. The administration of formaldehyde instillation could lower the symptoms of hematuria and maintain hemoglobin levels.
Keywords: Intractabel hematuria, formaldehyde, bladder cancer
EVALUATION OF PAIN SCALE ON CIRCUMCISION PATIENTS UNDER LIDOCAINE HYDROCHLORIDE LOCAL ANESTHESIA
Full text linkObjective: Evaluating the pain scale of circumcision patients under lidocaine hydrochloride local anesthesia. Material & Methods: An observational descriptive research was carried out on 30 children with a body weight of 20-29 kilograms from February 2023-April 2023. Circumcision was performed under 2 ampoules of 2% lidocaine as local anesthesia. Data consisted of pain onset measure using a stopwatch and the pain scale were obtained through the Wong-Baker Face Pain Rating Scale (WBFPRS), these variables were recorded when pain occurs post-local anesthesia effects ends. Results: The average onset of pain is 47.73 minutes with the fastest onset of pain was 20 minutes and the longest onset of pain was 72 minutes. The average pain scale as measured by the WBFPRS is 2.33. Conclusion: The average pain scale in this study was less than 3 which indicated that the pain felt did not interfere with activities.
Keywords: Circumcision, pain, anesthesia, lidocaine
LONG-TERM ADMINISTRATION OF TAMSULOSIN INCREASE APOPTOSIS ON PROSTATE CELL OF BPH PATIENT: STUDY ON TGF-ß1, SMAD-4, AND NF- KB
Full text linkObjective: In this study we aimed to know further mechanism and relation between the long-term usage of tamsulosin with the apoptotic mechanism on prostatic cells of BPH patients qualitatively. Material & Methods: A Case-control study from prostate resection specimens. Subjects were 20 male who underwent the TUR-P procedure, were divided into two groups equally, a group who got long-term administration of tamsulosin 0.4 mg, and one without tamsulosin. TGF-β1 and Smad-4 expression was measured by Enzyme-Linked Immunosorbent Assay (ELISA), meanwhile expression of NF- kB measured by immunohistochemistry assay. Results: There was a significant difference on the Independent T-Test that showed an increase in expression of TGF-β1 and Smad-4 expression and a decrease in expression of NF- kB p= 0.003 (p<0,05) from a group of patients who got long-term oral administration of tamsulosin 0.4 mg, compared with a group of patients who didn’t get any treatment. Conclusion: Long-term tamsulosin would induce an apoptotic process in the prostate cells shown by the activity of TGF-β1, Smad-4, and NF- kB.
Keywords: BPH, tamsulosin, TGF-β1, Smad-4, NF- kB, apoptosi
EFFECT OF RED GINGER (Zingiber officinale Rosc. Var Rubrum) ETHANOL EXTRACT OR SILDENAFIL IN LIBIDO: A COMPARATIVE STUDY USING MALE WHITE RATS (Rattus norvegicus) MODEL WITH DIABETES MELLITUS
Full text linkObjective: To compare the effect of red ginger ethanol extract and Sildenafil on increasing the libido of diabetic rat models and determine the dose that significantly affects the increase in libido of diabetic rat models. Materials & Methods: This study is an experimental was conducted on 30 male Sprague dawley white rats divided into 6 groups, namely normal control group, negative control group, sildenafil positive control group, 200 mg ginger group, 400 mg ginger group and 600 mg ginger groupstudy consisting of test animal groups: normal control group; negative control; positive control with sildenafil administration, and treatment groups consisting of: dose I (200mg/kgBB); dose II (400mg/kgBB) and, dose III (600mg/kgBB). All groups except the normal control received alloxan induction at the initial stage of testing. The effect of increasing the libido of rats is seen from sexual activity including: latency of copulation, latency of riding (climbing) and frequency of riding. Results: The results of this study indicate that the administration of red ginger ethanol extract at a dose of 400mg/kgBB or 600mg/kgBB has the same potential as sildenafil in increasing the libido of diabetic rat models. Conclusion: The administration of red ginger ethanol extract at a dose of 400mg/kgBB or 600mg/kgBB has the same potential as sildenafil in increasing the libido of diabetic rat models.
Keywords: Red ginger, libido, diabetic rat models
QUALITY OF LIFE OF ADVANCED CERVICAL CANCER PATIENTS WITH PERCUTANEOUS NEPHROSTOMY IN HASAN SADIKIN HOSPITAL BANDUNG FROM 2018-2020
Full text linkObjective: This study aims to assess the quality of life patients with advanced stage of cervical cancer in RSUP Dr. Hasan Sadikin Bandung from 2018-2020. Material & Methods: This is a retrospective cohort study. The data collected from woman with advanced stages of cervical cancer without history of mental health problems or recurrent cancer, and interviewed using a validated EORT CQLQ-C30 questionnaire to assess their quality of life, and functional status based Karnofsky Performance Score (KPS) and Eastern Cooperative Oncology Group (ECOG) Performance Scale. Scores are calculated into raw score and linear transformation to standardized the range of 1-100. Results: 77 women were included in this study. The average age was 47.98 ± 8.46 years. Cervical cancer predominated by stage IIIa and IV (37,66%) with bilateral nephrostomy (58.44%). This study revealed an average of 63.1 in overall health status, which means there is an improvement over patient’s symptoms resulted from the insertion of nephrostomy, and a poor quality of life with an average score of 48.3 which shows the progression of cervical cancer conditions suffered by patients. Conclusion: The use of nephrostomy in patients with advanced-stage cervical cancer (IIIa, IIIb, and IV) could help alleviate patient’s symptoms, but the progressive condition of cervical cancer has made the patient's quality of life continue to decline. This is shown by the poor quality of life score in the advanced stages of cervical cancer patients, even with nephrostomy insertion. A better understanding of the complexity of the relationship between patient’s quality of life, cervical cancer staging, and the use of nephrostomy is necessary to help cervical cancer patients deciding the best consent before any actions taken.
Keywords: EORTC QLQ-C30, cervical cancer, quality of life