Indonesian Journal of Urology
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THE CORRELATION OF NOCTURIA INCIDENCE AND ANXIETY LEVELS DURING THE COVID-19 PANDEMIC
Get PDFObjective: This study aims to examine the relationship between nocturia and anxiety levels as precipitating factors in related study population. Material & Methods: This study used a survey facilitated via Google Form, using the International Consultation on Incontinence Questionnaire Nocturia, Zung Self-Rating Anxiety Scale, and a Demographic Data Questionnaire to obtain corresponding data. The descriptive-analytic method was applied, and Chi-square statistical analysis was performed. Results: From 270 participants, 240 exhibited normal anxiety levels, 28 demonstrated mild to moderate anxiety levels, and two presented severe anxiety levels. Furthermore, 148 participants reported experiencing nocturia, while 122 participants did not exhibit nocturia. Conclusion: This study showed no correlation between anxiety levels and nocturia in students from the Nutritional Science and Nursing Science Programs at Universitas Brawijaya, batches 2019, 2020, and 2021.
Keywords: Anxiety level, nocturia, covid-19
BUCCAL MUCOSAL GRAFT ONLAY TECHNIQUE FOR UPPER URETERIC AND UPJ STRICTURES
Get PDFObjective: In this paper we report our experience in the use of buccal mucosal grafts in the reconstruction of difficult upper ureteric and uretero-pelvic junction strictures. Material & Methods: We retrospectively looked at our hospital inpatient and outpatient records of all patients who underwent surgical treatment for benign upper ureteric strictures and ureteropelvic junction strictures. Results: During the study period a total of 22 patients with a mean age of 326.07 years underwent buccal mucosal graft repair. The mean length of the narrowing/stricture was 6.40 1.44 cm. Conclusion: Buccal mucosal onlay graft ureteroplasty is a suitable treatment option for long, complicated benign upper ureteric and select ureteropelvic junction strictures. It is technically simple and capable of providing optimum patency of ureter with good urinary drainage. It is safe and effective.
Keywords: Buccal mucosa, ureteric stricture, ureteropelvic junction stricture, graft, ureteroplast
SIMULTANEOUS BILATERAL UPPER URINARY TRACT UROTHELIAL CARCINOMA (UTUC) WITH LEFT NEPHROURETERECTOMY AND RIGHT ILEOURETERAL REPLACEMENT: A CASE REPORT OF CURATIVE APPROACH
Get PDFObjective: The report aims to present a rare bilateral UTUC focusing on diagnostic and surgical treatment to improve the survival rate of patients with bilateral UTUC. Case(s) Presentation: We present a case report of a 59-year-old male who came in with gross hematuria accompanied with clots. Laboratory reveals a decreased renal function, while CT shows a bilateral mass in both ureters and left renal pelvis without bladder involvement. The patient then underwent left nephroureterectomy and right ureterectomy. In Intraoperative we preserve the right kidney by evaluating the tumor margin using ultrasound and ureteroscopy and deciding to substitute a full-length ureter with ileum as a precaution for a safety margin. Later on the pathological examination shown high-grade invasive urothelial cell carcinoma on both sides with staging pT2N0M0. Six months after surgery patient is in an excellent condition; weight and karnofsky score improvement. The Baseline Creatinin level was decreased, whereas CT showed no residual tumor in the right urinary tract system. Discussion: This article presents a rare case of bilateral UTUC with staging pT2N0M0 that was successfully treated with multidisciplinary care of radical and reconstructive surgery without chemotherapy. Conclusion: Bilateral UTUC is a scarce case, even among all urologic malignancies. Preserving kidney function in these cases is a priority to reduce further morbidity for the patient.
Keywords: Bilateral UTUC, nephroureterectomy, ileoureteral replacement
ASSESSING CARDIOVASCULAR SAFETY OF TESTOSTERONE REPLACEMENT THERAPY FOR MALE HYPOGONADISM: A SYSTEMATIC REVIEW AND META-ANALYSIS
Get PDFObjective: This study aims to comprehensively assess TRT's cardiovascular safety in males with hypogonadism, providing valuable insights for treatment decisions. Material & Methods: Adhering to PRISMA guidelines, we registered our PROSPERO protocol and analyzed relevant English-language randomized clinical trials published from 2008 to 2023. Results: Among 1187 initial papers, 7 studies met inclusion criteria, with 6 in quantitative analysis and all 7 in qualitative assessment. Our findings indicate that TRT does not significantly increase the risk of cardiovascular events compared to placebo. Specifically, the analysis of major adverse cardiac events (MACE) yielded an OR of 0.90 (95% CI: 0.74, 1.10; I² = 26%; p = 0.25), while the evaluation of all cardiovascular adverse events revealed an OR of 1.37 (95% CI: 0.73, 2.55; I² = 75%; p = 0.001). Conclusion: This study offers reassurance for clinical decision-making by suggesting that TRT is not significantly associated with an elevated cardiovascular risk in hypogonadal men, addressing the ongoing debates on this issue.
Keywords: Cardiovascular safety, hypogonadism, testosterone replacement therapy
GIANT HYDRONEPHROSIS DUE TO URETEROPELVIC JUNCTION STENOSIS IN PEDIATRICS: A RARE CASE
Get PDFObjective: This case report presented giant hydronephrosis (GH) due to Ureteropelvic Junction Stenosis in pediatrics. Case(s) Presentation: A three-year-old boy was admitted with abdominal distension and pain for the last three month. CT scan without contrast of the abdomen showed a left kidney size of 141x 97x 63.5 mm, massive dilatation of the pelvicalyceal system, thinning cortex in the left kidney, and left ureter measurement of 16 mm in diameter. An urgent percutaneous nephrostomy tube (10Fr) was placed in the left kidney for this patient, followed by a pyeloplasty procedure in the next three weeks. The patient was discharged on day five, and the six-month follow-up results were good. Discussion: Giant Hydronephrosis is a rare entity, with less than 500 global cases reported in the literature. The diagnostic approach to suspected hydronephrosis in pediatrics is sonography and may be followed by CT or MRI. Management of giant hydronephrosis requires two stages procedure with percutaneous nephrostomy followed by pyeloplasty. This two-stage method ensure the renal function is preserved. Conclusion: Ureteropelvic Junction Stenosis is a common cause of giant hydronephrosis in pediatrics. Appropriate physical examination and other diagnostic approaches are needed to diagnose patients with giant hydronephrosis and determine the best management.
Keywords: Giant hydronephrosis, ureteropelvic junction stenosis, pyeloplasty
A NOVEL TECHNIQUE SINGLE SITE MULTIPUNCTURES SUPINE PCNL: CASE SERIES REPORT
Get PDFObjective: To presents a case series of three patients who received PCNL during 2020 and 2021. Case(s) Presentation: We reported three cases of two females and one male, aged 54, 63, and 48. All patients were diagnosed for having the staghorn stones in the kidney. We performed the “Single Site Multipuncture Supine (SMS) PCNL” technique on these patients. Discussion: Percutaneous Nephrolithotripsy (PCNL) is the preferred surgical technique for treating staghorn or other complicated kidney stones. There are many techniques and modified positions available for PCNL. This technique removes complex kidney stones by making a one cm skin incision to accommodate multiple punctures to access all kidney poles. The highest reduction in hemoglobin was only 1.54 g/dL in the patient who got four punctures, no blood transfusion was needed during post-operative recovery, and no complications occurred during the follow-up period. All patients were stone-free post-operatively without any need for additional procedures. The mean time of overall surgery was 130 minutes. Conclusion: This single-site multi-punctures supine PCNL technique could give the advantage to cosmetics due to less tissue injury.
Keywords: Multi punctures, PCNL, staghorn stones
ASSOCIATION OF SMOKING STATUS, TYPE OF CIGARETTES AND OBESITY AS RISK FACTORS AMONG RENAL CELL CARCINOMA HISTOLOGICAL SUBTYPES
Get PDFObjective: This study aims to know the relationship between smoking and obesity as a risk factor among renal cell carcinoma histological subtypes. Material & Methods: This was a retrospective case-control study, with 67 patients with Renal Cell Carcinoma (RCC) at the Department of Urology, Hasan Sadikin Academic Medical Center Bandung from January 2012 to December 2021 as the case group, and 13 patients with benign tumors as the control group. The odds ratio and its significance were calculated. Results: In clear cell RCC, smokers (p-value=0.008), showed strong relationship to cigarette types (p-value=0.013), and obesity (p-value=0.042). In papillary RCC, smokers (p-value=0.035) showed a strong relationship to cigarette types (p-value=0.041). Cloves have a higher risk compared to filtered cigarettes (OR 2.25, 95% CI [0.54-9.25]). Conclusion: Clear cell RCC is most prevalent in smokers. Obesity is associated with clear cell RCC. Cloves pose the greatest risk of clear cell and papillary RCC.
Keywords: Obesity, RCC, smoking, cigarette
ASSOCIATION BETWEEN BODY HEIGHT AND DOUBLE J STENT INTRAVESICAL POSITION AND ITS RELATION WITH THE INDONESIAN VERSION OF URETERAL STENT SYMPTOM QUESTIONNAIRE (USSQ)
Get PDFObjective: This study aims to determine the relationship between the patient’s body height with the intravesical double J stent position and whether its position is related to the ureteral stent symptom questionnaire (USSQ). Material & Methods: A cohort study with a study population of patients inserted with double J stent size 4.7 Fr and length 26 cm was carried out at the Department of Urology Hasan Sadikin Academic Medical Center from July 2021 to July 2022. We assess the patient’s demographic features and different body heights into two categories, below and above average. Then we evaluate its stent position using a plain abdominal X-ray and the USSQ score. Results: Ninety samples were included in this study; 30 of them had a midline intravesical double J stent position, 30 pieces of contralateral, and 30 samples of ipsilateral. Only body height correlated to the stent’s position (p<0.05). The results of comparative statistical tests or the association of postoperative complications between 7 days and 30 days in the position of the double J stent midline, contralateral and ipsilateral had significant results (p<0.05). Stent with ipsilateral position showed a lower USSQ score. Conclusion: Men and women above the average height have a lower risk for migration stent to the contralateral side and are also associated with lower USSQ scores.
Keywords: Double J stent, USSQ score, double J stent position
COMPARISON OF PHARMACOLOGY AGENTS EFFECT IN TREATING URETERAL STENT RELATED SYMPTOMS: SYSTEMATIC REVIEW & META-ANALYSIS OF RANDOMIZED CONTROLLED TRIAL¬
Get PDFObjective: We wish to update existing meta-analyses to assess the effectiveness of pharmacological agents against ureteral stent-related symptoms with better design of RCTs, as well as more valid and reliable measurement methods. Material & Methods: Relevant published articles up to February 2022 were obtained from PubMed, CENTRAL, Google Scholar, Science Direct, and DOAJ. All single-blind or double-blind RCTs with various comparisons using pharmacological agents and/or placebo in patients with ureteral stent-related symptoms, with outcome assessment using USSQ at week 1 and week 4 during stent placement was included in the study. Statistical parameter Mean Difference (MD) with 95% CI was used to measure effect size. The p value less than 0.05 indicates statistical significance. Results: Alpha blockers (2 studies, 85 samples) significantly reduced fourth week UIS compared to placebo (MD: – 5.46, 95% CI: – 7.47 to -3.46, I2 = 0%, P = < 0.001), and alpha blockers (2 studies, 42 samples) significantly reduced first week SIS compared to combination therapy (MD: – 0.82, 95% CI: – 1.56 to – 0.08, I2 = 0%, P = 0.03). The results of the meta-analysis of USSQ scores in other domains have no significant differences. Conclusion: Alpha blockers were better than placebo in reducing UIS due to ureteral stent in the fourth week of stent placement, and better than combination therapy in reducing SIS due to ureteral stent in the first-week post stenting. However, more RCTs are needed with larger samples and better designs to reach valid conclusions.
Keywords: Stents, Randomized Controlled Trials as Topic, Single-Blind Method
THE EFFECT OF TAMSULOSIN 0.4 MG ADMINISTRATION TOWARDS ALTERATION OF PROSTATE SPECIFIC ANTIGEN (PSA) LEVELS IN BENIGN PROSTATIC HYPERPLASIA (BPH) PATIENTS IN PADANG CITY
Get PDFObjective: This study aims to determine the effect of tamsulosin administration on alteration in PSA levels in BPH patients in Padang. Material & Methods: This study employed an analytical method with a prospective cohort design. The research was conducted at M. Djamil General Hospital, BMC Hospital, Hermina Hospital, and Semen Padang Hospital in August - December 2022. Sampling was carried out by consecutive sampling. Results: At the end of the study, there were 23 patients with BPH. The mean age was 67.5 ± 7.7, which most of them having good education. Patients were mostly self-employed. The highest IPSS score is the severe stage. The PSA levels before and after tamsulosin administration were 1.7 ± 0.9 ng/ml and 1.6 ± 0.8 ng/ml, respectively. Bivariate analysis showed that tamsulosin administration affects PSA levels in benign prostatic hyperplasia patients in Padang. Conclusion: There is an effect of tamsulosin administration on PSA levels.
Keywords: Benign prostatic hyperplasia, tamsulosin, prostate-specific antigen