Indonesian Journal of Urology
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SURVIVAL IN PATIENTS WITH HISTOLOGIC VARIANTS OF UROTHELIAL TYPE BLADDER CANCER
Get PDFObjective: This study aims to determine the life expectancy of patients with histologic variants in urothelial type bladder cancer and the highest or lowest mortality rate in Hasan Sadikin Academic Medical Centre. Material & Methods: A cross-sectional study with total sampling. The samples in this study were patients with histologic variants of urothelial cell carcinoma bladder who received treatment at Hasan Sadikin Academic Medical Centre during the period of 2011 to 2022. Results: A total of 470 patients with a diagnosis of urothelial bladder cancer, 62 patients (13.19%) with histologic variants of urothelial bladder cancer treated with radical cystectomy or TURBT + intravesical chemotherapy at Hasan Sadikin Academic Medical Centre. The highest survival rate was in patients diagnosed with giant cell (66.7%) followed by small cell (50%) and glandular differentiation (40.0%). The 5-yearr survival rate of patients treated with radical cystectomy alone had a higher survival rate of 75.3% followed by radical cystectomy and adjuvant therapy, which was 75.2%. Conclusion: Histologic variants of bladder carcinoma that have the highest mortality rate are tropoblastic differentiation, nested type, micropappilary, and sarcomatoid with the lowest survival rate of 0%. Also, histologic variant of bladder carcinoma that has the lowest mortality rate is giant cell with a survival rate of 66.7%.
Keywords: Bladder carcinoma, chemotherapy, trophoblastic differentiation
A RARE CASE OF COEXISTING BLADDER SMALL CELL NEUROENDOCRINE CARCINOMA AND PROSTATE ADENOCARCINOMA: CASE REPORT AND LITERATURE REVIEW
Get PDFObjective: We present a case of synchronous malignancies of rare bladder small cell neuroendocrine carcinoma (SCNC) and prostate adenocarcinoma and provide literature review of bladder SCNC. Case(s) presentation: A 72-year-old male smoker presented with 3 months history of gross hematuria. Ultrasonography showed a large hypoechoic mass in the right bladder. TURBT was performed and histopathology of the TURBT specimen showed a high-grade papillary urothelial carcinoma. Abdominal contrast-enhanced computed tomography (CECT) demonstrated an isodense heterogenous undefined mass, with irregular border at right anterolateral side of bladder wall. Radical cystoprostatectomy, bilateral radical lymph node dissection and bilateral ureterocutaneostomy was performed. Histopathology and immunohistochemical examination after radical cystoprostatectomy revealed bladder small cell neuroendocrine carcinoma coexisting with prostate adenocarcinoma (Gleason score 3+3=6, group 1). The patient eventually succumbed to disease after having symptomatic disease progression and metastatic disease five months after the surgery. Discussion: Bladder SCNC is a rare malignancy with an incidence of 1–9/1,000,000 reported. This tumor has an aggressive clinical course with high incidence of metastasis, and it tends to confer dismal prognosis. No specific clinical symptom exists. Histopathological recognition and immunohistochemistry is required to differentiate this rare entity. Conclusion: Clinicians and pathologists should be alert to the possibility of bladder SCNC despite extremely scarce incidence.
Keywords: Bladder cancer, small cell neuroendocrine carcinoma, synchronous malignancy, case report
PROFILE OF NEPHROLITHIASIS PATIENTS TREATED WITH MINI-PERCUTANEOUS NEPHROLITHOTOMY (MINI-PCNL): A SINGLE CENTER EXPERIENCE IN JAMBI, INDONESIA
Get PDFObjective: This study aims to describe the characteristics of patients undergoing mini-PCNL at our center in Jambi, Indonesia. Material & Methods: This is a descriptive study involving patients with kidney stones treated with mini-PCNL during 2017 – 2021 in Jambi. The selection of the study subjects was using total sampling method. All patients had a medical history taken and a physical examination performed prior to surgery. The procedure was performed by three operators in one referral district hospital. Results: From 2017 to 2021, a total of 188 mini-PCNL procedures were performed at our center for the removal of kidney stones. However, only 186 cases were included in this study after excluding 2 due to incomplete data. The mean age of patients in this study was 49.3 years old (ranging from 12–87 years old) with the majority being male (101/165 [61.21%]). Of 186 cases, a total of 175 cases had no residual stone and only 11 had residual stone (stone-free rate [SFR] 94.08%). Most patients presented with hydronephrosis, and DJ stent placement was performed in 44 out of 186 cases. The SFR decreased as the stone size increased. Conclusion: Mini-PCNL proves to be a valuable choice for managing kidney stones, especially for medium-sized and hard stones, leading to enhanced patient results and reduced post-operative complications.
Keywords: Kidney stone, mini-PCNL, stone free rate
THE INDONESIAN LINGUISTIC VALIDATION OF THE URINARY STENT RELATED HEALTH QUESTIONNAIRE
Get PDFObjective: To validate the Indonesian version of the urinary stent related health (UriSteRH) questionnaire. Material & Methods: The Indonesian version of the UriSteRH was developed with multistep process by urologist, two nursing lecturers and two independent translators. A total 13 patients with indwelling DJ Stent completed the Indonesian UriSteRH questionnaires on the 30th day after Stenting. The reliability of the Indonesian version was evaluated using Cronbach’s alpha test. Domain structures were examined by using Pearson correlation coefficient (R). Results: Urinary pain, body pain, physical activity, social life, mental health, sexual activity and quality of life showed good internal consistency. There were strong correlations of physical activity (r=0.851) and social life (r=0.815) with the quality of life (r=0.736). In addition, there were moderate correlation of mental health general (r=0.676) related to urinary pain (r=0.612) and body pain (r=0.567). However, sexual activity had a lower correlation (r=0.456). Conclusion: The Indonesian version of UriSteRH is a reliable and valid instrument to evaluate health and quality of life in patients with indwelling DJ Stent.
Keywords: DJ Stent, indonesian validation, questionnaire, urinary stent related health . 
TEN YEARS EXPERIENCE IN MANAGEMENT OF BLADDER TRAUMA AT TERTIARY HOSPITAL IN WEST JAVA INDONESIA
Get PDFObjective: The aim of this study is to provide the characteristics, management, and outcome of bladder trauma at the center of trauma referral hospital in West Java, Indonesia. Material & Methods: This is a retrospective and descriptive study. The data of bladder trauma were collected from the medical records from January 2010 to December 2019. The data were presented using descriptive statistics in frequency and percentage. Results: Over a ten-year period, there were 1,174 cases of urogenital trauma, with 170 cases (14.48%) involving bladder injuries. The majority of the was 21-30 years old and were men (55.88%). The most common cause was blunt abdominal trauma (68.82%), which was caused by traffic accidents (91.45%). With 42.24% pelvic fracture as the most common associated injury. The most common type of bladder injury (45.88%) was bladder contusion. Iatrogenic trauma was the second leading causes (29.42%) with obstetrics and gynecology operations accounted for 84% of iatrogenic bladder trauma cases. The majority of bladder injuries were identified using a computed tomography (CT) scan. In 59.41% of cases, surgical intervention was required. The mortality rate was 2.94% during post-operative treatment due to coexisting or associated multiple injuries. Conclusion: We discovered that bladder trauma most commonly affects males of reproductive age with blunt abdominal trauma as the most common etiology and pelvic fractures as the most common associated injury. Surgical intervention often was required.
Keywords: Bladder injury, blunt abdominal trauma, iatrogenic bladder injury
ASSESSMENT OF TOBACCO SCREENING AND SMOKING CESSATION RECOMMENDATION AMONG UROLOGISTS IN INDONESIA : A CROSS SECTIONAL ANALYSIS USING NATIONAL SURVEY
Get PDFObjective: This study aims to assess the urologist role on tobacco screening and smoking cessation among bladder cancer patients in Indonesia. Material & Methods: A questionnaire regarding tobacco uses screening and smoking cessation recommendation practice patterns was sent to urologists in Indonesia via Ikatan Ahli Urologi Indonesia (IAUI) or Indonesian Urological Association (IUA). The survey was established by Google Form and was sent by email. Responses were automatically integrated to Google spreadsheet. Results: Total of 111 responses from 569 urologists in Indonesia were received, and of the respondents 96% were male and 4% were female. 70% urologists always educate their patients about smoking as one of risk factor for bladder cancer and only 4% never did it. Most common answer for the reason is patients never ask their urologists about it (7%). More than half (59%) of urologists sometimes discuss smoking cessation and 78% always recommend quitting smoking. The majority of responders have never smoked cigarettes (56%), 35% were former smokers, and 9% were current smokers. Conclusion: This study revealed that majority of urologists always educate that smoking is one of risk factor for bladder cancer and recommend to quit smoking. However, only 37% always discuss tobacco use cessation with their patients.
Keywords: Tobacco use, smoking cessation, bladder cancer, urologist
PREVALENCE OF URINARY TRACT STONES IN PATIENTS WITH BENIGN PROSTATIC HYPERPLASIA (BPH) UNDERGOING TRANS URETHRAL RESECTION OF THE PROSTATE (TURP) OPERATION
Get PDFObjective: This study aims to determine the prevalence of urinary tract stones in BPH patients undergoing TURP surgery. Material & Methods: This research is a descriptive study using secondary data with medical records of BPH patients who underwent TURP at Saiful Anwar General Hospital (RSSA) for the period of 2018 – 2022. Results: From the results of the 169 patient samples BPH undergoing TURP, there were 35 samples, who experienced urinary tract stones. The most frequent incidence of urinary tract stones in patients with BPH at the age of 60 – 70 years of 15 samples (42.90 %), with the highest prostate volume being >50 mL, there are 15 samples (42.90 %), and the location of the most urinary tract stone were in the lower urinary tract with the bladder stone type being 30 samples (85.7%). Conclusion: From the results, it can be concluded that the prevalence of urinary tract stones in BPH patients undergoing TURP surgery is 20.7%, which is an absolute indication for TURP.
Keywords: Benign prostatic hyperplasia, urinary tract stone, age, prostate volume
CYSTOSTOMY DIVERSION REDUCED COMPLICATIONS FOLLOWING HYPOSPADIAS REPAIR: A SYSTEMATIC REVIEW AND META-ANALYSIS
Get PDFObjective: This study aims to investigate the associations between the use of cystostomy diversion and the incidence of complications following hypospadias repair. Material & Methods: An extensive search of PubMed, ScienceDirect, Embase, and the Cochrane Library, was performed to identify studies that assessed the impact of cystostomy diversion on complication rates after hypospadias repair. To evaluate potential biases, the RoB 2 tool was applied for randomized controlled trials (RCTs), while the ROBINS-I tool was used for observational studies. Data analysis was conducted using Review Manager 5.4. Results: This review included ten studies involving 1.120 patients who underwent hypospadias repair. The overall complication was 16.9%. The meta-analysis revealed that opting against cystostomy diversion after hypospadias repair led to a notably increased risk of complications, as evidenced by a pooled odds ratio (OR) of 1.48 (95% confidence interval (CI) 1.07–2.03). The significant negative effect of not performing cystostomy on the risk of complications was consistent in sub-analysis of distal hypospadias (OR 1.97; 95% CI 1.11–3.51) and primary hypospadias repair (OR 1.80; 95% CI 1.19–2.73). In the funnel plot, there was no significant publication bias identified. Conclusion: Our meta-analysis demonstrated that cystostomy diversion reduces the incidence of complications following hypospadias repair. The positive effects were consistent in both distal hypospadias and primary hypospadias repair.
Keywords: Complications, cystostomy, hypospadias
CLINICOHISTOPATHOLOGICAL STUDY OF TESTICULAR TUMOURS IN DR. HASAN SADIKIN GENERAL HOSPITAL BANDUNG
Get PDFObjective: The purpose of this research was to describe the clinical and histopathological characteristics of testicular tumours at Hasan Sadikin General Hospital (RSHS) between 2017-2021. Material & Methods: This research was a cross-sectional descriptive study examining the clinical and histopathological profiles of testicular tumours. The secondary data sources included medical records from the Department of Urology, Anatomic Pathology, Medical Records, and Hospital Information System (SIRS). The collected data covered age, ethnicity, clinical symptoms, site, stage, annual prevalence rate, and analyzed using Microsoft Excel. Results: There were 42 patients who had primary testicular tumour. The highest prevalence of testicular tumours at RSHS was in 2019 consist of 12(29%) patients and the lowest in 2020 were 6(14%) patients. Most patients were >35 years old amounting 19(45%) patients, Sundanese ethnicity were 29(69%) patients, and testicular enlargement revealed in 27(64%) patients. Majority patients were in stage 0/IB 36(86%) patients and occurred in unilateral testis which 34(80%) patients, with 3(7%) patients metastasized. The most common histopathological type was seminoma 18(43%) cases followed by prepubertal-type yolk sac tumour 9(21%) patients. Seminomas, and the fibroma-thecoma group were mostly in patients over 35 years old, while prepubertal-type yolk sac tumour was more commonly in children under 15 years old. Conclusion: Prevalence of testicular tumours increased from 2017 to 2019, then started to decrease in 2020. Histopathologically, seminoma was the most common type. These tumours were most commonly found in older individuals (>35 YO) and unilateral, diagnosed in stage 0/IB, and were mostly presented with enlargement of testis.
Keywords: Testicular tumours, clinical features, histopatholog
SHORT-TERM COMPLICATIONS OF TRANSURETHRAL RESECTION OF THE PROSTATE PERFORMED BY UROLOGY RESIDENT IN EDUCATIONAL HOSPITAL: CHARACTERISTICS AND DETERMINANT FACTORS
Get PDFObjective: This research wanted to figure out the characteristics and determinant factors of short-term complications of TURP performed by urology resident in educational hospital. Material & Methods: This study was an analytical study using secondary data from electronic medical records of the total sample of 502 BPH patients undergoing TURP performed by urology resident January from 2015 until June 2022, and evaluated short-term complications, Clavien Dindo, and level of urology resident. Inclusion were BPH patients undergoing TURP by urology resident, while the criteria of exclusion were incomplete data of patient’s demographic and records of clinical data. Results were displayed descriptively in distribution tables and analyzed using logistic regression with STATA 17. Results: Short-term complications of TURP were found in 10 patients (1.99%), i.e., bleeding (0.79%), clot retention (0.6%), and urinary retention (0.6%). The commonest groups were age at 61-70 (0.79%), Clavien Dindo I (0.79%), urology resident level at 5th semester (0.99%), prostate volume >50cc (0.99%) and complaint of urinary retention (0.99%). There were no significant correlations between patient age, level of urology resident, prostate volume, and chief complaint compared to rate of complication (p>0.25). Conclusion: TURP remained surgery of choice for BPH despite several short-term complications performed by different level of urology resident and there were no significant correlations between level of urology resident and rate of complication.
Keywords: BPH, Urology Resident, Short-Term Complications of TURP, Clavien Dindo