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PROSTATIC CAPSULAR ARTERY RESISTIVE INDEX AND MALE BLADDER OUTLET OBSTRUCTION Soebadi, Moh. Ayodhia; Djojodimedjo, Tarmono; Wirjopranoto, Soetojo; P, Widodo J
Indonesian Journal of Urology Vol 20 No 1 (2013)
Publisher : Indonesian Urological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32421/juri.v20i1.46

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.

PERBANDINGAN ANGKA BEBAS BATU PADA PASIEN BATU KALIK DENGAN PEMBERIAN DIURESIS DAN TANPA DIURESIS SELAMA ESWL Budiyono, Nur Budiyono; Soebadi, Doddy M; 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.v16i2.335

Objective: To compare effects of intravenous hydration, both with and without diuretics on the stone free rate of calyceal stones during ESWL. Materials and Methods: We analyzed 22 patients with calyceal stone, primarily treated with Sonolith Vision lithotripter, between June 2008 and October 2008. Patients were divided in 2 groups, the 11 patients in group 1 were injected with 500 ml normal saline for intravenous hydration, and 20 mg of furosemide for diuretic effect during ESWL; the 11 patients in group 2 were used as controls. The same energy settings for the shockwaves in one session were equally applied to all patients during ESWL, with a 1 Hz shockwave frequency, 100% power and 1000 shocks. After 2 weeks the stone free rate and residual fragments were evaluated on the post ESWL KUB and compared with the pre-ESWL KUB. Results: After a single ESWL treatment, the stone-free rate was 81,8% (9 of 11 patients) in group 1 and 63,3% (7 of 11 patients) in group 2. The stone free rates of group 1 was higher than that of group 2, but there was no statistical difference between groups 1 and 2. Conclusion: Intravenous hydration with normal saline with a furosemide injection for diuretic effect during ESWL would be same effective method to facilitate fragmentation and stone free of calyceal stones.

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.

EFIKASI TAMSULOSIN PADA BENIGN PROSTATIC HYPERPLASIA DENGAN RETENSIO URINE AKUT YANG MENJALANI TRIAL WITHOUT CATHETER Kholis, Khoirul; Soetojo, Soetojo; Djojodimedjo, Tarmono; 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.v16i2.337

Objective: To evaluate the efficacy of tamsulosin on BPH patients with acute urinary retention on trial without catheter (TWOC). Materials & method: This study was a post test only-placebo group design comparing residual urine in BPH patients with acute urinary retention on TWOC between groups administered with tamsulosin and placebo. The efficacy of both groups with tamsulosin and placebo on the 3rd and 14th day was analyzed using Chi Square test while the efficacy of administration of tamsulosin and placebo on the 3rd and 14th day was analized using Mc Nemar test. Results: This study showed that there was still urinary retention in 7 patients (58,3%) and 4 patients (44,4%) shared recovery within 3 days of tamsulosin administration, while 5 patients (41,7%) still had urinary retention compared to 5 patients (55,6%) who showed recovery in the placebo group. The difference was insignificant with p=0,670. Patients who dropped out from TWOC on the 3rd day and given tamsulosin until the 14th day showed urinary retention in 4 patients (44,4%) and recovery in 3 patients (100%) while all samples who were given placebo showed urinary retention 5 patients (55,6%). The difference was insignificant with p=0,205. Follow up for 3 days in Tamsulosin groups which have urine retention in this study, 3 patients became free for urine retention and the other 4 patients still had urine retention. But in this study, no difference in efficacy with p=1,025. In placebo groups with urinary retention before the 3rd day of administration still showed urinary retention after the 14th day. Conclusion: There was no statistical differences on the success of TWOC, between groups administered with 0,2 mg of tamsulosin and placebo group, neither on the 3rd day nor on the 14th day. There was reduction of recatheterization because of failure of TWOC with patients who were given tamsulosin for 14 days.

PERBEDAAN ANGKA KEJADIAN FISTEL URETROKUTAN PADA PENGGUNAAN KATETER URETRA DAN KATETER SUPRAPUBIK DENGAN STENT SETELAH OPERASI HIPOSPADIA Sigumonrong, Yacobda H; Santoso, Adi; Djojodimedjo, Tarmono; 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.v16i2.338

Objectives: To study rate of urethrocutaneous fistula formation associated with usage of indwelling urethral catheter compared to suprapubic catheter with stent after hypospadias repair. Materials and methods: Twenty patients with primary hypospadias of penile shaft and posterior type underwent reconstruction with onlay technique by a single operator. Urinary diversion in 10 patients utilised a urethral catheter, while the remainder used a silicone suprapubic catheter with stent. Results: Seven urethrocutaneous fistula were observed (35%) with 4 fistulas in the group with suprapubic catheter and stent, and 3 fistulas in the group with urethral catheters. Fisher exact test value was 0,001 with significance level of 1,000 (p>0,05). Conclusion: There was no difference in rate of urethrocutaneous fistula with use of urethral catheter and suprapubic catheterisation with stent after hypospadias repair.

INTRATESTICULAR INJECTION OF 20% HYPERTONIC SODIUM CHLORIDE AS A NOVEL CASTRATION METHOD: A PRECLINICAL STUDY Hendry, Marta; Hardjowijoto, Sunaryo; Purnomo, Basuki B; Joewarini, Endang; Meles, Dewa Ketut; P, Widodo J
Indonesian Journal of Urology Vol 17 No 1 (2010)
Publisher : Indonesian Urological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32421/juri.v17i1.339

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

APOPTOSIS IN IPSILATERAL KIDNEY. COMPARISON BETWEEN GROUP RECEIVING VERAPAMIL AND CONTROL GROUP POST-ARTIFICAL TOTAL UNILATERAL URETERAL OBSTRUCTION Syahrir, Syakri; Soetojo, Soetojo; Santoso, Adi; Joewarini, Endang; P, Widodo J
Indonesian Journal of Urology Vol 17 No 1 (2010)
Publisher : Indonesian Urological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32421/juri.v17i1.340

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

COMPARISON OF APOPTOSIS IN CONTRALATERAL RENAL TUBULAR CELLS IN ORYCTALAGUS CUNICULUS DUE TO ARTIFICIAL UNILATERAL URETERAL OBSTRUCTION, WITH AND WITHOUT VERAPAMIL Boetoro, Djoyo M; Soetojo, Soetojo; Soebadi, Doddy M; Joewarini, Endang; 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.v17i2.344

Objective: To compare the effects of verapamil on the contralateral kidney affected by unilateral ureter obstruction. Material & method: The right ureter of oryctalagus cuniculus rabbits, were obstructed surgically with silk suture material, and kept alive for 14 days. One group was obstructed without other treatment, one group was given verapamil from day 7 until day 14 of the obstruction. One group was obstructed and given verapamil from day 0 through day 14. One group was given a sham operation as a control group. The contralateral kidney of all groups were harvested and processed with ApopTag. The increase of apoptotic tubular cells compared to the control group was then analyzed between each group. Results: The highest increase in apoptotic cells was in the obstructed group without verapamil, but increased significantly compared to control (p<0,001). The groups which received verapamil had lower increase of apoptotic tubular cells, in the group given verapamil for 14 days lower than the group which received verapamil only for 7 days. Both the 7 to 14 and the 0 to 14 groups were significantly lower than the group without verapamil (p=0,035 and p<0,001 respectively). Conclusion: verapamil has a protective effect on the contralateral kidney by inhibiting apoptosis caused by unilateral ureter obstruction. While the definitive treatment for urinary obstruction is to relieve it, verapamil can protect the kidney in the mean time.

COMPARISON OF POSITIVE BACTERIAL CULTURE RATE FROM URINE SPECIMEN AND CATHETER SWAB IN INDWELLING CATHETER PATIENTS 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.

HUBUNGAN TGF-β1 DAN ESTROGEN DENGAN VOLUME PROSTAT PADA PASIEN BPH, PASIEN TUA NON BPH, DAN PASIEN MUDA Soebhali, Boyke; Soetojo, Soetojo; Soebadi, Doddy M; Hendromartono, Hendromartono; 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.v16i1.356

Objective: To determine the correlation of TGF-b1 and estrogen with prostate volume in BPH patients, old patients without BPH and young patients. Materials and methods: We enrolled 30 patients and allocated them into three groups. First group consists of BPH patients, second group consists of old male patients with more than 55 years of age, and third group consists of young male patients with less than 40 years of age. We analyzed the level of TGF-b1 and estrogen in these patients. Transrectal USG was used to measure the prostate volume. We analyzed the correlations of TGF-b1 and estrogen level with prostate volume. Results: We found a positive strong correlation between estrogen and prostate volume in the BPH patient group (p=0,021; r coeff=0,786). Other group showed no significant correlations. Conclusion: Estrogen plays an important role in BPH pathophysiology. Further research on the influence of estrogen in BPH patients is recommended.

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