Indonesian Journal of Urology
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COMPARISON OF SEXUAL DYSFUNCTION BETWEEN END-TO-END ANASTOMOSIS AND BUCCAL MUCOSA GRAFT
Get PDFObjective: The aim of this study was to compare long term follow-up of sexual dysfunction between end-to-end anastomosis or buccal mucosa graft in short segment bulbar urethral stricture. Material & Method: We performed a meta analysis of cohort study. The data sources was MEDLINE from 1980 through 2011. A fixed effects model with Mantel-Haenszel method was used to calculate the pooled Risk Ratio (RRs) and 95% Confidence Interval (CIs). We assessed the heterogeneity by calculating the I2 statistic. All analyses were performed with Stata statistical software, version 10.0 (Stata Corp). Results: We analyzed 6 cohort studies. End-to-end anastomosis and buccal mucosa graft patients who complained about sexual dysfunction were 24.6% (45/183) and 9.1% (11/122) respectively, with overall RR 2.54 (95% CI, 0.22-0.69, p = 0.001). Conclusion: Buccal mucosa graft showed a superior outcome compared to end-to-end anastomosis, based on sexual dysfunction in ≤ 3 cm bulbar urethral stricture treatments.Keywords: Sexual dysfunction, end-to-end anastomosis, buccal mucosa graft, anterior urethral stricture
DISTRIBUTION OF GLEASON SCO¬RE IN PROSTATE ZONES AMONG PROSTATIC CANCER PATIENTS
Get PDFObjective: To analyze the distribution features of Gleason score in the different prostate zones. Material & Method: Twenty paraffin block specimens of radical prostatectomy were analyzed looking for Gleason score distribution in each zone. Specimens were stained with Hematoxilin Eosin. Results: Among the 20 cancers, 16 (80%) specimens had more than one focus. Most foci were found in peripheral zone (95%), only one specimen contained foci solely found in transitional zone. More than half (55%) prostate specimens contain three different Gleason grades. Only one specimen contained a single grade. Conclusion: Our results confirm the heterogeneous, multifocal, and multizonal nature of prostate carcinomas. Most specimens had more than one tumor focus, with predominant location in the peripheral zone. Almost all transition zone foci were found concomitantly with peripheral zone foci.
Keywords: Prostate cancer, prostate zones, Gleason score
EVALUATION OF PROSTATE BASAL CELL BY CYTOKERATIN 903 STAINING IN PROSTATIC ADENOCARCINOMA GLEASON SCORE 6
Get PDFObjective: To evaluate the role of prostate basal cell staining in diagnosing Gleason score 6 prostate cancer. Materials & Methods: During research period, we collected 20 medical records and paraffin block specimens of Gleason score 6 prostatic adenocarcinoma patients. Specimens were taken from prostate needle biopsy. Demographic data and PSA level were extracted from medical records. Basal cells were detected by immunohistochemical staining for antikeratin 34β-E12 on paraffin block specimens analyzed by an experienced pathologist. Positive results suggest a benign lesion. Results: Mean age is 70 ± 6,5 years. Mean prostate volume and PSA level was 52±17cc and 25±21 ng/ml. Three specimens (15%) showed presence of basal cells on antikeratin 34β-E12 staining, which indicated benign lesions. Leucocyturia was found in all patients of this group. There was a significant association between PSA level and antikeratin 34β-E12 staining (p=0,03). In multivariate analysis, there is no significant association between antikeratin 34β-E12 staining with age, prostate volume, and leucocyturia. Conclusions: 15 % cases of prostatic cancer Gleason score 6 still showed basal cell existence. Immunohistochemical staining of basal cell should be considered in suspicious cases of prostatic cancer.
HUBUNGAN TGF-β1 DAN ESTROGEN DENGAN VOLUME PROSTAT PADA PASIEN BPH, PASIEN TUA NON BPH, DAN PASIEN MUDA
Get PDFObjective: To determine the correlation of TGF-b1 and estrogen with prostate volume in BPH patients, old patients without BPH and young patients. Materials and methods: We enrolled 30 patients and allocated them into three groups. First group consists of BPH patients, second group consists of old male patients with more than 55 years of age, and third group consists of young male patients with less than 40 years of age. We analyzed the level of TGF-b1 and estrogen in these patients. Transrectal USG was used to measure the prostate volume. We analyzed the correlations of TGF-b1 and estrogen level with prostate volume. Results: We found a positive strong correlation between estrogen and prostate volume in the BPH patient group (p=0,021; r coeff=0,786). Other group showed no significant correlations. Conclusion: Estrogen plays an important role in BPH pathophysiology. Further research on the influence of estrogen in BPH patients is recommended
EFEK KATETER TERHADAP FUNGSI PSA SERUM SEBAGAI PREDIKTOR VOLUME PROSTAT PADA PASIEN YANG TERBUKTI BENIGN PROSTATIC HYPERPLASIA PADA PEMERIKSAAN HISTOPATOLOGIS
Get PDFObjective: To define the use of Prostate Specific Antigen (PSA) as a predictor of prostate volume in catheterized BPH patients. Material & methods: Data were collected from medical record of symptomatic BPH patients who underwent prostate biopsy at Cipto Mangunkusumo Hospital Urology Clinic since 1994 until 2006. Data of age, serum PSA, indwelling catheter, maximal flow, urine residue, and prostate volume were recorded as variables. Patients who had histopathological result of BPH with or without prostatitis were included; while who had prostate carcinoma, high grade prostatic intraepithelial neoplasm (HGPIN), and BPH with atypical small acinar proliferation (ASAP) were excluded. Subject were then divided into 2 groups, catheterized or not. Data were analyzed using Mann-Whitney test, analysis of variance, correlation test and linear regression test. Results: Of 2283 patients were performed prostate biopsy, 1036 patients had results of BPH with or without prostatitis, 766 patients had prostate carcinoma, while 581 patient’s biopsy result were not recorded. Of the 1036 patients, 347 were catheterized, 192 non-catheterized, and 457 were not recorded. In the catheterized group the average age were 67,04 years old, serum PSA 26,88 ng/ml, prostate volume 54,33 ml, PSA density 0,39. In non-catheterized group the average age were 66,32 years old, serum PSA 16,58 ng/ml, prostate volume 53,94 ml, PSA density 0,33. Regression test showed that serum PSA could be used as a predictor of prostate volume (F=12,830; p < 0,001); in non-catheterized group it was stronger (F=12,989; p<0,001) than in catheterized group (F=6,814; p<0,01). The accuracy of serum PSA as a prostate volume predictor based on Receiver Operating Curve (ROC) as indicated by Area Under the Curve (AUC), in the catheterized group was 0,678 - 0,725 (p<0,001); in non-catheterized group was 0,723 - 0,784 (p<0,001). Conclusion: Serum PSA could be used as a predictor of prostate volume in patients with BPH wether catheterized or not. This predictor function is stronger in non-catheterized patients. Catheter has the effect of lowering the function of serum PSA as a prostate volume predictor in patients with BPH
VALSARTAN TO ATTENUATE RENAL DAMAGE IN UNILATERAL URETERAL OBSTRUCTION
No full textObjective: This experimental study aims to observe the effect of valsartan to attenuate renal damage in unilateral ureteral obstruction. Material & method: Experimental study was performed using 30 wistar rats with unilateral ureteral obstruction achieved by ligation of the left ureter. Rats were divided into two groups, no treatment group and valsartan group. At the 14th day, evaluation was performed to compare interstitial fibrosis, hydropic degeneration, and tubular atrophy between the two groups using haematoxylin-eosin staining. Only rats surviving until at least the 7th day are included in the study. Results: From thirteen wistar rats in no treatment group, there were two with moderate interstitial fibrosis and eleven with mild interstitial fibrosis while all rats in valsartan group had mild interstitial fibrosis (p > 0.05). There is no significant difference on hydropic degeneration between no treatment and valsartan group (31.46 vs 33.67; p > 0.05). There is also no significant difference in tubular atrophy between the two groups (61.78 vs 62.07; p > 0.05). Conclusion: Valsartan therapy in antihypertensive dosage has no significant effect in to attenuate interstitial fibrosis, hydropic degeneration, and tubular atrophy in unilateral ureteral obstruction in wistar rats. Keywords: Unilateral ureteral obstruction, valsartan, interstitial fibrosis
VALIDATION OF INDONESIAN VERSION OF IPSS
No full textObjective: This study aims to validate the Indonesian version of International Prostate Symptom Score (IPSS)to ensure similar purpose and quality as the original version. Material & method: Validation and reliability of IPSS-Ina was performed on 174 subjects divided into 87 benign prostate hyperplasia(BPH) patients and 87 non-BPH subjects as a control group. A total of 33 patients in the BPH group then underwent TURP. Validation was assessed by correlating the IPSS score-Ina with a quality of life score (QoL). Reliability was tested by internal consistency with Cronbach α and test-retest trials. Sensitivity to changes in IPSS-Ina post-therapy was tested by comparing the mean IPSS before and after transurethral resection of the prostate (TURP) therapy. Results: Correlation between IPSS-Ina score with quality of life (QoL) was 0.85 (p <0.001),showing strong correlation.Results of Cronbach's α 0.93; while test-retest trials with the intraclass correlation coefficient (ICC) 0.99; which indicates a very good reliability. The mean initial IPSS-Ina (20.97 ± 4.4) with post-TURP (4.82 ± 1.77) differed significantly (p <0.001). Conclusion: IPSS-Ina proved excellent validation and reliability and was sensitive to symptomatic changeafter therapy. IPSS-Ina have the same goals and the quality of the original version.Keywords: International prostate symptom score, Indonesia, validation, reliability.
AGE-RELATED CHANGES IN RENAL RESISTIVE INDEX AFTER ESWL
No full textObjective: To determine relation between age and resistive index (RI) changes occurring after extracorporeal shock wave lithotripsy (ESWL). Material & Method: We performed a prospective study in Soetomo Hospital Surabaya. Using duplex ultrasonography, RI was determined in 20 patients with calyceal kidney calculi and pelvic kidney calculi. RI of the interlobar renal arteries were measured in the region near the calculi (distance, less than 2 cm), one hour before ESWL and RI was measured again at 1 hour, 3 days and 7 days after ESWL. Changes in RI values and relation with age (≤ 60 years old and > 60 years old) were evaluated. Results: The renal RI increased significantly 1 hour and 3 days after ESWL, but returned to before ESWL values 7 days after ESWL in the both groups. Although there was positive correlation between age and RI before ESWL, but there was no correlation between age and RI changes after ESWL. Conclusion: Renal RI is higher with age > 60 years, after ESWL renal RI showed transient increase which returned to baseline after 7 days.Key words: Color Doppler Ultrasonography, extracorporeal shock wave lithotripsy, renal resistive index, calyceal kidney calculi, pelvic kidney calculi
EFEK PAPARAN GLUKOSA KONSENTRASI TINGGI TERHADAP PENINGKATKAN AKTIVITAS ISOZIM PROTEIN KINASE C (PKC)-ALPHA PADA KULTUR SEL STROMA PROSTAT
Get PDFOBJECTIVE: To prove that glucose treatment in human prostatic stromal cells (HPSC) culture would increase PKC alpha isozyme activity. MaterialS & Methods: Primary cultures of HPSC were obtained from patients with bladder outlet obstruction caused by benign prostatic enlargement. The effects of various concentrations of glucose (5, 10, 15, 20, 25, 30, 35 micro-Mol) on PKC-alpha isozyme activity were examined quantitatively by spectrophotometry methods. ResultS: Spectrophotometry analysis, which is used to assess isozyme activity quantitatively, showed that exposures to various doses of glucose resulted in increased isozyme activity. The increment of activity is linear with the increment of glucose dose. There is a strong correlation between glucose doses and PKC-alpha activity, with R2 = 0,91. Conclusion: At different concentrations glucose increases PKC-alpha isozyme activity of HPSC
PROSTATE CANCER MANAGEMENT IN MOEWARDI HOSPITAL SURAKARTA FROM JANUARY 2000 – DECEMBER 2006
No full textObjective: To describe the prostate cancer management in Dr. Moewardi Hospital Surakarta on January 2000 – December 2006. Materials & Methods: This study is a retrospective descriptive. The data was collected from Dr. Moewardi Hospital Surakarta’s medical record in seven years, from January 2000 to December 2006. Results: We found that thirty patients with prostate cancer with age above 50 years and mostly found on age 71 – 75 years (23,3%). The most common complain that can be found are LUTS (76,7%). Malignancies was found on digital rectal examination on 76,7% patients. About 28 patients with PSA level > 4ng. Most of the patients (20/66,7%) comes with T2 stadium and seven of them (23,3%) with metastize to the pelvic bone. All of the patient was administered with TUR-P, 7 patients with metastize administered to orchidectomy and hormonal therapy (23,3%), and only one of them continued with radiotheraphy. All of the prostate materials that analyze on pathyologic examination are adenocarcinoma of the prostate with 50% speciments are poorly differentiated. Conclusion: From thirty patients diagnozed with prostate cancer, most of them was found between 71 – 75 years old. The common complain are urinary retention, LUTS and pelvic bone metastize. The pathologic examination we shows all of the speciments are adenocarcinoma of the prostate and they are poorly differentiated