bluuebunny/crossref_metadata_2025 huggingface dataset:
CHARACTERISTICS OF RENAL CANCER PATIENTS IN HAJI ADAM MALIK GENERAL HOSPITAL MEDAN IN THE YEAR 2011 -2015
Authors: Kurnia Riyan Adi , Kadar Dhirajaya Dharma , Prapiska Fauriski Febrian
Published: August 2019

Objective: The aim of this study is to identity the characteristics of kidney cancer patients at Haji Adam Malik Hospital between 2011 and 2015. Material & methods: This is a retrospective descriptive study of all kidney cancer patients treated at Haji Adam Malik Hospital between 2011 and 2015. Individual patient data was collected from medical record and compiled. Results: Between 2011 and 2015, there were 38 patients diagnosed with kidney cancer treated at Haji Adam Malik Hospital. The patients mean age is 48.26 ± 14.68 years, with a male to female ratio 1.7:1. Histological type found in the study was RCC (57.15%), urothelium based (19.05%), sarcoma variant (14.28%) and benign kidney tumor (9.52%). Clear cell RCC (58.3%) is the most common type of RCC. Based on the TNM classification, patients with kidney tumor of stage II, stage III and stage IV are 15.8%, 10.5% and 73.7% respectively. The treatment modalities for kidney cancer are nephrectomy (44.7%), nephroureterectomy (2.6%), biopsy (8.0%) and inoperable patients or treatment refusal (44.7%). The mortality rate of kidney cancer patients was 81.5%. Conclusion: Mean age of kidney cancer patients at Haji Adam Malik Hospital was lower than that reported in literature. Gender ratio was found similar as seen in literature. The ratio of histological type was differ, but we still found RCC as the most common type of kidney malignancies. Higher number of patients presented at advance stage at diagnosis and refusal to treatment may contribute to the high mortality rate in this study.
COMPLICATIONS OF PERCUTANEOUS NEPHROSTOMY USING PIGTAIL NEPHROSTOMY TUBE SIZE OF 8 FRENCH VS PEDIATRIC NASOGASTRIC TUBE SIZE OF 8 FRENCH IN UROLITHIASIS PATIENTS IN HASAN SADIKIN HOSPITAL BANDUNG
Authors: Rizki Dhika Ari , Tjahjodjati Tjahjodjati
Published: August 2019

Objective: To compare the complications and patient-reported problems using standard pigtail nephrostomy tube versus pediatric nasogastric tube (NGT) usage as nephrostomy tube. Material & Methods: During 2015 period, 79 patients were referred to Urology Department in Hasan Sadikin Hospital Bandung for percutaneous nephrostomy procedure. Data were collected from Medical Record Urology Department to identify the complications and the patients-related problems using standard pigtail nephrostomy tube versus pediatric NGT usage as nephrostomy tube. Results: 38 patients (48%) using pigtail and 41 patients (52%) using pediatric NGT as nephrostomy tube. Overall,12 patients using pigtail nephrostomy tube (31.5%) experienced at least 1 complication related to nephrostomy procedure, and only 7 patients using pediatric NGT (17%) experienced complications. The complications including fever (3 patients), pyuria (5 patients), infection on insertion site (1 patient, 1.2%), pain (7 patients, 8.8%) hematuria (4 patients, 5%) and detached nephrostomy tube (19 patients, 24%). Conclusion: The small number of complications observed in pediatric nasogastric tube patient group suggest that pediatric NGT is a safe, cheap and widely available substitute for pigtail nephrostomy tube.
PREDICTIVE FACTOR OF METASTATIC RENAL CELL CARCINOMA PATIENT IN SARDJITO HOSPITAL PERIOD 2010 - 2015
Authors: Kohar Moch Abdul , Tranggono Untung
Published: August 2019

Objective: To analyze the association between various prognostic factors and the incidence of renal cell carcinoma (RCC) metastatic. Material & methods: This is a descriptive retrospective study. In this research, the dependent variable is metastatic RCC while the predictor factor as independent variable influencing renal cell carcinoma metastasis. The study population were all patients with renal cell carcinoma that were diagnose in Sardjito Hospital from period 2010 to 2015. Results: In this study there were 34 patients who became the object of research. Consisting of men as many as 20 people (58.8%) while women as many as 14 people (41.2%), while for the age category <51 years as many as 16 people (47.1%) while RCC patients aged > 51 years old 18 People (52.9%). In this study, patients with RCC mostly found in stage 2 were 15 people (44.1%), stage 3 of 6 people (17.6%), stage 4 were 13 people (38.2%). These results are consistent with previous studies which suggest that RCC is found most frequently in stage 2 (Soblin et al, 1997). The p value = < 0.038 indicates that there is a significant correlation between tumor staging and metastatic occurrence in RCC, the result of this study is similar to the previous study which stated that the higher the staging of the tumor the greater the risk of metastasis with p value = 0.001 (Vina et al., 2016). Conclusion: There was a significant association between staging of renal cancer and metastatic events.
EFFICACY OF BLADDER TRAINING PROCEDURE IN PATIENTS UNDERGOING TURP
Authors: Harimurti Nicolaus Kresno , Ali Zulfikar , Utomo Trisula
Published: August 2019

Objective: Catheter management is conducted to the patients undergoing transurethral resection of the prostate (TURP). There were many arguments between clinical practitioners about bladder training procedure after TURP procedure. This study aims to determine whether there is a relationship between bladder training action and success of spontaneous micturition in post TURP procedure in patients with urinary retention caused by prostate enlargement. Material & methods: Randomized clinical trial was conducted at Kardinah General Hospital, Tegal from October 2015 to February 2016. 44 study participants who underwent TURP were randomly allocated into two groups. In Group I, patient’s Folley catheter was clamped prior to its removal (bladder training group); and in Group II was not clamped (control group). Results: Mean age of patients was 64.48 ± 8.1 years old. There were 23 patients (52.3%) have had history of recurrent urinary retention and 21 patients (47.7%) have had not (p=0.560). There were 4 patients (17.4%) in Group I and 1 patient (4.7%) in Group II who required re-catheterization and discharge with catheter. There was no statistically significant difference in spontaneous micturition rate between bladder training group and control group (p=0.187).  Conclusion: The result of the current study identified that bladder training to patients undergoing TURP procedure had no significant impact in spontaneous micturition.
THE EFFECT OF POVIDONE IODINE INTRARECTAL TO REDUCE BACTERIURIA, BACTEREMIA, AND SIRS AFTER TRUS PROSTATE BIOPSY
Authors: Aulia Rifky , Rizaldi Fikri , Hardjowijoto Sunaryo
Published: August 2019

Objective: To compare the incidence of bacteruria, bacteremia, and Systemic Inflammatory Response Syndrome (SIRS) after Transrectal Ultrasound (TRUS) of prostate biopsy for the patients whom given intrarectal povidone iodine, enema, prophylactic antibiotic with given enema and prophylactic antibiotic. Material & Methods: A Randomised, experimental study, 20 samples of men with suspicious of prostate cancer were divided into two groups, first group (control) were given enema (dulcolax supp 10 mg) and prophylactic antibiotic (ciprofloxacin 1000 mg), second group (treatment) were given enema (dulcolax supp 10 mg) prophylactic antibiotic (ciprofloxacin 1000 mg), and intrarectal povidone iodine befotre TRUS of prostate biopsy. Urine and rectal swab culture examination were performed before biopsy then urine, blood culture, and blood leucocyte 2 days after biopsy. To assess any bacterial translocation from rectum to urinary tract, we match the post biopsy urine culture antibiogram and rectal swab culture antibiogram before biopsy. Complications and serious adverse effects were also monitored. Outcomes were assessed using Unpaired T Test and Mann Whitney depends on the data distribution and homogeneity. Results: There was no significant difference bacteriuria between groups (p=0.26). Bacteremia and SIRS were not found within two groups 2 days after prostate biopsy.  Post biopsy bacteriuria positive patients antibiogram were compared with pre biopsy swab rectal culture antibiogram, there was no significant difference between two groups. But, significant correlation of pre biopsy rectal swab culture with post biopsy urine culture (p=0.04) were noted. Conclusion: Intrarectal povidone iodine before TRUS of prostate biopsy were not needed as part of rectal preparation, since enema and prophylactic antibiotic was proven to decrease the incidence of bacteriuria, bacteremia, and SIRS after TRUS of prostate biopsy. The occurrance of bacteriuria were caused by bacterial translocation from rectum to urinary tract.
PATIENT PERCEPTION RELATED TO URODYNAMIC TESTING: A QUESTIONNAIRE BASED STUDY
Authors: Astram Ari , Rahardjo Harrina Erlianti
Published: August 2019

Objective: Urodynamic test is a series of test to evaluate the bladder function including voiding and storage physiology. Several previous studies have found that urodynamic testing had association with physical and emotional discomfort. The primary goal of this study was to determine the parameters of anxiety, pain, and shame related to urodynamic testing. Material & Method: From June 2014 to June 2015, a total of 57 consecutive patients who underwent urodynamic study were included in the present study, consisting of 20 men and 37 women. They have completed the questionnaire before and after urodynamic study. Patients were requested to answer four questions related to pain, embarrassment, anxiety, and knowledge related to urodynamic test. Results: Overall, most of the patients felt not at all and nearly not anxious before urodynamic study. Thirty percent of patient thought that there would be moderate pain when the urodynamic test is performed. Majority of patients (68% of patients) felt no embarrassment prior to the test. Overall, patients felt better after urodynamic study in terms of anxiety and pain. Parameter of embarrassment significantly increased after the test. Patient perception of anxiety and pain before urodynamic test are not significantly different with perception after urodynamic test. Conclusion: Urodynamic tests are very well tolerated by men and women. Majority of patients felt better after urodynamic test according to pain and anxiety score. No statistical difference in level of pain and anxiety between before and after the procedure, while parameter of embarrassment was significantly higher after the test was done.
SUCCESS RATES OF TAMSULOSIN AND DUTASTERIDE AS MEDICAL THERAPY BASED ON IPSS IN SYMPTOMATIC BPH PATIENTS IN ARIFIN ACHMAD HOSPITAL PEKANBARU RIAU
Authors: Zamzami Zuhirman
Published: August 2019

Objective: To evaluate the success rates of tamsulosin and dutasteride as medical therapy based on international prostate symptom score (IPSS) in symptomatic benign prostatic hyperplasia (BPH) patients. Materials & Methods: We reviewed medical records of the symptomatic BPH patients in Arifin Achmad Regional General Hospital, Pekanbaru, Riau Province, Indonesia in 2011-2016. The previous and after IPSS of administering tamsulosin 0.2 mg or 0.4 mg or dutasteride 0.5 mg as a single therapy and tamsulosin 0.4 mg with dutasteride 0.5 mg as a combination therapy were assessed. Wilcoxon test was used for statistical analysis. Approval on the study was obtained from the Ethical Review Board for Medicine and Health Research, Medical Faculty, University of Riau. Results: 100 patients fulfilled the inclusion criteria. The results showed 50% patients with mild IPSS and 50% patients with severe IPSS before the medication. 70% patients administered tamsulosin 0.2 mg as first-line therapy, 35% patients administered medication for 6 months-1 year, and 3% patients with mild IPSS, 44% with moderate IPSS and 53% with severe IPSS after the medication. The Wilcoxon test showed there was a significant different (p<0.005) between IPSS levels before and after the medication with success rate 18%. Conclusion: There were good success rate of tamsulosin 0.2 mg, tamsulosin 0.4 mg, dutasteride 0.5 mg as single therapy and tamsulosin 0.4 mg with dutasteride 0.5 mg as combination therapy in symptomatic BPH patients based on IPSS, and the medical therapy are still recommended.
TESTICULAR TUBERCULOSIS: A CASE REPORT
Authors: Harahap Andre Lazuardi , Papriska Fauriski Febrian , Sigumonrong Yacobda H
Published: August 2019

Objective: We report a patient with unilateral testicular tuberculosis, referred to Haji Adam Malik Hospital, Medan, Indonesia. In this report we stressed on the findings in the physical examination of the patient, so it can be applied for the other case of testis tuberculosis. Case Presentation: A 3-years old boy came to the Hospital with a painless unilateral right scrotal enlargement. Based on the data from anamnesis, physical examination and laboratory testing, a diagnosis of right testicular tumor was made and the patient was planned for a right radical orchidectomy. Discussion: He was underwent of right orchidectomy and the histological findings and diagnosis was specific tuberculosis. No specific symptom of tuberculosis was found. On the physical examination, general state was normal. The local state was difficult to differentiate with testicular tumor. In the absence of a histology finding, the diagnosis of TB testis may be impossible (Shugaba et al., 2012). Patients with testicular masses should be fully investigated preoperative and post-operative in order to increase the diagnostic index of this condition. However, unilateral or bilateral Testicular Tuberculosis is uncommon and the report said that there are two patients with unilateral testicular tuberculosis referred to Sina Hospital Tehran University of Medical Science (Hassan et al., 2009). Conclusion: TB infection diagnosis might be missed when clinical findings assume a tumor (Hamm, 1997). Physical examination findings may include a non-tender or tender sensible nodule, dilation and thickening of the epididymis (Hassan et al., 2009). Testicular involvement may be either unilateral or bilateral. The clinical history of patients such as contact with lung tuberculosis patient and immune deficiency condition are not always helpful in diagnosis. Although it is a very rare disease, the clinician should consider tuberculosis of the testis as a possible differential of a scrotal mass especially in endemic area like Indonesia (Mbala et al., 1997). This will increase the possibility of early diagnosis, as well as proper and early management. And also have to remember that not testicular tuberculosis itself should be suspected, others kind of disease mimicking symptoms like hydrocele, spermatocele, epididymo-orchitis, non-hodgkin lymphoma, spleenogonadal fusion, and an adrenal rest or a second testis need to be considered.
PLATELET COUNT AND MEAN PLATELET VOLUME AS PROGNOSTIC MARKERS OF UROSEPSIS
Authors: Harmaya Andri Kusuma , Soebadi M Ayodhia , Soetojo Soetojo
Published: August 2019

Objective: To know and determine platelet count (PLT) and mean platelet volume (MPV) as prognostic factor for outcome in patients with urosepsis. Materials & Methods: This was an analytic observational study. Thirty patients were assigned to the test for PLT and MPV at the day of admission, 36 hours and 72 hours after admission. All subjects were managed according to standard urosepsis therapy. At the 28th day of treatment, patients were evaluated and classified the outcome as survivors and non-survivors. The statistical analysis was performed using multivariate logistic regression with software SPSS 21. In all tests, p<0.05 was considered to indicate significance. Results: The mean of PLT in non-survivors was lower than that in survivors at the day of admission (420 ± 343.57 x103/mm3 vs 423.04 ± 220.15 x103/mm3, p=0.838). Decrease in PLT during the first 72 hours after hospitalization in non-survivors (Δ PLT72h) was greater than that in survivors (-143.43 ± 154.15 x103/mm3 vs -51 ± 121.77 x103/mm3, p=0.050). The mean of MPV in non-survivors was lower than that in survivors at the day of admission (6.30 ± 0.53 fL vs 7.25 ± 1.78 fL, p=0.333). Increase in MPV during the first 72 hours after hospitalization in non-survivors (Δ MPV72h) was greater than that in survivors (3.51 ± 0.86 x103/mm3 vs 1.48 ± 1.54 x103/mm3, p=0.028). In multivariate analysis, Δ MPV72h was an independent predictor of 28-day mortality [OR 9.41 (95% CI, 1.27 – 69.81)]. Conclusion: An increase in MPV during the first 72 hours after hospitalization can be used as poor prognostic in urosepsis patients.
PRESEPSIN AND PROCALCITONIN VALUES TO DETERMINE THE PROGNOSIS OF UROSEPSIS
Authors: Addin Sofyan Rais , Djojodimedjo Tarmono , Rizaldi Fikri
Published: August 2019

Objective: To evaluate the prognostic value of presepsin and procalcitonin in patient with urosepsis. Material & Method: This is an observational prospective study. Patients who fulfilled the criteria for urosepsis at Soetomo Hospital Surabaya were enrolled. Presepsin and procalcitonin were measured at first admission. All patients were managed according to standard urosepsis therapy. At the 28th day of treatment, patients were evaluated and classified into survivor and non-survivor. The statistical analysis were tested with logistic regression test using software SPSS 23. Results: 30 urosepsis patients were included in this study with average age was 48.3 years (range 21-77 years). There were 23 survivor and 7 non-survivor. Mean presepsin values were higher in non-survivor than in survivor but the difference was not significant (4405 ± 4664 vs 4042 ± 2643, p=0.259). Mean procalcitonin value was significantly higher in non-survivor than in survivor (7.68 ± 6.81 vs 3.27 ± 2.74, p=0.013). Using the cut off value ≥2.24 ng/ml, procalcitonin can predict mortality in 28 days with sensitivity 71.4% and specificity 47.8%. Conclusion: Presepsin can not be used to determine the prognosis of urosepsis patients. Procalcitonin showed a significant correlation with outcome of urosepsis patients so it can be use to determine the prognosis of urosepsis.
COMPARISON OF PERITUBAL INFILTRATION OF ROPIVACAIN AND PLACEBO IN PERCUTANEOUS NEPHROLITHOLAPAXY FOR POST OPERATIVE ANALGESIA AT SOETOMO HOSPITAL SURABAYA
Authors: Telussa Arley Sadra , Hakim Lukman , Soebadi Doddy M
Published: August 2019

Objective: To observe the effects of ropivacain peritubal infiltration in reducing postoperative pain and analgesic requirements postoperatively in patients underwent percutaneous nephrolithotomy (PNL). Material & method: Double blind randomized controlled trial on 32 patients with renal stone who underwent PNL at Soetomo General Hospital Surabaya from February until August 2017, divided into 2 groups. Experimental group (A) who received peritubal infiltration of ropivacain pre-operative, and control (placebo) group (B) Evaluation using Wong Baker pain score 2 hour post operation, time from operation until first rescue analgesia, and total analgesia given in first 24 hours. Result: Mean age was 51.81 ± 9.13 and 49.31 ± 10.53 years in group A and B respectively. Mean operation time 49.31 ± 10.53 and 89.69 ± 17.74 hours in group A and B respectively. There was no significant difference in stone complexity, nephrostomy placement and stenting between two groups. There was no significant difference of Wong Baker pain score 2 hours post operation between group A and B (p 0.72). There was no significant difference in total analgesia in the first 24 hours between group A and B (p 0.48). The time of first rescue analgesia demand was significantly longer in the experimental group (p 0.00). Conclusion: Peritubal infiltration of ropivacain in percutaneous nephrolitholapaxy is safe and effective to prolong the need of first rescue analgesia in post operative pain management which result in patients convenience.
PROFILE OF URINALYSIS IN KIDNEY, URETER AND BLADDER STONE PATIENTS
Authors: Zamzami Zuhirman
Published: August 2019

Objective: To evaluate the profiles of urinalysis in kidney, ureter, and bladder stone patients. Material & Methods: We reviewed the medical records of kidney, ureter and bladder stone patients proved underwent operative managements and urinalysis in Arifin Achmad Regional General Hospital Pekanbaru Riau Province, Indonesia in 2011-2015. The sampling technique in this study was minimum sampling that meets the inclusion criteria. Univariate test was used for statistical analysis. Approval on the study was obtained from the Ethical Review Board for Medicine and Health Research, Medical Faculty, University of Riau. Results: There were 226 patients fulfilled the inclusion criteria. This study showed that in macroscopic urinalysis the mostly (94.7%) urine density was 1.003-1.030, urine color mostly (46%) was turbid yellow, all (100%) urine acidity showed normal results with mean acidity was 6, most (95.1%) erythrocytes >1 in urine sediment, most (66.2%) leukocytes was >5 hpf, mostly (99.1%) crystal was absent and most urinary epithelium <15 (63.1%). In microscopic urinalysis showed mostly  protein in urine was absent (56.4%), and mostly ketone (98.7%) was absent in urine and mostly (56.2%) was absent protein in urine. Conclusion: Urinalysis findings could be normal or abnormal in kidney, ureter and bladder stone patients.
THE SIZE PROFILE OF EXTERNAL URETHRAL ORIFICIUM IN MALE ADULT
Authors: Susanto Gaeta Nurprimavera , Danarto Raden , Ali Zulfikar
Published: August 2019

Objective: External urethral orificium (EUO) is the outermost part of the urethra. It lies on the outside, then the operation tool for endourology transurethra must pass urethra meatus externus first before they can go deeper. Unfortunately there is no study addresses the size of EUO of male adults in Indonesia. This study was aimed to know the size of the EUO in males adult. Material & Methods: This study was a prospective study by taking the primary data in the Sardjito General Hospital and Kardinah General Hospital, Tegal and implemented during the period from October to December 2016. There were 50 samples of males adult. The exclusion criteria in this study were male patients with meatal stenosis or patients with a history of surgery on the penis or instrumentation of the urethra. External urethra orifice size measurements performed with a digital caliper, and then converted to scale the size of Fr. The data were then analyzed by Npar test with the Kolmogorov-Smirnov test, and then T-test with linear regression. Results: There were 50 adult male patients with a mean age of 52.54 ± 10.34 years. For sizes vary with the size of 16.5-26.4 Fr. From the analysis of the size of the EUO obtained a mean size of 22.72 ± 2.62 for Indonesian adult male. Conclusion: The average size of the adult male EUO was 22.72 ± 2.62 Fr.
PENILE PARAFFINOMA RECONSTRUCTION WITH SCROTAL FLAP AND SURGICAL OUTCOME: A CASE REPORT
Authors: Putra Ida Bagus Oka Widya , Wahyudi Irfan , Rodjani Arry
Published: August 2019

Objective: To present a case of penile paraffinoma reconstructed with scrotal flap. Case presentation: We report a case of 33-year-old male patient with penile paraffinoma. The patient had a history of injecting liquid paraffin into his penis two times – at 6 months and 2 months prior to his admission to the hospital. His IIEF-5 was 10 (moderate erectile dysfunction). The penile shaft was circumferentially enlarged. There was ulceration on the ventral aspect with signs of inflammation on the surrounding skin. Discussion: We perform a complete excision of paraffinoma. The raw surface was repaired with a one-stage scrotal flap. At six-month follow up, the wound was good, and the patient was able to micturate normally. He was able to achieve painless erection, and IIEF-5 score was improved. Conclusion: A one-stage scrotal flap may offer a good choice in defect closure in penile paraffinoma reconstruction.
THE CORRELATION BETWEEN SERUM PSA LEVEL AND PROSTATE HISTOLOGIC AGGRESSIVENESS WITH PROSTATIC VOLUME IN BPH PATIENTS
Authors: Duarsa Gede Wirya Kusuma , Oka AA Gde , Santosa Kadek Budi , Yudiana Wayan , Tirtayasa Pande Wisnu , Udiyana Nyoman Dwi Maha , Mahadewa Tjok Gede Bagus
Published: August 2019

Objective: Prostate inflammation is one of pathophysiology of prostate hyperplasia in benign prostatic hyperplasia (BPH). There are several factor that involved in prostatic inflammation, such as prostate specific antigen (PSA) that play a role as an autoantigen. The objective of this study was to assess the correlation between free PSA level with prostate histologic aggressiveness, and also the correlation between prostate histologic aggressiveness with prostatic volume in BPH patients. Material & Methods: The design of this study was cross-sectional analytic observational study to determine correlation between serum PSA level with prostatic aggressiveness, and prostatic volume with prostatic aggressiveness. This study was performed from June to November 2016 in Sanglah Public Hospital, Surya Husadha, Balimed, Bhakti Rahayu, and Ganesa Hospital. Eighty three patients with BPH undergoing transurethral resection of the prostate (TURP) were recruited. Results: The result of gamma correlation analysis using Chi-square of PSA level with aggressiveness (p=0.000) and aggressiveness with prostatic volume (p=0.012). Conclusion: Serum PSA level were correlated with prostatic aggressiveness. Prostatic aggressiveness also correlated with prostatic volume.
PENILE CANCER: A STUDY OF 9 CASES AT HASAN SADIKIN HOSPITAL BANDUNG BETWEEN JANUARY 2010 AND DECEMBER 2015
Authors: Firmansyah Irfan , Safriadi Ferry
Published: August 2019

Objective: Penile cancer are the rarest carcinoma of the genitourinary system that are often devastating for the patient and frequently diagnostically and therapeutically challenging for the Urologist. In view of this, it would be interesting to study the incidence, demographics, presentation, and treatment of the patients. The aim of this study was to report the status of penile cancer at Hasan Sadikin Hospital Bandung. Material & Methods: This was a retrospective study of 9 patients. We study the incidence, demographics, presentation, and treatment of the patients at Hasan Sadikin Hospital Bandung between January 2010 and December 2015. Results: The mean age of the patients was 50.44 ± 12.09 years old. All patients had squamous cell carcinoma. Five patients underwent partial penectomy, 4 patients underwent total penectomy and perineostomy for urinary diversion. Four patients had lymph node localization. A Superficial lymph node dissection was performed in two patients. One of our patient was referred to hemato-oncologist for chemotherapy. Conclusion: Penile cancer seems rare in our hospital. General public should be educated about genital hygiene and early circumcision in male infant as a prophylactic measure. An understanding of the various operative procedures for treatment of the primary tumor and regional lymph nodes is therefore critical in the successful management of this condition.
EFFECT OF ERYTHROPOIETIN ADMINISTRATION ON THE AMOUNT OF SPERMATOGONIUM, SERTOLI CELL, AND LEYDIG CELL ON RATS TESTIS (WISTAR STRAIN) AFTER VAS DEFERENS LIGATION RELEASED
Authors: Negara Muhammad Surya , Soetojo Soetojo , Soebadi Doddy M
Published: August 2019

Objective: To determine the effect of Erythropoietin (EPO) on the number of spermatogonia, Sertoli cells, and Leydig cells in white rats wistar strain testis after the release of ligation vas deferens. Material & Methods: Twenty-four Wistar strain rats were grouped into 4 groups. The control group only performed an orchiectomy for testicular examination, ligation group vas deferens only, group performed release ligation of vas deferens, and group performed release ligation of vas deferens and given EPO injection with dose of 1000 iu/kg BW intraperitoneally for 1 week (3x/week). Observation of spermatogonium, Sertoli cells and Leydig cells by counting the amount on the 5 cross sections of the seminiferous tubules using a 400x light magnification microscope with Haematoxylin Eosin staining. Results: Ligation of vas deferens can significantly decreased the number of spermatogonia and Sertoli cells (p<0.05). In Leydig cells there was no significant difference in numbers after ligation of vas deferens (p>0.05). Release of vas deferens ligation turned out to be no significant amount difference in spermatogonia, Sertoli cells, and Leydig cells with ligation of vas deferens group. Similarly, the treatment of ligation vas deferens release and an EPO injection for 1 week was also no significant difference in number compared to the ligation release group of vas deferens. Conclusion: The number of Sertoli cells, Leydig cells, and spermatogonia in the ligation release group of vas deferens and given EPO for 1 week had the same number with the ligation release group vas deferens.
THE DIFFERENCES OF APOPTOSIS EFFECTS BETWEEN COMBINATION OF MELOXICAM WITH GEMCITABINE-CARBOPLATIN CHEMOTHERAPY COMPARED TO GEMCITABINE-CARBOPLATIN CHEMOTHERAPY ALONE IN UROTHELIAL CARCINOMA CULTURE CELLS
Authors: Nugroho Ananta Cahyo , Hakim Lukman , Dajtisoesanto Wahjoe , Soebadi Doddy M
Published: August 2019

Objective: To determine the differences of apoptosis effect between the combination of meloxicam and gemcitabine-carboplatin compared to gemcitabine-carboplatin alone as the standard of chemotherapy care in urothelial carcinoma culture cells. Material & Methods: This research is an in vitro experimental using human bladder cell carcinoma type 5637 which was cultured in the laboratory. In this study, the study group was divided into 3 groups: untreated control group, gemcitabine-carboplatin group, and the meloxicam-gemcitabine-carboplatin combination group, each group consist of 5 replications. To determine the dose of meloxicam, gemcitabine, carboplatin used and the time of apoptosis evaluation, cytotoxic tests were carried out using the MTT assay method. The time of apoptosis evaluation is carried out for 24 hours. Apoptosis was assessed using the Apoptotag reagent from Trevigen®. Observation of apoptosis characterized by a positive reaction (the color turning brown) against DNA strand damage using the TUNEL assay method. One Way ANOVA was used for comparative analysis of apoptosis between the group with a significant value of p<0.05. The analysis was continued with a post hoc test, to determine the differences in each group. Results: The mean of apoptosis in the control group, gemcitabine-carboplatin group, apoptosis and the meloxicam-gemcitabine-carboplatin combination group was 0.748%, 80.336%, and 83.312%, respectively. Post hoc Bonferroni analysis showed that the results had significant difference between the meloxicam-gemcitabine-carboplatin combination group compared to the gemcitabine-carboplatin group (p=0.026) and the control group (p=0.000). Conclusion: Meloxicam-gemcitabine-carboplatin combination therapy has a significantly higher apoptotic effect than gemcitabine-carboplatin alone.
COMPARISON BETWEEN GEMCITABINE-CARBOPLATIN AND COMBINATION OF GEMCITABINE-CARBOPLATIN AND CELECOXIB IN UROTHELIAL CARCINOMA CELL APOPTOSIS
Authors: Pratama Widya Sakti , Soetojo Soetojo , Hakim Lukman
Published: August 2019

Objective: To determine the combination effect of celecoxib and gemcitabine-carboplatin chemotherapy to the apoptosis of cultured-urothelial cancer cell line. Material & Methods: Urothelial carcinoma cell line originating from Bladder Ca 5637 was cultured and used in this in vitro study. Three-groups of cultured-urothelial cancer cell line consisted of (1) control (C), (2) gemcitabine-carboplatin treated group (GC) and (3) gemcitabine-carboplatin and celecoxib treated group (GCC) were treated with 0.086 µM gemcitabine, 290 µM carboplatin and 25 µM celecoxib. All groups were evaluated at 24 hours following treatment, and the apoptotic index (AI) measured accordingly. Results: Significant mean apoptotic index differences were found between the C and GC group; and between C and GCC groups at 24 hours following treatment. However, the AI of GCC was lower than the GC group although not statistically significant (p>0.05). Conclusion: Our study have shown that gemcitabine-carboplatin and the combination of both with celecoxib may increase the apoptosis of urothelial cancer cell line. The role of celecoxib in the addition of gemcitabine-carboplatin to treat urothelial cancer cell line needs to be elucidated further.
THE EFFECT OF N-ACETYL CYSTEINE TO SPERM MOTILITY, VIABILITY, AND CONCENTRATION OF SPRAGUE DAWLEY RATS WITH NICOTINE INHALATION EXPOSURE
Authors: Waskito Dwi , Renaldo Johan , Soebadi Doddy M
Published: August 2019

Objective: To prove and analyze the difference of sperm motility, viability, and concentration of Sprague Dawley rats which were exposed to nicotine inhalation, with rats treated with N-acetyl cysteine (NAC) orally and exposed to nicotine inhalation. Material & Methods: Twenty seven rats were allocated into three group. Control group (C) (aquadest inhalation 1 mL/kgBW/day), treatment group 1 (N) (nicotine inhalation 1 mg/kgBW/day), and treatment group 2 (N-NAC) (nicotine inhalation 1 mg/kgBW/day and oral NAC administration 150 mg/kgBW/day), with all treatment were given for 30 days. Orchidectomy was performed on day 31 to collect semen sample for sperm analysis (motility, viability, and concentration). Results: There was a significant decrease in all parameters from N group compared to C group. Significant increase were found in sperm motility and viability parameters in the N-NAC treatment group compared to N group. While the sperm concentration parameters of the N-NAC group had a non-significant increase compared to N group. Conclusion: Exposure to nicotine inhalation decreased sperm motility, viability, and concentration of Sprague Dawley strain rats, and NAC had a protective effect on sperm of rats which was exposed to nicotine inhalation.
IATROGENIC URINARY TRACT TRAUMA IN OBSTETRICS AND GYNECOLOGIC SURGERIES AT H. ADAM MALIK GENERAL HOSPITAL MEDAN
Authors: Djufri Teguh Risesa , Warli Syah Mirsya
Published: August 2019

Objective: Urinary tract iatrogenic trauma in abdominal or pelvic surgery may cause morbidity, mortality, or even medico-legal problems. The close embryonic, as well as anatomical relationship between urinary tract and genital organs, may be a predisposition for urinary tract trauma, especially ureter and bladder, in obstetrics and gynecology surgeries. This research aimed to evaluate the incidence of iatrogenic urinary tract trauma in obstetrics and gynecology surgeries. Material & Methods: This was a descriptive retrospective research. This research was conducted at Urology Division of Department of Surgery at H. Adam Malik General Hospital, Medan, from February to June 2016. Total sampling method was used. Data were collected from medical records of patients who had iatrogenic urinary tract trauma due to obstetrics and gynecology surgeries at H. Adam Malik General Hospital from January 2011 to December 2015. Parameters that were evaluated included patient characteristics, the type of obstetrics and gynecology procedure that was conducted, the type of urinary tract trauma, and the type of urologic procedure conducted. Data were registered and analyzed using statistical software SPSS version 22. Results: There were 25 patients with 28 incidences of iatrogenic urinary tract trauma, which consisted of 12 iatrogenic ureteral trauma and 16 iatrogenic bladder trauma, out of all patients who underwent obstetrics and gynecologic surgeries at H. Adam Malik General Hospital, Medan, from January 2011 to December 2016. The youngest patient was 19 years old, while the oldest patient was 78 years old. Mean age of patients was 46.48 years (SD ± 11.6). The age group with the most iatrogenic urinary tract trauma was between 26-45 years old, which consisted of 12 patients (48%). Gynecologic patients had the most iatrogenic urinary tract trauma, which was experienced by 23 patients (92%). The most common diagnosis was ovarian cancer. Hysterectomy was the most common procedure to cause iatrogenic urinary tract trauma, as was found in 23 patients (92%). All patients who were found with iatrogenic bladder trauma (15 patients; 60%) underwent bladder repair. Conclusion: Gynecologic procedure, especially hysterectomy, was the most common cause of iatrogenic urinary tract trauma. Bladder repair procedure was the most common procedure performed on patients who were found with iatrogenic urinary tract trauma.
THE RELATION OF HYPOSPADIAS TYPES, AGES, AND SURGICAL TECHNIQUES FOR URETHROCUTANEOUS FISTULA COMPLICATION IN CHILD HYPOSPADIAS CASES
Authors: Widjajana Desy Pratiwi , Wahyudi Septa Surya , Sutejo Ika Rahmwati
Published: August 2019

Objective: To find correlation between hypospadias type, age, and surgical technique for urethrocutaneous fistula in child hypospadias cases. Material & Method: This research was an observational analytic research with cross sectional approach. It was conducted at Bina Sehat Jember Hospital, Paru Jember Hospital, and Bhayangkara Bondowoso Hospital. The research samples were hypospadias patients who had done hypospadias repair with susceptible age from 0 months until 16 years. Result: In this study, was found correlation between type of hypospadias with urethrocutaneous fistula (p=0.03 and r=0.43). And the other hand, this research did not find relationship between age at hypospadias surgery with urethrocutaneous fistula complication (p=0.34 and r=0.3). The results of this study indicate that the incidence of urethrocutanoeus fistula complications in the surgery using TIP technique was greater than Onlay Island Flap technique, but in this study, there was no association between hypospadias surgery technique used with complications of uretrocutanoeus fistula (p=0.3 and r=0.22). Conclusion: In this study, there was a significant relationship between hypospadias type with urethrocutaneous fistula complication with statistically moderate strength and positive correlation direction. This study did not show any significant relationship between age and hypospadias surgery technique with complications of urethrocutanoeous fistula.
THE INDONESIAN LINGUISTIC VALIDATION OF THE URETERAL STENT SYMPTOMS QUESTIONNAIRE
Authors: Tansol Christiano , Noegroho Bambang Sasongko , Safriadi Ferry , Sani Wildan
Published: August 2019

Objective: To validate the Indonesian version of the ureteral stent symptoms questionnaire (USSQ) for patients with indwelling ureteral stents. Material & Methods: The Indonesian version of the USSQ was developed following a well-established multistep process by two urologists and two independent translators. A total of 38 patients with indwelling temporary unilateral ureteral stents completed the Indonesian USSQ. Patients completed questionnaires at 1 week after stent insertion and 1 week after stent removal. The reliability of the Indonesian version was evaluated for internal consistency using Cronbach’s alpha test. Domain structures were examined by interdomain (section) associations using Spearman’s correlation coefficient (r). Sensitivity to change of each domain was assessed using Wilcoxon test. Results: Urinary, pain, general health, work performance and additional problem showed good internal consistency whereas sexual problem and global quality of life displayed low consistency. There were strong correlations of urinary symptoms with body pain (r=0.633) and general health (r=0.686), moderate correlation with work performance. In addition there was also strong correlation between body pain and general health (r=0.723). Sensitivity to change were significant to all domain except sexual matters domain. (p<0.001). Conclusion: The Indonesian USSQ is reliable and can be utilize as a tool to investigate symptoms and to assess quality of life related issues due to ureteral stents in Indonesian patient.
FIVE YEARS CHARACTERISTIC OF KIDNEY TRAUMA IN TERTIARY HOSPITAL IN WEST JAVA FROM 2013-2017
Authors: Karim Ilhamul , Adi Kuncoro
Published: August 2019

Objective: Globally, trauma is one of the leading cause of mortality and morbidity. Kidney is an organ that is often affected in trauma cases in urology. This study aimed to determine the characteristics of cases of kidney trauma treated in Hasan Sadikin Bandung Hospital, and used as part of the database of urogenital trauma in Indonesia. Material & Methods: The secondary data was derived from the medical records of patients with kidney trauma treated at Department of Urology in Hasan Sadikin Hospital Bandung for 5 years period (January 2013 to August 2017), as many as 130 cases. Information used was patients’ gender, mechanism of trauma, grading of kidney trauma, associated injury, management, shock, and outcome after treatment. The data obtained was subsequently recapitulated and processed using a spreadsheet. Results: A total 20489 trauma cases admission in Hasan Sadikin Hospital, 477 cases (2.33%) were urogenital trauma, and 130 of which are cases of kidney trauma (0.63%). The majority of patients with kidney trauma are male (87.7%). Based on the mechanism of trauma, 80% of them were related to traffic accidents, especially in motorcycle traffic accidents, as well as the trauma mechanism of falling from a height (13%). There were 69 patients (53.1%) who had major kidney trauma, and 61 patients (46.9%) had minor kidney trauma; specifically, 42.3% grade I and 21.5% grade V kidney trauma. In general, kidney trauma patients experienced multiple trauma, only 19 cases (14.6%) had not associated injury. Most of patients (63%) did not experience shock, and 87.75% of patients survived after treatment. In the timespan of 5 years, 44 patients underwent McAnninch procedure. Conclusion: In Hasan Sadikin Hospital, most cases of kidney trauma were experienced by men, and were caused by blunt trauma in traffic accidents, especially on motorcyclists. Most patients with kidney trauma experienced multiple trauma.
COMPARISON OF BLEEDING COMPLICATIONS BETWEEN TURP AND OPEN PROSTATECTOMY IN PATIENT WITH BPH
Authors: Limantara Ancelia , Soebadi Doddy M , Pramesti MP Budyandini D , Rizaldi Fikri
Published: August 2019

Objective: Benign prostatic hyperplasia (BPH) is the enlargement of prostate glands. Two commonly used methods of BPH surgery in Indonesia are transurethral resection of prostate (TURP) and open prostatectomy. International studies have shown both methods have bleeding complications, occurring in 7% in TURP and 22% in open prostatectomy. But, only few researches for bleeding during BPH surgery are done in Indonesia. This study aimed to analyze the difference in bleeding complications between TURP and open prostatectomy in Indonesia. Material & Methods: An observational study with cross-sectional design, using consecutive sampling from medical records of patients above 21 years old with BPH who came to Poli Urologi Soetomo Hospital in 2015–2016 for TURP or open prostatectomy. Data were analyzed using Fischer and Mann-Whitney. Results: Information was obtained from 62 patients, TURP was done in 49 patients (79.03%) and 13 patients (26.53%) in which had bleeding complication. Open prostatectomy was done in 13 patients (20.97%) and 6 patients (46.15%) in which had bleeding complications. Fischer test showed no significant difference in bleeding complications between TURP and open prostatectomy in patients with BPH (p=0.192), including patients with urine retention (p=0.451), without urine retention (p=0.249), age below 70 (p=0.140) and above 70 (p=1). Mann-Whitney test showed significant difference in bleeding complications volume between TURP and open prostatectomy (p=0.012). Conclusion: There was no significant difference in bleeding complications between TURP and open prostatectomy in patients with BPH. But, between TURP and open prostatectomy significant difference in bleeding volume was found.
THE EFFECT OF CHRONIC EXPOSURE OF NICOTINE INHALATION TO THE COUNT OF SPERMATOGONIA, SERTOLI CELLS AND LEYDIG CELLS OF YOUNG WHITE RAT WISTAR STRAIN
Authors: Rizaldi Aril , Soebadi Doddy M , Soetojo Soetojo
Published: August 2019

Objective: To analyze the difference in the number of spermatogonia, leydig cells and sertoli cells in young age of  white mice Wistar strain after inhalation of chronic nicotine exposure. Material & Method: Laboratory experimental study with post test only control group design, measurement of spermatogonium, leydig cell, sertoli cell in 5 groups of young male Wistar strain, negative control group and treatment group given nicotine exposure 0.5 mg, 1 mg, 2 mg, and 4 mg/kg body weight/day for 30 days. Results: A significant reduction in spermatogonium was found in the group given nicotine 0.5 mg/kgBW/day (p=0.048), 1 mg/kgBW/day (p=0.002), 2 mg/kgBW/day (p=0.002) and 4 mg/kgBW/day (p=0.000) when compared to the control group. Significant decreases were also seen in the group receiving 4 mg of nicotine exposure compared with 0.5 mg (p=0.018). Significant decrease in sertoli cell count was seen only in the nicotine group of 4 mg/kgBW/day compared with the control group (p=0.047). A significant decrease in leydig cell count was found in the nicotine 2 mg/kgBW/day (p=0.037) and nicotine group 4 mg/kgBW/day (p=0.023) when compared with the control group. Significant decreases were also found in the 4 mg/kgBW/day group compared to the 0.5 mg/kgBW/day group (p=0.004). In this study there were also a decrease in the number of spermatogonia, sertoli cells, and leydig cells in the increased dose of nicotine given although not statistically significant. Conclusion: Chronic exposure of nicotine per inhalation may decrease the number of spermatogonia, sertoli cells, and leydig cells. The higher the dose of nicotine given the greater the decrease in the number of spermatogonium cells, sertoli cells, and leydig cells that occur. This proves that nicotine is one of the causes of infertility in men.
EFFECT OF NIFEDIPINE ON APOPTOSIS, NECROSIS AND VIABILITY OF GERMINAL EPITHELIAL CELLS IN THE CONTRALATERAL TESTICLE AND PLASMA TESTOSTERONE LEVELS IN MALE WHITE RATS (RATTUS NORVEGICUS, WISTAR STRAIN) AFTER UNILATERAL TESTICULAR TORSION
Authors: Mardihusodo Hajid Rahmadianto , Rizaldi Fikri , Hakim Lukman
Published: August 2019

Objective: To compare the number of apoptosis, necrosis and viability of germinal epithelial cells in the contralateral testicle (CT) and plasma testosterone (PT) levels in white male rats which administered Nifedipine after unilateral testicular torsion (TT) compared with control group. Material & Methods: This research was an experimental study using male white rats (Rattus Norvegicus, Wistar strain) aged 10-12 weeks and body weight 150-200 gram. A total of 30 rats were then randomly divided into 5 groups (n=6) which were negative control group (KN), positive control group (KP1 and KP2) and Nifedipine-administered group (N1 and N2). Each group performed unilateral left side torsion of testicular of 1080o anticlockwise except the KN group. There was 4-hour ischemic duration in the KP1 and N1 groups while 10 hours in the KP2 and N2 groups. Administration of Nifedipine 30 minutes before detorsion by intraperitoneal injection dosed 100 μg/kgBW. All groups performed right orchidectomy and plasma blood sampling. Measurement of apoptosis, necrosis and viability of germinal epithelial cells in the CT using flowcytometry. Measurement of PT levels using Enzyme-Linked Immunosorbent Assay (ELISA). Results: The number of apoptosis, necrosis and viability of contralateral testicular germinal epithelial cells and PT levels in the KN group compared with KP1 and KP2 groups were significantly different (p<0.05). There was no significant discrepancy in apoptosis (p>0.05) in KP1 group compared with N1 group, as well as in KP2 group compared with N2 groups. The number of necrosis, viability of germinal epithelial cells in the CT and PT level in KP1 group in compared with N1 group, as well as in KP2 group in compared with N2 group were significantly different (p<0.05). Conclusion: Nifedipine administration prior to testicular detorsion can maintain cell viability and decrease the amount of necrotic germinal epithelial cells in the CT and prevent the decrease in PT levels after unilateral TT.