Indonesian Journal of Urology
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URINALYSIS AS PREDICTOR OF UPPER-TRACT URINARY STONE ON COLIC PAIN PATIENTS: SINGLE-CENTER COHORT STUDY
Get PDFObjective: There was no study in our country especially in our hospital that studied correlation between urinalysis and upper tract urinary stone on colic pain patients, so we conducted the study. Material & Methods: We_collected patients' data with colic abdomen from January 2018 to January 2020 then divided into hematuria and non-hematuria group respectively. We excluded patients with lower-tract urinary stones, DJ-stent insitu, BPH, and malignancy. All patients had urinalysis and abdominal ultrasound, then continued with non-contrast abdominal CT-Scan or Intravenous Urography. Retrospective and prospective cohort study was performed to collect data: age, sex, serum ureum and creatinine, urinalysis results (pH, specific gravity, nitric, leucocyte, erythrocyte, crystal, and bacteria), stone number, site, and size, then analysed the relationship between urinalysis results with upper-tract urinary stone incidence using point biserial correlation. Results: We found 235 colic patients, 115 and 120 patients in hematuria and non-hematuria group respectively. Male patients were higher, 137_(58.3%). The highest incidence was in the range 41-50 years-old_(30.6%), mean 46.5313,53 years-old. Stone incidence was 55.7% in all colic patients. Stone was proven 78.3% and 34.2% in hematuria and non-hematuria group respectively. There was significant association between upper-tract urinary stone and haematuria compared to non-haematuria patients (p<0.05). Relative-risk (RR) was 2.29, CI_95%. Conclusion: Hematuria increases two-folds probability of upper-tract urinary stone. It is necessary to expand population data and follow-up center to make this representativ
A GIANT BLADDER STONE IN A YOUNG FISHERMAN FROM MOLUCCAS: A CASE REPORT
Get PDFObjective: To present a rare case of a giant bladder stone. Case(s) Presentation: We report a 20-year-old fisherman, with excessive exposure to sunlight, poor fluid intake, and unhealthy lifestyle, who came to the hospital clinic with a 2-year-history of progressing dysuria, frequency, and hematuria. Investigations revealed a giant bladder stone without bladder outlet obstruction. Open cystolithotomy was performed and a giant stone with 13.2x8x8.3 cm in size was extracted without adhesion to the bladder wall. Discussion: A Giant bladder stone is a rare disease and fewer than 100 cases have been reported globally. Patients commonly are accompanied by multifactorial conditions and have a wide range of presentations. Conclusion: This case presents a giant bladder stone without bladder outlet obstruction in a young adult, it is considered that the stone rose due to other significant factors that followed the patient
THE EFFECT OF TURMERIC EXTRACT (CURCUMA LONGA) ADMINISTRATION IN KIDNEY HISTOPATHOLOGY FEATURES OF SPRAGUE DAWLEY RAT INDUCED BY 7,12-DIMETHYLBENZ(A)ANTHRACENE (DMBA)
Get PDFObjective: The purpose of this study was to understand the effect of turmeric extract (Curcuma longa) on the histopathology features of male Sprague-Dawley rat’s kidney induced with 7,12-Dimethylbenz(a)anthracene (DMBA). Material & Methods: This is an experimental design with post-test only control group design with 6 experimental groups and 30 samples. A comparison model was made by comparing the first group (K1) received no DMBA and the second group (K2) received DMBA alone. Four groups (K3, K4, K5, K6) received DMBA and different dosages of turmeric extract. The exposure was given for 14 days and histopathology features of the samples were assessed using the Gibson-Corley scoring system for Interstitial Tissue Damage. The data obtained was analyzed using One-sample Kolmogorov-Smirnov normality test and then analyzed with the Dunnett t-test. Results: The interstitial tissue damage in the negative control group (K1) and positive control group (K2/DMBA) was found to have a significant difference (p 0.000). There was no significant difference between DMBA only (K2) group and the group with turmeric administration groups (K3, K4, K5, K6) (P<0.05). Conclusion: DMBA can alter kidney histopathology features of male Sprague-Dawley rats. Administering turmeric (Curcuma longa) orally did not cause a change in kidney histopathology features of male Sprague-Dawley rats induced by DMBA
ACTIVITY BASED COSTING METHOD IN DETERMINING UNIT COST OF LITHOTRIPSY FOR TREATMENT OF URINARY BLADDER CALCULUS AT VITA INSANI HOSPITAL PEMATANGSIANTAR
Get PDFObjective: To determine the unit cost of lithotripsy for treatment of urinary bladder calculus at Vita Insani Hospital Pematangsiantar. Material & Methods: This study is a descriptive quantitative study, in which the data was obtained from the finance division of Vita Insani Hospital. The research object is the unit cost of accommodation that occurs in patients with urinary bladder calculus with lithotripsy cases from January 2020 to December 2020. Results: The unit cost of lithotripsy for urinary bladder calculus services at Vita Insani Hospital Pematangsiantar which is calculated using the activity-based costing (ABC) method is Rp 4.167.009. There is a difference in cost among the ABC method, hospital calculations, and INA CBG’s rates with the following details: the amount calculated for the hospital is Rp 4.996.718, while the calculation using ABC method is Rp 4.167.009; the difference in costs is Rp 829.709. INA CBG’s rates Rp 6.137.500, and compared to calculation of hospital, the difference cost is Rp 1.140.782. Compared to the INA CBG’s rates, to the unit cost of the ABC method, there is a difference, amounting Rp 1.970.491. Conclusion: The results of unit cost lithotripsy for treatment of urinary bladder calculus through the ABC method are lower compared to hospital calculation and INA CBG’s rates
PERCUTANEOUS NEPHROSTOMY FOR OBSTRUCTIVE UROPATHY MANAGEMENT IN CERVICAL CARCINOMA
Get PDFObjective: This study aims to evaluate the role of percutaneous nephrostomy (PCN) in treating patients with hydronephrosis due to complications of cervical cancer. Material & Methods: This research was a retrospective analytical cohort study. All medical record data of patients with a diagnosis of cervical carcinoma and undergoing percutaneous nephrostomy at Soetomo General Hospital in 2017 – 2020 were collected and analyzed. Results: A total of 45 subjects were included in this research. The mean age of the subjects was 55.07, with the youngest being 34 years old and the oldest being 75 years old. Most of the subjects were stage IIIB cervical carcinoma (95.56%), and the rest were stage IIB. Contralateral PCN was required in 75.56% of subjects, and the rest only required unilateral PCN. Before being PCN performed, some patients had moderate HN (64.4%), and after the patients underwent PCN procedure, the majority of patients had the HN resolved (48.89%) (p<0.05). There was also an improvement in the laboratory parameter of urea and creatinine serum before and after PCN (p<0.05). Conclusion: PCN improves the laboratory and radiologic parameters of cervical cancer patients with hydronephrosis
DEMOGRAPHIC STUDY AND THE MANAGEMENT OF URETHRAL STRICTURE IN H. ADAM MALIK GENERAL HOSPITAL
Get PDFObjective: This study aims to describe the demographic data and clinical characteristics of patient
with urethral stricture in Adam Malik Hospital. Material & Methods: This research was a retrospectively designed descriptive study, with a consecutive sampling method. Data such as age, clinical symptoms, length and locations of stricture, and the type of operation conducted, were obtained from medical records from May 2013 to June 2017. All subjects had given consent that their medical records can be involved in this research. Results: 60 urethral stricture cases were found, with trauma as a major cause with a percentage of 58.3% of the cases. While the iatrogenic cause (combining post cystoscopy and post operation) contributed only 15% of the total cases. The mean age for subjects was 34.07 ± 2.044 and most of them complained about urinary retention and difficulty in initiating micturition (hesitancy). In contrast, the symptoms that were rarely revealed by subjects were weak stream and pain during micturition, with total of only 3.4% of the cases. A large part of the urethral stricture cases originated from the Bulbous part (30%) with the stricture mean length is 18.32 ± 1.944, and the part where stricture would least likely happen is the membranous and the prostatic part (8.3%). Urethrotomy (Sachse) was the favorite surgical technique used by urologists to manage urethral strictures. Conclusion: This research showed that the characteristics of patients who were diagnosed having urethral stricture in Indonesia are similar with the results from other studies conducted before. It also showed even though urethroplasty has vast advantages compared to the conventional urethrotomy (Sachse), it was still underappreciated by the surgeons.
 
THE ROLE OF R.E.N.A.L NEPHROMETRY SCORE TO PREDICT PERIOPERATIVE OUTCOME FOLLOWING PARTIAL NEPHRECTOMY IN A NATIONAL REFERRAL HOSPITAL
Get PDFObjective: This study aim to see the significance of R.E.N.A.L-NS in our center. Material & Methods: We retrospectively collected all the data of RCC patients that underwent partial nephrectomy (PN) in Cipto Mangunkusumo Hospital from January 2010-January 2018, with complete CT-scan examination. Patients with single kidney were excluded from our study. We evaluated intraoperative blood loss, length of operation, post operative length of stay, post operative kidney function, and complications as the perioperative parameters. Patients were categorized into 3 category based their complexity from RENAL-NS into: low (4-6), moderate (7-9), and high (10-12). Complications were based on Clavien-Dindo classification. Perioperative outcomes were analyzed based on the stratification of the patients and analyzed using ANOVA and chi-square. Results: We evaluated 25 partial nephrectomy cases which are suitable with inclusion and exclusion criteria. There were 8 (32%) low, 14 (56%) medium, and 3 (12%) high complexity cases. Median age of patients were 61 (46-71) years old, with mean tumor diameter 72.07 (+ 38.9) mm. Nine (36%) patients underwent open procedure and 16 (64%) underwent laparoscopic procedure. The laparoscopic procedure was tend to the lower complexity of R.E.N.A.L score (p=0.048). Higher complexity of R.E.N.A.L score correlated with higher blood loss (p<0.001), length of stay (p<0.001), complication rate (p<0.001), and length of operation (p=0.033). Conclusion: R.E.N.A.L-NS has a role for a selection of type of procedure and a prediction of perioperative outcome in partial nephrectomy. R.E.N.A.L-NS can be used in daily basis as it could determine the procedure and several outcomes of the partial nephrectomy procedure
PREVALENCE OVERACTIVE BLADDER AT TERTIARY HOSPITAL : A RETROSPECTIVE SINGLE CENTER STUDY
Get PDFObjective: Overactive bladder (OAB) is a chronic medical condition that has a tremendous impact on the quality of life for both men and women. Urgency is a primary symptom in diagnosing OAB and is closely related to the urge to urinate frequently during the day. Material & Methods : A retrospective study was conducted from January 2018 until December 2020 by using medical records database in our institution. There were 562 patients. Inclusion criteria used in this study are patients with OAB symptoms with any etiology who have undergone conservative, moderate, or future or postoperative measures in the study period. The patient who cannot be cooperative in filling out the International Prostate Symptom Score (IPSS) questionnaire or the patient who refuses were excluded from this study. Statistical analysis was performed using Pearson correlation and linear regression. Results: From the results, linear regression, obtained significance (p <0.05) on the variables of frequency, urgency and nocturia. A linear regression value of y= -0.005 + 0.987X was obtained which illustrates that the higher the frequency, urgency and nocturia variables, the higher the possibility of Lower urinary tract symptoms (LUTS) that can be correlated with OAB. Conclusion: Frequency, nocturia, and urgency are factors that influence the significance of the IPSS variable on the total IPSS score. Questionnaire items on overactive bladder symptoms score (OABSS) have a significant correlation with IPSS scores
MIRNA-92A PROFILING IN MUSCLE INVASIVE AND NON-MUSCLE INVASIVE BLADDER CANCERS IN RSUP DR SARDJITO YOGYAKARTA
Get PDFObjective: The purpose of this study was to determine the expression of miRNA-92A in Bladder Cancer can be used as a marker of tumor. Material & Methods: This study used a total of 30 samples. 15 samples of non-invasive bladder cancer and 15 samples of muscle invasive bladder cancer. The sample was obtained in the Anatomical Pathology laboratory from January 2016 to December 2016. Tumor tissue then extracted miRNA-92A with a RT-PCR examination with Total miRNA Mini Kit FavorPrepTM. The result is done by Mann Whitney U test. Results: The mean expression of miRNA-92A in non-muscle invasive bladder cancer is 12.75 while in muscle invasive bladder cancer had an average value of 31.79. The Mann Whitney U test was used to evaluate the median difference between these groups. There was a significant difference in the expression of miRNA-92A in both groups with P = 0.000 (<0.005). Conclusion: There is a significant difference between the expression of miRNA-92A in non-muscle invasive bladder cancer compared to muscle invasive bladder cancer with more dominant expression on muscle invasive bladder cance
USAGE OF PARAMEDIAN APPROACH FOR CONTINUOUS AMBULATORY PERITONEAL DIALYSIS CATHETER INSERTION TECHNIQUE AND COMPLICATION
Get PDFObjective: This study aims to review the usage and complication of paramedian approach for CAPD catheter insertion. Material & Methods: This is a retrospective study. All ESRD patients ongoing CAPD at the Dialysis Clinic of Zainoel Abidin General Hospital in Aceh, Indonesia between January 1, 2009 and December 31, 2018 were included in the present study. Complication outcomes included mechanical and infectious complications are documented and reviewed. Results: A total of 190 ESRD patients had been performed CAPD catheter insertion using paramedian approach in this period. Out of these patients, complication occurred in 31 cases (16.32%). All the complication that occurred in this study are 5 cases of leakage (2.63%), 9 cases of infection (4.74%), 8 cases of drainage problem (4.21%), 9 cases of malposition (4.74%), and no case of bowel perforation. From total of 9 cases of infections, 1 patient had peritonitis from the catheter insertion. The other infection was exit site infection. Conclusion: CAPD catheter insertion using paramedian approach is safe with low complication rates. It could decrease post-operative complications and can be recommended for CAPD catheter insertion technique due to its safety