Indonesian Journal of Urology
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COMPARISON OF BLEEDING COMPLICATIONS BETWEEN TURP AND OPEN PROSTATECTOMY IN PATIENT WITH BPH
No full textObjective: Benign prostatic hyperplasia (BPH) is the enlargement of prostate glands. Two commonly used methods of BPH surgery in Indonesia are transurethral resection of prostate (TURP) and open prostatectomy. International studies have shown both methods have bleeding complications, occurring in 7% in TURP and 22% in open prostatectomy. But, only few researches for bleeding during BPH surgery are done in Indonesia. This study aimed to analyze the difference in bleeding complications between TURP and open prostatectomy in Indonesia. Material & Methods: An observational study with cross-sectional design, using consecutive sampling from medical records of patients above 21 years old with BPH who came to Poli Urologi Soetomo Hospital in 2015–2016 for TURP or open prostatectomy. Data were analyzed using Fischer and Mann-Whitney. Results: Information was obtained from 62 patients, TURP was done in 49 patients (79.03%) and 13 patients (26.53%) in which had bleeding complication. Open prostatectomy was done in 13 patients (20.97%) and 6 patients (46.15%) in which had bleeding complications. Fischer test showed no significant difference in bleeding complications between TURP and open prostatectomy in patients with BPH (p=0.192), including patients with urine retention (p=0.451), without urine retention (p=0.249), age below 70 (p=0.140) and above 70 (p=1). Mann-Whitney test showed significant difference in bleeding complications volume between TURP and open prostatectomy (p=0.012). Conclusion: There was no significant difference in bleeding complications between TURP and open prostatectomy in patients with BPH. But, between TURP and open prostatectomy significant difference in bleeding volume was found.
THE EFFECTS OF NICOTINE EXPOSURE PER INHALATION TO THE CHANGE OF MOTILITY AND MORPHOLOGY OF THE RAT’S SPERM
No full textObjective: Smoking are known to have detrimental effect on sperm. The effects are suspiciously come from nicotine as its main pharmacologic component. This study is carried out to analyze the effect of nicotine exposure per inhalation to the difference of motile sperm percentage and normal morphology sperm percentage of male wistar rats. Material & Methods: Thirty male rats were used for this research. They were randomly divided into 5 groups and treated with nicotine inhalation 0.5 mg/kgBW, 1 mg/kgBW, 2 mg/kgBW and 4 mg/kgBW for 30 days while the control rats were not given any treatment. At the end of experiment, sperm analysis was carried out to measure the percentage of motile sperm and percentage of sperm with normal morphology. Results: Percentage of motile sperm significantly decreased (p<0.05) in all treatment groups compared to control group. Comparison between treatment groups revealed that the percentage of motile sperm significantly decreased in 0.5 mg/kgBW vs 2 mg/kgBW, 0.5 mg/kgBW vs 4 mg/kgBW, and 1 mg/kgBW vs 4 mg/kgBW. Percentage of normal morphology sperm decreased significantly (p<0.05) in 1 mg/kgBW, 2 mg/kgBW, and 4 mg/kgBW compared to control groups. Comparison between treatment groups revealed that there were no significant decreased between each treatment groups. Conclusion: This research conclude that nicotine exposure per inhalation can deteriorate the percentage of motile sperm and the percentage of normal morphology sperm of male wistar rats
IATROGENIC URINARY TRACT TRAUMA IN OBSTETRICS AND GYNECOLOGIC SURGERIES AT H. ADAM MALIK GENERAL HOSPITAL MEDAN
No full textObjective: Urinary tract iatrogenic trauma in abdominal or pelvic surgery may cause morbidity, mortality, or even medico-legal problems. The close embryonic, as well as anatomical relationship between urinary tract and genital organs, may be a predisposition for urinary tract trauma, especially ureter and bladder, in obstetrics and gynecology surgeries. This research aimed to evaluate the incidence of iatrogenic urinary tract trauma in obstetrics and gynecology surgeries. Material & Methods: This was a descriptive retrospective research. This research was conducted at Urology Division of Department of Surgery at H. Adam Malik General Hospital, Medan, from February to June 2016. Total sampling method was used. Data were collected from medical records of patients who had iatrogenic urinary tract trauma due to obstetrics and gynecology surgeries at H. Adam Malik General Hospital from January 2011 to December 2015. Parameters that were evaluated included patient characteristics, the type of obstetrics and gynecology procedure that was conducted, the type of urinary tract trauma, and the type of urologic procedure conducted. Data were registered and analyzed using statistical software SPSS version 22. Results: There were 25 patients with 28 incidences of iatrogenic urinary tract trauma, which consisted of 12 iatrogenic ureteral trauma and 16 iatrogenic bladder trauma, out of all patients who underwent obstetrics and gynecologic surgeries at H. Adam Malik General Hospital, Medan, from January 2011 to December 2016. The youngest patient was 19 years old, while the oldest patient was 78 years old. Mean age of patients was 46.48 years (SD ± 11.6). The age group with the most iatrogenic urinary tract trauma was between 26-45 years old, which consisted of 12 patients (48%). Gynecologic patients had the most iatrogenic urinary tract trauma, which was experienced by 23 patients (92%). The most common diagnosis was ovarian cancer. Hysterectomy was the most common procedure to cause iatrogenic urinary tract trauma, as was found in 23 patients (92%). All patients who were found with iatrogenic bladder trauma (15 patients; 60%) underwent bladder repair. Conclusion: Gynecologic procedure, especially hysterectomy, was the most common cause of iatrogenic urinary tract trauma. Bladder repair procedure was the most common procedure performed on patients who were found with iatrogenic urinary tract trauma.
THE CORRELATION BETWEEN SERUM PSA LEVEL AND PROSTATE HISTOLOGIC AGGRESSIVENESS WITH PROSTATIC VOLUME IN BPH PATIENTS
No full textObjective: Prostate inflammation is one of pathophysiology of prostate hyperplasia in benign prostatic hyperplasia (BPH). There are several factor that involved in prostatic inflammation, such as prostate specific antigen (PSA) that play a role as an autoantigen. The objective of this study was to assess the correlation between free PSA level with prostate histologic aggressiveness, and also the correlation between prostate histologic aggressiveness with prostatic volume in BPH patients. Material & Methods: The design of this study was cross-sectional analytic observational study to determine correlation between serum PSA level with prostatic aggressiveness, and prostatic volume with prostatic aggressiveness. This study was performed from June to November 2016 in Sanglah Public Hospital, Surya Husadha, Balimed, Bhakti Rahayu, and Ganesa Hospital. Eighty three patients with BPH undergoing transurethral resection of the prostate (TURP) were recruited. Results: The result of gamma correlation analysis using Chi-square of PSA level with aggressiveness (p=0.000) and aggressiveness with prostatic volume (p=0.012). Conclusion: Serum PSA level were correlated with prostatic aggressiveness. Prostatic aggressiveness also correlated with prostatic volume
PENILE CANCER: A STUDY OF 9 CASES AT HASAN SADIKIN HOSPITAL BANDUNG BETWEEN JANUARY 2010 AND DECEMBER 2015
No full textObjective: Penile cancer are the rarest carcinoma of the genitourinary system that are often devastating for the patient and frequently diagnostically and therapeutically challenging for the Urologist. In view of this, it would be interesting to study the incidence, demographics, presentation, and treatment of the patients. The aim of this study was to report the status of penile cancer at Hasan Sadikin Hospital Bandung. Material & Methods: This was a retrospective study of 9 patients. We study the incidence, demographics, presentation, and treatment of the patients at Hasan Sadikin Hospital Bandung between January 2010 and December 2015. Results: The mean age of the patients was 50.44 ± 12.09 years old. All patients had squamous cell carcinoma. Five patients underwent partial penectomy, 4 patients underwent total penectomy and perineostomy for urinary diversion. Four patients had lymph node localization. A Superficial lymph node dissection was performed in two patients. One of our patient was referred to hemato-oncologist for chemotherapy. Conclusion: Penile cancer seems rare in our hospital. General public should be educated about genital hygiene and early circumcision in male infant as a prophylactic measure. An understanding of the various operative procedures for treatment of the primary tumor and regional lymph nodes is therefore critical in the successful management of this condition
EFFECT OF VITAMIN E (α-TOCOPHEROL) ADMINISTRATION ON SPERM MOTILITY AND MORPHOLOGY OF SPRAGUE DAWLEY STRAIN RATS AFTER CISPLATIN TREATMENT
No full textObjective: To evaluate the protective effects of vitamin E α-tocopherol isomer against the toxicity of cisplatin on sperm motility and morphology in Sprague Dawley rats. Material & Methods: Twenty-four rats were grouped into four groups (n=6). The control group (CN) was injected with normal saline, second group (CP) was injected with cisplatin, the third group (P1) was injected with cisplatin and vitamin E 50 mg/kgBW for 7 weeks P.O, the fourth group (P2) was injected with cisplatin and vitamin E 200 mg/kgBW for 7 weeks P.O. Vitamin E was given from 3 weeks before cisplatin injection and 4 weeks following cisplatin injection. At 7th week, all the samples were undergoing bilateral orchidectomy. Vitamin E that being used in this study was α-tocopherol isomer. Results: Cisplatin decreased motility and morphology of spermatozoa significantly against controls. Vitamin E 50 mg/kgBW and 200 mg/kgBW significantly increased motility of spermatozoa (p<0.05) compared to those in the cisplatin group only. Vitamin E 50 mg/kgBW, and 200 mg/kgBW did not have a significant difference in spermatozoa motility compare to control groups. Vitamin E 50 mg/kgBW and 200 mg/kgBW could increase the spermatozoa morphology significantly compare to those cisplatin only group. Vitamin E 50 mg/kgBW, and 200 mg/kgBW did not have a significant difference in spermatozoa morphology compared to control groups. Conclusion: α-tocopherol 50 mg/kgBW and 200 mg/kgBW provided a same protective effect against spermatozoa damage especially in motility and morphology aspect due to cisplatin exposure. Therefore, in this study it was more recommended to use α-tocopherol in 50 mg/kgBW dose than 200 mg/kgBW
PENILE PARAFFINOMA RECONSTRUCTION WITH SCROTAL FLAP AND SURGICAL OUTCOME: A CASE REPORT
No full textObjective: To present a case of penile paraffinoma reconstructed with scrotal flap. Case presentation: We report a case of 33-year-old male patient with penile paraffinoma. The patient had a history of injecting liquid paraffin into his penis two times – at 6 months and 2 months prior to his admission to the hospital. His IIEF-5 was 10 (moderate erectile dysfunction). The penile shaft was circumferentially enlarged. There was ulceration on the ventral aspect with signs of inflammation on the surrounding skin. Discussion: We perform a complete excision of paraffinoma. The raw surface was repaired with a one-stage scrotal flap. At six-month follow up, the wound was good, and the patient was able to micturate normally. He was able to achieve painless erection, and IIEF-5 score was improved. Conclusion: A one-stage scrotal flap may offer a good choice in defect closure in penile paraffinoma reconstruction
EFFECT OF ERYTHROPOIETIN ADMINISTRATION ON THE AMOUNT OF SPERMATOGONIUM, SERTOLI CELL, AND LEYDIG CELL ON RATS TESTIS (WISTAR STRAIN) AFTER VAS DEFERENS LIGATION RELEASED
No full textObjective: To determine the effect of Erythropoietin (EPO) on the number of spermatogonia, Sertoli cells, and Leydig cells in white rats wistar strain testis after the release of ligation vas deferens. Material & Methods: Twenty-four Wistar strain rats were grouped into 4 groups. The control group only performed an orchiectomy for testicular examination, ligation group vas deferens only, group performed release ligation of vas deferens, and group performed release ligation of vas deferens and given EPO injection with dose of 1000 iu/kg BW intraperitoneally for 1 week (3x/week). Observation of spermatogonium, Sertoli cells and Leydig cells by counting the amount on the 5 cross sections of the seminiferous tubules using a 400x light magnification microscope with Haematoxylin Eosin staining. Results: Ligation of vas deferens can significantly decreased the number of spermatogonia and Sertoli cells (p<0.05). In Leydig cells there was no significant difference in numbers after ligation of vas deferens (p>0.05). Release of vas deferens ligation turned out to be no significant amount difference in spermatogonia, Sertoli cells, and Leydig cells with ligation of vas deferens group. Similarly, the treatment of ligation vas deferens release and an EPO injection for 1 week was also no significant difference in number compared to the ligation release group of vas deferens. Conclusion: The number of Sertoli cells, Leydig cells, and spermatogonia in the ligation release group of vas deferens and given EPO for 1 week had the same number with the ligation release group vas deferens
ROLE OF VITAMIN E (α TOCOPHEROL) TO PREVENT THE SPERMATOGONIA, SERTOLI CELL, AND LEYDIG CELL DAMAGE IN RATS TESTICLE (STRAIN WISTAR) AFTER CISPLATIN TREATMENT
No full textObjective: To determine the difference in spermatogonium cells, leydig cells and sertoli cells count in white rats testicle (wistar strains) obtained with the combination of cisplatin and vitamin E compared with that only received cisplatin. Material & Methods: There were 4 random groups out of a total of twenty four winstar strain rats (n=6). The control group (I) injected normal saline 0.9% intraperitoneally (i.p.) as the placebo on the 3rd week. Group (II) given cisplatin (5 mg/kgbw) injection i.p. on 3rd week, Group (III) given cisplatin injection 5 mg/kgbw i.p. on 3rd week + vitamin E 50 mg/kgbw by gavage for 7 weeks and group (IV) cisplatin injection 5mg/kgbw i.p. on 3rd week + vitamin E 200 mg/kgbw by gavage for 7 weeks. Vitamin E was given 3 weeks before up to 4 weeks after cisplatin injection (total 7 weeks). Observations by calculating the average number of spermatogonia, sertoli and leydig cells on a cross-sectional section of the seminiferous tubule with Haematoxylin-Eosin staining using a 400x light magnification microscope. Results: Cisplatin decreases spermatogonia, sertoli, and leydig cells significantly against control. Vitamin E 200 mg/kgbw significantly increased the number of spermatogonium, sertoli, and leydig cells (p<0.05) compared to group in combination with vitamin E 50 mg/kg bw and cisplatin or cisplatin only group. Only leydig cells count was significantly increased in the combination group of vitamin E 50 mg/kgbw and cisplatin compared to the cisplatin group. Conclusion: Vitamin E 200 mg/kgbw provides a protective effect against decreased spermatogonia, sertoli and leydig cells due to cisplatin 5 mg/kgbw exposure which its protectivity depends on the given dose
ANALYSIS OF DIFFERENCES DEGREE OF SEVERITY AND QUALITY OF LIFE OF BPH DIABETES WITH BPH NON-DIABETES PATIENTS
No full textObjective: Benign Prostatic Hyperplasia (BPH) is a benign tumor located in prostate caused by prostate cell that will continuously grows which covalent with the aging process and the dihidrotestosteron level (DHT) increase. Prostate Hyperplasia can stop the urethra pars prostatics and causesa clogging in the urine’s flow excretes from bladder. Lower Urinary Tract Symptomps (LUTS) is a bladder muscle compensation mechanism to excrete urine. Diabetes Mellitus (DM) is one of the risk factors of BPH. This research aimed to find the differences on the degree of severity and quality of life BPH DM with BPH non-DM. Material & Methods: This research was observational analytic with cross sectional design which done to 32 subjects that consist of 16 BPH-DM subjects and 16 BPH non-DM in Bina Sehat Hospital Jember, Paru Hospital Jember, and Bhayangkara Hospital Bondowoso which meet to the inclusion and exclusion criteria. Data acquired from lead interview result using International Prostate Symptoms Score (IPSS) questionnaire to evaluate the degree of severity and World Health Organization Quality of Life (WHOQOL-BREF) questionnaire to evaluate the quality of life. The data processing using Mann Whitney’s comparative test. Results: IPSS and physic domain, psychology and social had p value in a row 0.001; 0.000; 0.001; and 0.001. Conclusion: It showed that there was a meaningful difference between BPH DM with BPH non-DM. Environment domain had p value of 0.373. It showed the non-meaningful difference between BPH DM with BPH non-DM