bluuebunny/crossref_metadata_2025 huggingface dataset:
STONE COMPOSITION PATTERN OF KIDNEY STONE
Authors: Alpendri Aries , HR Danarto
Published: August 2019

Objective: The purpose of this study was to know the bacterial and sensitivity pattern towards antimicrobials on kidney stones and to know the stone composition of kidney stones. Material &Method: Data were collected from medical record in 1 year period from January until Desember 2008 with descriptive study design. Results: We found 59 patients in that period, 32 males and 27 females, the mean age was 52,5 ± 10,31 with age 31 – 75 years old, most patients came from Bantul (16,9%) and 25,4% patients were housewives. From urine analysis we found leucocyturia (44,1%), erythrocyturia (39,0%), nitrituria (3,4%) and bacteriuria (6,8%). Urine culture showed E. coli (12,5%) and Candida (12,5%) being the most common causative microorganism. No antimicrobials was sensitive to all bacteriae while all antifungal was sensitive to candida. Stone composition showed ammonium (98%), calcium oxalate (91,8%), calcium non oxalate (93,9%), carbonate (22,4%), cholesterol (14,3%), uric acid (10,2%) and phosphate acid (10,2%). Conclusion: The most common stone composition were ammonium, calcium oxalate, and calcium non oxalate. E. coli still being the most common causative microorganism.Keywords: Kidney stone, stone composition, urinary tract infection, urine analysis, urine culture.
ATHEROSCLEROTIC PLAQUE OF RENAL VASA RECTA ON PATIENT WITH CALCIUM STONE
Authors: Pramod Sawkar Vijay , Sugandi Suwandi , Sihombing Aaron T. , Makmuri Makmuri
Published: August 2019

Objective: We would like to identify whether atherosclerotic plaque inside renal vasa recta correlates with the formation of calcium stone. Material & Method: Samples are taken from kidney tissue removed by nephrectomy due to stone and non-stone disease. Histopathological examination with specific staining was performed by a single pathologist to find the atherosclerotic plaques inside the renal vasa recta. The result of each group was compared, and then analyzed using the Chi square test/Fischer exact test (SPSS ver.16.0; p < 0,05). Results: We found that the risk of calcium lithiasis is two-fold higher in the group with atherosclerotic plaques inside the renal vasa recta. (PR = 2,15; p < 0,05). Conclusion: Calcium stone are more likely to occur on patients with renal vasa recta atherosclerotic plaque, as possible sequelae of vascular injury.Keywords: Atherosclerotic plaque, vasa recta, calcium renal stone.
PROSTATIC CAPSULAR ARTERY RESISTIVE INDEX AND MALE BLADDER OUTLET OBSTRUCTION
Authors: Soebadi Moh. Ayodhia , Djojodimedjo Tarmono , Wirjopranoto Soetojo , P Widodo J
Published: August 2019

Objective: This study aims to explore the relationship between resistive index (RI) with clinical parameters and degree of bladder outlet obstruction (BOO). Materials & Methods: We performed clinical examination which included IPSS, uroflowmetry, transrectal prostate ultrasonography for measurement of prostatic volume and RI of prostatic capsular artery, and pressure flow study. We enrolled patients with lower urinary tract symptoms (LUTS) and prostatic volume of more than 20 ml. Statistical analysis utilised correlation and calculation of sensitivity, specificity, and area under curve of receiver operating characteristics. Results: Twenty-six patients provided consent to enroll in this study. Mean age was 66,5 ± 6,56 years, mean IPSS was 15,9 ± 7,27, and mean prostatic volume 36,0 ± 23,78. Kolmogorov-Smirnov test showed normal distribution of all study variables. There was significant correlation between RI and IPSS, Qmax, and BOO (p < 0,05). Correlation coefficients (r) for prostatic volume and BOO was 0,392 (p = 0,048), for Qmax and BOO was -0.515 (p = 0,007), and RI with BOO was 0,414 (p = 0,035). Using cutoff values for RI ≥ 0,70 and BOO ≥ 4, we found sensitivity of 70,0%, specificity of 50,0%, positive predictive value of 46,7% and negative predictive value of 72,7%. Conclusion: Resistive index of prostatic capsular artery is correlated with BOO and has a role in diagnosis of BOO in men with LUTS related toBenign Prostatic Hyperplasia (BPH).Keywords: Resistive index, transrectal power doppler ultrasonography, lower urinary tract symptoms, bladder outlet obstruction.
THE USE FGSI AS PREDICTIVE OF UROLOGICAL SIRS PATIENTS
Authors: Purnomo Basuki Bambang
Published: August 2019

Objective: To demonstrate the usefulness of Fournier’s Gangrene Severity Index (FGSI) score for differentiating the outcome between Systemic Inflammatory Response Syndrome (SIRS) patients with upper and lower urological abnormalities. Material & Method:A retrospective study of case records from year 2009-2012 of SIRS patients with urological abnormalities at Saiful Anwar General Hospital (SAGH) Malang was carried out. The data were collected from the Medical Record Division in SAGH Malang. SIRS was clinicaly diagnosed based on medical history, physical examination and laboratory findings. SIRS without urological abnormalities were excluded from the analysis. The FGSI, which was developed to assign a numerical score that describes the severity of disease, was used in our study. This index presents patients vital signs (temperature, heart and respiratory rates) and metabolic parameters (sodium, potassium, creatinine, and bicarbonate levels, hematocrit, and white blood cell count). Patients with SIRS and urological abnormalities were divided according to upper tract and lower tract urological abnormalities. Total FGSI score was classified as mild (0-8), moderate (9-17), severe (> 17). The data were assessed according to whether the patient survived or died.Results:75 of the 203 evaluated patients died. From those 75 patients, 67% were male and 33% were female, 75% with upper urological abnormalities and 25% with lower abnormalities (p < 0,05). From those 203 patients; the results were analyzed with binary logistical regression and Spearman correlation analysis using SPSS 15 softwarewith 95% confidence interval (CI). There is significant relationship between FGSI and outcome of the patient with upper urological abnormalities and lower urological abnormalities, with correlation coefficient more high in relationship between FGSI and outcome of the patient with upper urological abnormalities (0,4 vs 0,1). Conclusion: FGSI is simple and objective outcome predictor to differentiate survival between SIRS patients with upper urological abnormalities and lower urological abnormalities. There is a significant difference in outcome between SIRS patient with upper urological abnormalities and lower urological abnormalities even with same level of FGSI score.Keywords: Fournier’s gangrene severity index, systemic inflammatory response syndrome, upper urological abnormalities, lower urological abnormalities, outcome predictor.
DIURETIC DOPPLER ULTRASOUND FOR EVALUATING OBSTRUCTED AND NON-OBSTRUCTED KIDNEY
Authors: Fajrial Ahmad Fajrial , Soebadi Doddy M , Djojodimedjo Tarmono , S Muhammad Yamin , Pudjirahardjo Widodo
Published: August 2019

Objective: The objective of this study was to evaluate the implementation of diuretic Doppler Ultrasound (DDU) to differentiate the obstructed and non-obstructed kidney. Material & Method: From 28 patients, we gathered data of 48 kidneys in accordance with the inclusion criteria. We evaluated the Doppler Ultrasound Resistive Index (RI) before and after administration of diuretic, using the renogram as the comparison. The result of renogram was categorized into total obstruction (n = 19), partial obstruction (n = 18), and non-obstructive dilatation (n = 3). The statistical analysis was performed using Anova test followed by Tukey HSD test. We also performed diagnostic test, the total and partial obstruction were categorized within obstructed group (n = 37) whereas normal and non-obstructed dilated kidney categorized as non-obstructed group (n = 11). Results: Average change of RI (ΔRI) was 0,542 ± 0,0457 for total obstruction, 0,0428 ± 0,0439 for partial obstruction, 0,0275 ± 0,0392 for normal kidney, -0,0300 ± 0,0361 for non obstructed dilated kidney. The result of normality and homogeneity test indicated the data were normally distributed. One-way Anova test revealed significant differences of ΔRI between groups. The subsequent Tukey HSD test indicated that there were significant differences in total and partial obstruction groups, compared to non-obstructive dilated kidney group. Based on ΔRI cut-off point (0,035) the diagnostic characteristics were 88,5% sensitivity and 72,3% specificity. Conclusion: RI of Diuretic Doppler Ultrasound is a valuable examination to evaluate obstructed and non-obstructed kidney. The cut-off point of 0,035 indicated probability of obstructive kidney. Keywords: Resistive index, renogram, obstructive kidney, non-obstructive kidney.
TERAZOSIN EVALUATION AS MALE LUTS TREATMENT USING IPSS SUB-SCORING RATIO
Authors: Tanggo Christian Ronald K. , Safriadi Ferry
Published: August 2019

Objective: To evaluate the improvement of Lower Urinary Tract Symptoms (LUTS) in males treated with terazosin based on sub scoring ratio of the International Prostatic Symptoms Score (IPSS). Material & Method: Sixty eight male with LUTS subjected to terazosin 1 mg daily and divided into two groups based on IPSS sub scoring ratio. After 3 months improvement of the symptoms were evaluated using the IPSS. Data analysis was done using paired T-test. The conclusion was based on significance level p<0,05. Results: The IPSS score was improving on both failure to void group (IPSS- v/s >1) and failure to store group (IPSS- v/s ≤1) after 3 months of Terazosin therapy (mean= 9,56 versus 6,94). Statistically superior improvement was observed on failure to voiding group (p=0,0003) (95CI:1,30-3,93). Conclusion: Terazosin is best given to male LUTS with IPSS- v/s >1 although both groups respond well.Keywords:International prostatic symptoms score, sub score, failure to voiding, failure to storage, male, lower urinary tract symptoms.
PREOPERATIVE KETOROLAC EFFECT ON POSTOPERATIVE PAIN ON TURP PATIENTS
Authors: Hadi Choirul , Utomo Trisula
Published: August 2019

Objective: The aim of this study is to study the effect of preoperative Ketorolac on postoperative pain after transurethral prostatectomy at Sardjito Hospital Yogyakarta. Material & Methods: This is a cross sectional, analytic, prospective study. We divided benign prostatic hyperplasia patients, from October 2011 until February 2012 into two groups. Group I was given Ketorolac 30 mg intravenously twice daily starting one day before operation and in the morning before procedure. Group II did not receive Ketorolac preoperatively. Patients underwent transurethral operation with spinal anesthesia. We assessed postoperative pain at 24 hours using Visual Analogue Scale (VAS). Results: Twenty four patients were included in this study with mean age 66 years old with the youngest 45 years old and the oldest 80 years old (SD 8,77744). Group I (17 patients), VAS score 1 to 7 with median 3 and mean 3,4118 (SD 1,66053). Group II (7 patients) VAS score 1 to 8 with median 3 and mean 3,8571 (SD 2,8357). We count it using Mann-Whitney U (p = 0,951). Conclusion: There is no significance difference in post-operative pain after transurethral prostatectomy with preoperative ketorolac administration.Keywords: Ketorolac, bupivacaine, visual analogue scale, transurethral prostatectomy.
RELATIONSHIP BETWEEN TZI AND TZV WITH IPSS, QMAX, AND BOO
Authors: Satyagraha Paksi , Djojodimedjo Tarmono , Wirjopranoto Soetojo , Budiono Budiono
Published: August 2019

Objective: This study evaluate the relationship between the IPSS score, Qmax,  and degree of bladder outlet obstruction with transitional zone volume (TZV) and transitional zone index (TZI) in clinical BPH patient. Material & Methods: This is an observational cross sectional study which 26 patients included with clinical BPH between September 2011 until January 2012. General information and other variables are recorded (total prostate volume, TZV, TZI, IPSS score, Qmax and degree of bladder outlet obstruction (BOO) according to Schaefer normogram. The data will be descriptive and analytically analyzed. Results: 26 patients with clinical BPH are included in this study, with average age is 64,7 (± 5,98) years. The average volume of the total prostate volume and TZV are 30,35 (± 15,35) gram and 15,31 (± 11,77) gram. Meanwhile the average of TZI is 0,4 (± 0,13). After the normal distribution test was performed, all data is analyzed with Pearson correlation test. A strong correlation was found between IPSS and total prostate volume (r = 0,526, p = 0,006), TZV (r = 0,671, p = 0,000) and TZI (r = 0,812, p = 0,000). A strong correlation is also found between TZI and BOO (r = 0,560, p = 0,003). Meanwhile weak correlation is found between Qmax and total prostate volume (r = -0,105, p = 0,608), TZV (r = -0,103, p = 0,616) and TZI (r = - 0,084, p = 0,734). Another weak correlation is shown between total prostate volume (r = 0,233, p = 0,253) and TZV (r = 0,37, p = 0,062) with degree of BOO according to Schaefer nomogram. Conclusion: TZV has significant correlation with IPSS score, but no significant correlation with Qmax and degree of BOO in patients with clinical BPH. Meanwhile TZI has a significant correlation with IPSS and degree of BOO in patients with clinical BPH. TZI could be performed as a single non invasive procedure to determine BOO in patients with clinical BPH.Keywords: Prostatic hyperplasia, transition zone, ultrasonography, urodynamics.
PSA, TZI, RI OF PROSTATE AS RISK FACTORS OF URINARY RETENTION
Authors: Renaldo Johan , Hardjowijoto Sunaryo , Djojodimedjo Tarmono , Budiono Budiono
Published: August 2019

Objective: To evaluate some parameters as the predictors of urine retention incident in Benign Prostate Hyperplasia (BPH) patients. Materials & Methods: From May to August 2012, a total of 24 BPH patients aged 47-69 years with lower urinary tract symptomps (LUTS) including 12 patients with urine retention  were participated in the study. Prostate specific antigen (PSA) examination was performed on all patients. For urine retention patients, PSA was performed 2 weeks after catheterization as the procedure may affect PSA levels. Transrectal ultrasonography (TRUS) was examined to assess total prostate volume (VTP), transitional zone volume (VZT), transitional zone index (IZT = VZT / VTP), and resistive index of prostate capsulary arteries. Statistic was utilized using simple and multiple logistic regression. Receiver operating characteristic (ROC) was calculated to assess the usefulness of parameters as a predictor of urine retention. Results: There was no significant difference in age between LUTS and BPH patients with urine retention (p = 0,487). There was no relationship between PSA and transitional zone index to incidence of urine retention in BPH patients (PSA; p = 0,173 and TZI; p =  0,192). Multiple logistic regression analysis showed only resistive index of prostate capsulary arteries which correlates with urine retention incidence (p = 0,014), with area under ROC 0,865 (95% CI 0,721 to 1,008) and cut-off value of > 0,675 as a predictor of urine retention incidence. Conclusion: Resistive index of prostate capsulary arteries by transrectal ultrasonography (TRUS) is a predictor of urine retention incidence in BPH patients.Key words: prostate specific antigen, transitional zone index, resistive index of prostate capsulary arteries, benign prostate hyperplasia, lower urinary tract symptoms, urine retention.
PERIPROSTATIC NERVE BLOCK AND INTRAPROSTATIC INFILTRATION ON TRUS-P GUIDED BIOPSY
Authors: Rachman Wendi , Safriadi Ferry
Published: August 2019

Objective: This study is aimed to determine the effectiveness and complications of periprostatic block and intraprostatic infiltration anesthesia for transrectal prostate biopsy. Material & Method: Two consecutive group of patients, periprostatic block (group A) and intraprostatic infiltration (group B), underwent transrectal ultrasound (TRUS) guided prostate biopsy were entered into the study. Exclusion criteria were severe systemic infection, local infection (prostatitis, proctitis, anorectal abscess, and fissure), hemorrhoid (external and/or internal), and chronic pelvic pain (bladder pain syndrome (BPS) or other pelvic disease. Each group enrolled 58 patients. The patients were requested to choose indicate degree of pain on visual analog score (VAS) 3 times, during probe insertion (VAS1), during anesthesia (VAS2), and during the biopsy (VAS3). Complications from the procedures were recorded. The data were analyzed using Mann-Whitney and independent t-test. Results: There were no significant difference in average age of groups, 65,69 ± 7,019 years for group A and 65,34 ± 7,633 years for group B (p = 0,647). The VAS3 score of group B 5,17 ± 0,653 was significantly lower than group A 5,9 ± 0,612 (p < 0,001). The change in VAS score (VAS3-VAS2) in group B 0,55 ± 0,535 also significantly lower than group A 1,00 ± 0,530 (p = 0,004). The average days with pain were not significant on both group, group A 1,16 ± 0,362 day and group B 1,12 ± 0,329 day (p = 0,594). The duration of bleeding was significantly higher on group B 1,32 ± 0,562 day than group A 1,10 ± 0,307 day (p = 0,026). Conclusion: Intraprostatic infiltration resulted in less pain during prostate biopsy, but also reported more bleeding after the procedure than the periprostatic block.Keywords: Intraprostatic infiltration, periprostatic nerve block, transrectal ultrasound guided prostate biopsy.
VALSARTAN TO ATTENUATE RENAL DAMAGE IN UNILATERAL URETERAL OBSTRUCTION
Authors: Jusuf Samycha , Alvarino Alvarino
Published: August 2019

Objective: This experimental study aims to observe the effect of valsartan to attenuate renal damage in unilateral ureteral obstruction. Material & method: Experimental study was performed using 30 wistar rats with unilateral ureteral obstruction achieved by ligation of the left ureter. Rats were divided into two groups, no treatment group and valsartan group. At the 14th day, evaluation was performed to compare interstitial fibrosis, hydropic degeneration, and tubular atrophy between the two groups using haematoxylin-eosin staining. Only rats surviving until at least the 7th day are included in the study. Results: From thirteen wistar rats in no treatment group, there were two with moderate interstitial fibrosis and eleven with mild interstitial fibrosis while all rats in valsartan group had mild interstitial fibrosis (p > 0.05). There is no significant difference on hydropic degeneration between no treatment and valsartan group (31.46 vs 33.67; p > 0.05). There is also no significant difference in tubular atrophy between the two groups (61.78 vs 62.07; p > 0.05). Conclusion: Valsartan therapy in antihypertensive dosage has no significant effect in to attenuate interstitial fibrosis, hydropic degeneration, and tubular atrophy in unilateral ureteral obstruction in wistar rats. Keywords: Unilateral ureteral obstruction, valsartan, interstitial fibrosis.
EFFECT OF PLASMA ANGIOTENSIN CONVERTING ENZYM IN ERECTILE DYSFUNCTION
Authors: Sinrang Andi Wardihan
Published: August 2019

Objective:The aim of this study was to know the effect of aging and I/D angiotensin converting enzymes (ACE) gene polymorphisms in modulating plasma ACE level in erectile dysfunction(ED) subjects.Material & method:This case control study carried out in Makassar with 83 male subjects (49 ED subjects and 34 normal subjects). International Index of Erectile Function-5 was used for ED diagnosis while plasma ACE level and genotyping ACE gene examined with ELISA test and Rigat PCR method respectively.Results:The data showed that plasma ACE level siginificantly higher in ED group compared to normal group, while the plasma ACE level consistently raised following the increased of age in ED group but did not statistically significant (p>0.05) compare to normal group. DD genotype in ED group had mean plasma ACE higher compared to ID and II subjects eventhough did not statistically significant.Conclusion: The high level of ACE plasma appeared to have a pivotal rule in ED mechanisms as well as in older ED subjects. DD genotype partly modulated the raising of plasma ACE in ED subject comprared to ID and II genotype.  Keywords: Plasma ACE level, erectile dysfunction.
AGE-RELATED CHANGES IN RENAL RESISTIVE INDEX AFTER ESWL
Authors: Hermawan Anton , Alif Sabilal , Djatisoesanto Wahjoe , Wulanhandarini Tri , Budiono Budiono
Published: August 2019

Objective: To determine relation between age and resistive index (RI) changes occurring after extracorporeal shock wave lithotripsy (ESWL). Material & Method: We performed a prospective study in Soetomo Hospital Surabaya. Using duplex ultrasonography, RI was determined in 20 patients with calyceal kidney calculi and pelvic kidney calculi. RI of the interlobar renal arteries were measured in the region near the calculi (distance, less than 2 cm), one hour before ESWL and RI was measured again at 1 hour, 3 days and 7 days after ESWL. Changes in RI values and relation with age (≤ 60 years old and > 60 years old) were evaluated. Results: The renal RI increased significantly 1 hour and 3 days after ESWL, but returned to before ESWL values 7 days after ESWL in the both groups. Although there was positive correlation between age and RI before ESWL, but there was no correlation between age and RI changes after ESWL. Conclusion: Renal RI is higher with age > 60 years, after ESWL renal RI showed transient increase which returned to baseline after 7 days.Key words: Color Doppler Ultrasonography, extracorporeal shock wave lithotripsy, renal resistive index, calyceal kidney calculi, pelvic kidney calculi.
ONE-YEAR EVALUATION OF OVERALL URETHRAL STRICTURE MANAGEMENT USING QUESTIONNAIRES AND UROFLOWMETRY
Authors: Mediana Ervita , Wahyudi Irfan , Rodjani Arry
Published: August 2019

Objective: To evaluate the overall outcomes of patients who get definitive treatment of urethral stricture. Material & Method: All patients who underwent various urethral stricture management in Cipto Mangunkusumo Hospital were evaluated over 1 year period. Patient demographics, type of surgery, International Prostate Symptoms Score (IPSS), quality of life (QoL) score, flow rate (FR) and post void residual urine (PVR) of all patients were evaluated at 3 months, 6 months and 1 year after surgery. Results: Out of 230 urethral stricture patients, 65 patients were eligible this study. Mean patient age was 41.19 ± 20.44 years. 37Direct Vision Internal Urethrotomy (DVIU), 20 end-to-end anastomosis, and 8 graft urethroplasties were performed. All patients underwent urethral stricture management showed improvement of IPSS (-22.64, p < 0.001), QoL (-3.36, p < 0.001), FR (16.72 ml/s, p < 0.001) and PVR (-126.23 ml, p < 0.001). Compliant patients showed better improvement of IPSS and FR than non compliant patient after DVIU procedure. Overall, open surgery give better improvement of IPSS and FR than DVIU procedure. These differences were more pronounced in recurrent and long (≥ 2 cm) urethral stricture disease. In open surgery group, end-to-end anastomosis give better improvement in FR compared to graft urethroplasty. Conclusion: Patients undergoing urethral stricture management experienced a significant improvement in self-reported outcomes and functional uroflow studies. Overall, open surgery gives better improvement in FR and IPSS than DVIU procedure. In open surgery group, end-to-end anastomosis give better improvement compares to graft urethroplasty.Keywords: International Prostate Symptoms Score, quality of life, flow rate, post void residual urine, urethral stricture.
SENSITIVITY AND SPECIFICITY OF PROSTATIC BIOPSY RESULT BASED ON PROSTATE VOLUME
Authors: Pitoyo Joko , Safriadi Ferry
Published: August 2019

Objective: To compare the sensitivity and specificity of both types of prostate biopsies, between 6 core biopsy/sextant biopsy with volume based biopsy prostate. Material & method: The subjects were patients that have been performed prostate biopsy in Hasan Sadikin Hospital in 2006 – 2010. The data was divided into two groups, the group A (before 2009) 327 patients had performed 6 cores biopsy, group B (after 2009), the biopsy was performed based on prostate volume (volume < 40 cc : 8 cores, volume 40-60 cc : 10 coresand volume > 60 cc : 12 cores). Biopsy results confirmed by definitive results from surgery, then analyzed specificity and sensitivity between two groups. The analytical statistic test using unpaired T test and Levene’s test. Results: There were 654 patients divided in two groups. The data in both groups were similar based on analytical statistic test using unpaired t test (p = 0.28) and the data was in normal distribution (Levene’s test = p > 0.05). The group A, mean age 67.4 years, mean prostate volume 32.53 cc and mean PSA levels 29.89 ng/dl and at group B, mean age 66.7 years, mean prostate volume 30.89 cc and mean PSA levels 16.92 ng/dl. Volume based cores method in prostate biopsy have higher sensitivity and specificity compared with 6 core biopsy (97.5% vs 94.0%) and (92.2% vs 77.8%). Conclusion: The sensitivity and specificity of prostate biopsy was increased in volume based cores compared to 6 cores biopsy. Keywords: Prostate biopsy, volume based.
EFFECTIVITY OF PCNL WITH COMBINED ULTRASOUND AND FLUOROSCOPY
Authors: Herwandar Rajasa , Rochadi Sungsang
Published: August 2019

Objective: To assess the effectiveness of Percutaneous Nephrolithotomy (PCNL) at age > 65 years and its complication. Material & method: Fifty-four patients with renal and proximal ureteral stones who underwent PCNL with ultrasound techniques combined with X-Ray at Sardjito and Pantirapih hospital, during 2007 to 2012. Laboratory data is in the form of hemoglobin, leukocyte count, trombocyte, haematocrit, natrium, potassium, chloride, BUN, creatinine both pre-operative and post-operative. The samples were divided according to age < 65 years old and above. In analyzing categorical data, we used chi-square test, whereas the numeric data analysis is using independent t-test with p < 0.05. Results: We found no significant differences between the age groups < 65 years and age > 65 years in stone location, presence of hydronephrosis, its grade and location. There also no difference based on operative time, intra-operative procedure, its complication and the day of DJ stents removal and nephrostomy. Both group showed similar result on laboratory findings. However, we found that the older age group have 2 days longer in the length of hospitalization than the younger age groups (p = 0.05) and history of diabetes mellitus and hypertension with p < 0.05. Conclusion: PCNL is a safe and effective procedure with minimal complications for the treatment of kidney and proximal ureteral stone, even for patients with co-morbidity. PCNL technique with guidance of ultrasound for early access would help tomake the operating time shorter and less exposure to ionizing radiation.Keywords: Percutaneous nephrolithotomy, age > 65 years old, effectiveness, safety.
CORRELATION OF PSA, PV, AND IPP IN DETECTING BOO CAUSED BY PROSTATE ENLARGEMENT
Authors: Kurnia Indra Cahya , Ghinorawa Tanaya , Rochadi Sungsang
Published: August 2019

Objective: To define the relationship between intravesical prostatic protrusion (IPP), prostate specific antigen (PSA), and prostate volume (PV), and to determine which one is the best predictor of bladder outlet obstruction (BOO) due to benign prostatic enlargement. Material & method: 95 male patients > 40 years old presenting with LUTS and BPH, between January until July 2012. They were evaluated with digital rectal examination (DRE), International Prostate Symptoms Score (IPSS), total PSA serum, uroflowmetry, post-void residual urine measurement, IPP and PV using transabdominal ultrasound. Statistical analysis included Chi-square and Spearman’s Rank correlation test.Receiver Operator Characteristic (ROC) curves were used to evaluate the correlation of PSA, PV, and IPP with BOO. Results: Mean PSA was significantly higher in obstructed patients (8.6 ng/mL; 0.76-130) compared to non-obstructed patients (6.44 ng/mL; 1.0-40.6). Mean PV was significantly larger in obstructed patients (50.33 mL ± 24.34) compared to non-obstructed patients (45.39 mL ± 23.43). Mean IPP was significantly greater in obstructed patients (7.29 ± 2.78) compared to non-obstructed patients (6.59 ± 2.93). The Spearman rho correlation coefficients were 0.617, 0.721, and 0.797, for PSA, PV, and IPP, respectively. Using ROC curves, the areas under the curve for PSA, PV, and IPP were 0.509, 0.562 and 0.602, respectively. The positive predictive values of PV, PSA, and IPP were 59.7%, 55.6% and 60.2% respectively. Conclusion: PSA, PV, and IPP measured through transabdominal ultrasonography are noninvasive and accessible method that significantly correlates with BOO in BPH patients. IPP is a better predictor for BOO than PSA or PV.Keywords: Bladder outlet obstruction, intravesical prostatic protrusion, prostate specific antigen, prostate volume, transabdominal ultrasound, benign prostate hyperplasia.
CORRELATION OF FOLLICLE STIMULATING HORMONE AND LUTEINISING HORMONE WITH TESTICULAR SPERM BIOPSY RESULT
Authors: Ardiyansyah Fadhil , Utomo Trisula
Published: August 2019

Objective: To investigate the correlation of follicle stimulating hormone (FSH) and luteinising hormone (LH) with testicular sperm biopsy result in azoospermia patients. Material & methods: This is a cross sectional descriptive analytic study. Data were collected from medical record in Klinik Permata Hati Sardjito General Hospital Yogyakarta. We divided them into two groups, sperm group and non-sperm group of sperm biopsy result. We recorded the level of FSH and LH pre-operation. The results were expressed as mean ± standard deviation (SD). The correlation coefficient (r) between various parameters was determined by analysis for Spearman’s rank correlation test. Results: We found 35 patients who met the inclusion and exclusion criteria during 2010-2012, who performed testicular biopsy, age range between 28-44 yo. The mean of FSH on sperm group (12.75 mIU/mL) was higher than non-sperm group (7.26 mIU/mL). The mean of LH on sperm group (5.8 mIU/mL)was also slightly higher than non-sperm group (5.70 mIU/mL). We found weak correlation between FSH level and testicular biopsy (r = 0.095), while on LH level was found negative correlation with testicular biopsy (r = -0.053). There were 42.85% patients with negative sperm result within normal range of FSH and 100% with normal range of LH. The Level of FSH with positive result ranged between 1.94-19.7 mIU/mL and LH level with positive result were 1.38-17.69 mIU/mL. Conclusion: FSH and LH were important plasma hormones correlated with spermatogenesis. FSH level between 1.94-19.7 mIU/mL and LH level between 1.38-17.69 mIU/mL could be used as reliable criteria for testicular sperm biopsy.Keywords: Follicle stimulating hormone, luteinising hormone, testicular sperm biopsy, azoospermia.
COMPARISON OF SEXUAL DYSFUNCTION BETWEEN END-TO-END ANASTOMOSIS AND BUCCAL MUCOSA GRAFT
Authors: Yuri Prahara , Wahyudi Irfan , Rodjani Arry
Published: August 2019

Objective: The aim of this study was to compare long term follow-up of sexual dysfunction between end-to-end anastomosis or buccal mucosa graft in short segment bulbar urethral stricture. Material & Method: We performed a meta analysis of cohort study. The data sources was MEDLINE from 1980 through 2011. A fixed effects model with Mantel-Haenszel method was used to calculate the pooled Risk Ratio (RRs) and 95% Confidence Interval (CIs). We assessed the heterogeneity by calculating the I2 statistic. All analyses were performed with Stata statistical software, version 10.0 (Stata Corp). Results: We analyzed 6 cohort studies. End-to-end anastomosis and buccal mucosa graft patients who complained about sexual dysfunction were 24.6% (45/183) and 9.1% (11/122) respectively, with overall RR 2.54 (95% CI, 0.22-0.69, p = 0.001). Conclusion: Buccal mucosa graft showed a superior outcome compared to end-to-end anastomosis, based on sexual dysfunction in ≤ 3 cm bulbar urethral stricture treatments.Keywords: Sexual dysfunction, end-to-end anastomosis, buccal mucosa graft, anterior urethral stricture.
PERCUTANEOUS NEPHROLITOTOMY ON THE MANAGEMENT OF CALYX INFERIOR STONES
Authors: Tirtayasa Pande Made Wisnu , Birowo Ponco , Rasyid Nur
Published: August 2019

Objectives: To compare the stone free rates of inferior calyceal stones with stone burden < 20 mm, 21-30 mm, and > 30 mm on post-percutaneous nephrolithotomy (PCNL) patients in Cipto Mangunkusumo Hospital. Material & method: The data was collected retrospectively from PCNL medical records in Cipto Mangunkusumo Hospital between January 2000 until May 2012. Patients were followed-up with plain abdominal radiography (BNO) or renal ultrasonography (USG). Stone free status was defined as no residual fragments on radiography or USG. Results: As many as 88 patients with inferior calyceal stones who underwent PCNL were included. Forty-three cases had stone burden < 20 mm, 34 cases with stone burden 21-30 mm, and 11 cases with stone burden > 30 mm. Overall, 81 (92%) cases were defined as stone free. On group < 20 mm, 21-30 mm, and > 30 mm; 41 (95%), 32 (94%), and 8 (73%) cases defined as stone free respectively (p = 0.485). Conclusion: PCNL is the primary modalityon the management of calyx inferior stones with high stone free rate. The stone free rate of these three groups showed no statistically significant difference.Keywords: Percutaneous nephrolithotomy, inferior calyx stone, stone free rate.
THE INSIDENCE OF BLADDER SQUAMOUS CELL CARCINOMA IN LARGE BLADDER STONE CASES
Authors: Pitoyo Joko , Safriadi Ferry
Published: August 2019

Objective: To determine the incidence of squamous cell carcinoma (SCC) in patients with large bladder stone (> 40 mm). Material & method: This is a descriptive retrospective cross-sectional study, data was collected from medical record on patients with a diagnosis of large bladder stone (> 40 mm) that have been performed surgical removal of stone (vesicolithotomy) and bladder mucosa biopsy in Hasan Sadikin Hospital Bandung during 2006-2010. Furthermore, the data are classified according to pathology. Results: This study found cases of large bladder stone (> 40 mm) of 47 cases during the period 2006-2010, and of these 47 cases, there were 76.7% and 23.3% non-malignancy of a malignancy in 2 cases (4.3%) with anatomical pathology picture of SCC. Based on the age group of patients aged 31-40 years obtained 25.5%, 41-50 years 21.3%, 51-60 years 21.3% and > 60 years 23.4%, whereas for ages below 30 years 8.5%. Based on sex, male 95.7% and 4.3% of women. Based on the size, found a stone the size of 40 mm (48.9%), stone size of 50 mm (10.6%), stone size 60 mm and 70 mm respectively (8.5%), stone size 80 mm (12.8%), stone size > 80 mm (4.3%) and 6.4% with multiple bladder stones. Conclusion: There were only two cases of bladder SCC from 47 cases patients with large bladder stone (> 40 mm) in Hasan Sadikin Hospital Bandung during 2006-2010.
Keywords: Bladder Stone, bladder carcinoma, squamous cell carcinoma.
TRANSPERITONEAL LAPAROSCOPIC URETEROLITHOTOMY FOR LARGE DISTAL URETERIC STONE
Authors: Priyosantoso Bacilius Agung , Pramod Sawkar Vijay
Published: August 2019

Objective: This study is aim to share our experience (in videos) in Laparoscopic ureterolithotomy for large distal ureteric stone with transperitoneal approach. Material & methods: A 37 years old male has been diagnosed with a right hydronephrosis due to proximal ureterolithiasis and stone at left calyx inferior, first and stone migrated to right distal ureter on 12 hours prior surgery, in Hasan Sadikin Hospital Bandung. He underwent laparoscopic ureterolithotomy with transperitoneal approach. Results: We successfully perform laparoscopic ureterolithotomy with transperitoneal approach on a 37 years old male patient who diagnosed with a right hydronephrosis due to distal ureterolithiasis and stone at left calyx inferior. Duration of operation was 45 minutes. Patient was discharged at 2nd postoperative day without any complications. Conclusion: A transperitoneal laparoscopic ureterolithotomy for distal ureteric stone is a safe and feasible technique that should be an options on every patients who is planning to undergo distal ureterolithotomy especially large stone.
Keywords: Transperitoneal, laparoscopy, distal ureterolithotomy.
Prognosis of obstructive nephropathy patients after percutaneous nephrostomy
Authors: Sukmagara Jefri , Danarto H R
Published: August 2019

Background: Percutaneous nephrostomy is a life-saving procedure for the treatment of obstructive uropathy associated with septicaemia and uraemia. It is regarded as a temporary interventional procedure before definitive treatment. Several factors can affect recovery of renal function after nephrostomy, such as patient age, duration of obstruction, function of the contralateral kidney, pyelolymphatic backflow and compliance of the ureter and renal pelvis.Objective: To determine factors that can predict the decrease in creatinine levels after percutaneous nephrostomy (< 2mg/dl).Methods: This is a retrospective analysis descriptive study. All patients previously performed nephrostomy at Sardjito General Hospital Yogyakarta, from January 2009 to December 2012 were identified. The data were analyzed to evaluate the relationship between reduction of serum creatinine level and following variables including: etiology, nephrostomy (unilateral or bilateral), symptom duration (≤14 days or >14 days), comorbid disease (hypertension, diabetes melitus, heart disease) and degree of hydronephrosis (mild, moderate and severe). The data were analyzed with Chi-Square test and multiple logistic regression to obtain predictive factor and predictive scoring equation to measure the possibility of recoverability of renal function after nephrostomy.Results: We analyzed 117 patients that previously treated by percutaneous nephrostomy. It showed the relationship between reduction of serum creatinine level and the following variables:  nephrostomy (unilateral or bilateral) (p=0,000), symptom duration (p=0,000), hypertension (p=0,004) and degree of hydronephrosis (p=0,000). Whereas etiology of urinary obstruction and other comorbid diseases showed no relationship. Predictive equation result: P= 1/(1+ey), where y= -0,271 + 1,636 (degree of hydronephrosis) + ((-2,216) unilateral or bilateral nephrostomy) + 1,694 (symptom duration) + ((-0,862) hypertension), with sensitivity 74,3% and specificity 70,7% in predicting renal function recoverability.Conclusions: Bilateral or unilateral nephrostomy, symptom duration, hypertension and degree of hydronephrosis are factors affecting the decrease in serum creatinine level. They role as independent predictor to predict recoverability of renal function can be considered. Key words: obstructive uropathy, percutaneous nephrostomy, multiple logistic regression.
Laparoscopic Live Donor Nephrectomy: Comparison of Left-sided and Right-sided Approach in Our First 50 Cases
Authors: Marcelino Albertus , Mochtar Chaidir Arif , Wahyudi Irfan , Baskoro Bagus , Rodjani Arry , Rasyid Nur
Published: August 2019

Objectives: To compare the operative results and outcomes between right and left laparoscopic live donor nephrectomy (LLDN). Methods: We retrospectively analyzed the first 50 consecutive LLDN in Indonesia performed between November 2011 and February 2013. Of these patients, 6 underwent right LLDNs and 44 left LLDNs. All patients underwent LLDNs in Cipto Mangunkusumo Hospital. All LLDNs were done by the same surgical teams. Intraoperative, post-operative donor and recipient data results were compared.Results: There were no significant differences of intraoperative, post-operative and recipient data results in both groups.  The first warm ischemic time (mean±SD, 6min 55sec±145sec vs 7min 37sec±177 sec, p>0.05), the second warm ischemic time (41min 35sec ± 7min 45sec vs 48min 36sec ± 8min 41sec, p>0.05), and the operative time (4hour 41min ± 31min vs 4hour 32min ± 49 min, p>0.05) showed similar results in the right and left LLDN, respectively. Active mobilization on 72-hour post-operation was found in 83,3% in the right LLDN compared to 95,5% (p>0.05). There were no delayed graft function and post-operative hemodialysis within one week in the recipients of right LLDN group. Conclusion: Right LLDN has equal operative results and outcomes compared to left LLDN. Right-sided LLDN may be a judicious approach for donors with unfavorable characteristics of the left kidney.
Early detection of Prostate Cancer with Prostate Specific Antigen > 4 ng/ml : A Multivariate Logistic Regression
Authors: Yuri Prahara , Rochadi Sungsang
Published: August 2019

Background:Early detection of prostate cancer is a possible means of decreasing the mortality and increasing the quality of life. Objective :To determine whether the prostate specific antigen (PSA), abnormal DRE, family history, age, and prostate volume could increase the specificity and sensitivity of screening for prostate cancer. Methods :We included 92 patients with PSA > 4 ng/ml between January and December 2011 in Sardjito Hospital. Patients received prostate biopsy due to having abnormal serum prostate specific antigen (PSA) level. The relationship between the possibility of prostate cancer and the following variables were evaluated including: age; PSA level, prostate volume, DRE finding and family history. By using chi-square analysis, multiple logistic regression and receiver operating characteristic (ROC) curve were drawn based on the predictive scoring equation to predict the possibility of prostate cancer. All analyses were performed with SPSS, version 18.0. Results:We analyzed 92 patients with PSA > 4 ng/ml. It showed the relationship between the possibility of prostate cancer and the following variables, including : age (p < 0.001), PSA level (p < 0,001), DRE finding (p < 0.001) family history (p < 0,001) except prostate volume (p = 0.398). Using a predictive equation, P = 1/(1-e-X), where X= -3,821 +1.846 (if DRE positive) + 2,488 ( if family history positive ) + 1.718 ( when PSA > 10 ) + 1.414 ( when age > 68), followed by receiver-operating characteristic curve analysis, it showed the sensitivity 90,4% and specificity 85 % in predicting the possibility of prostate cancer. Conclusion:  Age,  DRE  finding,  PSA  and  family  history  are  factors  associated prostate cancer. They can be used as independent predictor to predict prostate cancer. Key words: Logistic regression, early detection,prostate cancer
COMPARISON OF FOSFOMYCIN TROMETAMOL WITH CIPROFLOXACIN FOR UNCOMPLICATED UTI DUE TO E.COLI IN WOMEN
Authors: Budiono Heri , Hardjowijoto Sunaryo , Djojodimedjo Tarmono , Soebadi Doddy M , Widodo Agung Dwi Wahyu , Budiono Budiono
Published: August 2019

Objective: To compare clinical therapeutic effects (frequency, dysuria, and pyuria), microbiology, pharmacokinetics index Cmax/MIC Fosfomycin Trometamol 3 gr single dose with Ciprofloxacin 2 x 500 mg/12 hours for 5 days in the treatment of uncomplicated UTI in women due to Escherichia coli (E.Coli). Materials & Methods: Experimental observational design from February until July 2013. Twenty two women with uncomplicated UTI due to E.Coli performed clinical and microbiological examination. Pharmacokinetics index (Cmax/MIC) is looked for. Patients are divided 2 group, Ciprofloxacin 500 mg/12 hours 5 days and Fosfomycin Trometamol single dose. Repeat clinical and microbiological evaluation is performed in 7 days after therapy. Statistic analysis use Chi Square test, Paired T test, and Independent T test. Results: In the treatment of uncomplicated UTI in women, Fosfomycin Trometamol single dose therapy provides clinical cure (dysuria 81.2%, p = 0.338, frequency 90.9%, p = 0.004, pyuria 90.9%, p = 0.009) much better than Ciprofloxacin 500 mg/12 hours 5 days. Fosfomycin Trometamol single dose therapy also provides bacteriological eradication (100%) better than Ciprofloxacin 500 mg/12 hours 5 days (p = 0.035). Fosfomycin Trometamol single dose had a higher pharmacokinetics index (Cmax/MIC) compared to Ciprofloxacin 500 mg/12 hours (p = 0.035). Conclusion: Fosfomycin Trometamol single dose therapy is superior to Ciprofloxacin 500 mg/12 hours 5 days in the treatment of uncomplicated UTI in women. Keywords: Therapeutic effect, fosfomycin trometamol, ciprofloxacin, uncomplicated UTI, Escherichia coli.
RISK FACTORS IN SEVERE ERECTILE DYSFUNCTION POPULATION
Authors: Johanes Charles , Birowo Ponco , Rasyid Nur
Published: August 2019

Objective: To find the risk factors of severe erectile dysfunction. Material & methods: This Cross sectional study subjects completed the questionnare at the time of diagnosing Erectile Dysfunction (ED). Amount of 297 ED patients with mean age of 49.08 ± 13.69 years were enrolled consecutively at Urology Outpatient Clinic from 2005 to 2012. The questionnaire consisted of marital status, educational status, and occupation, comorbidities, habits, and International Index of Erectile Dysfunction-5 (IIEF-5) questionnare. We compared population proportion of ED severity (severe vs not severe) between sociodemographic, comorbidities and habits group and we also compared the mean of ED onset age and ED duration between those groups. Results: Of the patients, 29.3% were classified as severe ED, and 70.7% were classified other than severe ED (mild, mild-moderate, etc). The median of ED onset age was 47 years (46.64 ± 13.77 years) and the median of ED duration was 52 weeks (126.75 ± 167.69 weeks) ranged from 1 to 1040 weeks. We found status of low education level, unemployed, not married and having diabetes mellitus could increase the risk of having severe ED in ED population with each prevalence ratio was 1.44 (1.12-1.87), 2.02 (1.20-3.42), 1.91 (1.10-3.30), 2.01 (1.30-3.12). Not married group was also found have an earlier mean of ED age onset (mean difference 6.78 (2.37-11.19) years. Conclusion: We found that education level, occupation status, marital status and diabetes mellitus contributes in determining ED severity.
RETROPERITONEOSCOPIC HEMINEPHRECTOMY: INITIAL EXPERIENCE IN CIPTO MANGUNKUSUMO HOSPITAL JAKARTA
Authors: Irdam Gampo Alam , Wahyudi Irfan , Rodjani Arry , Situmorang Gerhard Reinaldi
Published: August 2019

Objective: To explain efficacy and feasibility of heminephrectomy laparoscopic with retroperitoneal approach in double collecting system patients with non-functional upper moiety. Material & methods: Three cases in Cipto Mangunkusumo Hospital’s urology outpatient clinic from July 2013 - January 2014 with double collecting system and non-functional upper moiety. Laparoscopic heminephrectomy with retroperitoneal approach were done to these patients. Results: Surgery was done within 200 - 240 minutes with minimal bleeding and no significant complication. There was no significant hemodynamic disturbance observed during surgery. Patients were able to mobilize and to get immediate oral intake. Pains were minimal and can be treated with first-line analgesics. The patients were discharged on the fourth and fifth day of hospitalization. Conclusion: We are reporting our initial experience doing retroperitoneoscopic heminephrectomy in double collecting system patient. This procedure was feasible and produced good outcomes for the patients.
LAPAROSCOPIC LEFT HEMINEPHRECTOMY IN COMPLETE DOUBLE COLLECTING SYSTEM WITH MULTIPLE UPPER MOEITY KIDNEY STONE
Authors: Parardya Aga , Pramod Sawkar Vijay
Published: August 2019

Objective: Laparoscopic heminephrectomy was firstly reported by Jordan and Winslow in 1993. Laparoscopic heminephrectomy has recently been described as a feasible procedure for the treatment of poorly functioning renal moiety in the duplex kidney. However, this minimally invasive technique is a complex procedure that has remained confined to the hands of experienced teams, with a limited number of reports of relatively few cases. In Indonesia, it has rarely been done. Material & method: A 49-year-old male with chief complaint of pain at the left flank for 2 months. From IVU, we found double collecting system with left upper moiety kidney stone. Then we performed laparoscopic left heminephrectomy. Result: Operative time was 2 hours 30 minutes with bleeding < 100 mL. Post operative VAS was 3 with paracetamol analgetic. Patient was discharged 5 days after operation without any complaint. Conclusion: Laparoscopic heminephrectomy is safe to treat patient with complete double collecting system with multiple upper moeity kidney stone.