Indonesian Journal of Urology
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THE EFFECT OF SUKUN LEAF (ARTOCAPTUS ALTILIS) EXTRACT ON RENAL ISCHEMIA/REPERFUSION INJURY IN WISTAR RATS WITH PARAMETER OF KIDNEY HISTOPATHOLOGICAL FINDINGS SERUM CYSTATIN-C AND SERUM CYSTATIN-C
Get PDFObjective: To determine the effects breadfruit leaf extract (Artocaptus altilis)in Wistar rats, which had induced renal ischemic-reperfusion injury, with evaluation of serum cystatin C level and kidney histopatologic findings. Material & Methods: A total of 30 Wistar rats, three groups of ten, were included in the study and were performed in Bandung Eijkman Animal Laboratory. In group I (sham group), a right nephrectomy was done. In group II (control), a right nephrectomy was also done and the left renal pedicles were occluded for 60 minutes and reperfused for 60 minutes. In group III (treatment), the treatment was equal with group II, and breadfruit leaf extract (4.75%) was administered intraperitoneally. At the end of the study, a left nephrectomy was performed on all groups. Afterward, serum cystatin C levels and kidney histopathological findings of all rats were examined. Data were analyzed by an unpaired numerically comparative analysis with SPSS 20.0 software. Results: The mean of serum Cystatin C in group I was 3183.2 ± 680.9 pg/dL, group II was 3776.4 ± 326.7pg/dL, and group III was 3492.7 ± 1.326.7pg/dL. The mean of histopathology renal score was also assessed, group I was 4.4 ± 0.52, group II was 8.6 ± 0.84, and group III was6.3 ± 1.70. Comparative test of serum cystatin C level, using ANOVA test and Benferroni post hoc test, in the treatment group has a p-value of > 0.05, it showed that there were no significant differences on the value of cystatin C level on the treatment group. In correlation test of renal histopathology score, suing Kruskal-Wallis test and Mann-Whitney post hoc test has a p-value of < 0.05, therefore there were significant differences on the mean value of renal histopathology score in the treatment group, with Eta correlation coefficient 0.847. Conclusion: The beneficial effects of breadfruit leaf extract can be attributed to its protective effects on renal cells damage. This treatment has an important role in reducing renal injury resulting from renal ischemia-reperfusion. However, breadfruit leaf extract did not significantly improve renal function based on serum cystatin C level.
 
COMPARISON OF ILEAL CONDUIT AND TUUC: A 4 YEARS STUDY
Get PDFObjective: This study aims to compare 4 years of experience of IC and TUUC in the same period and among similar experienced surgeons. Material & Methods: Between January 2016 and August 2019, 44 radical cystectomies were performed, but 4 patients were excluded due to incomplete data or who underwent neo-bladder procedures. The primary endpoint was 30 days of complication rate and intraoperative complications. Bowel movement, ambulation, and length of stay (LOS) postoperatively were followed-up over a period of 30-day postoperatively. Results: 12 male patients underwent TUUC and 24 male patients IC, while only 4 female patients underwent IC. The mean of LOS of IC was 12.72 8.6 and 10.08 3.5 for TUUC; there were no significant differences between arms. However, TUUC had lower intra-operatively bleeding (779.17 441.15 ml) compared to IC (1328.57 810.40 ml). There was no difference in early complications between arms. Conclusion: Our results suggest that TUU with UC diversion may be used as a viable option of urinary diversion in radical cystectomy. This technique provides similar safety both surgically and oncologically
FIVE YEARS SURVIVAL AND QUALITY OF LIFE AFTER RADICAL NEPHRECTOMY: A DESCRIPTIVE SINGLE CENTER STUDY
Get PDFObjective: This study aims to evaluate five years of survival rate, and quality of life of the patient after radical nephrectomy in our center. Material & Methods: This descriptive longitudinal study included thirty patients who were diagnosed as having renal mass in the Urology division H. Adam Malik General Hospital between January 2014 and December 2015. All patients were completely followed-up for 5 years or the patient died during the observation. We used a translated and validated Indonesian written European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Version 3.0 (EORTC QLQ-C30) questionnaire to assess the patient’s quality of life. Results: Overall 5-years survival of kidney tumor patients was 100%, 66.67%, 50%, 8.33%, respectively for stage 1 to 4. We found a sharp decrease in the cumulative survival rate of stage IV group in the first 24 months compared to the first 12 months, from 66.67% to 25%. This pattern of decrease was not found in the other group of stage. Overall, the quality of life of patients has increased in the first three years postoperatively and decreased in the two years afterward. These fluctuations consistently occur in all groups. All of the groups had reached the maximum quality of life at the third year postoperatively. Conclusion: Stage I renal cell carcinoma patient shown the best five-years survival rate and quality of life among others. The quality of life for all groups inclined for the first three years after surgery and decline consistently afterward. These findings are in accordance with many studies that have been published previously.
 
A SYSTEMATIC REVIEW: THE ASSOCIATION BETWEEN URINE LEUKOCYTES AND THE TYPES OF URINARY TRACT INFECTION
Get PDFObjective: This study aimed to determine the functional role of the urine leukocyte count on type of UTI. Material & Methods: This is a systematic review study with searches for articles from 2010-2020 through the PubMed, ProQuest, and EBSCO databases. The exclusion criteria in this study are patients using catheters (CAUTI), UTI patients in the Intensive Care Unit (ICU), and pediatric or infant patients. There were 1158 studies found and 3 studies synthesized. Results: There are 1130 patients studied. Age range from 18 to 89.1 years. Three studies showed that there was an association between the number of urinary leukocytes and the type of UTI (Tommaso Cai et al., p < 0.0001; and Alexander R. Levine et al., p < 0.001) and one study had no relationship. Conclusion: There is a relationship between the number of urinary leukocytes with the type of UTI. An increase in the number of urinary leukocytes above the normal limit is the sign of body’s immune response to eliminate uropathogens. The innate immune characteristic factors and the body’s immune response have an important role in causing symptoms in UTI patients
EFFECTIVITY OF LI-ESWT FOR ERECTILE DYSFUNCTION MANAGEMENT BASED ON EHS AND IIEF-5
Get PDFObjective: This study was conducted to determine the effectiveness of LI-ESWT as therapeutic modality in ED patients. Material & Methods: Erectile Hardness Scales (EHS) and International Index of Erectile Function (IIEF-5) scores was measured in 22 patients. The observation was performed before therapy started, each therapy session, and each follow-up session. Therapy sessions were carried out once a month for 8 months and follow-up was done once a month for 8 months. Results: There was a significant increase in IIEF-5 scores since the 5th LI-ESWT therapy session (P<0.05, Wilcoxon Test). Also, there’s a significant increase in EHS score in 1 month after LI-ESWT therapy sessions was completed (P=0.05, Wilcoxon Test). Conclusion: There is a significant improvement in the EHS and IIEF-5 score before and after treatment using LI-ESWT. LI-ESWT seems to be a promising future therapy for ED
IN VITRO STUDY ON NIGELLA SATIVA AS INHIBITOR OF CALCIUM OXALATE CRYSTALLIZATION
Get PDFObjective: This study aims to test the efficacy of Nigella Sativa plant as an inhibitor of calcium oxalate crystallization. Material & Methods: Nigella Sativa alcohol extract was made by maceration of 100 grams Nigella seeds which were dried and powdered for 72 hours and then filtered, so as to produce 100 percent Nigella alcohol extract. Then make dilutions of 10 and 50 percent. The precipitation of calcium oxalate at 37 0C and pH 5.7 was studied by measurement of turbidity at 620 nm with and without inhibitor which is Nigella Sativa. Results: Tmax, the slope of nucleation (SN) and slope of aggregation (SA) was measured with control and with inhibitor. With increasing concentration of inhibitor, Tmax progressively increased, whereas SN and SA decreased. The nucleation percentage inhibition ratio was 86.0% and inhibition of crystal aggregation took place by 66.6% with 100% extract. Crystallization was inhibited (growth and aggregation) in a concentration dependent manner. Conclusion: Nigella Sativa is strong inhibitor of calcium oxalate crystallization. However, comprehensive work is needed to establish the results
SINGLE STAGE HYPOSPADIAS REPAIR IN PRIMARY CASES AND THEIR PATIENT RELATED OUTCOMES – TERTIARY CARE CENTER EXPERIENCE
Get PDFObjective: This study aims to study whether hypospadias repair in primary cases can be done in a single stage. We present patients’ perspective and their outcomes in 268 primary hypospadias cases among which around 90% of patients (n=240) had their hypospadias surgery after recommended age of repair (18 months). All primary cases were managed in a single stage. Material & Methods: From January 2010 – December 2019, 377 patients were included and outcomes were documented. Patients with prior hypospadias with complications (n=48), chordee without hypospadias (n=16), isolated penile torsion (n=12), and 33 patients who were lost to follow-up were excluded. The age at surgery, location of the meatus, chordee, associated anomalies, techniques used for correction, postoperative complications with overall success rate and patient related outcomes were evaluated. Results: After orthoplasty, distal hypospadias was seen in 59% (n=158), middle in 22.8 % (n=61) & proximal in 13.1% (n=35) patients. Fourteen patients (5.2%) had penoscrotal transposition. Chordee was present in 71.2% (n=192) cases. Urethral closure was done using TIP alone in 18 cases, TIP, and spongioplasty (n=233). The success rate of one-stage surgery was 73.5% in our series which correlated with PRO with high significance. Conclusion: The rate of complications increased with the length of urethral tube reconstruction. Hypospadias fistula was the most common, followed by glanular dehiscence. The use of the TIP in primary repairs, spongioplasty & additional buffering layers reduced the complication rates. Patients can have acceptable residual chordee and torsion and their surgical results correlated well with patient related outcomes(PRO)
INVESTIGATIONS AND DIAGNOSIS OF GIANT PERIURETHRAL CONDYLOMA AND EFFICACY OF THE MANAGEMENT WITH CONVENTIONAL APPROACH: A CASE REPORT
Get PDFObjective: This study aims to show our first case of female with periurethral condyloma and how we managed it. Case(s) Presentation: A 40-year-old female came with asymptomatic lesion in the genital area for 4 months, without any history of promiscuity. The physical examination showed a mass of 5 x 5 cm located in the periurethral area. The patient underwent mass excisions without any complication, further pathological examination confirmed the diagnosis of CA. Discussion: After operation and discharge there are no sign of recurrence after 6 months follow up. Conclusion: Despite the rare occurrence in periurethral region, clinicians should be aware of CA case in female and for our first case we used mass excision with satisfactory result
USAGE OF SUPPORTING PAD FOR SUPINE PCNL: A SINGLE CENTER EXPERIENCE
Get PDFObjective: This study aims to compare the safety, efficacy, and other surgical outcomes of supine PCNLs performed with and without the use of supporting pad. Material & Methods: We enrolled 27 patients who undergone PCNL procedure with supine position for renal stones with all sizes between January - December 2019. Divided into two groups, operated with and without supporting pad, with 13 and 14 patients respectively. Inclusion criteria are patients with renal stones, including staghorn, multiple calyx, and proximal ureteral stones. Meanwhile, pediatric patients under 12 years old, uncorrectable bleeding disorders, active urinary infection, and pregnancy are excluded. Results: Our observation showed no statistically significant difference between the two groups, although blood loss and length of stay in supporting pad showed better results. A statistically significant difference was found in stone-free-rate (P = 0.006) favoring in supine PCNL with supporting pad. Conclusion: Supine PCNL with support padding may be a safe and more effective choice to treat renal stones. Nevertheless, the patient’s anatomic variations may influence this. Thus, a prospective study with a larger population is needed to verify our outcomes
MATURE TESTICULAR TERATOMA IN PEDIATRIC PATIENT: A CASE REPORT
Get PDFObjective: To report our experience on management of testicular teratoma in pediatric patient. Case(s) presentation: A 2-years-old boy presented with progressive mass in his left testis. The mass was found 3 months ago but became larger in a few days. The patient had no other genitourinary complaint. Vital signs were within normal limits. A hard and tender mass in the left scrotum sized 5x4x2.5 cm was palpated from the physical examination. An imaging study with Computed Tomography (CT) Scan revealed an enhancement in the left scrotum mass area. There was no ring enhancement in pelvic and paraaortic lymph nodes. The laboratory examination within normal limit. Inguinal radical orchiectomy was performed, and histopathological examination revealed a mature testicular teratoma of the left testis. Discussion: Testicular teratoma in children is usually benign. Testicular germ cell tumors generally have a good prognosis with current therapy. Post-orchiectomy management depends on the histology type, staging, and tumor markers. Conclusion: Testicular teratoma is a rare case and can cause minimal symptoms until it grows significantly. Testicular teratoma should be considered in the differential diagnosis of non-traumatic painless progressive scrotal mass. Inguinal radical orchiectomy may be considered as the primary management