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AGE-RELATED CHANGES IN RENAL RESISTIVE INDEX AFTER ESWL Hermawan, Anton; Alif, Sabilal; djatisoesanto, wahjoe; Wulanhandarini, Tri; Budiono, Budiono
Indonesian Journal of Urology Vol 21 No 1 (2014)
Publisher : Indonesian Urological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32421/juri.v21i1.7

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.

CHANGES IN ERECTILE FUNCTION BEFORE AND AFTER PROSTATE BIOPSY wibisono, Wibisono; Soebadi, Doddy Musbadianto; Alif, Sabilal; Pudjirahardjo, Widodo
Indonesian Journal of Urology Vol 20 No 2 (2013)
Publisher : Indonesian Urological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32421/juri.v20i2.9

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

TRANSPLANTATION OF ALLOGENIC ADIPOSE-DERIVED STEM CELL IMPROVE URETHRAL MUSCLE-COLLAGEN RATIO AFTER VAGINAL DISTENSION Yudiana, I Wayan; Hardjowijoto, Sunaryo; Alif, Sabilal; Purwati, Purwati; Sandhika, Willy; Budiono, Budiono
Indonesian Journal of Urology Vol 21 No 2 (2014)
Publisher : Indonesian Urological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32421/juri.v21i2.30

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

THE EFFECTIVENESS OF RENALOF® COMPARED TO KALKURENAL® AND PLACEBO Kristyantoro, Benny; Alif, Sabilal; Djojodimedjo, Tarmono; Budiono, Budiono
Indonesian Journal of Urology Vol 19 No 2 (2012)
Publisher : Indonesian Urological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32421/juri.v19i2.61

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

RELATIONSHIP BETWEEN OBESITY, PSA, AND PROSTATE VOLUME IN PATIENTS WITH BPH WITHOUT URINARY RETENTION Ambeng, Yudi Y; Alif, Sabilal; Soebadi, Doddy M
Indonesian Journal of Urology Vol 18 No 1 (2011)
Publisher : Indonesian Urological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32421/juri.v18i1.65

Objective: To study the relationship between obesity, prostate specific antigen (PSA) level, and prostate volume in patients with benign prostate hyperplasia (BPH) without urinary retention.Material & Method: Twenty two BPH patients without urinary retention were enrolled in this study. Patients were classified into 2 groups based on body mass index (BMI). The first group consisted of 11 patients with obesity (BMI ≥ 27 kg/m2), the second group consisted of 11 non obese patients (BMI < 27 kg/m2). Each patient underwent measurement of PSA, prostate volume and hematocrit. We performed tests for correlation between all variables in both groups. Results: From correlation testing there was a significant relationship between obesity and PSA. With increasing BMI, a lower PSA level was observed (p< 0,05). There was no significant relationship between prostate volume and hematocrit (p > 0,05).Conclusion: There is a significant negative correlation between obesity and PSA in BPH patients without urinary retention

COMPARATIVE EFFICACY OF INTERMITTENT AND DAILY DOXAZOSIN THERAPY FOR LUTS ASSOCIATED WITH BPH Nurdianto, Heru; Alif, Sabilal; Tarmono, Tarmono
Indonesian Journal of Urology Vol 18 No 1 (2011)
Publisher : Indonesian Urological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32421/juri.v18i1.66

Objective: To investigate the efficacy of intermittent doxazosin therapy on LUTS associated BPH. Material & Method: This study was performed between January to April 2010 enrolling 20 patients with LUTS associated BPH. Study subjects were randomly allocated to 2 therapeutic groups. The first group was assigned daily doxazosin therapy (11 patients), while the second group was assigned intermittent doxazosin therapy (9 patients). Initially all subjects were given doxazosin 2 mg daily for 2 weeks. Subsequently group I received doxazosin 2 mg daily therapy, while group II received doxazosin 2 mg every other day. All medications were taken up to 12 weeks. Outcomes were evaluated prior to therapy, and after 2, 4, 8, and 12 weeks of therapy. Efficacy of doxazosin therapy was measured by International Prostate Symptom Score (IPSS), peak urinary flow rate (Q max), and residual urine volume. Statistical analysis was performed to evaluate difference in efficacy between the treatment groups. Results: Daily doxazosin therapy for 2 weeks resulted in significant improvement of Q max and IPSS. After 4, 8, and 12 weeks significant improvement was maintained in both daily and intermittent groups, as measured by Q max, residual urine volume and IPSS. There were no significant differences in Q max, residual urine volume, and IPSS between the daily and intermittent groups at 4, 8, and 12 groups. Conclusion: There were significant improvements of Q max, residual urine and IPSS at 2 to 12 weeks in daily as well as intermittent doxazosin therapy groups. There were no significant differences in efficacy between daily and intermittent therapy groups

ADIPOSE-DERIVED STEM CELL TRANSPLANTATION ON URETHRAL MICROVESSEL AND VOIDING FUNCTION Mahadi, Endi Prilansa; Hardjowijoto, Sunaryo; Alif, Sabilal; Purwati, Purwati; Sandhika, Willy; Budiono, Budiono
Indonesian Journal of Urology Vol 22 No 1 (2015)
Publisher : Indonesian Urological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32421/juri.v22i1.101

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

HUBUNGAN ANTARA DERAJAT INTRAVESICAL PROSTATIC PROTRUSSION DENGAN Q MAX, VOLUME PROSTAT, DAN INTERNATIONAL PROSTATE SYMPTOM SCORE PADA PASIEN BPH DENGAN LUTS TANPA KOMPLIKASI As'ari, Musa; Alif, Sabilal; Santoso, Adi; P, Widodo J
Indonesian Journal of Urology Vol 16 No 2 (2009)
Publisher : Indonesian Urological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32421/juri.v16i2.336

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

COMPARISON OF POSITIVE BACTERIAL CULTURE RATE FROM URINE SPECIMEN AND CATHETER SWAB IN INDWELLING CATHETER PATIENTS Yusuf, Marzuki; Alif, Sabilal; Soebadi, Doddy M; Debora, Kartuti; P, Widodo J
Indonesian Journal of Urology Vol 17 No 2 (2010)
Publisher : Indonesian Urological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32421/juri.v17i2.345

Objective: The study aims to study the difference between urinary culture before and after indwelling catheter insertion and also the difference in positive bacterial culture rate between urine and catheter swab at the 7th and 14th days. Material & method: The subject of this study were patients who used indwelling catheters in urology outpatient department. The sample was allocated into two groups of 10 patients each, 7 and 14 days group. Sterile urinary culture was initially checked before catheter insertion. After 7 and 14 days of catheterisation respectively, urine and intraluminal catheter swab were performed upon removal. All samples were examined in Microbiology Department using McConkey and Nutrient agar (Mayo technique – T/T33). After 24 hours incubation, bacterial colonies were identified. Results: All urinary cultures obtained before the study were sterile, after 7 days catheter insertion two cultures (20%) remained negative and the remainder (80%) became positive. McNemar test result was 0,008 (p<0,05). In 14 days group after catheter insertion only one (10%) remained negative while 9 others were positive for bacteria. Mcnemar test shows 0,004 (p<0,05). The urinary and catheter swab culture is not significantly different in 7 days of indwelling catheterization patients (0,500; p>0,05) and also in 14 days patients (1,000, p>0,005). While the catheter swab culture is significantly positive after administering the urinary catheter in 7 and 14 days of catheterization (0,002; p<0,05). Conclusion: There was significant difference in urinary culture positive rate before and after catheter insertion in 7th and 14th day. Bacteriuria rose sharply after urinary catheter insertion despite aseptic procedure. There was no difference in culture positive rate between urine and catheter swab at 7th day as well as 14th day.

NATRIUM DIKLOFENAK UNTUK PENGOBATAN NOKTURIA YANG DISEBABKAN OLEH NOCTURNAL POLYURIA Sunarno, Eddy; Alif, Sabilal; Hardjowijoto, Sunaryo; P, Widodo J
Indonesian Journal of Urology Vol 16 No 1 (2009)
Publisher : Indonesian Urological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32421/juri.v16i1.358

Objective: To investigate the efficacy of diclofenac 50 mg (Non-Steroidal Anti-Inflammatory Drug) in the treatment of nocturnal polyuria. Materials and methods: Twenty four patients (23 male and 1 female) with a mean age of 61 years (range 34 – 80) diagnosed with nocturnal polyuria were recruited. The study period comprised 2 weeks of either placebo or active medication. Following one-week rest period, patients were crossed over to the other medication for a further 2 weeks. Frequency volume charts were completed during the second week of each of the two study periods along with feedback forms to assess any subjective improvement in symptoms during each of the study periods. Results: A significant improvement in the symptoms was noted for diclofenac when compared with the placebo. The mean nocturnal frequency decreased from 3,61 ± 2,45 to 2,39 ± 1,1 (p<0,05) and the mean 24 h urine volume decreased from 1139,64 ± 365 to 1089 ± 324 (p>0,05), but there is no statistically different. No significant side effects were reported. Conclusion: Natrium diclofenac 50 mg are effective in the treatment of nocturnal polyuria causing a decrease in nocturnal frequency with subjective symptom improvement. Our study suggests, Natrium diclofenac not to prolonged treatment. Further research to find the alternative treatment is recommended.

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