bluuebunny/crossref_metadata_2025 huggingface dataset:
PROSTATE CANCER MANAGEMENT IN MOEWARDI HOSPITAL SURAKARTA FROM JANUARY 2000 – DECEMBER 2006
Authors: Mahadi Endi Prilansa , Widjanarko Suharto
Published: August 2019

Objective: 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.
PERANAN ISOZIM PROTEIN KINASE C-ΑLFA DALAM MEMEDIASI EFEK ANTIPROLIFERASI ALFA-TOKOFEROL PADA SEL STROMA PROSTAT
Authors: Purnomo Basuki B
Published: August 2019

Objective: Alpha tocopherol, other than its anti-oxidant activity, also has a non anti-oxidant activity that correlates with inhibition of PKC-alpha isozyme activity. Several studies had confirmed its role in inhibition of vascular smooth muscle proliferation. Inhibition of stromal cell proliferation is an alternative method of prevention in BPH development. The aim of this in vitro study is to confirm that alpha-tocopherol, by its ability to inhibit PKC-alpha activity, has the capability to inhibit human prostatic stromal cell proliferation rate. Materials & Method: Primary cultures of human prostatic stromal muscle cells were obtained from 4 patients with bladder outlet obstruction caused by benign prostatic enlargement. The effects of various concentrations of alpha-tocopherol (20, 30, 40, 50, and 60 microM) were examined by cell proliferation and PKC-alpha isozyme activity assay. Cell proliferation study was performed using the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay method. Caspase-3 activity assay was also performed to examine apoptotic mechanism. Results: MTT method, which is used to count viable cells, showed that exposures to various doses of alpha-tocopherol resulted in decreased proliferation rate. The decrement of proliferation rate is linear with the increment of alpha-tocopherol dose. Immunocytochemistry staining with anti caspase-3 antibody showed that no cells developed apoptosis. Alpha-tocopherol also inhibits PKC-alpha activity. Isozyme activity is reduced along with the increment of the dose (dose-dependent). There is a correlation between PKC-alpha activity with cell proliferation rate after exposure to alpha-tocopherol (R2=0,9279; p=0,000). Conclusion: Alpha-tocopherol at different concentrations reduces prostatic stromal cell proliferation rate, without effect on apoptosis. This antiproliferative property correlates with decreased activity of PKC-alpha isozyme.
HUBUNGAN ANTARA DERAJAT INTRAVESICAL PROSTATIC PROTRUSSION DENGAN Q MAX, VOLUME PROSTAT, DAN INTERNATIONAL PROSTATE SYMPTOM SCORE PADA PASIEN BPH DENGAN LUTS TANPA KOMPLIKASI
Authors: As'ari Musa , Alif Sabilal , Santoso Adi , P Widodo J
Published: August 2019

Objective: The prostate volume is an objective due to BPH diagnosed, however it is not always concerned with the LUTS degree. LUTS is a syndrome of BOO which marked by obstructive and irritable symptoms. The ball valve mechanism in bladder neck results in increasing of BOO. The aim of this study is to prove the relation of intravesical prostatic protrussion (IPP) with prostate volume, Q max, and international prostate symptom score (IPSS) in non complicated BPH LUTS patients. Materials and method: This research is an analysis observational that involved 85 male patients aged 50 to 91 years old (average 63,98 years old) in Urology Outpatient Clinic RSUD Dr. Soetomo, starting November 2007 until April 2008. Such IPSS evaluation, prostate volume measurement, uroflowmetry examination, and IPP examination with TAUS were applied to all of these patients. Results: The calculation shows the increasing of IPP degree followed by the decreasing of Q max value, where Spearman rank correlation indicates r=-0,465 with p=0,001 (smaller than 0,05), which shows the relation between IPP and Q max. In Spearman rank correlation, with the IPP degree increasing followed by IPSS value increasing indicates r=0,456 and p=0,001, which is smaler than 0,05. Also shows the increasing of IPP degree followed by prostate volume increasing, with r=0,230 and p=0,034 is smaller than 0,05 in Spearman rank correlation. Conclusion: The research reveals a connection between IPP degree and Q max, where the higher IPP degree the lower Q max value, the higher IPP degree the bigger IPSS value, and the higher IPP degree the bigger prostate volume.
PERBEDAAN ANGKA KEJADIAN FISTEL URETROKUTAN PADA PENGGUNAAN KATETER URETRA DAN KATETER SUPRAPUBIK DENGAN STENT SETELAH OPERASI HIPOSPADIA
Authors: Sigumonrong Yacobda H , Santoso Adi , Djojodimedjo Tarmono , P Widodo J
Published: August 2019

Objectives: To study rate of urethrocutaneous fistula formation associated with usage of indwelling urethral catheter compared to suprapubic catheter with stent after hypospadias repair. Materials and methods: Twenty patients with primary hypospadias of penile shaft and posterior type underwent reconstruction with onlay technique by a single operator. Urinary diversion in 10 patients utilised a urethral catheter, while the remainder used a silicone suprapubic catheter with stent. Results: Seven urethrocutaneous fistula were observed (35%) with 4 fistulas in the group with suprapubic catheter and stent, and 3 fistulas in the group with urethral catheters. Fisher exact test value was 0,001 with significance level of 1,000 (p>0,05). Conclusion: There was no difference in rate of urethrocutaneous fistula with use of urethral catheter and suprapubic catheterisation with stent after hypospadias repair.
INTRATESTICULAR INJECTION OF 20% HYPERTONIC SODIUM CHLORIDE AS A NOVEL CASTRATION METHOD: A PRECLINICAL STUDY
Authors: Hendry Marta , Hardjowijoto Sunaryo , Purnomo Basuki B , Joewarini Endang , Meles Dewa Ketut , P Widodo J
Published: August 2019

Objectives: To demonstrate that intratesticular injection of 20% hypertonic sodium chloride can result in permanent castration and to evaluate serum changes in sodium chloride levels. Materials and Methods: A total of 40 Wistar rats were divided into 4 groups, consisting of bilateral orchidectomy (n=10), control (n=10) and 2 groups receiving intratesticular injections of 20% sodium chloride (n=10 in each group). Serum testosterone was measured on day 0, day 1, day 15 and day 30. Serum sodium chloride was assessed before injection, at 1 hour and 24 hours after injection. All testicles were harvested for histological examination. One way ANOVA and student t-test were used for statistical analysis. Results: Serum testosterone decreased to castrate levels in the orchidectomy and injected groups with no significant difference (p>0,05). Significant rise in serum sodium chloride was found 1 hour post injection (p<0,05) but after 1 day it decreased significantly (p<0,05). There was no significant difference in histopathological findings between the 2 injected groups after day 15 and 30 (p>0,05). Conclusion: Twenty percent hypertonic chloride injection has the same permanent castration effect with bilateral orchidectomy in rats. The serum sodium chloride changes did not reach the lethal level for rats. Therefore this treatment has a promising potential as a novel and cost-effective castration method with the additional benefit of retaining both testes.
EVALUATION OF PROSTATE BASAL CELL BY CYTOKERATIN 903 STAINING IN PROSTATIC ADENOCARCINOMA GLEASON SCORE 6
Authors: Nasution Ramlan , Sugandi Suwandi , Sihombing Aaron Tigor , Yantisetiasti Anglita , Hernowo Betthy S
Published: August 2019

Objective: 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.
COMPARISON OF EPITHELIAL CELL COUNTS BETWEEN MIDDLE AND LATERAL LOBES IN BENIGN PROSTATIC HYPERPLASIA (BPH) PATIENT
Authors: Rahman Eka Yudha , Singodimedjo Prawito
Published: August 2019

Objective: The aim of this study was to compare the epithelial cell counts in each lobe of prostate glands with benign prostatic hyperplasia (BPH). Material and methods: Twenty-two BPH patients who underwent transurethral resection of the prostate (TURP) in Diponegoro Dua Satu Surgery Hospital Klaten, from May until November 2006 were enrolled in this study. Tissue from each lobe of the prostate gland was separately collected, from the middle (A), left lateral (B), right lateral lobes (C). All samples were fixed in 10% formalin buffer, embedded in paraffin and sectioned in 4 micrometer slices with microtome. After hematoxylin eosin (HE) staining, number of epithelial cells was counted under light microscopy. Difference in epithelial cell counts in each alveolus between the three lobes was statistically analyzed using t-test (p<0,05). Results: Twenty-two patients were included in this study from May to November 2006, mean age was 66,64±7,6 (54-88) years old. The most common occupation was farmer. Almost all patients had symptoms of chronic urinary retention (95,45%). Length of hospital stay was 8,77±2,7 (6-17) days, mean weight of prostate resected was 47,05±23,2 (5-90) grams, mean operative time 77,73±22,24 (45-115) minute, mean volume of irrigation fluid (sterile water) was 24,18±7,87 (5-34) liter. Mean number of cells in groups A, B, and C were 23,67±8,4 (13,6-44,4), 29,22±8,8 (16,4-41,2), and 29,11±8,7 (16,4-41,2) respectively. There was significant difference between groups A and B, and between groups A and C (p<0,05) respectively. Conclusion: There was statistically significant difference in epithelial cell count between the middle lobes compared to lateral lobes of the prostate in BPH surgical samples. These findings are supported by cystoscopic observation of smaller middle lobe compared to the lateral lobes in BPH.
RELATIONSHIP BETWEEN OBESITY, PSA, AND PROSTATE VOLUME IN PATIENTS WITH BPH WITHOUT URINARY RETENTION
Authors: Ambeng Yudi Y , Alif Sabilal , Soebadi Doddy M
Published: August 2019

Objective: To study the relationship between obesity, prostate specific antigen (PSA) level, and prostate volume in patients with benign prostate hyperplasia (BPH) without urinary retention.Material & Method: Twenty two BPH patients without urinary retention were enrolled in this study. Patients were classified into 2 groups based on body mass index (BMI). The first group consisted of 11 patients with obesity (BMI ≥ 27 kg/m2), the second group consisted of 11 non obese patients (BMI <  27 kg/m2). Each patient underwent measurement of PSA, prostate  volume and hematocrit. We performed tests for correlation between all variables in both groups. Results: From correlation testing there was a significant relationship between obesity and PSA. With increasing BMI, a lower PSA level was observed (p< 0,05). There was no significant relationship between prostate volume and hematocrit (p > 0,05).Conclusion: There is a significant negative correlation between obesity and PSA in BPH patients without urinary retention
RELATIONSHIP BETWEEN P53 EXPRESSION AND PROBABILITY OF ORGAN CONFINEMENT IN PATIENTS WITH PROSTATE CANCER IN SARDJITO HOSPITAL
Authors: Soeroharjo Indrawarman , Danarto H R
Published: August 2019

Objective: To determine the association between p53 expression and the probability of organ confinement in patients with prostate cancer in Sardjito Hospital, Yogyakarta. Material & method: Prostate specimens were obtained from patients with clinical  stage  T1-T2 prostatic  adenocarcinoma  in Sardjito  Hospital between January  2007 and December 2008. Samples were processed and immunohistochemically stained in the Department of Anatomical Pathology Gadjah Mada University. Probability of organ confinement was determined by updated Partin table 2007 from preoperative serum PSA level, Gleason Score, and clinical stage. Correlation  between p53 expression and probability of organ confinement were statistically analyzed by Spearman correlation test. Results: There were 28 prostate cancer patients eligible for this study. Mean age was 65,19 ± 10,9 (28 - 81) years old. Mean preoperative PSA level were 107,13 ± 165,82 (0,20  734,20) ng/ml. Mean number of p53 expression was 97,47 ± 97,27 (5 - 396)/HPF. Significant correlation was found between p53 expression and probability of organ confinement (Spearman r = -0,441; p = 0,019). Conclusion:  p53 expression was negatively correlated with the level of organ confinement in patients with prostate cancer
ENDOTHELIN-1, NITRIC OXIDE, AND RATIO OF ET1/NO IN ERECTILE DYSFUNCTION
Authors: Sinrang Andi Wardihan
Published: August 2019

Objective: The aim of this study was to observe the level of Endothelin-1 (ET-1), Nitric oxide (NO), and the ratio of ET-1/NO in Erectile dysfunction (ED) and normal subjects. Material & method: This case-control study was carried out in Makassar with subjects recruited from outpatient clinic at Wahidin Sudirohusodo Hospital and divided into 2 groups (56 subjects DE and 34 subjects normal). ET-1 and NO plasma were measured by ELISA technique according to protocol. Results: The data showed that mean value of ET-1 in erectile dysfunction subjects was significantly higher (p < 0,05), while NO was significantly lower (p < 0,05) in DE groups compared to normal groups. The ratio of ET-1/NO was also significantly different between both groups. Conclusion: We concluded that level of plasma ET-1, plasma NO, and the ET-1/NO ratio are important factors involved in ED pathomechanism.

Keywords: Erectile dysfunction, plasma endothelin-1, plasma nitric oxide, ratio ET-1/NO.
RISK FACTORS FOR URETHROCUTANEOUS FISTULAS FORMATION AFTER ONE STAGE HYPOSPADIAS REPAIR
Authors: Fariz Mohammad , Rodjani Arry , Wahyudi Irfan
Published: August 2019

Objective: To evaluate risk factors that contribute to urethrocutaneous fistulas formation after one stage hypospadias repair. Material & method: A case control study was performed on hypospadias patients that underwent one stage hypospadias repair. We analyzed the correlation of urethrocutaneous fistula formation with patient age, hypospadias classification, chordee severity, other urogenital anomalies, history of hormonal therapy, suture size, duration of operation, type of dressing, type of stent, duration of stenting, and three types of operation technique, which are TIP, Duckett, and Onlay Island Flap. Results: There were 116 patients with mean age 5,7 ± 3,9 years old (4 months – 19 years old). Urethrocutaneous fistula occured in 12 patients (10,3%). From the data analysis, we didn’t find any significant correlation between urethrocutaneous fistula formation and patient’s age (p = 0,426), hypospadias classification (p = 0,695), chordee severity (p = 0,564), other urogenital anomalies (p = 0,964), history of hormonal therapy (p = 0,739), suture size (p = 0,248), duration of operation (p = 0,856), type of dressings (p = 0,580), type of stents (p = 0,600), and duration of stenting (p = 0,796). We also didn’t find any significant correlation between urethrocutaneous fistula formation and operation technique TIP vs Duckett (p = 0,314), and TIP vs Onlay Island Flap (p = 0,644). Conclusion: There were no significant correlation between urethrocutaneous fistula formation and patient age, hypospadias classification, chordee severity, other urogenital anomalies, history of hormonal therapy, suture size, duration of operation, type of dressing, type of stent, and duration of stenting. There were also no significant correlation between urethrocutaneous fistula formation and operation technique TIP vs Duckett, and TIP vs Onlay Island Flap.

Keywords: Hypospadias, one stage urethroplasty, urethrocutaneous fistula.
DISTRIBUTION OF GLEASON SCO¬RE IN PROSTATE ZONES AMONG PROSTATIC CANCER PATIENTS
Authors: Jaya Indra , Sugandi Suwandi , Yantisetiasti Anglita , Hernowo Betthy S. S.
Published: August 2019

Objective: 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.
METABOLIC RISK FACTORS OF URINARY STONE DISEASE IN CHILDREN
Authors: Tanuwidjaja Dandy , Siregar Safendra
Published: August 2019

Objective: To evaluate metabolic risk factor of urinary stone disease in children. Material & method: In this hospital-based preliminary study, children with urinary stone disease who underwent stone removal in Hasan Sadikin Hospital were included. Control group consisted children with other diseases, matched for age and BMI. Blood evaluation (uric acid, calcium and phosphate) and 24-hour urine evaluation (calcium, phosphate, sodium, magnesium, uric acid, acidity, and urine volume) were measured before the stone removal. Stone analysis was performed later. Data was analyzed using Kruskal Wallis and Spearman correlation test. Results: Eight subjects with urinary tract stone and 8 normal subjects were included to the study. This study included 4 (50%) subjects with renal stone, 3 (37,5%) subjects with bladder stone, and 1 (12,5%) subject with distal urethral stone. Stone analysis revealed 6 (75%) calcium oxalate, 1 (12,5%) calcium phosphate, and 1 (12,5%) struvite stone. There was no significant difference in blood calcium, phosphate, and uric acid between groups. 24 hours urinary calcium level was higher in subjects with stone disease (40,8 mg vs 10,6 mg, p=0,027). Urinary calcium-to-creatinine ratio was also higher in stone disease (0,23 vs 0,02 mg/mg creatinine, p=0,002). There was no significant difference of other urinary electrolites and uric acid level between groups. Conclusion: Twenty four hours urinary calcium level and urinary calcium-to-creatinine ratio is higher in children with urinary stone disease.

Keywords: Urinary stone disease, children, metabolic risk factors.
THE DIAGNOSTIC VALUE OF PROCALCITONIN FOR EARLY DETECTION OF UROSEPSIS
Authors: Nasution M. Andriady S. , Hardjowijoto Sunaryo , Soebadi Doddy M. , Aryati Aryati , Pujiraharjo Widodo J
Published: August 2019

Objective: To study procalcitonin as an early and accurate marker for urosepsis. Material & Method: We performed a diagnostic study of procalcitonin, CRP and peripheral blood leucocyte in 21 patients. Patients included 12 urosepsis patients with urosepsis, and 9 trauma patients without urosepsis. This study was conducted from September 2010 to December 2010. Results: Mean and standard deviation of procalcitonin level in urosepsis patients was 27,9 ± 30,7 ng/ml, CRP was 8,9 ± 7,9 mg/l and blood leucocyte was 15125,0 ± 8969,9 mm3. Sensitivity of procalcitonin in diagnosis of urosepsis was 83,3%, specificity was 77,8%, positive predictive value was 83,3%, negative predictive value was 77,8%, positive odds ratio was 3,75 and negative odds ratio was 0,2. Diagnostic value of procalcitonin was better compared to CRP and blood leucocyte. In the receiver operating characteristics (ROC) plot, area under the curve (AUC) for procalcitonin, blood leucocyte, and CRP were 0,806 (95% CI = 0,607 – 1,004), 0,773 (95% CI = 0,568 – 0,979), and 0,602 (95% CI = 0,341 – 0,863), respectively. Conclusion: Procalcitonin is an early marker for urosepsis cases with better diagnostic value than CRP and blood leucocyte.

Keywords: Urosepsis, Procalcitonin, CRP, Blood Leucocyte.
THE EFFECT OF PREDNISONE ON SERTOLI CELL OF CONTRALATERAL TESTICULAR TORSION
Authors: Tanuwidjaja Dandy , Sugandi Suwandi , Sihombing Aaron Tigor Tigor , Yantisetiasti Anglita , Hernowo Betthy S.
Published: August 2019

Objective: To evaluate the effect of prednisone in unilateral testicular torsion on Sertoli cell quality of contralateral testis. Material & Method: Thirty Wistar rats were divided into three groups i.e. group A (sham procedure), group B (unilateral torsion + orchiectomy after 6 hours), and group C (unilateral torsion + orchiectomy after 24 hours). Group B and C were further divided into subgroup with and without Prednisone administration. Prednisone was given orally once a day an hour after torsion, continued till one month later. Orchiectomy of contralateral testis was performed one month later. Those testes were examined by a pathologist. Results: In group A, no abnormality on Sertoli cell quality was found. There is significant difference among groups in Sertoli cell quality (p = 0,01). Ischemic time is associated with Sertoli cell quality (2 rats with severe damage in group C and none in group B). In group B and C, prednisone administration inhibited Sertoli cell damage. Prednisone administration in 6 hours group gave better results than 24 hours group (3 rats vs 1 rat with good Sertoli cell quality). Conclusion: Sertoli cell in contralateral testis is significantly affected by unilateral testicular torsion. Prednisone inhibit Sertoli cells damage. Ischemic time affected Sertoli cell quality of contralateral testis and respond to prednisone.Keywords: Prednisone, unilateral testicular torsion, sertoli cell.
ANTIBIOTIC PROPHYLAXIS WITH DIFFERENT ANTIBIOTIC REGIMEN IN PROSTATE BIOPSY PATIENTS
Authors: Wibisono Dimas Sindhu , Soebadi Doddy M. , Soetojo Soetojo , Budiono Budiono
Published: August 2019

Objective: To know the incidence of urinary tract infection (UTI) with different antibiotic prophylaxis for transrectal ultrasonography (TRUS) prostate biopsy. Material & Method: The study included 34 patients at Soetomo Hospital Surabaya, who were divided into 2 groups, each group consisting of 17 patients. In the first group patients received 1000 mg of ciprofloxacin orally, in the second group cefotaxime 1000 mg iv was given prior to biopsy. The two groups were compared in terms of UTI incidence as observed from the blood levels of leukocytes, C-reactive protein (CRP) and urine culture 3 days after the procedure. Results: Based on blood leukocyte levels, there was no statistically significant difference between the two groups (p = 0,74 and p = 0,42). So was the comparison of CRP levels. There was no other significant difference found (p = 0,53 and p = 0,27). From the results of urine culture, the ciprofloxacin group had positive urine culture results lower than the cefotaxime group (29,4% : 35,3%), although it was not statistically significant (p = 1,0). Conclusion: Based on the parameters of blood leukocytes levels, CRP and urine culture, there were no differences in the incidence of UTI after biopsy in the two groups.Keywords: TRUS prostate biopsy, UTI, ciprofloxacin, cefotaxime.
TAMSULOSIN OR SOLIFENACIN IN LUTS PATIENTS DUE TO DJ-STENT INSERTION
Authors: Subkhan Subkhan , Djojodimedjo Tarmono , Hakim Lukman , Budiono Budiono
Published: August 2019

Objective: To evaluate the efficacy of tamsulosin or solifenacin for treatment of Lower Urinary Tract Symptoms (LUTS) due to an indwelling ureteral stent. Material & Method: In this study, we enrolled 24 patients who had polyurethane DJ-stent inserted for urinary stone disease or ureteral stenosis. Patients were divided into 3 equal groups as follows and study medications were started on postoperative day 7. Group I received tamsulosin 0,4 mg once daily, group II received solifenacin 5 mg once daily, and group III only received placebo. LUTS were evaluated using International Prostatic Symptoms Score (IPSS) questionnaire at 7 and 14 days after the procedure and stent insertion. The evaluation of IPSS score included not only total score but also irritative and obstructive subcores. Results: All 24 patients fulfilled the inclusion and exclusion criteria, mean age of tamsulosin group was 54,3 years old, solifenacin group was 45,3 years old and placebo was 46,7 years old. There was significant difference in the total IPSS and irritative subscores between groups who received either tamsulosin or solifenacin (group I and II), whereas the obstructive subscore showed a difference though not statistically significant. Conclusion: Tamsulosin or solifenacin significantly improved irritative symptoms of LUTS in patients with an indwelling ureteral stent.Keywords: Lower urinary tract symptoms, DJ-stent, tamsulosin, solifenacin.
CHANGES IN ERECTILE FUNCTION BEFORE AND AFTER PROSTATE BIOPSY
Authors: Wibisono Wibisono , Soebadi Doddy Musbadianto , Alif Sabilal , Pudjirahardjo Widodo
Published: August 2019

Objective: To evaluate erectile function before and after transrectal ultrasound (TRUS) guided prostate biopsy using International Index of Erectile Function-5 (IIEF-5) and Erection Hardness Score (EHS) instrument. Material & Method: We conducted a study on 17 BPH LUTS patients who underwent TRUS guided prostate biopsy from January to April 2011 in Urological Minimal Invasive Installation (IIU) Dr. Soetomo Hospital. Out of 17 patients, three patients had mild ED, while 14 other patients had normal erectile function before the procedure. After TRUS guided prostate biopsy, we performed erectile function assessment using the IIEF-5 and EHS at weeks I, II, and IV. Results: Pathological examination of all specimens from prostate biopsy results revealed BPH. There were 2 patients with hematuria and 1 patient with rectal bleeding shortly after the biopsy, which resolved spontaneously less than 24 hours. Based on the IIEF-5 there were 4 patients (23,5%) with decreased erectile function in the evaluation of first week after prostate biopsy, and it reduced to 2 patients (11,7%) whose erectile function was still decreasing in the evaluation week II, while in fourth week evaluation there was 1 patient (5,9%) with decreased erectile function. Based on EHS data obtained, there were 5 patients (29,4%) with decreased scores in evaluations week II, and in the evaluation of week IV there were no patients having erectile function problems compared with EHS data before prostate biopsy. Conclusion: TRUS guided prostate biopsy can have temporary effect on erectile function.Keywords: Erectile dysfunction, prostate biopsy, international index of erectile function-5, erection hardness score.
PREVALENCE OF SEXUAL DYSFUNCTION IN MEDICAL AND NON-MEDICAL PROFESSION WOMEN
Authors: Satyawan Yopie T. , Rahardjo Harrina E.
Published: August 2019

Objective: The study was conducted to determine the prevalence of sexual dysfunction and the factors affecting the medical and non-medical profession women using of Female Sexual Function Index (FSFI) as an assessment instrument. Material & Method: Respondents were women aged ≥ 18 years that consist of medical groups, working in the field of health care (doctors, nurses, pharmacists, hospital staff), and non-medical groups that have regular sexual partner and sexually active for 3 months. Data was taken with the Female Sexual Function Index (FSFI), translated into Indonesian. Results: There are 206 respondents consisting of 103 people medical and 103 people non-medical group. Mean age was 32.92 ± 7.23 respondents in the youngest age of 21 years and the oldest 53 years. Most respondents (75.2%) were well educated (graduate diploma) with a long marriage has a range of 6-372 months. The majority of respondents (94.2%) married one time. The overall prevalence of sexual dysfunction (FSFI total score < 55) in the study was 9.2%. Statistically, there was no significant difference in the prevalence of sexual dysfunction (p > 0.05) between the medical groups 12,6% when compared to non-medical group (5.8%). Most interference was in the domain of satisfaction (34.0%) in the medical group and 27.2% in non-medical. Conclusion: The medical profession has high potential to experience sexual dysfunction. Night shifts were associated with the prevalence of sexual dysfunction in healthcare workers. Other factors were not found to be related to sexual dysfunction.Keywords: Sexual dysfunction, factors that affect sexual function.
VALIDATION OF INDONESIAN VERSION OF IPSS
Authors: Monoarfa Richard Arie , Mochtar Chaidir Arif
Published: August 2019

Objective: 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.
CORRELATION OF ROUTINE URINE CULTURE AND STONE CULTURE TO POST-OPERATIVE SIRS
Authors: Indrawan Taufik , Hardjowijoto Sunaryo , Soebadi Doddy M. , Juniastuti Juniastuti , Budiono Budiono
Published: August 2019

Objective: This study evaluated the correlation between preoperative urine culture and intraoperative stone culture and the impact of stone culture ﬁndings on post-operative systemic inﬂammatory response syndrome. Material & Method:Patients with kidney stones who underwent percutaneous nephrolithotomy (PCNL) from February to May 2012 were prospectively analyzed. A pre-operative urine culture was obtained in the morning before the operation, fragmented stone collected were cultured in Departement of Microbiology. Patients were monitored closely in the postoperative period for signs of systemic inflammatory response syndrome (SIRS). Results:A total of 33 patients underwent PCNL and examined for urine cultures, stone culture and postoperative SIRS, 15 (45.45%) patients with positive urine culture, 18 patients (54.54%) with positive stone culture but only 1 patient (3.03%) had same pathogen (p = 0.629). Ten patients (55.6%) with positive stone cultures had evidence of systemic inflammatory respose syndrome postoperatively. The calculated stone culture value for sensitivity, specificity, positive predictive value and negative predictive value were 100%, 65.2%, 55.6%, and 100%. Preoperative hydronephrosis (p = 0.003) and operative time (p = 0.001) are identified as the key risk factors for SIRS after PCNL.Conclusion: Positive stone culture are better predictors for SIRS after PCNL. Stone culture examination is an essential in directing the proper antibiotic therapyin patients with SIRS after PCNL.  Keywords: Percutaneous nephrolithotomy (PCNL), urine culture, stone culture, systemic inflammatory response syndrome after PCNL.
DOXAZOSIN AND MELOXICAM COMBINATION THERAPY FOR BPH TREATMENT WITH LUTS
Authors: Suarsana Wayan , Hardjowijoto Sunaryo , Wirjopranoto Soetojo , Budiono Budiono
Published: August 2019

Objective: To compare the efficacy of combination therapy of 4 mg doxazosin + 15 mg meloxicam with 4 mg doxazosin single therapy for benign prostate hyperplasia (BPH) patients with lower urinary tract symptoms (LUTS). Materials & Methods: A prospective, randomized and double blind study with total of 22 BPH patients with LUTS were randomized to receive 4 mg doxazosin + placebo once daily for 6 weeks or a combination of 4 mg doxazosin + 15 mg meloxicam once daily for 6 weeks. Inclusion criteria included IPSS ≥ 8, age > 50 years, prostate blood flow grade II. Therapeutic efficacy was assessed by comparing changes in IPSS, maximal urinary flow (Q-max) and changes in prostate blood flow between baseline and immediately after 6 weeks of therapy. Results: There was no significant difference in IPSS change between the two treatment groups (delta IPSS 4 ± 1.1 versus 3.7 ± 1.5, p = 0.630). There was a significant difference in Q-max changes between the two groups (delta Q-max 4 ± 1.5 versus 2.1 ± 0.7, p < 0.001). In group therapied with 4 mg doxazosin + 15 mg meloxicam prostate blood flow decreased from grade II to grade I in 9 of 11 patients (81%). Whereas, in the treatment group of 4 mg doxazosin + placebo no reduction was found in prostate blood flow. Conclusion: Combination therapy of 4 mg doxazosin + 15 mg meloxicam once daily for 6 weeks is better than 4 mg doxazosin therapy alone in improving Q-max and decreasing prostate blood flow in BPH patients with LUTS.Keywords: Benign prostate hyperplasia, inflammation, COX-2 inhibitors.
THE IGF-1 LEVEL OF ESRD PATIENTS AND ITS RISK FACTORS
Authors: Hidayati Titiek , Yuningtyaswari Yuningtyaswari , Sadewa Ahmad Hamim , Soesatyo Marsetyawan HNE
Published: August 2019

Objective: To identify the Insulin-like Growth Factor–1 (IGF-1) level of End Stage Renal Disease (ESRD) and non ESRD populations, and correlation between IGF-1level and ESRD incidences. Material & Method: This case study was carried out in Yogyakarta with 72 volunteers. The cases involved Chronic Kidney Disease (CKD) patients. The controls were non-CKD patients. CKD parameters were established with PERNEFRI diagnostic criteria. Comparison of IGF-1 levels between case and control groups was performed through ANOVA, with confidence level of 95%. Bivariate analysis to identify the correlation between IGF-1 plasma level, smoking status, illness history and body mass index (BMI) by determining odds ratio (OR) of individual risk factor of p < 0.05. Results: We enrolled 72 volunteers, 45 male and 27 female subjects. Of the 45 male patients, 15 CKD and 30 non CKD patients served as cases and controls, respectively. The difference in plasma IGF-1 level was detected in the case and control groups (42.01 ± 10.66 vs. 56.05 ± 24.91) (p < 0.05). The result of bivariate analysis showed passive smoking status, IGF-1 plasma level, DM history and hypertensive illness history had correlation with ESRD incidence with odds ratios of 7.88 (p < 0.005; CI: 1.6-37.5) for passive smokers, 4.3 (p < 0.05, CI: 1.36 to 13.33) for IGF-1 level, 21.5 (p < 0.05; CI) for DM history and 12.4 (p < 0.05; CI: 3.7 to 41) for hypertensive history. Conclusion: There was difference in IGF-1 plasma level between ESRD and non-ESRD patients. The IGF-1 plasma level, passive smoking status, diabetes history, and hypertensive history have correlation with ESRD incidence.Keywords: Insulin-like Growth Factor–1 level, End Stage Renal Disease, case control, odds ratio.
IPP AS PREDICTIVE FACTOR FOR ACUTE URINARY RETENTION IN BPH PATIENTS
Authors: Budaya Taufiq Nur , Purnomo Basuki B. , Daryanto Besut , Seputra Kurnia Penta , Satyagraha Paksi
Published: August 2019

Objective: To demonstrate usefulness of Intra Prostatic Protrusion (IPP) as Predictive Factor for Acute Urinary Retention (AUR) in Benign Prostate Hyperplasia (BPH) Patients. Material & methods: Cross sectional retrospective study of case records from January to July 2012 of BPH patients at Saiful Anwar General Hospital (SAGH) Malang was carried out. The data were collected from the Medical Record Division in SAGH Malang. We noted age, prostate volume, IPP, IPSS and urinary retention status. The patients were classified by IPP degree < 5 mm (group A), 5-10 mm (group B), 10 -15mm (group C), > 15mm (group D) and we compared all parameters that we noticed. Results: Eighty patients, mean age was 66.32 years were enrolled. Transabdominal ultrasound determined the mean IPP was 13.5 mm, and prostatic volume 95 cc. IPP values were distributed as follows: group A 10 (12.5%), group B 25 (31.25%), group C 24 (30%), group D 21 (26.25%), with AUR incidence in group A 20%, group B 36%, group C 79%, and group D 81%. The IPP showed a significant correlation with urinary retention (r = 0.8, p < 0.05, OR = 15) and IPSS (r = 0.6, p < 0.05). Conclusion: IPP can be used as predictive factor for the incidence of acute urinary retention in BPH Patients.Keywords: Intra Prostatic Protrusion, Acute Urinary Retention, Benign Prostate Hyperplasia.
ESWL FOR RENAL AND URETERAL STONES
Authors: Ridha Muhammad , Soebadi Doddy M.
Published: August 2019

Objective: To report patient characteristics and results of Huikang HK-V extracorporeal shockwave lithotripsy (ESWL) machine for renal and ureteral stones. Material & methods: We retrospectively analyzed medical records of all patients treated with ESWL using HK-V deviceat Department ofUrology Soetomo Hospital from May2011 - February 2012. Results: There were 241 selected patients, consisted of 148 men (61.4%) and 93 women (38.6%). Mean age was 47.8 years (range 7-87). ESWL was conducted to 130 single stones and 111 multiple stones, using fluoroscopy as guidance for 166 patients, ultrasound for 31 patients (12.9%) and both for 44 patients (18.3%). Stone location was 109 in lower pole(41%), 69 in middle pole(26%), 41 in proximal ureter (16%), 28 in upper pole (11%), 14 at renal pelvis (5%), 1 at distal ureter(0.3%) and 2 staghorn stone (0.7%).There were 130 patients with stone less than 10 mm (53.9%), 102 with stone 10-20 mm (42.3%), and 9 more than 20 mm (3.7%). There were slightly more left-sided treatment was 141 patients (58.5%). Of 181 patients with hydronephrosis (75%), 104 had DJ stent inserted (43.2%). Overall, we found 158 patients (65.5%) were stone free after treatment, 49 patients (20.3%) with residual stones less than 4 mm and 34 patients (14.1%) had more than 4 mm residuals. Conclusion: ESWL is the treatment of choice for simple renal and ureteral stones less than 20 mm (opaque and non opaque).Keywords:Extracorporeal Shockwave Lithotripsy, renal stones, ureteral stones.
LAPAROSCOPIC LIVING DONOR NEPHRECTOMY IN INDONESIA
Authors: Mochtar Chaidir Arif , Wahyudi Irfan , Baskoro Bagus
Published: August 2019

Objective: To evaluate and analyze variables related to the surgical and direct post-operative outcomes of our initial experience of laparoscopic living donor nephrectomies (LLDN). Material & methods: This retrospective analysis describes the first 10 laparoscopic nephrectomies in living donors performed in Cipto Mangunkusumo Hospital. All surgeries were performed by the same surgical team. Variables related to the surgical and post-operative outcome and complications in donors were evaluated and analyzed.Results: The average age of the donors was 31.8 years with male : female ratio of 7 : 3. Thirty percent of them were family related to the recipient. The left kidney was extracted from all patients and multiple renal vessels were found in one cases. The mean operation time was 321.9 ± 27 min, first warm ischemia time was 9.37 ± 3.34 min and estimated blood loss was 270 ± 182.87ml. The hospital stay was 4.1 ± 1.3 days, VAS in the first day post surgery was 3 ± 1 with epidural analgesia needed for 1.8 ± 0.6 days, and drain was kept in for 2.8 ± 1.2 days while urethral cathether for 2.4 ± 1.2. Time to return to work was 16 ± 8.4 days. Conclusion: LLDN results in acceptable blood loss,less post-operative pain, short hospital stay and short time to return to work for the donors, therefore promising to be the gold standard among living donor nephrectomy surgical options.Keywords: Laparoscopic living donor nephrectomy,renal transplantation, Indonesia.
TRANSPLANTATION OF ALLOGENIC ADIPOSE-DERIVED STEM CELL IMPROVE URETHRAL MUSCLE-COLLAGEN RATIO AFTER VAGINAL DISTENSION
Authors: Yudiana I Wayan , Hardjowijoto Sunaryo , Alif Sabilal , Purwati Purwati , Sandhika Willy , Budiono Budiono
Published: August 2019

Objective:To investigate the effects of allogenic adipose-derived stem cell (ADSC) transplantation on urethral tissue regeneration after vaginal distension in a rat model.Material & Method:32 female wistar rats underwent vaginal distension (VD) for 4 h. Subsequently, PKH-labeled ADSCs (2 x 105 in 200 µl PBS, ADSC group, n = 18) or PBS (200 µl, placebo group, n = 18) were injected into periurethral tissue. Two and four weeks following transplantation (ADSC or PBS), voiding behavior (frequency) and muscle-collagen ratio of urethral tissue were measured to evaluate urethral sphincter regeneration. Data were analysed by paired-t test, one-way ANOVA and post hoc LSD.Results:Mean voiding frequency was significantly different in the ADSC group at two weeks (p<0.0001), but not significantly different at four weeks (p=0.448) when compared with the placebo group.Masson’s trichrome staining revealed that the muscle-collagen ratio of urethral tissue was not significantly different between study groups at two or four weeks (p=0.053 or p=0.166 respectively). Muscle-urethral ratio was more specific showing a significant difference at two weeks (p=0.043). There were significant differences about muscle-collagen or muscle-urethral ratio between control and placebo groups (p<0.05), whereas between control and ADSC groups no significant difference was observed (p>0.05).Conclusion:ADSC transplantation promotes urethral muscle-collagen ratio with development of striated muscle after vaginal distension, so that can improve voiding behavior in a rat model.Keywords:Adipose-derived stem cell, vaginal distension, rat-SUI model, muscle-collagen ratio, voiding stain on paper.
PROFILE OF BLADDER TRANSITIONAL CELL CANCER IN SOETOMO HOSPITAL SURABAYA
Authors: Abdih M. Asro , Djatisoesanto Wahjoe , Hardjowijoto Sunaryo
Published: August 2019

Objectives: To describe the characteristic of bladder transitional cell cancer (TCC). Material & methods: We reviewed the medical records of patients with bladder TCC admitted in Soetomo General Hospital Surabaya, from January 2008 until December 2012. The data regarding demographic characteristics, clinical presentation and staging, grading and staging based on pathological examinations results, and the management of the cancer.Results: The 126 cases, consisted of 102 men (81%) and 24 women (19%) with its ratio was 4.2 : 1. All male patients were heavy cigarette smokers. Mean age was 57.8 years, peak incidence was50-59 years. Hematuria was the mostfrequent clinical presentation (112 patients, 88.9%), urinary retention and other complaints (12 patients, 9.5%), and chronic dysuria (2 patients, 1.6%). Clinical staging was T1 as NMIBC in 7 patients (5.7%). MIBC consisted of T2 in 37 patients (30.3%), T3 in 35 patients (28.7%), T4 in 43 patients (35.2%). The pathological grading as an high-grade were 74 patients (64.3%). All patients had underwent TURBT for diagnosis and staging, followed by definitive treatment. It consisted of TURBT and chemotherapy bladder instillation in 7 patients (5.6%), radical cystectomy in 13 patients (10.3%), EBRT in 5 patients (4%), MVAC chemotherapy in 24 patients (19%), EBRT and chemotherapy with MVAC in 3 patients (2.4%). There were 74 patients (58.7%) underwent TURBT alone.Conclusion: Bladder TCC was in advanced stage when diagnosed, most of the patients received only TURBT and refused further treatment. Keywords: Bladder transitional cell cancer, characteristics, managements.
ADIPOSE-DERIVED STEM CELL TRANSPLANTATION ON URETHRAL MICROVESSEL AND VOIDING FUNCTION
Authors: Mahadi Endi Prilansa , Hardjowijoto Sunaryo , Alif Sabilal , Purwati Purwati , Sandhika Willy , Budiono Budiono
Published: August 2019

Objective: To examine the effects of adipose-derived stem cell (ADSC) transplantation on urethral tissue microvessel and voiding function on artificial stress urinary incontinence (SUI) in rats. Material & methods: 25 of 32 female wistar rats underwent vaginal distension as animal-SUI model. ADSCs were isolated from the peri-ovary fat, examined for stem cell properties, and labeled with PKH-2. Seven rats without vaginal distension and periurethral ADSCs injection as control. Twelve rats received periurethral injection of phosphate buffer saline as plasebo and 13 rats received periurethral injection of ADSCs. 14 and 28 days later, voided volume was meassured with voided stained on paper and microvessel density was meassured with immunohistochemical analysis (factor VIII R-Ag). Results: Voided volume analysis showed that rats in the plasebo group had abnormal voided volume compare to normal rats in day 14 (168.5 ± 119.05l vs 621.21 ± 283.85l; p < 0.05), and insignificant improvement of voided volume compare to normal rats in day 28 (852.09 ± 626.7l vs 868.49 ± 578.0l; p > 0.05). While in the ADSCs group only showed significant improvement of voided volume compare to abnormal rats in days 14 (379.35 ± 191.74l vs 228.18 ± 56.26l; p < 0.05). Immunohistochemical analysis showed that microvessel density higher in the ADSCs group compare to plasebo group in days 28 (12.86 ± 2.5 vs 9.50 ± 1.64; p < 0.05). Conclusion: ADSCs transplantation promotes improvements voided volume and urethral microvessel in the rat-SUI model.
Keywords: Adipose-derived stem cell, vaginal distension, voided stained on paper, microvessel density.