Indonesian Journal of Urology
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EFIKASI TAMSULOSIN PADA BENIGN PROSTATIC HYPERPLASIA DENGAN RETENSIO URINE AKUT YANG MENJALANI TRIAL WITHOUT CATHETER
Get PDFObjective: To evaluate the efficacy of tamsulosin on BPH patients with acute urinary retention on trial without catheter (TWOC). Materials & method: This study was a post test only-placebo group design comparing residual urine in BPH patients with acute urinary retention on TWOC between groups administered with tamsulosin and placebo. The efficacy of both groups with tamsulosin and placebo on the 3rd and 14th day was analyzed using Chi Square test while the efficacy of administration of tamsulosin and placebo on the 3rd and 14th day was analized using Mc Nemar test. Results: This study showed that there was still urinary retention in 7 patients (58,3%) and 4 patients (44,4%) shared recovery within 3 days of tamsulosin administration, while 5 patients (41,7%) still had urinary retention compared to 5 patients (55,6%) who showed recovery in the placebo group. The difference was insignificant with p=0,670. Patients who dropped out from TWOC on the 3rd day and given tamsulosin until the 14th day showed urinary retention in 4 patients (44,4%) and recovery in 3 patients (100%) while all samples who were given placebo showed urinary retention 5 patients (55,6%). The difference was insignificant with p=0,205. Follow up for 3 days in Tamsulosin groups which have urine retention in this study, 3 patients became free for urine retention and the other 4 patients still had urine retention. But in this study, no difference in efficacy with p=1,025. In placebo groups with urinary retention before the 3rd day of administration still showed urinary retention after the 14th day. Conclusion: There was no statistical differences on the success of TWOC, between groups administered with 0,2 mg of tamsulosin and placebo group, neither on the 3rd day nor on the 14th day. There was reduction of recatheterization because of failure of TWOC with patients who were given tamsulosin for 14 days
COMPARISON OF POSITIVE BACTERIAL CULTURE RATE FROM URINE SPECIMEN AND CATHETER SWAB IN INDWELLING CATHETER PATIENTS
No full textObjective: The study aims to study the difference between urinary culture before and after indwelling catheter insertion and also the difference in positive bacterial culture rate between urine and catheter swab at the 7th and 14th days. Material & method: The subject of this study were patients who used indwelling catheters in urology outpatient department. The sample was allocated into two groups of 10 patients each, 7 and 14 days group. Sterile urinary culture was initially checked before catheter insertion. After 7 and 14 days of catheterisation respectively, urine and intraluminal catheter swab were performed upon removal. All samples were examined in Microbiology Department using McConkey and Nutrient agar (Mayo technique – T/T33). After 24 hours incubation, bacterial colonies were identified. Results: All urinary cultures obtained before the study were sterile, after 7 days catheter insertion two cultures (20%) remained negative and the remainder (80%) became positive. McNemar test result was 0,008 (p<0,05). In 14 days group after catheter insertion only one (10%) remained negative while 9 others were positive for bacteria. Mcnemar test shows 0,004 (p<0,05). The urinary and catheter swab culture is not significantly different in 7 days of indwelling catheterization patients (0,500; p>0,05) and also in 14 days patients (1,000, p>0,005). While the catheter swab culture is significantly positive after administering the urinary catheter in 7 and 14 days of catheterization (0,002; p<0,05). Conclusion: There was significant difference in urinary culture positive rate before and after catheter insertion in 7th and 14th day. Bacteriuria rose sharply after urinary catheter insertion despite aseptic procedure. There was no difference in culture positive rate between urine and catheter swab at 7th day as well as 14th day
ANGIOTENSIN II TYPE-1 RECEPTOR (AT1R) DISTRIBUTION IN BPH, HIGH GRADE PIN AND ADENOCARCINOMA OF THE PROSTATE
Get PDFObjective: The aim of the study was to detect the differences in number and the distribution of angiotensin II type-1 receptor (AT1R) in BPH, high grade PIN, and adenocarcinoma of the prostate. Material & method: A prospective study was performed in RSHS, in collaboration with the Department of Anatomical Pathology. Prostate samples were taken by TUR of the prostate, and then divided into 5 groups. They were BPH, high grade PIN, adenocarcinoma of the prostate in 3 difference grades (well, moderate, and poorly differentiated). Kidney tissue for control. Immunohistochemical staining was done to determine the angiotensin II type-1 (AT1R) receptor distribution as primary antibody used was mouse monoclonal antibody AT1 (TONI-1): sc-57036, Santa Cruz Biotechnology Inc., CA. Results: Angiotensin II type-1 receptor was found in material of BPH, high grade PIN and adenocarcinoma of the prostate. The number and distribution of the receptors were not different. Conclusion: There are no significant differences in number and distribution of angiotensin II type-1 receptor on BPH, high grade PIN, and adenocarcinoma of the prostate
PENGARUH PEMBERIAN KONTRAS MEDIA NON IONIK LOW OSMOLAR INTRA VENA TERHADAP KADAR CYSTATIN–C SERUM PADA ORYCTALAGUS CUNICULUS
Get PDFObjective: To measure effects of low osmolar non ionic contrast media on cystatin–C serum levels on different days after administration. Material and Method: Twenty-two oryctalagus cuniculus were divided into two groups of 11 subjects, each subject receiving intravenous injection of low osmolar non ionic contrast or a placebo solution (NaCl 0,9%). Cystatin-C serum levels of each subject were measured before injection, on days 1, 3, 7, and 10. Cystatin–C serum levels were determined with a sandwich ELISA method. Statistical analysis was performed with t–test. Results: Mean cystatin–C serum levels before injection was 0,00337 ± 0,00101 mg/L. Means from days 1, 3, 7, and 10 after injections were 0,00498 ± 0,00153 mg/L; 0,00565 ± 0,00247 mg/L; 0,00468 ± 0,00157, and 0,00339 ± 0,00188 mg/L respectively. Conclusion: Increase in serum cystatin–C levels on days 1, 3, and 7 was significant. On the 10th day no significant escalation was observed. Compared to the control group, there were significant differences in serum cystatin–C increase on days 1 and 3 in the intervention group, but no significant differences 7 and 10 days after injection
HUBUNGAN ORKIDEKTOMI DAN DETORSI DENGAN RESPON IMUN TESTIS KONTRALATERAL PADA TORSIO TESTIS
Get PDFObjective: In attempt to explain effects of orchiectomy and detorsion in contralateral testis immune response after unilateral testicular torsion. Materials and methods: Forty eight rattus norwegicus strain wistar white rats testes underwent 720º unilateral left testicular torsion. The experimental animals were divided into 6 group: 2 had sham operation which served as control, 2 groups had ligation left testicular torsion with subsequent orchiectomy at 4 and 24 hours, 2 groups had ligation left testicular torsion followed by detorsion at 4 and 24 hours. Contralateral testes were analyzed 7 days later for examination percentage of IL-4 producing lymphocyte and immunoglobulin G producing plasma cells in contralateral testis by means of immunohistochemical method. Results: Multivariate analysis result revealed that in unilateral left testicular torsion followed by detorsion at 24 hours group we found IL-4 and IgG had entered intratubules and were different from orchiectomy and control group (p=0,0001 and p=0,0001). This indicated damage of germinal epithelium in contralateral testes caused by imunologic response stimulated by detorsion. In left testicular torsion and orchiectomy or detorsion at 4 hours did not show both IL-4 and IgG in intratubules and no significant different both IL-4 and IgG in extratubules among orchiectomy, detorsion and control group (p=0,326 and p=0,064). This indicated that in 4 hours immune response were not significantly different between those groups and germinal epithelium were still intact. Conclusion: Detorsion in 24 hours testicular torsion had stimulated immune response which caused damage of germinal epithelium in contralateral testis. In 4 hours testicular torsion immune response happened not significantly different between detorsion, orchiectomy and control
AGE, TOTAL PSA, PSA DENSITY AND GLEASON SCORE, TAUS AS PREDICTIVE FACTORS IN PATIENTS WITH PROSTATE CANCER
No full textObjective: To find the factors related as predictive factors for Gleason score in prostate cancer patients. Material & methods: This study obtained a total sample of 144 patients with prostate cancer in Sardjito General Hospital Yogyakarta in 2009-2013. Of the total 144 patients, only 64 patients had complete medical records. All patient samples were patients who had biopsy of the prostate. This study is a retrospective case-control study to predict the Gleason Score in patients with prostate cancer in terms of age, total prostate specific antigen (PSA), PSA density and TAUS. Normality test assessed the distribution of the data. Pearson test assessed normal distribution and Spearman test for normal distribution. All data were analyzed using SPSS version 18. Results: Analysis of data from 64 patients with prostate cancer with a normal distribution of the variables obtained on age and TAUS with p > 0.05 whereas abnormal distribution obtained on total PSA, PSA density with p < 0.05. Of the data on the data with a normal distribution, age and TAUS with values obtained p 0.039 and p 0.738. From these data it can be said there is a relationship between age and Gleason score where the higher the age the higher the Gleason score. TAUS of the data can be said there is no relationship between TAUS and Gleason score. Then the abnormal distribution of the data obtained with a total PSA p < 0.001 and PSA density p < 0.001. The data is obtained from the relationship between total PSA and PSA density with Gleason score. Conclusion: It was found that age, total PSA, PSA density affect the increase in Gleason score where the higher the age, total PSA and PSA density the higher the Gleason score in patients
ETIOLOGY OF MALE INFERTILITY IN JAKARTA
No full textObjective: The etiology and risk factors of male infertility in huge Indonesian population has not yet been defined. This study was aim to evaluate the distribution and pattern of male infertility in Jakarta. Material & Methods: Retrospective study of Infertility database of Cipto Mangunkusumo Referral Hospital Jakarta, Bunda Hospital Jakarta, and ASRI Hospital Jakarta from 2005 until 2015 were analyzed using SPSS ver. 20. Patients’ characteristic and demography were stated. Results: There were 1062 patients with most of them suffered from primary infertility of their first time-marriage. Average age of husband, wife, and duration of marriage were 36.63± 7.10, 32.32 ± 4.92, and 5.7 ± 4.18 years old respectively. Smoking habit was recorded in 25% of patients while exposure and occupational hazard were only found in less than 2% of them. Coital problems occured in 17% of patients with 30% of them did not have routine sexual intercourse per week. Physical examination revealed that more than 70% of them had varicocele while USG Doppler of scrotum found varicocele in less than 50%. Only 5.13% of patients had normal sperm analysis, mostly azoospermia. Hormonal abnormality occured in more than 30% patients, varied in testosterone, FSH, and LH level.Conclusion: Male infertility was mostly caused by abnormal sperm characteristics followed by abnormal hormonal analysis. Exposure and occupational hazard did not play a big role in male infertility. Future study in risk factors of abnormal sperm characteristics could be done
PERBEDAAN ANGKA KEJADIAN FISTEL URETROKUTAN PADA PENGGUNAAN KATETER URETRA DAN KATETER SUPRAPUBIK DENGAN STENT SETELAH OPERASI HIPOSPADIA
Get PDFObjectives: To study rate of urethrocutaneous fistula formation associated with usage of indwelling urethral catheter compared to suprapubic catheter with stent after hypospadias repair. Materials and methods: Twenty patients with primary hypospadias of penile shaft and posterior type underwent reconstruction with onlay technique by a single operator. Urinary diversion in 10 patients utilised a urethral catheter, while the remainder used a silicone suprapubic catheter with stent. Results: Seven urethrocutaneous fistula were observed (35%) with 4 fistulas in the group with suprapubic catheter and stent, and 3 fistulas in the group with urethral catheters. Fisher exact test value was 0,001 with significance level of 1,000 (p>0,05). Conclusion: There was no difference in rate of urethrocutaneous fistula with use of urethral catheter and suprapubic catheterisation with stent after hypospadias repair
COMPARISON OF STONE FREE RATE OF STAGHORN STONE, RENAL PELVIC STONE, AND INFERIOR CALYX STONE FOLLOWING PCNL
No full textObjective: To compare the stone free rates on patients with staghorn, renal pelvic, and inferior calyx stones with stone burden 30 mm following percutaneous nephrolithotomy (PCNL) in Cipto Mangunkusumo General Hospital Jakarta. Material & methods: The data were collected retrospectively from PCNL medical records in Cipto Mangunkusumo General Hospital Jakarta between January 2000 and March 2011. Six hundred and twenty-three patients with 651 kidney stones underwent PCNL. The inclusion criteria were staghorn stones, renal pelvic stone, and inferior calyx stone. All cases outside these three criteria and incomplete data were excluded. Stone free status was defined as no residual fragment on radiography or ultrasonography. Results: As many as 364 kidney stones from 344 patients were included, with 47.8% cases of staghorn stones, 31.9% cases of renal pelvic stones, and 20.3% cases of inferior calyx stones. Overall, 273 (75%) cases were defined as stone free. In group 30 mm, 83 staghorn stones (55.7%), 28 renal pelvic stones (75.7%), and 8 inferior calyx stones (80%) were cleared (p = 0.037). Conclusion: PCNL is an important tool for treating various kinds and sizes of kidney stones with high stone free rate
PERBANDINGAN ANGKA BEBAS BATU PADA PASIEN BATU KALIK DENGAN PEMBERIAN DIURESIS DAN TANPA DIURESIS SELAMA ESWL
Get PDFObjective: To compare effects of intravenous hydration, both with and without diuretics on the stone free rate of calyceal stones during ESWL. Materials and Methods: We analyzed 22 patients with calyceal stone, primarily treated with Sonolith Vision lithotripter, between June 2008 and October 2008. Patients were divided in 2 groups, the 11 patients in group 1 were injected with 500 ml normal saline for intravenous hydration, and 20 mg of furosemide for diuretic effect during ESWL; the 11 patients in group 2 were used as controls. The same energy settings for the shockwaves in one session were equally applied to all patients during ESWL, with a 1 Hz shockwave frequency, 100% power and 1000 shocks. After 2 weeks the stone free rate and residual fragments were evaluated on the post ESWL KUB and compared with the pre-ESWL KUB. Results: After a single ESWL treatment, the stone-free rate was 81,8% (9 of 11 patients) in group 1 and 63,3% (7 of 11 patients) in group 2. The stone free rates of group 1 was higher than that of group 2, but there was no statistical difference between groups 1 and 2. Conclusion: Intravenous hydration with normal saline with a furosemide injection for diuretic effect during ESWL would be same effective method to facilitate fragmentation and stone free of calyceal stones