bluuebunny/crossref_metadata_2025 huggingface dataset:
PRODUKSI ANTIBODI POLIKLONAL HASIL INDUKSI ISOLAT PROTEIN NON KINASE DARI MEMBRAN SPERMATOZOA MANUSIA
Authors: Lestari Umie , Purnomo Basuki B
Published: August 2019

Objective: 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.
PERBEDAAN IPSS, Q MAX, DAN VOLUME PROSTAT PADA PEMBERIAN KOMBINASI INHIBITOR 5α-REDUKTASE (DUTASTERIDE) DAN ANTI ESTROGEN (TAMOXIFEN) PADA PASIEN BPH YANG MENGALAMI LUTS TANPA KOMPLIKASI
Authors: Seputra Kurnia Penta , Soetojo Soetojo , Soebadi Doddy M
Published: August 2019

Objective: To compare the IPSS, Q max, and volume of the prostate pre and post treatment of 5α-reductase inhibitor and tamoxyfen in patients with BPH. Material and Methods: We collected 40 patients who had been diagnosed as BPH without urine retention. They were classified in to 4 groups, each group contained of 10 patients who were given tamoxifen, dutasteride, combination tamoxyfen with dutasteride, or placebo. We recorded IPSS, uroflow, and volume of the prostate before and after 3 months of medication. Data were analyzed by the SPSS 12 program. Results: Q max (7,75 + 3,5538 to 9,15 + 2,9448) and IPSS (z score –1,633) after treatment with tamoxyfen (p > 0,05) was not improved. We found significant decrease of the prostate volume (40,124 + 7,9129 to 36,323 + 8,2573) after treatment with tamoxifen (p < 0,05). There is significant improvement of Q max (9,55 + 3,2793 to 15,12 + 4,3522), IPSS (z score –2,887), and significant decrease of the prostate volume (30,93 + 9,0031 to 24,506 + 7,3267) after treatment with dutasteride (p < 0,05). There was also significant improvement of Q max (6,55 + 2,5435 to 8,86 + 4,4475), IPSS (z score –2,449), and decrease of prostate volume (31,403 + 9,0031 to 26,78 + 7,3267) after treatment with the combination dutasteride and tamoxifen (p < 0,05). None of those parameters were improved in placebo group. Conclusion: Q max and IPSS improve significantly in the dutasteride and the combination group. There was a significant decrease of the prostate volume in all groups except the placebo group.
NATRIUM DIKLOFENAK UNTUK PENGOBATAN NOKTURIA YANG DISEBABKAN OLEH NOCTURNAL POLYURIA
Authors: Sunarno Eddy , Alif Sabilal , Hardjowijoto Sunaryo , P Widodo J
Published: August 2019

Objective: To investigate the efficacy of diclofenac 50 mg (Non-Steroidal Anti-Inflammatory Drug) in the treatment of nocturnal polyuria. Materials and methods: Twenty four patients (23 male and 1 female) with a mean age of 61 years (range 34 – 80) diagnosed with nocturnal polyuria were recruited. The study period comprised 2 weeks of either placebo or active medication. Following one-week rest period, patients were crossed over to the other medication for a further 2 weeks. Frequency volume charts were completed during the second week of each of the two study periods along with feedback forms to assess any subjective improvement in symptoms during each of the study periods. Results: A significant improvement in the symptoms was noted for diclofenac when compared with the placebo. The mean nocturnal frequency decreased from 3,61 ± 2,45 to 2,39 ± 1,1 (p<0,05) and the mean 24 h urine volume decreased from 1139,64 ± 365 to 1089 ± 324 (p>0,05), but there is no statistically different. No significant side effects were reported. Conclusion: Natrium diclofenac 50 mg are effective in the treatment of nocturnal polyuria causing a decrease in nocturnal frequency with subjective symptom improvement. Our study suggests, Natrium diclofenac not to prolonged treatment. Further research to find the alternative treatment is recommended.
EFIKASI TAMSULOSIN PADA BENIGN PROSTATIC HYPERPLASIA DENGAN RETENSIO URINE AKUT YANG MENJALANI TRIAL WITHOUT CATHETER
Authors: Kholis Khoirul , Soetojo Soetojo , Djojodimedjo Tarmono , P Widodo J
Published: August 2019

Objective: 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.
APOPTOSIS IN IPSILATERAL KIDNEY. COMPARISON BETWEEN GROUP RECEIVING VERAPAMIL AND CONTROL GROUP POST-ARTIFICAL TOTAL UNILATERAL URETERAL OBSTRUCTION
Authors: Syahrir Syakri , Soetojo Soetojo , Santoso Adi , Joewarini Endang , P Widodo J
Published: August 2019

Objective: Obstruction of the urinary tract has marked effects on renal blood flow, glomerular filtration rate (GFR), and tubular function. Ureteral obstruction results in an injury response that can progress to irreversible renal fibrosis and tubular damage by apoptosis. Materials and Methods: Forty five rabbits aged 13-17 weeks with body weights of 1250-1750 grams were divided into 4 groups. Group 1 underwent a sham operation and group 2 had unilateral ureteral ligation to cause total obstruction. Groups 3 and 4 also underwent unilateral ureteral ligation but with verapamil given on day 0 and day 7 respectively. Apoptosis to the renal tubules were assessed after nephrectomy on day 14 using immunohistochemistry by counting the number cell deaths/high power field (hpf). Results: The groups that received verapamil showed significantly less apoptosis compared to those without verapamil (2,73 vs 12,46 cell deaths/hpf; p<0,05). However, there was no significant difference between groups 3 and 4 (2,73 vs 2,89 cell deaths/hpf; p>0,05), although both groups still showed more cell deaths compared to group 1 (0,38 cell deaths/hpf). Conclusion: Verapamil appears to significantly decrease apoptosis during total unilateral ureteral obstruction. However, it cannot replace the benefit of relieving total obstruction
EFFICACY OF DICLOFENAC COMPARED TO PLACEBO IN PAIN RELIEF DURING REMOVAL OF URETHRAL CATHETER
Authors: Maulana Akhada , Danarto H R
Published: August 2019

Objective: To investigate efficacy of diclofenac compared to placebo in relieving pain on removal of indwelling urethral catheters. Materials and methods: This study was a randomized controlled trial, double blind, comparing diclofenac with placebo in relieving pain on removal of indwelling urethral catheters. Adult male patients with indwelling catheters admitted in surgical ward of RSUP Dr. Sardjito Yogyakarta who met the inclusion criteria were recruited. The independent variables were diclofenac or placebo treatment, while the dependent variables were visual analogue scale (VAS) score, and the external variables were age, education level, and duration of indwelling urethral catheter. We gave patients diclofenac or placebo in capsules 2 hours before urethral catheter removal. Immediately after removal by assistant, the patient filled VAS form. We used Chi-square test, independent T-test, and bivariate analysis with SPSS program version 11.5, with p<0,05 was set as statistically significant level. Results: Thirty patients met inclusion criteria. Mean VAS score of both groups was 33,467 + 20,4577, diclofenac group was 31,567 + 20,0934, and placebo group was 35,367 + 21,3412. There was no statistically significant difference of VAS score between both groups (p=0,844). Conclusion: Efficacy of diclofenac and placebo in relieving pain when performing urethral catheter removal is not significantly different.
COMPARISON OF APOPTOSIS IN CONTRALATERAL RENAL TUBULAR CELLS IN ORYCTALAGUS CUNICULUS DUE TO ARTIFICIAL UNILATERAL URETERAL OBSTRUCTION, WITH AND WITHOUT VERAPAMIL
Authors: Boetoro Djoyo M , Soetojo Soetojo , Soebadi Doddy M , Joewarini Endang , P Widodo J
Published: August 2019

Objective: To compare the effects of verapamil on the contralateral kidney affected by unilateral ureter obstruction. Material & method: The right ureter of oryctalagus cuniculus rabbits, were obstructed surgically with silk suture material, and kept alive for 14 days. One group was obstructed without other treatment, one group was given verapamil from day 7 until day 14 of the obstruction. One group was obstructed and given verapamil from day 0 through day 14. One group was given a sham operation as a control group. The contralateral kidney of all groups were harvested and processed with ApopTag. The increase of apoptotic tubular cells compared to the control group was then analyzed between each group. Results: The highest increase in apoptotic cells was in the obstructed group without verapamil, but increased significantly compared to control (p<0,001). The groups which received verapamil had lower increase of apoptotic tubular cells, in the group given verapamil for 14 days lower than the group which received verapamil only for 7 days. Both the 7 to 14 and the 0 to 14 groups were significantly lower than the group without verapamil (p=0,035 and p<0,001 respectively). Conclusion: verapamil has a protective effect on the contralateral kidney by inhibiting apoptosis caused by unilateral ureter obstruction. While the definitive treatment for urinary obstruction is to relieve it, verapamil can protect the kidney in the mean time.
COMPARISON OF POSITIVE BACTERIAL CULTURE RATE FROM URINE SPECIMEN AND CATHETER SWAB IN INDWELLING CATHETER PATIENTS
Authors: Yusuf Marzuki , Alif Sabilal , Soebadi Doddy M , Debora Kartuti , P Widodo J
Published: August 2019

Objective: 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.
RELATION BETWEEN AGING MALE SYMPTOM SCORE (AMS SCORE) AND AGE
Authors: Ghinorawa Tanaya , Rahardjo Djoko
Published: August 2019

Objective: To study the relation of the Aging Male Symptom Score (AMS score) with age groups, and to find the age when the AMS score increases. Material & method: In all, 347 patients with age beginning at 50 years underwent an interview with the AMS Score questionnaire, then they were divided according to age in groups, less than or equal to 50 years, 51 – 55 years, 56 – 60 years, and more than 60 years. Results: In the age group less than or equal to 50 years, there were 26 men (7,5%). With an abnormal AMS psychology, there were 18 men, with abnormal AMS somatovegetative score there were 20 men, with an abnormal AMS sexual score 20 men, and with abnormal total AMS Score 14 men. In the age group 51 – 55 years, there were 146 men (42,07%), with an abnormal AMS psychology in 75 men, with abnormal AMS somatovegetative score 114 men, abnormal AMS sexual in 123 men, and abnormal total AMS Score in 71 men. In age group 56 - 60 years there were 48 men (13,83%), abnormal AMS psychology in 35 men, abnormal AMS somatovegetative score in 44 men, abnormal AMS sexual in 45 men, and abnormal total AMS Score in 35 men. In the age group of more than 60 years, there were 127 men (36,6%), abnormal AMS psychology was found in 87 men, abnormal AMS somatovegetative score in 112 men, abnormal AMS total sexual score 122 men, and abnormal total AMS score was in 96 men. All of the AMS score values significantly increased after 55 years old, p value at AMS psychology was 0,005, AMS somatovegetative was 0,000, AMS sexual was 0,000, and at total AMS Score was 0,000. To define the age when AMS score increases. The conclusion was that AMS psychology values begin to increase after 55 years (sensitivity 69,71, specificity 45,93), AMS somatovegetative values increase after 55 years (sensitivity 89,14, specificity 22,09), and total AMS score value begins to increase at 55 years (sensitivity 74,86, specificity 50,58). However, AMS sexual value increase at 50 years (sensitivity 90,34, specificity 23,08). Conclusion: All of the AMS score values increase significantly at 55 years.
CONGENITAL HYDRONEPHROSIS: PROBLEMS IN DIAGNOSIS AND MANAGEMENT
Authors: Hutasoit Yonas Immanuel , Wahyudi Irfan , Rodjani Arry
Published: August 2019

Objective: To evaluate problems in diagnosis and management of congenital hydronephrosis. Material & methods: This study was retrospective. Data was collected from medical records of patients with congenital hydronephrosis, which were hospitalized or went to urologic outpatient clinic at Ciptomangunkusumo Hospital from January 1999 to December 2008 and Harapan Kita Maternal and Pediatric Hospital from January 2004 to December 2008. Data was analyzed with SPSS programme version 13.0. Statistical analysis was performed to find the relationship between age at diagnosis and kidney function (Mann-Whitney test) and between age at diagnosis and nephrectomy rate (Chi-Square test). Results: There were 15 patients who presented because of antenatal diagnosis. Of the 145 patients, we could collect antenatal history only from 63 patients.  Obstetricians provided antenatal care in 56 out of 63 patients. Antenatal ultrasound was performed in only 59 out of 63 patients and only 44,07% (26 patients) with hydronephrosis was detected antenatally. Eleven out of 26 antenatally diagnosed patients came to our clinic at a later age. Three standard studies (postnatal ultrasound, voiding cystourethrogram, and renal scintigraphy) were performed only in 12 out of 145 patients (8,27%). Ultrasound was performed in 108 patients (74,5%), voiding cystourethrogram in 79 patients (54,5%), and renal scintigraphy in only 26 ptients (17,9%). The suggested management was conducted in 115 patients; operative management in 95 patients (82,61%) and conservative treatment in 20 patients (17,39%). The most common operative procedures were ureteroneocystostomy, pyeloplasty, nephrectomy, and posterior urethral valveablation. Mean serum creatinine in below 12 months old group and above 12 months old group was 0,78±0,93mg/dl dan 1,03±0,88 mg/dl respectively(p<0,05). There was no significant difference in nephrectomy rate in both age groups (p>0,05). Nephrectomy was performed in 16 patients, with the most common indication was grade IV hydronephrosis with thin parenchyma in 11 patients (68,75%) and the most common etiology was UPJ obstruction in 10 patients (62,5%). We can only collect follow up data from 73 out of 115 managed patients (63,48%). Urinalysis, ultrasound/voiding cystourethrogram, and renal function studies were not routinely conducted during follow up. Conclusion: The management of congenital hydronephrosis in Indonesia needs improvements in antenatal care standards, particularly obstetric ultrasound, to improve early detection of congenital hydronephrosis. Better education for parents about the importance of follow up is needed, especially for antenatally diagnosed patients. A consensus regarding diagnostic tools used in managing congenital hydronephrosis must be established among urologists, pediatricians, and radiologists.
COMPARATIVE EFFICACY OF INTERMITTENT AND DAILY DOXAZOSIN THERAPY FOR LUTS ASSOCIATED WITH BPH
Authors: Nurdianto Heru , Alif Sabilal , Tarmono Tarmono
Published: August 2019

Objective: To investigate the efficacy of intermittent doxazosin therapy on LUTS associated BPH. Material  & Method: This study was performed between January to April 2010 enrolling 20 patients with LUTS associated BPH. Study subjects were randomly allocated to 2 therapeutic groups. The first group was assigned daily doxazosin therapy (11 patients), while the second group was assigned intermittent doxazosin therapy (9 patients). Initially all subjects were given doxazosin 2 mg daily for 2 weeks. Subsequently group I received doxazosin 2 mg daily therapy, while group II received doxazosin 2 mg every other day. All medications were taken up to 12 weeks. Outcomes were evaluated prior to therapy, and after 2, 4, 8, and 12 weeks of therapy. Efficacy of doxazosin therapy was measured by International Prostate Symptom Score (IPSS), peak urinary flow rate (Q max), and residual urine volume. Statistical analysis was performed to evaluate difference in efficacy between the treatment groups. Results: Daily doxazosin therapy for 2 weeks resulted in significant improvement of Q max and IPSS. After 4, 8, and 12 weeks significant improvement was maintained in both daily and intermittent groups, as measured by Q max, residual urine volume and IPSS. There were no significant differences in Q max, residual urine volume, and IPSS between the daily and intermittent groups at 4, 8, and 12 groups. Conclusion: There were significant improvements of Q max, residual urine and IPSS at 2 to 12 weeks in daily as well as intermittent doxazosin therapy groups. There were no significant differences in efficacy between daily and intermittent therapy groups
CONTINUOUS AMBULATORY PERITONEAL DIALYSIS USING STRAIGHT TYPE VS COILED TYPE TENCKHOFF CATHETER IN END-STAGE RENAL DISEASE PATIENTS AT SARDJITO HOSPITAL
Authors: Rahman Eka Yudha , Rochadi Sungsang , Utomo Trisula
Published: August 2019

Objective: The purpose of this study was to compare straight type versus coiled type Tenckhoff catheter for continuous ambulatory peritoneal dialysis (CAPD) in end stage renal disease. Material & method: A prospective cohort study enrolled end-stage renal disease patients undergoing CAPD for renal replacement therapy in Urology and Nephrology Department, Sardjito Hospital from January to December 2007. Identity and type of Tenckhoff catheter were recorded. Patients were grouped into two groups who used straight type catheter and coiled type catheter for CAPD, then observed for post-operative complication. Statistical analysis was done using SPSS 14.0 with chi-square test. Results: There were 27 patients included in this study. The cause of end-stage renal disease was mostly DM and hypertension. The most common complication after  operation  was catheter  obstruction  (9 patients). Another complication was intraabdominal bleeding (1 patient), and catheter migration (1 patient). In patients with straight catheter (20 patients), there were 8 patients (40%) with complication. In patients with coiled catheter (7 patients), there were 3 patients (42%) with complication. There was no significant difference in complications between straight and coiled catheter groups (p = 0,895). Conclusion: The result of this study revealed that no significant difference in complication between straight and coiled catheter for CAPD in end-stage renal disease patients
COMPARISON BETWEEN GLYCOGEN LEVEL OF KIDNEY TUBULAR CELLS IN DIABETIC KIDNEY STONE PATIENTS AND NON DIABETIC KIDNEY STONE PATIENTS
Authors: Ramadhan Ken , Sugandi Suwandi , Noegroho Bambang S , Tjahjodjati Tjahjodjati , Safriadi Ferry , Siregar Safendra , Adriansjah Ricky , Adi Kuncoro , Sihombing Aaron Tigor , Yusuf Makmuri
Published: August 2019

Objective: To compare glycogen level of kidney tubular cells in diabetic kidney stone patients with nondiabetic kidney stone patients. Material & method: We reviewed kidney stone patients who underwent nephrectomy in Hasan Sadikin Hospital from February 2008 to January 2009. Age, gender, type of DM, and urine pH were recorded. Glycogen level of kidney tubular cells were evaluated histochemically using HE, PAS, and PAS diastase. The results were categorized into 3 grades, based on the staining appearance compared to liver cells as controls. The results of diabetic group were compared to non diabetic patients. Results: There were 30 patients eligible for this study, 15 in diabetic group and 15 non diabetic patients. In the diabetic group, there were 10 patients with urine pH < 6 and 5 patients with a pH of 6,5. In the non diabetic group all urine pH were > 6,5. Examination revealed that glycogen level of kidney tubular cells in diabetic group was higher than in non diabetic group. Conclusion: Glycogen level of kidney tubular cells in diabetic kidney stone patients was higher than in non diabetic kidney stone patients.

Keywords: Tubular cell, kidney stone, diabetes mellitus.
IS INFLAMMATION AN AGE-RELATED CAUSE OF BPH PROGRESSION
Authors: Herman Hendra , Hamid Agus Rizal AH , Mochtar Chaidir Arif
Published: August 2019

Objective: To find the role of inflammation in BPH progression represented by prostate enlargement compared between age group. Material & method: Tissue samples of BPH were collected from biopsy, transurethral resection or open surgery. Clinical information was collected including such as patient age, prostate volume, serum prostate specific antigen (PSA) and history of retention before procedure. Patients were divided into three groups, below 63 years old (young adult), 63 - 69 years old (older adult) and equal or above 70 years old (elderly). The samples were analyzed to define the microscopic structure of the hyperplasia (stromal or glandular) and to detect prostatic intraepithelial neoplasia, atypical stromal acinic proliferation, atypical acinar hyperplasia or prostate cancer. Prostate cancer was excluded from study samples. Grade of inflammation was determined by a pathologist depending on number of inflammatory cells. Grade of inflammation was classified in two groups, with mild inflammation or moderate-to-severe inflammation. Results: A total of 1189 patients were reviewed, 1172 were diagnosed with BPH. There were 381 patients (32,5%) with age below 63 years old (young adult), 380 (32,4%) between 63-69 years old (older adult) and 411 (35,1%) in equal or above 70 years old (elderly). In young-adult group, median of prostate volume between mild and moderate to severe inflammations was 42,56 and 45,75 (p = 0,500), for older adult group median was 45,00 and 51,00 (p = 0,038), for elderly group median was 49,00 and 51,98 (p = 0,621). Conclusion: Inflammation has a role in progression of prostate enlargement especially for the older adult group.

Keywords: inflammation in BPH progression, prostate volume, age, PSA.
STONE-FREE RATE DIFFERENCES IN KIDNEY STONES PATIENTS WITH AND WITHOUT TAMSULOSIN AFTER ESWL
Authors: Prasadja Nindra , Soebadi Doddy M , Djatisoesanto Wahjoe , Pudjirahardjo Widodo J
Published: August 2019

Objective: To determine whether the administration of tamsulosin, as adjunctive medical therapy, increases the efficacy of one session of extracorporeal shock wave lithotripsy (ESWL) to treat renal stones. Material & Method: A prospective randomized placebo controlled study enrolled 21 patients. They underwent a single ESWL session to treat solitary radiopaque renal stones 4 to 20 mm in diameter. After ESWL, the study group (11) received 0,4 mg tamsulosin daily and the control group (10) received placebo until stone clearance or a maximum period of 8 weeks. The primary endpoint was stone-free rate and parameters were stone size and clearance time. Results: The overall stone-free rate was better in the study group than in the control group (90,9% vs. 60,0%). The clearance time after 2, 4, 6 and 8 weeks was greater in the study group than in the control group (36,4%; 63,6%; 72,7% and 90,9% vs 30,0%; 50,0%; and 60,0% respectively) but statistically insignificant. Conclusion: Clinically, the results of our study have demonstrated that tamsulosin therapy, as an adjunctive medical therapy after ESWL, is more effective than lithotripsy alone for the treatment of patients with renal stones.

Keywords: ESWL, tamsulosin, medical expulsive therapy, renal stones.
COMPARISON OF SERUM SODIUM, SERUM POTASSIUM, AND BLOOD HEMOGLOBIN CHANGES AFTER TRANSURETHRAL RESECTION OF THE PROSTATE BETWEEN IRRIGATION WITH NORMAL SALINE AND STERILE WATER
Authors: Kurniawan Wikan , Utomo Trisula
Published: August 2019

Objective: This study aims to know whether there are significant differences of blood sodium, potassium and hemoglobin level among patients post TURP who was irrigated by using normal saline and the sterile water. Material & Method: This is a single blind randomized clinical trial study performed from September 1, 2008 until August 31, 2009. Thirty-one subjects participated in this study. The subjects were divided into two groups, 14 subjects for normal saline (group I) irrigation and 17 subjects for sterilized water irrigation (group II). Results: There are statistically differences (p < 0,05) between hemoglobin concentrations changes in group I, and hemoglobin and sodium concentration changes in group II. There were no statistically differences (p > 0,05) in sodium and potassium changes in group I and potassium in group II. There are no statistically differences in hemoglobin, sodium, and potassium changes among two groups. Conclusion: Normal saline irrigant for irrigation after TURP give more stable post operative electrolyte profile compared to sterilized water. Keywords: TUR prostate, irrigation, serum sodium, potassium level differences.
THE INCIDENCE OF ED AFTER TURP AND TVP ON BPH PATIENTS
Authors: Alpendri Aries , Utomo Tjahyo Kelono , Utomo Trisula , Singodimedjo Prawito
Published: August 2019

Objective: The aim of this study was to know the incidence of erectile dysfunction (ED) after transurethral resections of the prostate (TURP) and transvesical prostatectomy (TVP). Material & method: Data were collected in 1 year period from January until December 2005 with cross sectional study design. There were 60 patients who met the inclusion and exclusion criteria and patient who participated in this study underwent TURP and TVP and divided in TURP group and TVP group. Erectile Dysfunction measured by International Index of Erectile Function-5 (IIEF-5) data was analyzed by statistic chi-square and independent t-test. Results: Sixty patients include this study with 30 patients in each group. The mean age of TURP was 64 ± 5,68 and TVP was 63,23 ± 4,83 with age ranging from 50 – 70 years. The incidence of ED after TURP and TVP was 36,67% and 16,70% respectively with p = 0,08. The IIEF-5 scores for TURP and TVP was 19,40 ± 3,95 and 21,03 ± 2,57 respectively and by statistical analysis the differences was not significant. Conclusion: The incidence of ED after TURP showed higher than TVP and by statistical analysis the differences was not significant.

Keywords: Benign prostatic hyperplasia, erectile dysfunction, transurethral resection of the prostate, transvesical prostatectomy.
THE ROLE OF UROLOGISTS IN MANAGEMENT OF DISORDERS OF SEX DEVELOPMENT
Authors: Wahyudi Ilham , Wahyudi Irfan , Sumadipradja Kanadi , Batubara Jose RL , Rodjani Arry
Published: August 2019

Objective: To evaluate disorder of sex development (DSD) profile at Cipto Mangunkusumo Hospital (RSCM), the management profile, and the role of urologist on diagnostic and therapeutic management. Material & method: We retrospectively collected data from medical record of all DSD cases managed by pediatric endocrinologist, urologist, obstetric gynaecologist at RSCM from January 2002 up to December 2009. 2006 IICP criteria was used as classification. The management profile and the role of urologist were evaluated. Results: there were 133 DSD cases with the majority of cases was congenital adrenal hyperplasia (CAH) followed by androgen insensitivity syndrome (AIS). Most of the cases were diagnosed before one year old and other on pubertal period. Karyotyping, laboratory examination, ultrasonography, genitography, uretrocystoscopy, kolposcopy, diagnostic laparascopy were performed as diagnostic management. Gender assignment was performed by multidisciplinary team. Masculinizing surgery, feminizing surgery, and gonadectomy was done as therapeutic management. Conclusion: The majority case on RSCM’s DSD profile was CAH. The management was performed by multidisciplinary team. Gender assignment decision should be based upon thorough diagnostic evaluation. The urologist has important role on diagnostic and therapeutic management.

Keywords: Disorder of sex development, diagnostic management, gender assignment, therapeutic management, urologist.
THE EFFECT OF TESTOSTERONE DEPRIVATION ON ATHEROPLAQUE FORMATION, TESTOSTERONE RECEPTORS, AND COLLAGENIZATION IN WISTAR PENILE TISSUE
Authors: Azrul Imam Dirgantara , Tigor Aaron , Sugandi Suwandi , Hernowo Betthy S.
Published: August 2019

Objective: To evaluate the association between testosterone deprivation and atheroplaque formation, testosterone receptors, and collagenization in Wistar penile tissues. Material & method: Two months after orchiectomized bilaterally, penile tissue of eight Wistar were harvested for semi-quantitative analysis of atheroplaque formation using hematoxyllin-eosin staining. Similar analysis were also conducted to look for collagenization by collagenase staining as well as the expression of testosterone receptors by immunohistochemistry staining. Control group were eight Wistar underwent Sham surgery. Statistical analysis for atheroplaque formation in Wistar compare to control group used was Chi-square, Fishers’ exact test was used for the expression of testosterone receptors, and independent t-tests for evaluating collagenization. Results: A significant decline in the testosterone receptors and increase collagenization were obtained in orchiectomized Wistar, while atheroplaque formation was not significantly different. Conclusion: Testosterone deprivation revealed a significant decline in the expression of testosterone receptors, and a significant increase in collagenization while atheroplaque formation was not significantly changed.

Keywords: Erectile dysfunction, testosterone receptors, collagenization, atheroplaque formation, orchiectomy.
LAPAROSCOPIC LIVING DONOR NEPHRECTOMY: FEASIBILITY AND FIRST EXPERIENCE IN INDONESIA
Authors: Mochtar Chaidir A. , Wahyudi Irfan , Rasyid Nur , Rodjani Arry , Birowo Ponco , Atmoko Widi , Satyawan Yopie Tjandradiguna , Tiera Hery
Published: August 2019

Objective: To report our first experience laparoscopic living donor nephrectomy (LLDN). Material & Method: A 37 year-old man was planned for the living-donor transplantation. The recipient was a 63 year-old man sufferingfrom end stage renal disease, and hypertensive heart disease. The donor and recipient were allowed for positive qualification evaluated preoperatively. We applied a transperitoneal approach for the left kidney. Results: The operation time was 300 minutes and the estimated blood loss was 600 mL. The first warm ischemia time was 15 minutes and 24 seconds. There were no major intraoperative and postoperative complications. The donor began oral intake and mobilization within 10 hours and was hospitalized for 4 days. The recipient’s serum creatinine levels reached near baseline levels (1,5 mg/dL) at day 6. Conclusion: LLDN is technically feasible in Indonesia and may increase the rate of kidney donation in Indonesia due to the minimally invasive nature of the procedure.Keywords: Renal transplantation, laparoscopic living donor nephrectomy, Indonesia.
RELATIONSHIP BETWEEN P53 EXPRESSION AND PSA SERUM
Authors: Hendri Ahmad Zulfan , HR Danarto
Published: August 2019

Objective: To know the relationship between p53 expression and prostate specific antigen (PSA) serum level in prostate cancer patients. Material & method: Specimens were studied from patients with pathological diagnosis of prostate cancer in Sardjito Hospital Yogyakarta during 2007 to 2008. The p53 expression was measured by immunohistochemical staining. The stains were done in Department of Anatomical Pathology and examined by a pathologist. The relationship between p53 mutated expression and PSA serum level were analyzed with correlation coefficient (rs). Results: There were 29 patients included in this study. The mean age was 66,34 ± 8,15 (50 - 83) years old. The mean PSA serum level was 165,98 ± 269,208 (1,4 – 1051) ng/ml. The mean number of p53 expression was 111,38 ± 94,30 (16 – 396). There was positive correlation between p53 expression and increasing PSA serum level in the prostate cancer patients (rs + 0,497; p = 0,006). Conclusion: P53 expression was positively correlated with increasing PSA serum level.Keywords: Prostate cancer, p53 expression, PSA serum level.
EVALUATION OF CAPD AS RENAL REPLACEMENT THERAPY IN CHILDREN
Authors: Prasetyo Risky Vitria , Ramadhani Noershanti , Soemyarso Ninik Asmaningsih , Noer Mohammad Sjaifullah
Published: August 2019

Objective: To evaluate the outcome of pediatric patients treated with continuous ambulatory peritoneal dialysis (CAPD) performed by experienced pediatric urologists. Material & Method: A retrospective study of children with end-stage renal disease (ESRD) by peritoneal dialysis (PD) in Division of Nephrology Department of Child Health, Faculty of Medicine Airlangga University, Soetomo Hospital, Surabaya, from January 2003 to February 2012 was conducted. Children with acute kidney injury treated by PD were excluded.Data reviewed were age, sex, primary renal disease, age at start of CAPD, duration of CAPD, outcome and cause of death. Descriptive statistics were used to analyze the data.Results: Twenty seven cases of children with CAPD within 9-year period were included. Most patients were 11-15 years old with 62,9% being male. Chronic glomerulonephritis and nephrotic syndrome were the main primary renal diseases. Fifteen (55,6%) patients had peritonitis. The longest duration on CAPD was 53 months. Outcome of 27 children was as follows, 11 patients died (40,8%), 8 patients survived (29,6%), and another 8 were lost to follow-up (29,6%). All (100%) patients had cardiovascular abnormalities as cause of death. Conclusion: The outcome and mortality rate of children with CAPD remain unfavourable. This is a challenge still to be overcomed. Keywords: Continuous ambulatory peritoneal dialysis, children, outcome.
THE EFFECT OF CATHETER TRACTION DIRECTION ON HEMOSTASIS AND PAIN POST TURP
Authors: Ariani Devintha Tiza , Umbas Rainy , Rasyid Nur , Suprabawati Tri Endah
Published: August 2019

Objective: To compare the effect the direction of catheter traction to the abdomen with direction to the leg on hemostasis and pain degree post-TURP. Material & Method: 122 patients with BPH came to Cipto Mangunkusumo Hospital and Budi Asih Hospital, Jakarta during the period between January 2005 to January 2011. Results: 101 patients with retention and 21 patients without retention were included in this study. Resected tissue weight was 22,95 grams, irrigation time was 2,24 days, catheterisation time was 3,97 days, and post TURP hospitalization was 3,9 days. Hb decline was 1,17g/dl. There was no statistical difference on Hb decline between leg direction 1,23 g/dl and abdominal direction 1,12 g/dl. Resected tissue weight in abdominal direction group was 25 grams, while in leg direction group was 21 grams. Irrigation time in abdominal direction group was 2 days while in leg direction group was 2,4 days. Catheterisation time in abdominal direction group was 3,3 days while in leg direction was 3,4 days. Post TURP hospitalization in abdominal direction group was 3,7 days while in leg direction groups was 4,2 days. In this study resected tissue weight, irrigation time, catheterisation time, and hospitalization time. There were 64 patients with pain degree registration, patients with abdominal traction had mean pain degree scale 1,52 and 33 patients with leg traction had pain degree scale 2,97, in this study this differences were significant. Conclusion: Abdominal traction post TURP was statistically difference on shortened postoperative irrigation and catheterisation time, including reduced post TURP hospitalization and pain degree. Abdominal traction was recommended from this study to be used as the reference standard for changing leg traction.

Keywords: Catheter traction, visual analog scale, hemostasis, transurethral resection of the prostate.
THE EFFECTIVENESS OF RENALOF® COMPARED TO KALKURENAL® AND PLACEBO
Authors: Kristyantoro Benny , Alif Sabilal , Djojodimedjo Tarmono , Budiono Budiono
Published: August 2019

Objective: To compare the effectiveness after administration of Renalof to Kalkurenal and placebo in patient with renal calculus. Material & Method: We analyzed 30 patient with renal calculi less than or equal to 20 mm (2 cm) between January 2011 and March 2011. Patients were divided into 3 groups. Nine patients were treated with placebo, 8 patients were treated with Kalkurenal and the last 13 patients were treated with Renalof. After 30 days, we analyzed calcium and uric acid excretion for 24 hours and measured the stone with plain abdominal film and renal ultrasound. Results: There were decreased in excretion of calcium and uric acid all of patients but not significant statistically (p > 0,05) and there were significant decreased on stone measurement in patient treated with Renalof. Conclusion: Renalof  can be given as adjunct therapy for patient with renal calculi.

Keywords: Calcium and uric acid excretion in urine 24 hours, stone measurement and stone surface area.
THE DIFFERENCE OF PAIN PERCEPTION BETWEEN KETOPROFEN SUPPOSITORY AND 1% PERIPROSTATIC LIDOCAINE INJECTION
Authors: Azis Abdul , Djatisoesanto Wahjoe , Soebadi Doddy M. , Hakim Lukman , Budiono Budiono
Published: August 2019

Objective: To compare the pain control results of ketoprofen suppository and periprostatic injection of lidocaine 1% for prostate biopsy. Material & Method: A total of 30 patients who underwent transrectal ultrasound guided prostate biopsy were randomized into 2 groups. Group 1 consisted of 15 patients received 200 mg of ketoprofen suppository. Group 2 received 1% periprostatic lidocaine injection. A visual analog scale was used to assess the pain score during prostate biopsy. Statistical analysis of pain scores was performed using independent t-test and Pearson correlation test. Results: The 2 groups were homogenous in age and prostate volume. There was significant difference in pain score among groups 1 and 2 during prostate biopsy (mean VAS ± SD 0,8 ± 0,8 and 4,5 ± 1,6 respectively, p < 0,0001). There was no significant correlation between pain perception with age (p = 0,779), or prostate volume (p = 0,389) in both groups. Conclusion: Periprostatic lidocaine injection is more effective for decreasing the pain for prostate biopsy compared to ketoprofen suppository.

Keywords: Prostate biopsy, pain, transrectal ultrasonography, periprostatic nerve block, visual analog scale.
PRELIMINARY REPORT: LAPAROSCOPIC RADICAL PROSTATECTOMY IN JAKARTA
Authors: Johan Mohammad , Mochtar Chaidir Arif , Umbas Rainy
Published: August 2019

Objective: To report initial experience of laparoscopic radical prostatectomy (LRP) in Jakarta and evaluate the functional and oncology outcome. Material & Method: Between June 2007 until September 2008, we had done 9 times LRP surgery. All data is retrospectively taken and divided in three groups, i.e. pre-operative data (patient demography, pre-operative PSA, prostate volume, Gleason Score, clinical and functional staging), intra-operative data (intra-operative complication, conversion to open surgery, bleeding volume, and operating time), and post-operative data (post-operative complication, duration of urine catheter usage, duration of hospitalization, functional and oncology status). Results: Among nine subjects who underwent LRP, five subjects (55,55%) did not converted into open surgery. There are 2 subjects who gain their sexual potency and urine continence in one year post op. Only one subject is proven without biochemical failure in 1 year. Conclusion: We confirmed that radical prostatectomy can be performed with transperitoneal laparoscopic technique by a team that has been experienced in laparoscopic.

Keywords: Laparoscopic radical prostatectomy, functional result, oncological result.
ESTROGEN-TESTOSTERONE RATIO IN PLEXUS PAMPINIFORM OF NORMAL RABBITS AND RABBITS WITH LEFT ARTIFICIAL VARICOCELE
Authors: Simorangkir Lambok , Sihombing Aaron T. , Noegroho Bambang S.
Published: August 2019

Objective: To evaluate estrogen-testosterone ratio in rabbits with a left artificial varicocele. Material& Method: Eight rabbits were divided into two groups.The first group underwent ligation of left renal vein to induce artificial varicocele and the second group underwent a sham operation as control group. Eight week after ligation, blood samples were taken from the pampiniform plexus in both groups. Serologic examination (ELISA) was performed to measure testosterone and estrogen level. The t-test was used to compare the differences of the estrogen-testosterone ratios, a p value < 0,05 is considered significant.Results: Testosterone level was increased with 279% and estrogen level was increased with 33% blood from the pampiniform plexus in group 1 compared with group 2 (normal rabbits). The ratio of estrogen-testosterone between the control group and the artificial varicocele group were 1 : 3. Differences of the ratio between two groups were statistically significant (p < 0,05). Conclusion: Estrogen-testosterone ratio was lower in varicocele rabbit compared with normal rabbits.Keywords: Estrogen-testosteron ratio, left artificial varicocele.
EFFECT OF TESTOSTERONE REPLACEMENT ON EPITHELIAL AND STROMAL TISSUE IN PROSTATIC LOBE IN ORCHIDECTOMIZED WISTAR
Authors: Irawan Yudi , Sihombing Aaron T.
Published: August 2019

Objective: To evaluate the effect of testosterone replacement on epithelial and stromal changes of prostatic lobes in castrated wistar rats. Material & Method: The subjects were 30 wistars equally assigned to castrated + testosterone replacement group (n = 10), castrated group (n = 10), and control group (n = 10). After 60 days, prostatectomy was performed in all rats and prostatic specimens were analyzed by haematoxylin eosin (HE) staining under microscope. Semi–quantitative analysis was performed by evaluating growth of epithelial structure and loss of fibromuscular stroma. Results were analyzed using ANOVA test method for normally distributed data. The statistical analysis was performed using SPSS. Results: There was significant reversibility in castration + testosterone replacement groups in all prostatic lobes compared with castration groups (p = 0,010).There were 5 rats showing normal structure of prostate gland compared to control groups in all prostatic lobes (50%), and 5 showed hyperplasia in all prostatic lobes (50%). Conclusion: Testosterone deprivation can cause prostatic atrophy. Dominant atrophy was found in ventral and lateral lobes. Testosterone replacement can prevent atrophy in all prostatic lobes regardless of specific prostatic lobes.Keywords: Testosterone deprivation, testosterone replacement, prostatic lobes.
CORRELATION BETWEEN PROSTATIC URETHRAL ANGLE WITH CLINICAL PARAMETERS AND BOO IN LUTS ASSOCIATED WITH BPH
Authors: Santoso Kristian Yoci Santoso Yoci , Soebadi Doddy M. , Djatisoesanto Wahjoe , Budiono Budiono
Published: August 2019

Objective: We investigated the correlation of the PUA on clinical parameters and bladder outlet obstruction (BOO) in men with lower urinary tract symptoms (LUTS) suggestive of benign prostatic hyperplasia (BPH). Material & Method: This study was performed between January to April 2011. A cross sectional analysis of 24 men with LUTS associated BPH aged > 50 years was performed. Patients underwent evaluation including International Prostatic Symptom Score (IPSS), transrectal ultrasonography, uroﬂowmetry, and pressure-ﬂow study. Statistical analysis was performed to evaluate correlation of the PUA on clinical parameters and bladder outlet obstruction (BOO). Results: A total of 24 patients, aged 51 to 78 years were enrolled in this study. The mean value of total IPSS, prostate volume, PUA, and Qmax was 22 (range 7-35), 34,4 cm3 (range 21–70 cm3), 37,3° (range 25°–55°), and 10,5 mL/s (range 4,2–17,9 mL/s), respectively. Pearson’s correlation analysis showed that PUA was not signiﬁcantly correlated with IPSS (p = 0,117), Qmax (p = 0,434), total prostate volume (p = 0,213). Patients with increased PUA (PUA > 35°) had higher incidence and degree of BOO (p < 0,05). Conclusion: PUA may be one method to assess the presence of BOO in men with LUTS associated BPH. Our investigation suggest that PUA may help in the treatment of individuals by better predicting their likely classiﬁcation from a pressure-ﬂow study.Keywords: Prostatic urethral angle, benign prostatic hyperplasia, lower urinary tract symptoms, bladder outlet obstruction.