Indonesian Journal of Urology
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ESWL EFFECTIVENESS FOR LOWER POLE KIDNEY STONES
No full textObjective: To describe the profile of lower pole kidney stone patients who underwent Extracorporeal Shock Wave Lithotripsy (ESWL) and the clearance rate of ESWL for lower pole kidney stones at Soetomo General Hospital from 2012 to 2016. Material & Methods: This research design was analytical retrospective, lower pole kidney stone patients who underwent ESWL in Soetomo General Hospital from 2012 to 2016 who fulfill inclusion criteria become samples in this research. Samples were divided into two group, stone size <15 mm and 15-20 mm. Results: Total samples in this study were 128, consist of 81 males and 47 females. The age average was 48 ± 11.124. The stone size average was 9.5 ± 4.5 mm consisted of 109 patients with stone size <15 mm and 19 patients with stone size 15-20 mm. There were 119 single lower pole kidney stones and 9 multiple ones. From all patients, 77 patients (60.2%) were stones free and the rest (39.8%) were not. Stone free rate for lower pole kidney stones was higher in stone size <15 mm compared with 15-20 mm, 65.2% and 31.5% respectively. Statistical analysis with Chi-square showed significant ESWL clearance rate difference between lower pole kidney stone size <15mm group and 15-20 mm (p<0.05). Conclusion: ESWL was a safe option for lower pole kidney stones with high success rate. There was significant relationship between stone size and stone clearance rate. ESWL was effective for lower pole kidney stones size <15 mm.
THE INDONESIAN LINGUISTIC VALIDATION OF THE URETERAL STENT SYMPTOMS QUESTIONNAIRE
No full textObjective: To validate the Indonesian version of the ureteral stent symptoms questionnaire (USSQ) for patients with indwelling ureteral stents. Material & Methods: The Indonesian version of the USSQ was developed following a well-established multistep process by two urologists and two independent translators. A total of 38 patients with indwelling temporary unilateral ureteral stents completed the Indonesian USSQ. Patients completed questionnaires at 1 week after stent insertion and 1 week after stent removal. The reliability of the Indonesian version was evaluated for internal consistency using Cronbach’s alpha test. Domain structures were examined by interdomain (section) associations using Spearman’s correlation coefficient (r). Sensitivity to change of each domain was assessed using Wilcoxon test. Results: Urinary, pain, general health, work performance and additional problem showed good internal consistency whereas sexual problem and global quality of life displayed low consistency. There were strong correlations of urinary symptoms with body pain (r=0.633) and general health (r=0.686), moderate correlation with work performance. In addition there was also strong correlation between body pain and general health (r=0.723). Sensitivity to change were significant to all domain except sexual matters domain. (p<0.001). Conclusion: The Indonesian USSQ is reliable and can be utilize as a tool to investigate symptoms and to assess quality of life related issues due to ureteral stents in Indonesian patient
THE EFFECT OF SILODOSIN AND SODIUM DICLOFENAC TO REDUCE PAIN AFTER DJ STENT REMOVAL IN SOETOMO HOSPITAL: DOUBLE-BLINDED RANDOMIZED-CONTROLLED TRIAL
No full textObjective: To analyze, measure, compare, prove, and evaluate effectiveness of silodosin, diclofenac sodium, and the combination of both drugs in pain management after stent removal. Materials & Methods: Thirty-three patients were divided into three groups. Group I was given diclofenac Sodium 50 mg, group II was given silodosin 8 mg and group III was given the combination of diclofenac sodium 50 mg and silodosin 8 mg. The Wong Baker Pain Scale (WBPS) was assessed serially: two hours before the DJ stent removal, during DJ stent removal, and after the DJ stent removal (2 hours and 24 hours after). The data was analyzed by ANOVA and Kruskal-Wallis test. Results: In this study, 33 patients who underwent DJ stent removal were obtained. Wong Baker was presented in median (min-max) form. The WBPS study in each group did not differ statistically significant. Lowest WBPS during DJ stent removal was found in group III. Group III was better and statistically significant in reducing pain compared to group I and group II (p<0.05). WBPS two hours after removal in each group decreased and group III was better and statistically significant in reducing pain compared to group II, whereas group III compared to group I had an equivalent effectiveness. While the WBPS 24 hours after removal had the same value and did not differ significantly. No side effects or adverse events were found in the use of diclofenac sodium, silodosin, and their combinations. Conclusion: Single oral dose of diclofenac sodium combined with silodosin is effective to reduce pain after DJ stent removal
COMPARISON BETWEEN GEMCITABINE-CARBOPLATIN AND COMBINATION OF GEMCITABINE-CARBOPLATIN AND CELECOXIB IN UROTHELIAL CARCINOMA CELL APOPTOSIS
No full textObjective: To determine the combination effect of celecoxib and gemcitabine-carboplatin chemotherapy to the apoptosis of cultured-urothelial cancer cell line. Material & Methods: Urothelial carcinoma cell line originating from Bladder Ca 5637 was cultured and used in this in vitro study. Three-groups of cultured-urothelial cancer cell line consisted of (1) control (C), (2) gemcitabine-carboplatin treated group (GC) and (3) gemcitabine-carboplatin and celecoxib treated group (GCC) were treated with 0.086 µM gemcitabine, 290 µM carboplatin and 25 µM celecoxib. All groups were evaluated at 24 hours following treatment, and the apoptotic index (AI) measured accordingly. Results: Significant mean apoptotic index differences were found between the C and GC group; and between C and GCC groups at 24 hours following treatment. However, the AI of GCC was lower than the GC group although not statistically significant (p>0.05). Conclusion: Our study have shown that gemcitabine-carboplatin and the combination of both with celecoxib may increase the apoptosis of urothelial cancer cell line. The role of celecoxib in the addition of gemcitabine-carboplatin to treat urothelial cancer cell line needs to be elucidated further.
THE RELATION OF HYPOSPADIAS TYPES, AGES, AND SURGICAL TECHNIQUES FOR URETHROCUTANEOUS FISTULA COMPLICATION IN CHILD HYPOSPADIAS CASES
No full textObjective: To find correlation between hypospadias type, age, and surgical technique for urethrocutaneous fistula in child hypospadias cases. Material & Method: This research was an observational analytic research with cross sectional approach. It was conducted at Bina Sehat Jember Hospital, Paru Jember Hospital, and Bhayangkara Bondowoso Hospital. The research samples were hypospadias patients who had done hypospadias repair with susceptible age from 0 months until 16 years. Result: In this study, was found correlation between type of hypospadias with urethrocutaneous fistula (p=0.03 and r=0.43). And the other hand, this research did not find relationship between age at hypospadias surgery with urethrocutaneous fistula complication (p=0.34 and r=0.3). The results of this study indicate that the incidence of urethrocutanoeus fistula complications in the surgery using TIP technique was greater than Onlay Island Flap technique, but in this study, there was no association between hypospadias surgery technique used with complications of uretrocutanoeus fistula (p=0.3 and r=0.22). Conclusion: In this study, there was a significant relationship between hypospadias type with urethrocutaneous fistula complication with statistically moderate strength and positive correlation direction. This study did not show any significant relationship between age and hypospadias surgery technique with complications of urethrocutanoeous fistula
THE DIFFERENCES OF APOPTOSIS EFFECTS BETWEEN COMBINATION OF MELOXICAM WITH GEMCITABINE-CARBOPLATIN CHEMOTHERAPY COMPARED TO GEMCITABINE-CARBOPLATIN CHEMOTHERAPY ALONE IN UROTHELIAL CARCINOMA CULTURE CELLS
No full textObjective: To determine the differences of apoptosis effect between the combination of meloxicam and gemcitabine-carboplatin compared to gemcitabine-carboplatin alone as the standard of chemotherapy care in urothelial carcinoma culture cells. Material & Methods: This research is an in vitro experimental using human bladder cell carcinoma type 5637 which was cultured in the laboratory. In this study, the study group was divided into 3 groups: untreated control group, gemcitabine-carboplatin group, and the meloxicam-gemcitabine-carboplatin combination group, each group consist of 5 replications. To determine the dose of meloxicam, gemcitabine, carboplatin used and the time of apoptosis evaluation, cytotoxic tests were carried out using the MTT assay method. The time of apoptosis evaluation is carried out for 24 hours. Apoptosis was assessed using the Apoptotag reagent from Trevigen®. Observation of apoptosis characterized by a positive reaction (the color turning brown) against DNA strand damage using the TUNEL assay method. One Way ANOVA was used for comparative analysis of apoptosis between the group with a significant value of p<0.05. The analysis was continued with a post hoc test, to determine the differences in each group. Results: The mean of apoptosis in the control group, gemcitabine-carboplatin group, apoptosis and the meloxicam-gemcitabine-carboplatin combination group was 0.748%, 80.336%, and 83.312%, respectively. Post hoc Bonferroni analysis showed that the results had significant difference between the meloxicam-gemcitabine-carboplatin combination group compared to the gemcitabine-carboplatin group (p=0.026) and the control group (p=0.000). Conclusion: Meloxicam-gemcitabine-carboplatin combination therapy has a significantly higher apoptotic effect than gemcitabine-carboplatin alone
THE SIZE PROFILE OF EXTERNAL URETHRAL ORIFICIUM IN MALE ADULT
No full textObjective: External urethral orificium (EUO) is the outermost part of the urethra. It lies on the outside, then the operation tool for endourology transurethra must pass urethra meatus externus first before they can go deeper. Unfortunately there is no study addresses the size of EUO of male adults in Indonesia. This study was aimed to know the size of the EUO in males adult. Material & Methods: This study was a prospective study by taking the primary data in the Sardjito General Hospital and Kardinah General Hospital, Tegal and implemented during the period from October to December 2016. There were 50 samples of males adult. The exclusion criteria in this study were male patients with meatal stenosis or patients with a history of surgery on the penis or instrumentation of the urethra. External urethra orifice size measurements performed with a digital caliper, and then converted to scale the size of Fr. The data were then analyzed by Npar test with the Kolmogorov-Smirnov test, and then T-test with linear regression. Results: There were 50 adult male patients with a mean age of 52.54 ± 10.34 years. For sizes vary with the size of 16.5-26.4 Fr. From the analysis of the size of the EUO obtained a mean size of 22.72 ± 2.62 for Indonesian adult male. Conclusion: The average size of the adult male EUO was 22.72 ± 2.62 Fr.
RISK FACTORS OF MORTALITY IN CHILDREN WITH WILMS’ TUMOR AT SOETOMO HOSPITAL SURABAYA
No full textObjective: Wilms’ tumor is the most common childhood renal tumor for about 6% of pediatric malignant disease. The 5-year survival rate in United States increased from approximately from 70% (1970-1973) to 92% (1989-1996). This study was aim to analyze the risk factors of mortality in children with Wilms’ tumor. Material & Methods: A cross-sectional study was conducted in children with Wilms’ tumor at Soetomo Hospital during 2006-2011. The data of demographic, clinical profile, complete blood count, blood urea nitrogen, glomerular filtration rate, histological type, disease stage, metastases and relapse were analyzed as risk factors of mortality using logistic regression. Results: There were 37 Wilms’ tumor children and 5 children were excluded because of incomplete data. The mean age was 3.0 (SD 2.6) years, and male-to-female ratio was 2.5 : 1. There were 5/32 children in stage I, 7/32 children in stage II, 8/32 children in stage III, 11/32 children in stage IV, and 1/32 children in stage V. There were 15/32 children underwent operation. Complete remission occurred in 12/32 children and 1/32 children relapsed. There were 20/32 children died, associated with anemia (P=0.033, OR=6.111, 95% CI=1.056-35.352) and advanced stage (P=0.021, OR=8.000, 95% CI=1.575-40.632). The risk of mortality increased 3.284 folds with every increased stage (P=0.007, 95% CI=1.338-7.775). Conclusion: Disease stage is the significant risk factor of mortality in children with Wilms’ tumor.
THE EFFECTIVENESS OF TAMSULOSIN, SOLIFENACIN, AND COMBINATIONS THERAPY TAMSULOSIN ADDED SOLIFENACIN ON LOWER URINARY TRACT SYMPTOMS AFTER DOUBLE J STENT INSERTION
No full textObjective: Insertion of DJ Stent is a procedure that is often done by urologist. Insertion of DJ Stent can cause LUTS complaints and greatly affect the physical and psychosocial health of patients. The aim of this study was to determine the effectiveness difference of tamsulosin therapy 0.4 mg/day, solifenacin 5 mg/day and the combination of tamsulosin therapy 0.4 mg/day added solifenacin 5 mg/day to manage LUTS complaint after DJ Stent insertion. Material & Methods: This study was a randomized placebo-controlled trial. There were 4 groups, group I received placebo, group II received tamsulosin 0.4 mg/day, group III received solifenacin 5 mg/day, and group IV received combination therapy of tamsulosin 0.4 mg/day added solifenacin 5 mg/day. Evaluation based on International Prostatic Symptom Score (IPSS) and Ureteral Stent Symptom Questioner (USSQ) score. Data were analyzed using SPSS 21.0. It is said to be significant if p<0.05. Results: There were a total of 32 samples consist of 19 (59.3%) men and 13 (40.6%) women. There were significant improvements in the score of total IPSS, IPSS storage and IPSS quality of life score in patients who received combination therapy (p<0.05) when compared with patients who received monotherapy. The highest decrease in USSQ scores 1, 2, 3, 4, 5 and 6 were in the group that received combination therapy when compared with the monotherapy group. Conclusion: The combination therapy is safe and effective to improve IPSS total, IPSS storage and IPSS Quality of Life scores compared with monotherapy
THE EFFECTIVITY OF EUTECTIC MIXTURE OF LOCAL ANESTHETICS CREAM AS EXTRACORPOREAL SHOCKWAVE LITHOTRIPSY ADJUVANT ANALGESIA IN SOETOMO GENERAL HOSPITAL
No full textObjective: The Extracorporeal Shockwave Lithotripsy (ESWL) procedure is the first choice for kidney stone therapy with the size ≤20mm. One of the complications of ESWL is the pain. Pain control during ESWL is essential to maintain the focus point of ESWL and give enough time to achieve complete stone fragmentation. Until now there is still no data about the effectiveness of Eutectic Mixture of Local Anesthetics (EMLA) cream as an adjuvant analgesic for ESWL procedure in Soetomo Hospital Surabaya. To compare the onset of pain and ESWL Wong-Baker Pain Scale (WBPS) between the EMLA group and placebo group. Material & Methods: The design of this study was a single-blind randomized control trial comparing the onset of pain and Wong Baker pain scale between the patient in EMLA group and placebo one. WBPS is assessed in minute 15, 30, 45, and 60 of ESWL sessions and 60 minutes post ESWL procedure. The results were analyzed with SPSS. Pain onset and differences of WBPS were tested by using independent T-test if the data is normally distributed and using Mann-Whitney test if the data is not normally distributed. Results: 10 patients were obtained in each group. The mean onset of pain in the EMLA group was longer than the mean onset of pain in the placebo group but statistically not significant (p>0.05). The WBPS in the EMLA group was significantly lower compared with the placebo group in the 30, 45, and 60 minutes of ESWL (p<0.05). Conclusion: EMLA cream application before ESWL was effective and safe as an adjuvant analgesic to reduce pain during ESWL