Indonesian Journal of Urology
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THE EFFECT OF ERYTHROPOIETIN SUPPLEMENTATION ON SPERM MOTILITY AND MORPHOLOGY IN WISTAR RAT AFTER LIGATION RELEASE OF THE VAS DEFERENS
No full textObjective: The patency rates after vasectomy reversal ranges from 71-97%, but there is 26-72% possibility of persistent infertility. Dysfunction or obstruction of the epididymis and oxidative stress are thought to be the important cause of male infertility by disrupting spermatozoa maturation process, causing poor sperm quality. Human erythropoietin or better known as EPO is a glycoprotein hormone that has been purified since three decades ago. Research on the EPO has evolved and become a major research topic the researchers aimed as a therapeutic agent. The cloning and expression of erythropoietin has developed recombinant erythropoietin as a drug that serves as an anti-oxidant, anti-apoptotic and anti-inflammatory. This study aimed to determine the effect of erythropoietin supplementation on sperm motility and morphology in Wistar rat after the release of the vas deferens’ ligation. Material & Methods: Twenty four male Wistar rats were randomly divided into four groups (6 each). On the vasectomy group, the vas deferens were serially ligated for 7 weeks using a non-absorbable suture. The vasectomy reversal group get the same surgical treatment and after 7 weeks the ligation were released. While as in the erythropoietin group, recombinant eryhtropoietin (1000 IU/kg) was administered intraperitoneally three times for 1 week after releasing the ligation. Normal control animals received no surgical manipulation and followed by sperm retrieval for analysis. Eosin-stained slides were prepared to assess the motility and morphology of sperm cells and observed under a light microscope. Results: Ligation of vas deferens significantly decreased sperm motility and morphology. Releasing the ligation of the vas deferens did not improve the sperm motility and morphology. Supplementing eryhtropoietin 1000 IU/kg 3 times for a week after releasing the ligation did not improve the sperm motility and morphology. Conclusion: Erythropoietin supplementation did not improve the sperm motility and morphology in Wistar rat after releasing the ligation of vas deferens
EFFECT OF NIFEDIPINE ON APOPTOSIS, NECROSIS AND VIABILITY OF GERMINAL EPITHELIAL CELLS IN THE CONTRALATERAL TESTICLE AND PLASMA TESTOSTERONE LEVELS IN MALE WHITE RATS (RATTUS NORVEGICUS, WISTAR STRAIN) AFTER UNILATERAL TESTICULAR TORSION
No full textObjective: To compare the number of apoptosis, necrosis and viability of germinal epithelial cells in the contralateral testicle (CT) and plasma testosterone (PT) levels in white male rats which administered Nifedipine after unilateral testicular torsion (TT) compared with control group. Material & Methods: This research was an experimental study using male white rats (Rattus Norvegicus, Wistar strain) aged 10-12 weeks and body weight 150-200 gram. A total of 30 rats were then randomly divided into 5 groups (n=6) which were negative control group (KN), positive control group (KP1 and KP2) and Nifedipine-administered group (N1 and N2). Each group performed unilateral left side torsion of testicular of 1080o anticlockwise except the KN group. There was 4-hour ischemic duration in the KP1 and N1 groups while 10 hours in the KP2 and N2 groups. Administration of Nifedipine 30 minutes before detorsion by intraperitoneal injection dosed 100 μg/kgBW. All groups performed right orchidectomy and plasma blood sampling. Measurement of apoptosis, necrosis and viability of germinal epithelial cells in the CT using flowcytometry. Measurement of PT levels using Enzyme-Linked Immunosorbent Assay (ELISA). Results: The number of apoptosis, necrosis and viability of contralateral testicular germinal epithelial cells and PT levels in the KN group compared with KP1 and KP2 groups were significantly different (p<0.05). There was no significant discrepancy in apoptosis (p>0.05) in KP1 group compared with N1 group, as well as in KP2 group compared with N2 groups. The number of necrosis, viability of germinal epithelial cells in the CT and PT level in KP1 group in compared with N1 group, as well as in KP2 group in compared with N2 group were significantly different (p<0.05). Conclusion: Nifedipine administration prior to testicular detorsion can maintain cell viability and decrease the amount of necrotic germinal epithelial cells in the CT and prevent the decrease in PT levels after unilateral TT
EFFECT OF VITAMIN E (α TOCOPHEROL) ADMINISTRATION ON APOPTOSIS OF GERMINAL CELLS EPITHELIUM TESTIS IN SPRAGUE DAWLEY WHITE STRAIN RATS AFTER EXPOSED BY CISPLATIN
No full textObjective: To determine the differences of germinal epithelial testicular cell apoptosis in white Sprague Dawley strain rat that received combination of cisplatin and vitamin E compared to Sprague Dawley strain rat that received cisplatin only. Material & Methods: Twenty four Sprague Dawley rats were divided into 4 groups randomly. Group 1 Negative Control (NC) was given an injection of 1 cc 0.9% normal saline intraperitoneally as a placebo, group 2 Positive Control (PC) was given 5 mg/kgBW cisplatin intraperitoneally, group 3 (P1) was given cisplatin injection 5 mg/kgBW intraperitoneally + vitamin E (α tocopherol) 50 mg/kgBW by gavage and group 4 (P2) was given cisplatin injection 5 mg/kgBW intraperitoneally + vitamin E (α tocopherol) 200 mg/kgBW by gavage. Vitamin E (α tocopherol) was given 3 weeks before up to 4 weeks after cisplatin injection. Observation of the germinal epithelial cells apoptosis was carried out by calculating germinal epithelial cells apoptosis in the cross-section preparations of the seminiferous tubule which gave a positive reaction to the apoptag staining, using a 400x magnification light microscope. Results: Apoptosis on positive control (PC) group was different significantly compared to the negative control (NC) group (p<0.05). There was a significant difference in the apoptosis of germinal epithelial testicular cells in the cisplatin + vitamin E 50 mg/kgBW compared to the PC group (p<0.05). The cisplatin + vitamin E 200 mg/kgBW group; had a lower number of apoptosis compared to the cisplatin + vitamin E 50 mg/kgBW (p<0.05). Conclusion: Vitamin E provides a protective effect on decreasing the amount of apoptosis due to cisplatin exposure. The protective effect of vitamin E is dose-dependent
IS NEOBLADDER SAFE FOR HIGH GRADE BLADDER CANCER PATIENTS?: EVALUATION OF RADICAL CYSTECTOMY COMPLICATIONS AND ILEAL NEOBLADDER RECONSTRUCTION IN AMC KARIADI GENERAL HOSPITAL
No full textObjective: The purpose of this study was to evaluate complications of ileal neobladder reconstruction in high grade bladder cancer patients. Material & Methods: The descriptive study included 12 patients who underwent radical cystectomy and bladder reconstruction with ileal neobladder in Academic Medical Center Kariadi General Hospital Semarang from 2009 until 2016. Base data recorded retrospectively and followed at outpatient clinic. The complications were evaluated from perioperative care, postoperative care, and outpatients clinic. Clavien Dindo classification use to rank complication. Results: The average ages distribution range from 39-70 year. There were 2 patients with comorbid of renal failure, 11 patients with history of TUR and 1 patient underwent adjuvant external radiation. There were 11 patients in high grade bladder cancer (≥T3) and 1 patient with T2. Of the 8 patients underwent orthotopic neobladder procedure and 3 patients underwent cutaneous w-shape procedure. From the histopathology results, 10 patients with high grade transitional cell carcinoma, and 2 patients with invasive urothelial cell carcinoma. There were complication caused by neobladder-related of 1 patient with urinary leakage from ureteroileal anastomose, 1 patient with peritonitis caused by ileo-ileal anastomose leakage, and 1 patients with bowel necrosis caused by internal hernia who need re-operation. All neobladder related complication were 4/33%. From neobladder nonrelated of 1 patient with chronic renal disease and sepsis, and 1 patient with acute renal failure and hyperchlor metabolic acidosis. All of neobladder related complications described above end with mortality (2/16%), except the urinary leakage. Conclusion: Our complication and mortality radical cystectomy - neobladder related rate were 33% and 16% compare with literature show 28-64% and 5.1-8.1%, respectively. Patients selection (<T3, no comorbid) and experience according high volume operation can reduced the mortality rate
THE INCIDENCE AND CORRELATION OF CHRONIC PROSTATITIS WITH PSA IN BPH PATIENT
No full textObjective: The aim of this study is to determine the incidence of incidental chronic prostatitis proven by biopsy in prostate enlargement patients and to correlate with Prostate Specific Antigen (PSA) level serum. Material & Methods: This was a retrospective study with cross-sectional method. All of the prostate enlargement subjects with urinary retention and treated by surgical therapy were taken into inclusion criteria. The patient with acute prostatitis proven by biopsy and uncompleted medical records were excluded. Statistical analysis used Spearman correlation test. Results: The mean values of age and PSA were 70.24 years and 27.2 ng/mL. The patients characteristic such as surgery waiting time were 81 patients in 1-3 days, the most common length of stay were 3 patients (4%) for 1-3 days. The most common biopsy result was Benign Prostatic Hyperplasia (BPH) in 55 patients (61.5%). 64 patients (70.3%) were treated by Trans Urethral Resection of Prostate (TURP) and 14 patients (9.9%) had secondary surgery. There was a correlation between chronic prostatitis with PSA levels in BPH patients (p=0.000). Conclusion: Chronic prostatitis is often found incidentally in BPH patients and affecting PSA serum level. The existence of chronic prostatitis in BPH may predict the progress of prostate growth
PLATELET COUNT AND MEAN PLATELET VOLUME AS PROGNOSTIC MARKERS OF UROSEPSIS
No full textObjective: To know and determine platelet count (PLT) and mean platelet volume (MPV) as prognostic factor for outcome in patients with urosepsis. Materials & Methods: This was an analytic observational study. Thirty patients were assigned to the test for PLT and MPV at the day of admission, 36 hours and 72 hours after admission. All subjects were managed according to standard urosepsis therapy. At the 28th day of treatment, patients were evaluated and classified the outcome as survivors and non-survivors. The statistical analysis was performed using multivariate logistic regression with software SPSS 21. In all tests, p<0.05 was considered to indicate significance. Results: The mean of PLT in non-survivors was lower than that in survivors at the day of admission (420 ± 343.57 x103/mm3 vs 423.04 ± 220.15 x103/mm3, p=0.838). Decrease in PLT during the first 72 hours after hospitalization in non-survivors (Δ PLT72h) was greater than that in survivors (-143.43 ± 154.15 x103/mm3 vs -51 ± 121.77 x103/mm3, p=0.050). The mean of MPV in non-survivors was lower than that in survivors at the day of admission (6.30 ± 0.53 fL vs 7.25 ± 1.78 fL, p=0.333). Increase in MPV during the first 72 hours after hospitalization in non-survivors (Δ MPV72h) was greater than that in survivors (3.51 ± 0.86 x103/mm3 vs 1.48 ± 1.54 x103/mm3, p=0.028). In multivariate analysis, Δ MPV72h was an independent predictor of 28-day mortality [OR 9.41 (95% CI, 1.27 – 69.81)]. Conclusion: An increase in MPV during the first 72 hours after hospitalization can be used as poor prognostic in urosepsis patients.
TESTICULAR TORSION: CAUSATIVE FACTOR IN DELAYED MANAGEMENT
No full textObjective: Analyzing the factors causing delays in the management of patients with testicular torsion in Dr. Cipto Mangunkusumo General Hospital Jakarta. Material & methods: This research is a retrospective research using questionnaire from patients as primary data and from Dr. Cipto Mangunkusumo General Hospital medical records or urologic reports as secondary data from 1st January 2011 to 30th April 2015. Results: 4 patients diagnosed with left testicular torsion admitted to hospital with >4 hours onset (as a prehospital factor). 3 of 4 patients were adult, who came with left testicle pain. The minimum VAS score perceived is 2. 3 of 4 patients had 540o medial left testicle rotation intraoperatively while all patients left testicles were unvital. Conclusion: Further examination is required to diagnose testicular torsion in adult-geriatric. Non-specific complaints, such as lower abdominal pain or painful testicles and mild pain in scrotum were some of the most important factors, thus causing delays in testicular torsion management. However, a comprehensive education to all health workers, especially for doctors is still required, because the complaints of pain in patients with testicular torsion does not always appear acutely. This becomes important for early identification of patients with testicular torsion, in order to prevent delay in management
COMPLICATIONS OF PERCUTANEOUS NEPHROSTOMY USING PIGTAIL NEPHROSTOMY TUBE SIZE OF 8 FRENCH VS PEDIATRIC NASOGASTRIC TUBE SIZE OF 8 FRENCH IN UROLITHIASIS PATIENTS IN HASAN SADIKIN HOSPITAL BANDUNG
No full textObjective: To compare the complications and patient-reported problems using standard pigtail nephrostomy tube versus pediatric nasogastric tube (NGT) usage as nephrostomy tube. Material & Methods: During 2015 period, 79 patients were referred to Urology Department in Hasan Sadikin Hospital Bandung for percutaneous nephrostomy procedure. Data were collected from Medical Record Urology Department to identify the complications and the patients-related problems using standard pigtail nephrostomy tube versus pediatric NGT usage as nephrostomy tube. Results: 38 patients (48%) using pigtail and 41 patients (52%) using pediatric NGT as nephrostomy tube. Overall,12 patients using pigtail nephrostomy tube (31.5%) experienced at least 1 complication related to nephrostomy procedure, and only 7 patients using pediatric NGT (17%) experienced complications. The complications including fever (3 patients), pyuria (5 patients), infection on insertion site (1 patient, 1.2%), pain (7 patients, 8.8%) hematuria (4 patients, 5%) and detached nephrostomy tube (19 patients, 24%). Conclusion: The small number of complications observed in pediatric nasogastric tube patient group suggest that pediatric NGT is a safe, cheap and widely available substitute for pigtail nephrostomy tube
PROGNOSTIC PARAMETERS FOR THE RECOVERY OF RENAL FUNCTION IN PATIENTS WITH OBSTRUCTIVE UROPATHY
No full textObjective: The aim of this study was to determine the prognostic parameters for the recovery of renal function in patients with obstructive uropathy after the release of obstruction. Material & methods: This is a retrospective cohort study. Secondary data from the patient's medical record was used to determine whether the ratio of blood urea nitrogen (BUN)/creatinine, hemoglobin, hyperkalemia, blood glucose, renal parenchymal thickness, and obstruction etiology are prognostic parameters for recovery of renal function in patients with obstructive uropathy after release of obstruction. Bivariate was used to analyze the data using Chi-square and Fisher's exact test with significance level of p<0.05 to evaluate the significance. Results: Based on total of 66 research samples, it was found that renal parenchymal thickness was ≥10 mm (p=0.001), hemoglobin level was ≥10 mg/dL (p=0.001), and BUN/creatinine ratio was ≥10 (p=0.003), it had significant correlation with the recovery of renal function, meanwhile, obstruction etiology variable (p=0.566), and hyperkalemia (p=0.792) did not provide significant recovery of renal function. Conclusion: Renal parenchymal thickness, hemoglobin level, and BUN/Creatinin ratio are the prognostic parameters for recovery of renal function after release of obstruction
CHARACTERISTIC OF PEDIATRIC UROLITHIASIS PATIENTS IN ZAINOEL ABIDIN HOSPITAL
No full textObjective: We conducted a study to describe the characteristics of pediatric urolithiasis patients in Zainoel Abidin Hospital, Aceh-Indonesia. Material & Methods: Between January 2013 and March 2016, we retrospectively reviewed the medical records of 16 pediatric patients with urolithiasis in Zainoel Abidin Hospital, Aceh-Indonesia. The patients were come from whole Aceh region and the variables are sex, age, family history of stone disease, and stone location. The data were described in graphics and tables. Results: From 16 pediatric urolithiasis patients, 9 patients (56.3%) were males and 7 patients (43.7%) were females. In 2013 there were 4 pediatric urolithiasis patients (1.2%), in 2014 there were 5 (1.6%), and in 2015 there were 3 (2.3%). From January – March 2016 there were 4 pediatric urolithiasis patients (4.5% of all urolithiasis patients). The mean age of all pediatric patients were 7.7 ± 5.5 years (1-17 years). The incidence of urolithiasis for group < 5 years of age were 6 patients (37.5%) with mean age of 2 ± 1.14 years (1-4 years), in 5–10 years age group, there were 4 patients (25.0%) with mean age 7 ± 2.16 years (5-10 years), and 11–18 years age group, there were 6 patients (37.5%) with mean age 13.8 ± 2.16 years (12-16 years). Stones were located in the upper urinary tract in 9 cases (56.3%), lower urinary tract in 6 cases (37.5%), and combine stone located in upper and lower urinary tract in 1 case (6.2%). There were 5 patients (31.3%) with family history of stone disease. Conclusion: Pediatric urolithiasis case in Aceh Province is slightly predominant in male children, with mean age of 7.7 ± 5.5 years (1-16 years). The most common age group is evenly distribute between <5 years old and 11-18 years old. The most common stone location is in the upper urinary tract