Indonesian Journal of Urology
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URINARY NEUTROPHIL GELATINASE-ASSOCIATED LIPOCALIN AND CREATININE SERUM BPH PATIENTS WITH ACUTE URINE RETENTION TO DETECT KIDNEY FUNCTION DISORDERS
No full textObjective: The main objective of this study was to determine renal function in patients with Benign Prostate Hyperplasia (BPH) in acute urinary retention period and two weeks after catheter insertion using creatinine serum and urinary Neutrophil Gelatinase-Associated Lipocalin (NGAL) biomarker parameters.Materials & Method:This is an observational co-hort study conducted in patients with BPH with acute urinary retention who came to Soetomo General Hospital, Surabaya. All the patients underwent laboratory investigation that were urinary NGAL and creatinine serum, marker of renal function.Result: The mean creatinine serum of 31 samples when retention phase was 1.6 ± 0.9 mg/dL and it decreased after 2 weeks of urinary catheter insertion (1.46 ± 0.89 mg/dL). Mean urinary NGAL level when retention phase was 308.1 ± 244.8 ng/dL, and after 2 weeks after urinary catheter insertion it decreased to 158.5 ± 123.3 ng/dL. There was significant decreasing creatinine serum and urinary NGAL levels in patients with BPH and acute urinary retention in the retention phase 2 weeks after urinary catheter insertion, with p value < 0.006 and < 0.0001, respectively. There was no significant correlation between the duration of retention and urinary retention volume (p>0.05).Conclusion: There was a significant decreasing creatinine serum and urinary NGAL levels in patients with BPH and acute urinary retention in retention phase and two weeks after urinary catheter insertion. There was no significant correlation between the urinary NGAL and creatinine serum and the duration of retention and urinary retention volume
MATURE RETROVESICAL TERATOMA IN AN ADULT MALE: A CASE REPORT AND LITERATURE REVIEW
No full textObjective:We reported a case of mature (benign) cystic retrovesical teratoma. Retrovesical teratoma is a very rare extragonadal tumour, especially in adults, moreover in male patients. Grading and classification of teratoma is important for management and prognosis.Material & method:The patient in this study was a 49-year-old male who had chief complaints of abdominal mass and difficulty in urination. We performed Ultrasonography (USG) and Abdominal Multislice Computed Tomography (MSCT) scan on the patient. Results: USG showed a large mass in the pelvic region demonstrating a well-defined hypoechoic mass with septations at posterior of vesica urinaria. MSCT scan showed a large inhomogeneous hypodense mass with thin septations as well as multiple areas of fatty collections and coarse calcifications in pelvic region. We performed complete surgical resection per laparotomy. Grossly, the mass measured 12 x 10 x 5 cm and had rubbery consistency. Cut section of the mass revealed multilocular cystic spaces, whitish-gray walls, scattered yellowish adipose tissue collection, mucus secretions, and areas of calcifications. Pathological diagnosis of the resected tumour was a matured teratoma. The diagnosis was made because the tumour showed signs of a mature teratoma such as lined by stratified squamous and respiratory columnar eptithelium, fat and muscle tissue, nerve tissue, and calcifications. Conclusion: There were no neuroepithelium appearance. To our knowledge, this is the first retrovesical teratoma case being reported in Indonesia
HUBUNGAN ANTARA DERAJAT INTRAVESICAL PROSTATIC PROTRUSSION DENGAN Q MAX, VOLUME PROSTAT, DAN INTERNATIONAL PROSTATE SYMPTOM SCORE PADA PASIEN BPH DENGAN LUTS TANPA KOMPLIKASI
Get PDFObjective: The prostate volume is an objective due to BPH diagnosed, however it is not always concerned with the LUTS degree. LUTS is a syndrome of BOO which marked by obstructive and irritable symptoms. The ball valve mechanism in bladder neck results in increasing of BOO. The aim of this study is to prove the relation of intravesical prostatic protrussion (IPP) with prostate volume, Q max, and international prostate symptom score (IPSS) in non complicated BPH LUTS patients. Materials and method: This research is an analysis observational that involved 85 male patients aged 50 to 91 years old (average 63,98 years old) in Urology Outpatient Clinic RSUD Dr. Soetomo, starting November 2007 until April 2008. Such IPSS evaluation, prostate volume measurement, uroflowmetry examination, and IPP examination with TAUS were applied to all of these patients. Results: The calculation shows the increasing of IPP degree followed by the decreasing of Q max value, where Spearman rank correlation indicates r=-0,465 with p=0,001 (smaller than 0,05), which shows the relation between IPP and Q max. In Spearman rank correlation, with the IPP degree increasing followed by IPSS value increasing indicates r=0,456 and p=0,001, which is smaler than 0,05. Also shows the increasing of IPP degree followed by prostate volume increasing, with r=0,230 and p=0,034 is smaller than 0,05 in Spearman rank correlation. Conclusion: The research reveals a connection between IPP degree and Q max, where the higher IPP degree the lower Q max value, the higher IPP degree the bigger IPSS value, and the higher IPP degree the bigger prostate volume
PRODUKSI ANTIBODI POLIKLONAL HASIL INDUKSI ISOLAT PROTEIN NON KINASE DARI MEMBRAN SPERMATOZOA MANUSIA
Get PDFObjective: The aim of this research is to get the profile of human sperms membrane protein based on identification for molecular weight, concentration protein, phosphorylation activity, and ability to raise enough antibodies. Material and methods: There are three phases in this research, first, isolation protein of human sperms membrane with using lysis buffer containing Tween-20, second, determination of molecular weight, phosphorylation activity, and protein concentration, and third, antibody production. Molecular weight of protein membrane was detected by SDS-PAGE, confirmation of protein concentration measured Biuret method, kinase activity measured using spectrophometry at its optimum condition, and then production of antibody that corfirmed by ELISA technique. Results: Human sperms contain the protein with molecular weight of 201, 163, 116, 97, 72, 56, 48, 32, 27, 20, and 17kDa. The highest phosphorylation activity was found on protein with molecular weight of 20 kDa is 30.197x 10-3 unit, while the lowest phosphorylation activity is 28.976x10-3 unit was shown on protein with 116 kDa of molecular weight and then this protein can induce production of antibody. Biuret method show the protein concentration from protein with molecular weight 116 kDa is 410 ug/mL. Conclusion: The protein that has molecular weight of 116 kDa can be used as immunocontraception agent because phosphorylation activity has lower, good concentration, and could induce the production of antibody
FACTORS ASSOCIATED WITH TUMOR RECURRENCE IN STAGE 1 BLADDER TRANSITIONAL CELL CARCINOMA IN SARDJITO HOSPITAL YOGYAKARTA
No full textObjective: This study is assigned to evaluate factors associated with tumor recurrence in patients with superficial transitional cell carcinoma (TCC) of bladder in Sardjito General Hospital Yogyakarta. Material & methods:A prospective observational study design is conducted to evaluate patients with T1 TCC of bladder between 2011 and 2012. Inclusion criteria was patients with T1 TCC of bladder from pathological report. The independent variables are ages, hemoglobin, albumin, creatinine level, urine cytology, tumor grade, tumor diameter, number of tumor, and intravesical chemotherapy. The outcome measure is tumor recurrence during cystoscopy at 3, 6, 9, and 12 month after first resection. This study used chi-square and logistic regression analysis as statistical methods with p < 0.05 and a = 5% are considered significant. All analyses were performed with SPSS statistical software, version 20.0. Result: Sixty-two patients were participated in this study with mean age 60.62 ± 12.15 years. There were 32 patients (51.6%) who had tumour recurrence during first year that need to be resected. Of these patients, 9 patients (14.5%) had tumour recurrence more than one time during first year. In multivariate analysis, factors associated with tumour recurrence were tumour grade (p = 0.041, CI = 0.008-0.908), number of tumor (p = 0.003, CI = 0.003-0.293), and intravesical chemotherapy (p = 0.022, CI = 0.015-0.719). Conclusion: Degree of tumor differentiation, number of tumor and intravesical chemotherapy are factors affecting recurrence of stage 1 transitional cell carcinoma of the bladder
EVALUATION OF SIGN AND SYMPTOMS RELATED TO INDWELLING URETERAL STENTS
No full textObjective: To study factors that influence signs and symptoms related to stented ureter. Material & methods: This was a prospective-cross sectional study, from March 2014 to August 2014, to know factors that influence signs and symptoms of patients with ureteral stent. All patients were inserted ureteral stent participated in this study. Exclusion criteria were patients with malignancy, patients who had history of DJ stent placement previously, patients with bilateral DJ stents and patients with urinary tract infection. All patients completed IPSS questionnaire before inserted stents. After 1 month, when removal DJ stents performed, all patients completed IPSS, USSQ and VAS. All data was analyzed with Chi-square/fisher exact test, Pearson/Spearman correlation and Mann Whitney. Results: Fourty patients consisted of 23 man (57.5%) and 17 women (42.5%) completed this study. The mean age was 44.92 years old and length of stented ureter was 38.22 days. There was significance correlation between IPSS of DJ stent pre-insertion and post insertion (p < 0.001; r = 0.628). Of the patients reported dysuria (62.5%), frequency (55%), nocturia (52.5%), incomplete emptying (47.5%), hematuria (35%) and urgency (15%). On bivariate analysis, there was significance correlation between DJ stent position and frequency (p < 0.001), nocturia (< 0.001), urgency (p = 0.002), incomplete emptying (p = 0.049), dysuria (p = 0.030), hematuria (p = 0.026) and pain (p < 0.001). Conclusion: Previous urinary symptoms and DJ stent position were factors that influenced sign and symptoms related to ureteral stent insertion
HOLMIUM LASER: YAG LITHOTRIPSY IN URETERAL CALCULI MANAGEMENT
No full textObjective: To know predictive factors for success of holmium laser: YAG lithotripsy in ureteral calculi management. Materials & Methods: This prospective cohort study was conducted in January 2013 to May 2015 at Kardinah Tegal Hospital Central Java. Patients diagnosed with proximal and distal stones were included. Pediatric, obesity, pregnancy, ureteral anomaly, and ureteroscopy (URS) cannot reach ureteral level of stone were excluded. We used semirigid URS (Wolf) 6/7.5F, monitor video, and holmium laser: YAG litotriptor (Versa Pulse, Lumenis, Germany), with wavelength 2100 nm, output 1-60 watt, fiber length 365 μm, laser power 2.5-10 watt with energy 0.5-1 Joule/5-15 Hz. Results: Of 50 ureteral stone patients, consisted proximal 13 (26%) and distal 37 (74%) were included in this study. Mean age 42.94 ± 11.31 years, with 28 male (56%) and 22 female (44%). Mean stone burden was 88.10 ± 57.41 mm2. There were 6 (12%) patients with multiple stones. This procedure consumed energy 1079.02 ± 1624.00 joule and duration of operation was 19.02 ± 21.17 minutes. We inserted DJ stent after the procedure in 41 patients (82%). There were 2 failure (4%), which were stone migration to kidney and conversion to open surgery. There were significant differences of stone burden (p 0.013), duration of operation (p 0.038), and stone number (p 0.000) with stone free rate, but not in age, sex, stone location and energy. Stone free rate of this procedure was 90%. Conclusion: Stone burden, duration of operation, and stone number were predictive factors for success of holmium laser: YAG lithotripsy in ureteral calculi management
Sensitivity and Specificity of Urinalysis to Diagnose Urinary Tract Infection (UTI) in Patients with Urolithiasis at RSUP Dr. Sardjito Hospital
No full textObjective: Urolithiasis could be caused by urinary tract infection (UTI). UTI in patients with urolithiasis need to be diagnose and manage as soon as possible. This study was aim to determine the diagnostic value of urinalysis examination to diagnose urinary tract infection (UTI) in patients with urolithiasis.Material & method: This study was an observational analytic with cross sectional study design, comparing one diagnostic tool with the gold standard tool to diagnose UTI. Total samples collected were 186 patients at Sardjito General Hospital, Yogyakarta. Urine culture and urinalysis were performed in patients with urinalysis and UTI. The results of urine culture and urinalysis were then compared by 2x2 table.Results: The sensitivity results on leukocyte esterase, eritrocyturia, bacteriuria, and nitrite respectively were 82.7%, 57.14%, 37.59%, and 13.53%. The specificity results on nitrite, bacteriuria, eritrocyturia, and leukocyte esterase respectively were 63.26%, 56.60%, 50.94%, and 33.96%. The highest level of accuracy was leukocyte esterase with 68.81% accuracy.Conclusion: This study showed that leukocyte esterase had good sensitivity with an accuracy of 68.81%. Examination of nitrite had the highest specificity compared to the other variables in urinalysis examination
PERANAN ISOZIM PROTEIN KINASE C-ΑLFA DALAM MEMEDIASI EFEK ANTIPROLIFERASI ALFA-TOKOFEROL PADA SEL STROMA PROSTAT
Get PDFObjective: Alpha tocopherol, other than its anti-oxidant activity, also has a non anti-oxidant activity that correlates with inhibition of PKC-alpha isozyme activity. Several studies had confirmed its role in inhibition of vascular smooth muscle proliferation. Inhibition of stromal cell proliferation is an alternative method of prevention in BPH development. The aim of this in vitro study is to confirm that alpha-tocopherol, by its ability to inhibit PKC-alpha activity, has the capability to inhibit human prostatic stromal cell proliferation rate. Materials & Method: Primary cultures of human prostatic stromal muscle cells were obtained from 4 patients with bladder outlet obstruction caused by benign prostatic enlargement. The effects of various concentrations of alpha-tocopherol (20, 30, 40, 50, and 60 microM) were examined by cell proliferation and PKC-alpha isozyme activity assay. Cell proliferation study was performed using the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay method. Caspase-3 activity assay was also performed to examine apoptotic mechanism. Results: MTT method, which is used to count viable cells, showed that exposures to various doses of alpha-tocopherol resulted in decreased proliferation rate. The decrement of proliferation rate is linear with the increment of alpha-tocopherol dose. Immunocytochemistry staining with anti caspase-3 antibody showed that no cells developed apoptosis. Alpha-tocopherol also inhibits PKC-alpha activity. Isozyme activity is reduced along with the increment of the dose (dose-dependent). There is a correlation between PKC-alpha activity with cell proliferation rate after exposure to alpha-tocopherol (R2=0,9279; p=0,000). Conclusion: Alpha-tocopherol at different concentrations reduces prostatic stromal cell proliferation rate, without effect on apoptosis. This antiproliferative property correlates with decreased activity of PKC-alpha isozyme
PENGARUH ISKEMIA TERHADAP PENINGKATAN KOLAGEN PADA KORPUS KAVERNOSUM
Get PDFObjective: To demonstrate that ischemia causes elevation of collagen in cavernous body. Material & Method: Sample used in this study were male adult rabbits (Oryctalagus Cuniculus) 6 – 9 months of age. Partial ligation of both common iliac arteries was performed in this study to induce cavernous body ischemia. Results: Collagen mean for 7 x 24 hours ligation group (group B) increased to 113,83/200 compared to the collagen mean for the 2 x 24 hours ligation group (group A) which was 91,08/200 and collagen mean for control group (group C) which was 86,90/200. There was collagen elevation on treatment group which caused by ligation (Anova, F value= 12,110 and p=0,0001). Conclusion: Ischemia may elevate collagen in cavernous body.