Indonesian Journal of Urology
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NEEDLE RENAL LIFTING TECHNIQUE IN MANAGEMENT OF COMPLICATED PROXIMAL URETERAL LITHOTRIPSY: A CASE REPORT
Get PDFObjective: To described a needle renal lifting technique using an 18-gauge needle to adjunct ureterorenoscopy (URS) in the management of complicated proximal ureteral stones. Case(s) Presentation: A 46 years old man presented with right flank pain for 1 month. This patient was diagnosed with ureteral stone and ureteral kinking that prohibits access to the proximal side of the ureter. Due to difficult access to the proximal ureter, we perform a needle renal lifting technique which is initialized by puncturing the middle renal calyx with 18-gauge needle. Then, the proximal end of the needle was pushed to the caudal direction to move the kidney to the cephalic direction and straighten the kinked ureter. After that procedure, the URS sheat can easily enter the proximal ureter to the stone site. Discussion: The success rate of this procedure is based on the operator skills to access the calyx and perform URS simultaneously. Like a previous technique, needle renal lifting is effective only when the kidney is mobile. Conclusion: The needle renal lifting technique can be used to adjunct URS in the management of complicated ureteral stones which prohibited access to the proximal ureter.
 
COMPARATIVE EFFICACY OF COMBINED LOW-INTENSITY EXTRACORPOREAL SHOCKWAVE THERAPY AND ORAL THERAPY VS ORAL THERAPY ALONE FOR CHRONIC PELVIC PAIN SYNDROME: A META-ANALYSIS OF RANDOMIZED CONTROLLED TRIAL
Get PDFObjective: This study aimed to compare the efficacy of Low-Intensity Extracorporeal Shockwave Therapy (Li-ESWT) and oral therapy combination compared to sole oral therapy for reducing symptoms in CP/CPPS patients. Material & Methods: A systematic search was conducted from the electronic database including PubMed, Clinicaltrial.gov, and Cochrane Library, published up to July 2020 following the PRISMA guideline. We screened RCTs with the inclusion criteria and assessed the quality with the Cochrane Risk of Bias tool. The primary outcome was the National Institute of Health Chronic Prostatitis Symptom Index (NIH-CPSI) and subgroup analysis for triple therapy users was conducted to improve interpretability. The analysis was performed using Review Manager 5.3. Results: A total of 2 RCTs consisted of 91 CP/CPPS patients were analyzed. Pooled analysis showed that compared to the oral therapy only group, combination therapy had a significant lower NIH-CPSI total score at the endpoint of the treatment (MD -7.46, 95% CI -9.85 to -5.07, p<0.001) and NIH-CPSI component pain score (MD -3.48, 95% CI -5.04 to -1.93, p<0.0001), urinary symptoms score (MD -0.96, 95% CI -1.47 to -0.45, p<0.001), and quality of life (QoL) impact score (MD -2.94; 95% CI -3.68 to -2.20, p=<0.001). Conclusion: This review revealed that patients undergoing combination Li-ESWT therapy have lower total NIH-CPSI scores than patients receiving oral therapy alone, this finding is consistent with each component of the score: pain, urinary symptoms, and impact on QoL
THE EFFECT OF CONDITIONED MEDIUM ADIPOSE DERIVED MESENCHYMAL STEM CELLS IN UROTHELIAL CARCINOMA CULTURE CELLS VIABILITY
Get PDFObjective: This study aimed to gives a perspective in CM-ADMSCs effect in urothelial bladder cancer viability. Material & Methods: Human bladder cell carcinoma type 5637 was used as the subject of this in vitro study. This study contains four different groups: untreated control group, Culture medium: hADMSCs with 1:1, 1:2, and 1:4 concentration group. Each group consists of 6 replications to prevent bias of the study. Viability was determined with MTT assay methods and evaluation performed after 48 h exposure of conditioned medium. Results: A post hoc test was conducted to analyze the data. The 5637 bladder cancer cell line demonstrated significantly decreased viability after exposure to culture medium: CM-hADMSCs 1:1 (p: 0.002) compared to the negative control group, but there are no significant differences in viability between the control groups with groups that were exposed to culture medium: CM-hADMSCs 1:2 and culture medium: CM-hADMSCs 1:4 with p: 0.480 and p: 0.060 respectively. Conclusion: Decreased viability of urothelial bladder cancer cells after exposure to CM-hADMSCs occurs at a concentration of 1:1 and Dosage addition more than 1:1 concentration doesn’t give any advantages
PREVALENCE OF LOWER URINARY TRACT SYMPTOMS POST KIDNEY TRANSPLANTATION AND ITS URODYNAMIC PROFILE
Get PDFObjective: This study aimed to describe the urodynamic characteristics of post-transplant kidney patients with LUTS who were indicated for urodynamics. Material & Methods: This research is a cross-sectional study conducted at Cipto Mangunkusumo General Hospital between 2011-2017. Data were collected from patients who had undergone urodynamic examination after kidney transplantation due to LUTS/urinary retention. Data were collected from the patient’s medical record. Results: A total of 536 patients underwent kidney transplants at Cipto Mangunkusumo General Hospital from 2011-2017. Eleven patients (2%) developed LUTS and then underwent urodynamic examination with an average age of 41.4 (30.1 ± 52.6) years. Six patients (55%) had type 2 diabetes mellitus (DM) and 5 patients (45%) had hypertension (HT). A total of 6 out of 11 patients (54%) experienced urinary retention of which 4 subjects (67%) had decreased bladder compliance, 4 (67%) patients experienced detrusor overactivity (DO), 3 patients (50%) had bladder outlet obstruction (BOO), while 2 patients (33%) experienced detrusor underactivity (DU) respectively. Of 5 patients without urinary retention, decreased bladder compliance was found in 1 patient (20%), DO in 2 patients (40%), BOO in 1 patient (20%), and no subject experienced DU. In both groups, no subject was discovered to experience any urinary incontinence. Conclusion: Small number of post renal transplantation patients developed LUTS and half of which accompanied by urinary retention. Among these patients, urodynamic examination revealed detrusor overactivity as the most common underlying problem followed by decreased bladder compliance, BOO, and detrusor underactivit
FIVE YEARS CHARACTERISTIC OF URETERAL TRAUMA IN TERTIARY HOSPITAL IN WEST JAVA FROM 2013-2017
Get PDFObjective: This study aims to determine the characteristics of trauma patients, especially ureteral trauma in Hasan Sadikin General Hospital and expected to be used as data for trauma nationally. Material & Methods: This study was descriptive. Retrospective data collection is taken from medical records of ureteral trauma from 2013 until August 2017 at Hasan Sadikin General Hospital, Bandung. The data obtained are gender, mechanism of trauma, and management of ureteral trauma. Results: A total of 20489 cases of trauma handled in Hasan Sadikin General Hospital, 2.3% is a case of urogenital trauma and 40 of which are cases of ureteral trauma (0.19%). Most ureteral trauma patients are female (90%). Based on the trauma mechanism, 39 patients iatrogenic trauma (97.5%) and 1 patient gunshot wounds (2.5%). From iatrogenic ureteral trauma, 36 patients (90%) had iatrogenic trauma from the gynecological procedure, 5% as a result of the urological procedure, and 2.5% due to gastrointestinal procedure. Management of ureteral trauma is 47.5% ureteroureterostomy and 25% ureteroneocystostomy. Conclusion: Most cases of ureteral trauma are experienced by women, and most commonly due to iatrogenic trauma. Iatrogenic ureteral trauma caused by gynecology procedure is the most common
COMPARISON OF PAIN INTENSITY BETWEEN LIDOCAINE GEL AND INTRAURETRAL TRAMADOL WITH LIDOCAINE GEL IN THE DJ STENT REMOVAL
Get PDFObjective: To determine the difference in pain intensity between the administration of a combination of tramadol and intraurethral lidocaine gel with only lidocaine gel during the removal of DJ stents. Material & Methods: This study was a prospective randomized clinical trial with 22 patients that were divided into 2 groups. Group 1 was given a combination of tramadol and lidocaine gel urethral injection 3 to 5 minutes before DJ stent removal, whereas group 2 was given lidocaine gel urethral injection 3-5 minutes before the removal. The inclusion criteria in this study was all patients with a DJ stent placement with 1 to 3 months prior to release who were willing to participate. The Wong-Baker scale was used directly to determine the scale of pain during the procedure. Mann Whitney analysis was used to analyze the findings. Results: Most patients in group 1 are shown to have a pain rating of 2. There are 2 patients with a high pain rating scale of 6 and 7. In group 2, most patients claimed that the procedure was painless. The average Wong-Baker pain scale in group 1 (2.9) compared to group 2 (0.36) was significantly different. Conclusion: The combination of intraurethral tramadol and 2% lidocaine gel can significantly decrease pain during DJ stent removal more effectively than sole intraurethral 2% lidocaine gel based on the Wong-Baker pain scale
NEFROPROTECTOR EFFECT OF CURCUMIN (CURCUMA LONGA) AND VITAMIN E (α-TOCOPHEROL) IN WISTAR STRAIN RATS AFTER CISPLATIN TREATMENT
Get PDFObjective: To analyze the effect of curcumin and vitamin E on kidney function and inflammatory response of Wistar strain rats that received cisplatin. Material & Methods: An experimental laboratory study with a post-test only control design, using male Wistar strain rats (Rattus norwegicus). Rats were randomized using the simple randomized sampling method. Samples were treated with cisplatin 5 mg/kg (positive control group), vitamin E 100 mg/kg, curcumin 100 mg/kg body, and a combination of both (treatment group), to evaluate its effect on and kidney function and inflammatory response as measured by tumor necrosis factor-α (TNF-α), blood urea nitrogen (BUN) and serum creatinine. Results: There were differences in TNF-α levels in the positive control group (cisplatin 5 mg/kg) against each treatment group (p<0.05). Further analysis showed that there was a significant difference between the treatment group that received vitamin E and curcumin from the treatment group that received a combination of both (P<0.05). In addition, there were differences in BUN and serum creatinine levels in the positive control group (cisplatin 5 mg/kg) against each treatment group (p<0.05). However, there was no significant difference in BUN levels in the treatment group that received vitamin E with the treatment group that received curcumin or a combination of both (p>0.05). No differences were found in serum creatinine levels between treatment groups receiving vitamin E, curcumin, or a combination of both. Conclusion: Vitamin E 100 mg/kg, curcumin 100 mg/kg, and the combination of both have a nephroprotector feature in Wistar rats exposed to cisplatin
ERECTILE DYSFUNCTION AFTER TRANSURETHRAL PROSTATE RESECTION (TURP) IN PATIENTS WITH LOWER URINARY TRACT SYMPTOMS AT KOJA HOSPITAL, JAKARTA
Get PDFObjective: Aim of this study is to identify risk factors associated with erectile dysfunction in post-transurethral prostate resection (TURP) patients for the management of benign prostatic hyperplasia (BPH). Material & Methods: During 2019, 22 patients met the TURP indication criteria in the urology polyclinic of Koja Hospital for symptomatic BPH management. All patients underwent transabdominal ultrasonography to confirm prostate volume and underwent laboratory tests to measure serum prostate-specific antigen (PSA). History of comorbidities such as diabetes mellitus, cardiovascular events, and hypertension was recorded. The patient's sexual function was determined using the International Index of Erectile Function questionnaire (IIEF-5) before surgery and six months postoperatively, where erectile dysfunction was established for scores below 21. Mean comparisons were made to see if there was a significant change in IIEF score six months postoperatively. Results: There were 22 subjects as samples with a mean age of 63 ± 3.8 years, prostate volume 47.64 ± 5.5 mL and a median PSA level of 3.3 [1-47] ng/dL. The comorbidities found in the subjects were diabetes mellitus (22.7%), cardiovascular events (36.4%), and hypertension (27.3%). The mean IIEF-5 score before surgery was 14.55 ± 0.78 and was not significantly different (p= 0.225) with a reevaluation six months after surgery of 14.18 ± 0.76. Conclusion: There was no change in the severity of erectile dysfunction in patients undergoing TURP surgery
THE EFFECT OF CONDITIONED-MEDIUM HUMAN ADIPOSE-DERIVED MESENCHYMAL STEM CELL IN APOPTOSIS OF BLADDER CANCER CELLS
Get PDFObjective: To determine the effect of conditioned medium human Adipose-Derived Mesenchymal Stem Cells (CM-hADMSC) on apoptosis of urothelial bladder cancer cells. Material & Methods: Bladder (5637) cancer cell lines cultured in conditioned media harvested from human adipose-derived mesenchymal stem cells (hADMSC). Flow cytometry tests were carried out using the Flowcytometry Acquisition cell sorting (FACS) Calibur to measure apoptosis. Results: There was a significant difference in the percentage of late apoptosis in the group receiving culture medium treatment: CM-hADMSC 1: 1 to the entire study group. Further analysis revealed no difference in the average percentage of late apoptosis in groups exposed to culture medium: CM-hADMSC 1: 2 and culture medium: CM-hADMSC 1: 4 (p> 0.05). Conclusion: CM-hADMSC at a 1: 1 dose concentration to culture medium obtain a significant increase of apoptosis in bladder cancer cells
COMPARISON OF S.T.O.N.E. SCORE AND GUY SCORE IN PREDICTING STONE FREE RATES OF PERCUTANEOUS NEPHROLITHOTOMY PROCEDURES IN THE SOETOMO GENERAL HOSPITAL
Get PDFObjective: To determine the effectiveness of Modified Guy's Stone Score (GSS) and S.T.O.N.E score (SS) as predictors of stone free rates in patients undergoing PCNL. Material & Methods: The design of this study was a prospective observational analytic. Samples were patients with kidney stones who came to the Urology Polyclinic of Soetomo0 General Hospital Surabaya, which was planned to undergo PCNL surgery, patients who met the inclusion criteria will have a CT stonographic examination then counted for the S.T.O.N.E score and Modified Guy's Stone Score before the PCNL procedure. Postoperative stone size evaluation used KUB X-ray (BOF) to assess Stone Free Rate (SFR). Results: In the ETA statistical test there was a strong relationship between GSS and SFR with a relationship strength value of 0.609, the direction of the relationship between these two variables was positive. This means that the greater the GSS, the less likely the SFR could be achieved. The relationship between these two variables was significant with p= 0.05. While between SS and SFR with a relationship strength value of 0.55, the strength of the relationship in these two variables was positive which indicated the higher the SS, the less likely the occurrence of SFR. But both of them were not statistically significant with p= 0.228. Conclusion: Guy Stone Score (GSS) gives a better predictive value than the STONE score (SS) on the stone free rates in patients undergoing PCNL procedures