Indonesian Journal of Urology
Not a member yet
480 research outputs found
Sort by
THE EFFECT OF N-ACETYL CYSTEINE TO SPERM MOTILITY, VIABILITY, AND CONCENTRATION OF SPRAGUE DAWLEY RATS WITH NICOTINE INHALATION EXPOSURE
No full textObjective: To prove and analyze the difference of sperm motility, viability, and concentration of Sprague Dawley rats which were exposed to nicotine inhalation, with rats treated with N-acetyl cysteine (NAC) orally and exposed to nicotine inhalation. Material & Methods: Twenty seven rats were allocated into three group. Control group (C) (aquadest inhalation 1 mL/kgBW/day), treatment group 1 (N) (nicotine inhalation 1 mg/kgBW/day), and treatment group 2 (N-NAC) (nicotine inhalation 1 mg/kgBW/day and oral NAC administration 150 mg/kgBW/day), with all treatment were given for 30 days. Orchidectomy was performed on day 31 to collect semen sample for sperm analysis (motility, viability, and concentration). Results: There was a significant decrease in all parameters from N group compared to C group. Significant increase were found in sperm motility and viability parameters in the N-NAC treatment group compared to N group. While the sperm concentration parameters of the N-NAC group had a non-significant increase compared to N group. Conclusion: Exposure to nicotine inhalation decreased sperm motility, viability, and concentration of Sprague Dawley strain rats, and NAC had a protective effect on sperm of rats which was exposed to nicotine inhalation
PREOPERATIVE INTRAVENOUS TRAMADOL FOR PERCUTANEOUS NEPHROSTOMY TO REDUCE INTRAOPERATIVE PAIN
No full textObjective: To evaluate the effect of additional preoperative intravenous tramadol for reducing intraoperative pain. Material & Methods: This study was a double blind randomized controlled study from April - June 2017 in Urology Department in Hasan Sadikin Hospital. Inclusion criteria were cervical cancer patients who were performed percutaneous nephrostomy. Exclusion criteria were patients with infection and pain before the procedure. Written informed consent was obtained from each patient and the study protocol was approved by the local human ethics committee. The subjects were randomly divided into 2 groups. Group A were given 100 ml dripped normal saline 1 hour before the procedure and intraoperative local anesthesia with lidocaine 2% and group B were given preoperative intravenous tramadol 100 mg dripped within 100 ml of normal saline 1 hour before the procedure and intraoperative lidocaine 2%. Visual Analogue Score (VAS) were used to evaluate the pain score. All calculation were done using SPSS version 20. Results: There were 60 cervical cancer patients who were performed percutaneous nephrostomy (29 patients in Group A and 31 patients in Group B). The mean age in group A was 48.86 ± 8.524 (years old) and the mean age in group B was 51.90 ± 6.76 (years old). The median VAS score in group A was 4, with the minimum score was 2.00, maximum score was 6.00. The median VAS score in group B was 2, with the minimum score was 0.00, maximum score was 4.00. In group A, 11 patients (18.3%) were mild pain, 16 patients (26.7%) were moderate pain, 2 patients (3.3%) were severe pain. In group B, 29 patients (48.3%) were mild pain, 2 patients (3.3%) were moderate pain, 0 patients (0.0%) were severe pain. Based on Mann-Whitney U test, there was a significant pain score reduction in group B compared to group A (p=0.0001). There were no significant differences in the prevalence or proportion of patients with nausea and vomiting in group A and B (10% and 12%, respectively). There were no other adverse events and other complications observed in both groups. Conclusion: Preoperative intravenous tramadol significantly reduced intraoperative pain in cervical patients who were performed percutaneous nephrostomy compare to those who were only given intraoperative local anesthesia.
FIVE YEARS CHARACTERISTIC OF KIDNEY TRAUMA IN TERTIARY HOSPITAL IN WEST JAVA FROM 2013-2017
No full textObjective: Globally, trauma is one of the leading cause of mortality and morbidity. Kidney is an organ that is often affected in trauma cases in urology. This study aimed to determine the characteristics of cases of kidney trauma treated in Hasan Sadikin Bandung Hospital, and used as part of the database of urogenital trauma in Indonesia. Material & Methods: The secondary data was derived from the medical records of patients with kidney trauma treated at Department of Urology in Hasan Sadikin Hospital Bandung for 5 years period (January 2013 to August 2017), as many as 130 cases. Information used was patients’ gender, mechanism of trauma, grading of kidney trauma, associated injury, management, shock, and outcome after treatment. The data obtained was subsequently recapitulated and processed using a spreadsheet. Results: A total 20489 trauma cases admission in Hasan Sadikin Hospital, 477 cases (2.33%) were urogenital trauma, and 130 of which are cases of kidney trauma (0.63%). The majority of patients with kidney trauma are male (87.7%). Based on the mechanism of trauma, 80% of them were related to traffic accidents, especially in motorcycle traffic accidents, as well as the trauma mechanism of falling from a height (13%). There were 69 patients (53.1%) who had major kidney trauma, and 61 patients (46.9%) had minor kidney trauma; specifically, 42.3% grade I and 21.5% grade V kidney trauma. In general, kidney trauma patients experienced multiple trauma, only 19 cases (14.6%) had not associated injury. Most of patients (63%) did not experience shock, and 87.75% of patients survived after treatment. In the timespan of 5 years, 44 patients underwent McAnninch procedure. Conclusion: In Hasan Sadikin Hospital, most cases of kidney trauma were experienced by men, and were caused by blunt trauma in traffic accidents, especially on motorcyclists. Most patients with kidney trauma experienced multiple trauma
FIRST EXPERIENCE IN VIDEOURODYNAMIC STUDY AT CIPTO MANGUNKUSUMO HOSPITAL IN 2012-2014
No full textObjective: Accuracy of diagnosis is a fundamental thing in terms of plan of treatment. Nowadays, symptoms from lower urinary tract can be diagnosed accurately with videourodynamic study (VUDS). Videourodynamic combines a fluoroscopic voiding cystourethrogram with multichannel urodynamics, allowing anatomic and functional assessment of the bladder and outlet. Material & Methods: This research is a descriptive retrospective. Data was taken from the patients who underwent VUDS at Department of Urology Cipto Mangunkusumo Hospital from 2012 to 2014. Patient’s characteristics were gender, age, chief complaint, working diagnosis pre investigation, and diagnosis after VUDS was performed. Then, data was analyzed in a descriptive fashion and presented using tables and narative form. Results: There were 8 male patients (67%) and 4 female (33%) who underwent VUDS. Most of the patients were children (75%). Five patients (42%) complained about incontinence with or without other LUTS, only 1 patient (8%) had LUTS and disuria. Overall, working diagnosis pre investigation was neurogenic bladder with various causes. We found a variable diagnoses after VUDS. At filling phase, we found 7 patients (58%) with small bladder capacity, 5 patients (42%) with low bladder compliance then followed respectively by overflow incontinence (33%), detrusor overactivity (17%) and urethral sphincter incompetence (8%). At voiding phase, the most common abnormality detected were detrusor underactivity (42%), followed by infravesical obstruction (8%). VUR was found both at filling phase (42%) and voiding phase (33%). Conclusion: VUDS could be the first choice of modality for diagnosing dysfunction of lower and upper urinary tract especially in neurogenic cases.
COMPARISON BETWEEN TRANSRECTAL ULTRASONOGRAPHY GUIDED TRANSRECTAL PROSTATE BIOPSY AND TRANSRECTAL ULTRASONOGRAPHY GUIDED TRANSPERINEAL PROSTATE BIOPSY
No full textObjective: Prostate cancer is the fourth most common malignancy in men. TRUS guided transperineal prostate biopsy and TRUS guided transrectal prostate biopsy are two main approach to take prostate tissue as diagnostic of prostate cancer. To compare prostate biopsy approach between TRUS guided transrectal and TRUS guided transperineal toward duration of examination, pain perception, and complications. Material & Method: This study was an experimental study with prospective approach. There were two groups, group one was performed TRUS guided transrectal prostate biopsy (TRB) and group two was performed TRUS guided transperineal prostate biopsy (TPB). Evaluation was based on the duration of examination, pain perception, and complication. Data was analyzed using independent T test for duration of examination and Mann-Whitney test for pain perception. Data was performed using SPSS 21.0 version. The statistical significant difference was consider if p value <0.05. Results: There were 20 samples in this study. There was a significant difference in the duration of examination, the average duration of TPB examination (17.40 ± 2.50) was longer than the duration of TRB examination (14.1 ± 2.77). There was no significant statistical difference between TPB group and TRB group in pain perception when USG probe into the anal (p=0.65), anesthesia process (p=0.28), prostate tissue sampling (p=1.00), and post biopsy (p=0.34). Rectal bleeding was found mostly in TRB group (40%) compared to TPB group (0%). Hematuria was experienced by three patients (30%) in TRB group and two patients (20%) in TPB group. Conclusion: TRB was more effective in duration of biopsy than TPB. The complications of rectal bleeding and hematuria were more in TRB group than TPB. The pain perception were the same between both groups. There were no fever, sepsis, hematospermia and vasovagal event in two groups
THE EFFECT OF NIFEDIPINE ON SURVIVE CELL, APOPTOTIC CELL AND NECROTIC CELL OF IPSILATERAL TESTICULAR GERMINAL EPITELIAL CELLS ON MALE WISTAR RATS WITH UNILATERAL TESTICULAR TORSION
No full textObjective: This study aimed to compare the number of survival, apoptotic and necrotic cells of ipsilateral testicular germinal epithelial cells in male wistar rats with unilateral testicular torsion between nifedipine given and control groups. Material & Methods: Thirty male wistar rats aged 10-12 weeks were randomly divided into 5 groups, each consisted of 6 rats. The negative control group (KN) underwent a sham procedure and left orchidectomy. Positive control group 4 (KP4) and 10 (KP10) performed left torsio testis 3 x 360 degrees medially for 4 hours and 10 hours respectively, then performed orchidectomy 4 hours after detorsion. The 4-hour (N4) and 10 hours (N10) nifedipine treatment group received the same treatment with positive control, but 30 min before detorsion performed, nifedipine were given intraperitoneal 100μg/kg. Within 1 hour after orchidectomy, cell count was calculated using flow cytometry. Results: It was found that the 4 (N4) and 10 hours (N10) nifedipine treatment group had a higher survival cells and also a lower number of apoptotic and necrotic cells compared to the positive control group. It was found that the 10 hours nifedipine treatment group (N10) had a lower number of apoptotic and necrotic cells compared to the 10 hour positive control group (KP10). The difference was statistically significant with p value <0.05. However, in KP4 and N4 group compared with KP10 and N10 group, higher apoptotic cells was obtained. This was a new phenomenon that needs to be investigated more deeply. Conclusion: Intraperitoneal administration of nifedipine prior to testicular detorsion may reduce the number of apoptotic and necrotic cells of testicular germinal epithelial cell, and may increase the number of survival cells in ipsilateral testes with unilateral testicular torsion
THE EFFECT OF CHRONIC EXPOSURE OF NICOTINE INHALATION TO THE COUNT OF SPERMATOGONIA, SERTOLI CELLS AND LEYDIG CELLS OF YOUNG WHITE RAT WISTAR STRAIN
No full textObjective: To analyze the difference in the number of spermatogonia, leydig cells and sertoli cells in young age of white mice Wistar strain after inhalation of chronic nicotine exposure. Material & Method: Laboratory experimental study with post test only control group design, measurement of spermatogonium, leydig cell, sertoli cell in 5 groups of young male Wistar strain, negative control group and treatment group given nicotine exposure 0.5 mg, 1 mg, 2 mg, and 4 mg/kg body weight/day for 30 days. Results: A significant reduction in spermatogonium was found in the group given nicotine 0.5 mg/kgBW/day (p=0.048), 1 mg/kgBW/day (p=0.002), 2 mg/kgBW/day (p=0.002) and 4 mg/kgBW/day (p=0.000) when compared to the control group. Significant decreases were also seen in the group receiving 4 mg of nicotine exposure compared with 0.5 mg (p=0.018). Significant decrease in sertoli cell count was seen only in the nicotine group of 4 mg/kgBW/day compared with the control group (p=0.047). A significant decrease in leydig cell count was found in the nicotine 2 mg/kgBW/day (p=0.037) and nicotine group 4 mg/kgBW/day (p=0.023) when compared with the control group. Significant decreases were also found in the 4 mg/kgBW/day group compared to the 0.5 mg/kgBW/day group (p=0.004). In this study there were also a decrease in the number of spermatogonia, sertoli cells, and leydig cells in the increased dose of nicotine given although not statistically significant. Conclusion: Chronic exposure of nicotine per inhalation may decrease the number of spermatogonia, sertoli cells, and leydig cells. The higher the dose of nicotine given the greater the decrease in the number of spermatogonium cells, sertoli cells, and leydig cells that occur. This proves that nicotine is one of the causes of infertility in men
THE ROLE OF VITAMIN E (α-TOCOPHEROL) ON TESTOSTERONE LEVEL IN SPRAGUE DAWLEY RATS FOLLOWING CISPLATIN TREATMENT
No full textObjective: To observe the difference of testosterone levels in adult male Sprague Dawley rats treated with combination of cisplatin and vitamin E compared to those treated with cisplatin only. Material & Methods: We used 24 adult male Sprague Dawley rats weight 200–300 grams and randomly assigned into 4 groups (n=6). Rats in negative control group (NC) were given intraperitoneal normal saline injection, while the positive control (PC) group were injected with cisplatin 5 mg/kgBW at the end of the 3rd week. Two other groups, P1 and P2, were injected with cisplatin 5 mg/kgBW and given vitamin E orally 50 mg/kgBW and 200 mg/kgBW, respectively. Cardiac blood was aspirated at the end of the 7th week and processed for analysis of testosterone levels. Results: We recorded a significantly lower testosterone levels in rats treated only with cisplatin 5 mg/kgBW (CP) compared to those in CN group (p=0.006), and those receiving combination of cisplatin and vitamin E 50 mg/kgBW (p=0.003) and 200 mg/kgBW (p=0.001). Though not significant, testosterone levels were higher in P2 group than in P1 group (p=0.702). Conclusion: Exposure to cisplatin can lower testosterone levels in white rats, and the administration of vitamin E gives protection against such effect.
COMPARISON OF EFFICACY AND SAFETY SILODOSIN 8 MG ONCE DAILY AND SILODOSIN 4 MG TWICE DAILY IN BPH PATIENTS WITH LUTS
No full textObjective: This study was aimed to compare the efficacy and side effect of silodosin 8mg once daily and silodosin 4mg twice daily in BPH-LUTS patients after 4 and 12 weeks. Material & Methods: Single blind randomized controlled trials in 60 male patients aged ≥45 years with BPH-LUTS from July 2017 to October 2017 was divided into groups who received 8mg of silodosin once daily and those who received 4mg of silodosin twice daily. Efficacy and adverse events were evaluated after 4 and 12 weeks of treatment. Results: There was no significant difference of mean age of the two groups was 67.93 ± 6.49 years and 69.07 ± 6.28 years respectively (p 0.49). Both doses of this drug decreased the International Prostate Symptom Score (IPSS) and significantly increased the maximum urinary flow (Qmax) (p<0.05) but there was no significant differences between the two groups (p>0.05). Ejaculation disorder was the most common side effect in all groups (6.7% and 5%) and there was no significant difference between the two groups (p>0.05). Conclusion: The administration of 8mg of once daily silodosin has similar efficacy as 4mg twice daily silodosin. There were no adverse events differences in the two groups. Ejaculation disorder is the most common adverse event of silodosin administration
BLADDER RECONSTRUCTION DURING SEPARATION OF A CONJOINT TWIN ISCHIOPAGUS TRIPUS
No full textObjective: Conjoined twins represent one of the rarest congenital anomalies occurring with a varying incidence of about approximately 1 : 50.000 - 1 : 200.000 births. Ischiopagus conjoined twinning (Fuse at the hip region) is even rare representing only 6% of all conjoined twins. Here we report our experience in lower urinary tract reconstruction during separation of a conjoined twin ischiopagus tripus in Hasan Sadikin Hospital, Bandung. Case(s) Presentation: Two years old female conjoined twins, weighing in total of 8 kilograms, were brought to our hospital. The twins were fused at the lower halves of their bodies with two separate lower limbs at the right side and a fused left lower limb. External genitalia were absent. From CT Angiography we found four kidneys, two in each child with two separate bladders, with right ureter of baby A and left ureter of baby B enter the right bladder, while left ureter of baby A and right ureter of baby B enter the left bladder. There was one cloaca that drains urine and feces. During the separation surgery, we performed ureteroneocystostomy and temporary ureteral stenting, followed by cystostomy. The pediatric surgeon performed bowel separation by stapling technique, pelvic wall separation, ileostomy, and pelvic floor reconstruction. The orthopedic surgeon performed femur separation, pelvic floor reconstruction, reconstruction of the pelvic ring, and femur reconstruction. The patients underwent defect closure, which performed by plastic surgeon. The operation was successful, without any complication to the kidney and the urinary tract of both babies. Discussion: Ischiopagus conjoined twins are the most complex conjoined twins and occur in only 6% of all conjoined twin cases. Ischiopagus is usually located along the axis with the head located on the opposite side. This case usually has one umbilicus and the two bodies are fused below this level, the union occurs in the lower abdomen and the pelvis. The internal organs that usually coalesce in cases of ischiopagus conjoined twins are liver, lower gastrointestinal, and genitourinary. The fused gastrointestinal part is the ileo-colic part of terminal ileum (Meckel's diverticulum). Conclusion: The separation of conjoined twin is a unique challenge due to its complex anatomy and physiology. Although advancement in imaging and monitoring has improved the survival rate separation can be successfully achieved only with meticulous planning and team work