Indonesian Journal of Urology
Not a member yet
480 research outputs found
Sort by
VALIDATION OF AFFORDABLE AND APPLICABLE KIDNEY PHANTOM MODEL (AARM) FOR ULTRASOUND-GUIDED PERCUTANEOUS NEPHROSTOMY SIMULATION
Get PDFObjective: Percutaneous nephrostomy (PN) is a medical skill that requires the repetition of hand and eye coordination exercises. The limited opportunity to achieve learning curve at mastering it, increases the morbidity risk to the patient. We therefore developed an Affordable and Applicable Renal Model (AARM) phantom to simulate percutaneous nephrostomy with ultrasound (USG) guiding. Our goal is to present the development of an affordable cost kidney phantom model and evaluate validity (face, content, and construct) with its reliability. Material & Methods: The AARM phantom made from mixture of gelatin, glycerin and sorbitol, then molded with latex gloves comprising the parenchymal portion and the renal pelvicalyceal system connected to a 10Fr nasogastric tube and a 20 cc syringe. Phantom then assessed by urology residents at Hasan Sadikin Hospital Bandung. Senior resident (n=20) who are adept at performing independent PN then compared with junior resident (n=15), and then we analysis both group skills by measure PN initial puncture time and its failure to establish its validity and reliability. Results: This phantom cost production was 30USD (400.000 IDR) and after tested by urology residents, it had simulated the series of PN action steps which described the face and content validation test, with correlation results (Pearson, p<0.05); Very strong (53.8%), strong (30.8%), and medium (15.4%). The reliability test with cronbach alpha value was 0.934 (reliable if cronbach alpha>0.60). The average initial puncture time measure and PN failure result of junior and senior residents are respectively 37.03 ± 9.5 vs 10.90 ± 0.65 seconds and 4.93 ± 1.33 vs 0.75 ± 0.63 times. When both skills performance was analyzed, the senior resident showed significantly (p<0.01) faster and fewer errors. Conclusion: This AARM phantom had successfully represent the whole sequence actions key step of PN skills and this study has been established its validity (face, content and construct). In addition, this phantom material not only made from affordable cost but also applicable and could be used repeatedly (recycled). We propose the use of this AARM phantom simulator as an initial steps practices to introduce percutaneous nephrostomy skills to residents before they went to the operating room
COMPARISON OF PAIN DEGREES USING VISUAL ANALOG SCALE (VAS) IN VARICOCELE PATIENT AFTER MICROSURGERY VARICOLECTOMY COMPARED TO NON MICROSURGERY VARICOCELECTOMY PROCEDURE AT HASAN SADIKIN HOSPITAL BANDUNG IN 2014 – 2015
No full textObjective: This study aimed to report the demographic, presentation, and compare the pain degree after varicocelectomy procedure at Hasan Sadikin Hospital Bandung from 2014 until 2015. Material & Methods: We study the demographic, presentation, and outcome of varicocelectomy to pain degree in patient who came to Hasan Sadikin Hospital Bandung from 2014 until 2015. Results: The mean age of patients was 29.43 years old. Patient consist of 2 (2.89%) patients with varicocele grade I, 32 (46.37 %) patients with varicocele grade II, 33 (47.82%) patients with varicocele grade III, and 2 (2.89 %) with varicocele grade IV. We found incidences of varicocele at the right side in 1 (1.44 %) patient, at the left side in 34 (49.27%) patients, and at bilateral in 34 (49.27%) patients. Thirty eight patients (55%) patients underwent non-microsurgical varicocelectomy and 31 (45%) patients underwent microsurgical varicocelectomy. 22 (57.89%) patients still had pain after non microsurgical varicocelectomy and 30 (96.77%) patients had no pain after microsurgical varicocelectomy. Only one (4.34%) patient experienced scrotal pain after microsurgical varicocelectomy but the pain relieves after 6 months postoperative. Conclusion: Microsurgical varicocelectomy is an effective treatment of varicocele. Our comparative study among open surgical and microsurgical varicocelectomy has confirmed microsurgical varicocelectomy has a better postoperative outcome
THE SIZE OF EXTERNAL URETHRAL MEATUS ON MAXIMUM STRETCH IN WEST JAVA PEDIATRIC MALE: IS THERE ANY CORRELATION WITH AGE?
No full textObjective: To determine the average size of external urethral meatus in children in West Java, and to find out whether there was a correlation between the size of external urethral meatus and age of boys in West Java. Material & Methods: This research was an analytical with prospective study design. Our research subjects consist of children hospitalized between November 2017-November 2018 at Hasan Sadikin General Hospital, Bandung. Measurement is done by measuring the diameter of the external urethra using meatal calibrator, recorded as meatus size on a French scale. Inclusion criteria in this study were all pediatric patients aged 0-12 years who consented to be involved in the study. The exclusion criteria were patients who had urethral diseases such as hypospadias, epispadias, strictures, and history of instrumentation and interventional procedures on the urethra. After data collection, data were analyzed using SPSS 18. Results: We included 187 patients in our study, with the youngest being 1 month old and the oldest being 12 years. We documented the mean external urethra meatal measurement and grouped the subjects into 4 age groups. The average size of the external urethral meatus in the infant age group (0-12 months) was 5.82 Fr, the toddler age group (1-3 years) it was 6.34 Fr, in the preschool age group (3-6 years) it was 8.51 Fr, and in the primary school age group (6-12 years) it was 12.90 Fr. Based on the results of measurements, there is a correlation between age and external urethral meatal size (p=0,000). The older the child, the greater the size of the external urethral meatus obtained. Conclusion: The size of the external urethral meatus maximum stretch in boys in West Java increases with age. The results of this study are expected to be used as a reference of normal anatomical size, particularly the external urethral meatal size in boys in West Java
SCAPHOIDAL MEGALOURETHRA: A RARE CASE PRESENTATION
Get PDFObjective: To propose reduction urethroplasty as a technique for urethral reconstruction for scaphoidal megalourethra. Case(s) Presentation: A male child with the age of one year and four months was known to suffer from megalourethra when dorsumcision was done. The procedure was done starting with marking sutures at the penile gland. Disclose the penile skin as proximal as possible. When disclosed, identify the urethra and dilation was seen so as a finger could be inserted for around 2 centimeters. Urethra was incised, then excise the excess urethral tissue, suturing was done based on the 6F Folley catheter to the point where the urethra dilates. After Folley catheter was inserted, inversion suture was done on the urethra with PDS 6.0 and glanulopasty with PDS 6.0. After evaluation, urethral lumen was found not narrowed, skin was sutured with PDS 6.0. Cystostomy was inserted to divert urine and maintained until one week post-operation. Discussion: Cosmetic and functional results were good and satisfactory. Patient could urinate with no hindrance. Post-operation complication was not found. However, erectile function was difficult to obtain in pediatric patients. Conclusion: Megalourethra is a rare case that needs appropriate diagnosing and management to prevent complication. Operation technique of reduction urethroplasty was done as the chosen management for scaphoidal megalourethra. Furthermore, more in depth research with better methodology was needed to determine the outcome of patients with megalourethra
METABOLIC SYNDROME TRAITS IN UROLITHIASIS PATIENTS
Get PDFObjective: To explore the relation of MetS and urolithiasis in our center. Material & Methods: This is a prospective study of all patients diagnosed with urolithiasis in Kardinah Hospital, Tegal, from April to June 2018, who were screened for metabolic syndrome criteria. The data was collected from the medical record and analyzed with SPSS ver. 23. Results: We included 71 cases of urinary tract stone in our center. 8.4% of the patients didn’t undergo definitive therapy for stones caused by patients’ preferences or the surgery being postponed with various reasons. The patient's mean age is 54.7 ± 11.24, with a male to female ratio 2.4:1. The average BMI is 20.9 ± 2.3 kg/m2. Most of the stones are found in kidney (38.0%) and bladder (26.8%). The average blood pressure is 127.2 ± 7.96 mmHg for systolic pressure and 81.6 ± 5.77 mmHg for diastolic pressure. The average values of lipid profile include total cholesterol, high- and low-density lipoprotein, and triglyceride were 177.0 ± 35.92, 52.0 (27-96), 107.3 ± 37.58 and 131 (50-406), respectively. The mean of patient’s blood glucose level is 122 mg/dL, and the highest level is 203 mg/dL. Conclusion: Not all of the MetS traits found in our patients in Kardinah Hospital. The HDL level is the only variable that shown abnormal level and it could be included into one of the MetS criteria of diagnosis. Thus, this observational study needs further research to confirm the correlation between urolithiasis and MetS, and also the underlying mechanism
THE ASSOCIATION OF URINARY SPECIFIC GRAVITY AND ACIDITY WITH UROLITHIASIS
Get PDFObjective: This study aimed to know the association between urinary specific gravity and acidity with the formation of urolithiasis. Material & Methods: This retrospective descriptive study was conducted among proven urolithiasis patients reporting to the Kardinah Hospital, Tegal. The patient’s age, gender, anatomical sites of the stone, and biochemical parameters were obtained from the case records. The correlation of kidneys stone with specific gravity and pH changed according to anatomical sites of stone was analyzed by One way Anova. Results: The resulted show urinary stones patients with lower pH tend to have a higher probability of stone formation but not specific to its location. Higher pH values were found in the patient with urinary stones at the kidney, ureter, and also bladder. The average of specific gravity in ureter stone patients was lower than stones on other sites. One-way ANOVA shows no statistically significant difference in patient's urinary pH with stones on different sites, but there is a statistically significant difference in specific gravity examination (p<0.05) on ureter stone patients compared to other locations. There is a statistically significant difference (p=0.000) of urine specific gravity of ureter stone compared to other anatomical sites with the lower mean value. Conclusion: A decrease in urinary pH is associated with the risk of urinary stone formation. The specific gravity value of the patient’s urine with kidney and bladder stones is higher than the patient with ureter stones but there is no association of urine specific gravity toward the risk of urinary stone formation
COMPARISON OF INTERLEUKIN-6, PROCALCITONIN AND C-REACTIVE PROTEIN AS A DIAGNOSTIC BIOMARKER IN PATIENTS UROSEPSIS
Get PDFObjective: To compare the diagnostic value of Interleukin-6 (IL-6), Procalcitonin (PCT) and C-Reactive Protein (CRP) in detecting urosepsis. Material & Methods: This study is an analytical descriptive cross-sectional study about the diagnostic value of IL-6, PCT, and CRP to determine the diagnosis of urosepsis. The study sample consisted of all SIRS patients with urological disorders. The entire sample was examined by IL-6, PCT, CRP, and urine culture as the gold standard diagnosis. Data were analyzed using 2x2 table analysis and ROC curve to obtain AUC value. Results: There are a total of 36 samples in this study. With a cut-off 140 pg/ml, IL-6 provides a sensitivity, specificity, Positive Predictive Value (PPV), Negative Predictive Value (NPV), Positive Likelihood Ratio (+LR) and Negative Likelihood Ratio (-LR) was 95.8%, 83.3%, 92%, 90%, 5.75, and 0.05 with AUC 90.8% (95% IK 80.2% -100%, p<0.001). Sensitivity and specificity for PCT with cut off 0.65 ng/ml were 75% and 83.3%. The sensitivity and specificity for CRP with cut off 41 mg/l was 70.8% and 58.3%. The AUC of PCT and CRP was 81.1% and 66.5%. Conclusion: IL-6 has the best diagnostic value followed by PCT and CRP in urosepsis cases. IL-6 can be used as a biomarker diagnostic of urosepsis
COMPARISON OF THE EFFECTIVENESS OF EXTRACORPOREAL SHOCKWAVE THERAPY (ESWT) AND TADALAFIL ON ORGANIC ERECTILE DYSFUNCTION
No full textObjective: To find a comparison of the effectiveness of ESWT and Tadalafil on organic erectile dysfunction. Material & Methods: This is a Quasi Experiment study that was carried out from February 2018 to April 2018. ESWT treatment was performed in Urology Outpatient Clinic. Cialis 10 mg was used in cased of Tadalafil. The sample size is 40 patients consists of 20 patients each treatment. The data was processed with a significance limit of p<0.05. Results: The sample age average is 61.7 years, the level of total cholesterol is 191 mg/dL, FBG 112.5 mg/dL, 2hPPBG 134.5 mg/dL, HDL 44.9 mg/dL, LDL 137.5 mg/dL, ureum 27 mg/dL, and creatinin 0.8 mg/dL. The proportion of Diabetes Mellitus patients in this study is 50% and hypertension 57.5%, which is 15% of them belong to mild erectile dysfunction category, 37.5% mild to moderate, 5% moderate, and 42.5% severe. We found an increasement of EHS on 75% patients that were treated with ESWT and 5% on patient that were treated with Tadalafil, and it is statistically significant (p<0.05). Conclusion: We found that ESWT and Tadalafil can increase EHS of organic erectile dysfunction patients, which ESWT is more effective than Tadalafil
SUPERIOR INFERIOR CALYCES AXIS IN SAGITTAL VERSUS CORONAL PROJECTION OF NON CONTRAST ABDOMINAL MULTISLICE COMPUTED TOMOGRAPHY: AN ANATOMICAL STUDY IN SUPINE PCNL
No full textObjective: Getting the right access to the kidney calyces that has been determined is the most important part of PCNL. Less optimal access can cause an increase in operating time and a decrease in stone free rate. The use of inferior calyx as access decreases the risk of complications, but there are difficulties in reaching the superior calyx, which affects the stone free rate. The angle and depth of the puncture on PCNL can be determined by coronal and sagittal cuts in the non contrast MSCT scan of the abdomen. Material & Methods: This is an analytical study with a prospective cross-sectional method. An analysis was done to 198 samples of patients in Kardinah Tegal Hospital. Samples were taken with 16 slices non-contrast abdominal MSCT using Philips MSCT MX16 (120 kVp; 2x0.75 mm slice thickness). Samples were collected with consecutive sampling method, excluding patients who had a history of other illnesses or surgical history that resulted in anatomical changes in kidney position, age<18 year old, BMI>30 (obesity), grade 4 hydronephrosis (calyces had disappeared). Reconstruction of 3D non contrast abdominal MSCT was performed by measuring the angle of the coronal cut which was simulated as a puncture in the supination position and sagittal cut which was simulated as puncture in pronation position. An imaginary line was drawn from the imaginary point between the iliac crest and 12th rib as high as 3th to 4th lumbar to the inferior renal calyx. Axis was drawn from the inferior renal calyx towards the superior renal calyx. Results: There is significant difference (P=0.000) in the angle of the imaginary line drawn from the inferior calyx to the superior calyx between the right supination position compared to the right pronation position. The angle in the supination position is more gentle 142.8 (±9.7)/(118-165) degrees compared to 96.5 (±13.2)/(11-138) degrees. On the left side, the angle formed from inferior calyx to the superior calyx in the supination position is more gentle 143.4 (±9.6)/(119-162) degrees) compared with 97.3 (±11.2)/(76-132) degrees formed in pronation position, with a value of P=0.000. Conclusion: PCNL puncture with an inferior calyx approach to reach the superior calix on abdominal MSCT without contrast will be easier to do in the supine position. This is because the angle from the inferior calyx to the superior calyx is more gentle in the supine position so that maneuvers are easier to do
OUTCOME COMPARISON OF TRANSURETHRAL RESECTION PROSTATE IN BENIGN PROSTATIC HYPERPLASIA PATIENT IN KARAWANG GENERAL REFERRAL HOSPITAL
No full textObjective: Benign Prostatic Hyperplasia (BPH) is the most common pathological condition in man and causes Lower Urinary Tract Syndrome (LUTS). The most popular therapeutic modality for BPH is the Transurethral Resection of Prostate (TURP). This study describes the TURP outcome in BPH patients with prostate volume >75 grams compared to <75 grams Karawang General Referral Hospital. Material & Methods: We performed a retrospective review of clinical outcome from BPH patient with LUTS who underwent TURP procedure between January 2017–April 2018. Data is taken through patient medical records and processed descriptively to describe complications, quality of life, laboratory. Qualitative data compared with Chi-Square test. Results: During this study, we evaluate 40 patients, 20 patients with prostate volume >75 grams (Group 1) and 20 patients prostate volume <75 grams. Mean age in group 1 65,60 ± 9.960 and in group 2 65,35 ± 10,297. IPSS after TURP between group 1 and group 2 show a significant difference, where the Incomplete Emptying found most in group 2 (P<0,05). There is no significant difference Quality of Life Score between group 1 and group 2 (P>0,05). From laboratory result obtain decrease of mean Haemoglobin percentage in both groups with P value <0,05 in group 1 and P value <0,05 in group 2. Conclusion: TURP procedure for patient with prostate volume >75 grams is safety and effective with lower complications and there is no significant difference compared to patient with prostate volume <75 grams