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RELATIONSHIP BETWEEN TZI AND TZV WITH IPSS, QMAX, AND BOO Satyagraha, Paksi; Djojodimedjo, Tarmono; Wirjopranoto, Soetojo; Budiono, Budiono
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.v20i2.15

Abstract

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.
DOXAZOSIN AND MELOXICAM COMBINATION THERAPY FOR BPH TREATMENT WITH LUTS Suarsana, Wayan; Hardjowijoto, Sunaryo; Wirjopranoto, Soetojo; 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.v21i1.22

Abstract

Objective: To compare the efficacy of combination therapy of 4 mg doxazosin + 15 mg meloxicam with 4 mg doxazosin single therapy for benign prostate hyperplasia (BPH) patients with lower urinary tract symptoms (LUTS). Materials & Methods: A prospective, randomized and double blind study with total of 22 BPH patients with LUTS were randomized to receive 4 mg doxazosin + placebo once daily for 6 weeks or a combination of 4 mg doxazosin + 15 mg meloxicam once daily for 6 weeks. Inclusion criteria included IPSS ≥ 8, age > 50 years, prostate blood flow grade II. Therapeutic efficacy was assessed by comparing changes in IPSS, maximal urinary flow (Q-max) and changes in prostate blood flow between baseline and immediately after 6 weeks of therapy. Results: There was no significant difference in IPSS change between the two treatment groups (delta IPSS 4 ± 1.1 versus 3.7 ± 1.5, p = 0.630). There was a significant difference in Q-max changes between the two groups (delta Q-max 4 ± 1.5 versus 2.1 ± 0.7, p < 0.001). In group therapied with 4 mg doxazosin + 15 mg meloxicam prostate blood flow decreased from grade II to grade I in 9 of 11 patients (81%). Whereas, in the treatment group of 4 mg doxazosin + placebo no reduction was found in prostate blood flow. Conclusion: Combination therapy of 4 mg doxazosin + 15 mg meloxicam once daily for 6 weeks is better than 4 mg doxazosin therapy alone in improving Q-max and decreasing prostate blood flow in BPH patients with LUTS.Keywords: Benign prostate hyperplasia, inflammation, COX-2 inhibitors.
ANTIBIOTIC PROPHYLAXIS WITH DIFFERENT ANTIBIOTIC REGIMEN IN PROSTATE BIOPSY PATIENTS Wibisono, Dimas Sindhu; Soebadi, Doddy M.; Soetojo, Soetojo; Budiono, Budiono
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.v20i1.42

Abstract

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

Abstract

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.
DIFFERENCE IN SERUM PSA LEVEL AND IIEF-5 BEFORE AND AFTER TURP IN BPH PATIENTS WITHOUT URINARY RETENTION Hasibuan, Zulfian; Wirjopranoto, Soetojo; Djatisoesanto, Wahjoe; Pujiraharjo, Widodo J
Indonesian Journal of Urology Vol 19 No 1 (2012)
Publisher : Indonesian Urological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32421/juri.v19i1.54

Abstract

Objective: Determine change in serum prostate-specific antigen (PSA) and International Index of Erectile Function (IIEF-5) following transurethral resection of the prostate (TURP). Material & Method: Eighteen men with age range of 50 – 69 years, were divided in two groups, group I 50-59 years (mean 56,5) and group II 60-69 years (mean 67,2). Both groups underwent measurement of serum PSA and IIEF-5 pre-operative, and repeated at 30, 60, and 90 days after TURP. Results: Level of serum PSA after TURP is decreased in most patients after 30, 60, and 90 days (72%, 72% and 78%). Mean value of PSA pre-operatively is 5,3 ± 3,3 ng/ml. After TURP, serum PSA level was 3,5 ± 3,0 ng/ml (30 days); 2,9 ± 2,9 ng/ml (60 days) and 1,8 ± 1,3ng/ml (90 days). Pre-operative PSA level was significantly decreased in Group I during the 60 and 90 days post TURP, while in Group II pre-operative PSA level was significantly decreased only in 90 days of observation. Overall there is no significant difference in PSA levels in both groups (p > 0,05). The decrease of PSA per gram resected in 30, 60, and 90 days were 0,10 ng/ml; 0,16 ng/ml and 0,24 ng/ml consecutively. There is no change in normal IIEF-5 score. Decrease of the IIEF-5 score in group I was measured at 30 days, but the score increased after 60 and 90 days. Meanwhile Group II showed decrease of IIEF-5 score. Pre-operative IIEF-5 score compared to the 30 days post TURP was significantly different but not significantly different compared with to score at 60 and 90 days. In Group I IIEF-5 score was significantly higher compared to Group II (p < 0,05). Prostatitis was found in 8 patients, but there is no difference in serum PSA level decrease between patients with or without prostatitis. Conclusion: There was significant decrease in serum PSA after TURP in BPH patients with LUTS at every measurement at 30, 60, and 90 days. PSA level after TURP depends on various factors, including pre-operative PSA, pre-operative prostate volume and prostate volume resected. Incidence of erectile dysfunction post TURP was low. Keywords: Prostate-specific antigen, benign prostatic hyperplasia, transurethral resection of the prostate, erectile dysfunction.
TOTAL CHOLESTEROL AND C-REACTIVE PROTEIN LEVELS AS A PROGNOSTIC MARKERS OF UROSEPSIS wahyudi, septa surya; Hardjowijoto, Sunaryo; Soebadi, Doddy M; Soetojo, Soetojo; Djojodimedjo, Tarmono; Budiono, Budiono
Indonesian Journal of Urology Vol 23 No 1 (2016)
Publisher : Indonesian Urological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32421/juri.v23i1.198

Abstract

Objective: To investigate whether total cholesterol and C-reactive protein levels could be use as a prognostic factor for outcome in patients with urosepsis. Material & Methods: An analytic observational study using 30 patients assigned for total cholesterol and CRP level at the day of admission, three days later, and on the last day of sepsis or on the dead day. All subjects were managed according to standard urosepsis therapy. At the 14th day of treatment, patients were evaluated with a clinical severity score. Then we classified the outcome as improve/good condition, worse, and died. The variables were statistically tested using Spearman’s rho test with software SPSS 20. P < 0.05 was consider significant. Result: From 30 subjects with urosepsis, we found 15 patients in septic condition, 14 patients had severe sepsis and one patient had septic shock. The mean of total cholesterol level in patient with died and worse was lower than that in patient with good outcome. Day-1 (63.25 mg/dl and 101.38 mg/dl vs 119.5 mg/dl), day-3 (56.0 mg/dl and 93.6 mg/dl vs 128.6 mg/dl) and last day/died day (51.0 mg/dl and 82.25 mg/dl vs 154.8 mg/dl). The mean of CRP level in patient with died and worse was higher than that in patient with good outcome. Day-1 (177.18 mg/l and 146.74 mg/l vs 88.1 mg/l), day 3 (127.1 mg/l and 148.8 mg/l vs 56.2 mg/l) and last day/died day (141.88 mg/l and 88.71 mg/l vs 31.58 mg/l). These were statistically significant between total cholesterol and CRP levels in determining the outcome of urosepsis patient. Day-1 (p 0.000 vs 0.011), day-3 (p 0.000 vs 0.002), and last day/died day (p 0.000 vs 0.000). The coefficient correlation total cholesterol was better than CRP in day-1 (rho -0.633 vs 0.459), day-3 (rho -0.755 vs 0.543), and last day/died day (rho -0.874 vs 0.686). Conclusion: Low total cholesterol and high C-reactive protein levels can be used as poor prognostic in urosepsis patients. Total cholesterol level was better than CRP as a prognostic marker.
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

Abstract

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.
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

Abstract

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

Abstract

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.
PERBEDAAN IPSS, Q MAX, DAN VOLUME PROSTAT PADA PEMBERIAN KOMBINASI INHIBITOR 5α-REDUKTASE (DUTASTERIDE) DAN ANTI ESTROGEN (TAMOXIFEN) PADA PASIEN BPH YANG MENGALAMI LUTS TANPA KOMPLIKASI Seputra, Kurnia Penta; Soetojo, Soetojo; Soebadi, Doddy M
Indonesian Journal of Urology Vol 15 No 2 (2008)
Publisher : Indonesian Urological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32421/juri.v15i2.351

Abstract

Objective: To compare the IPSS, Q max, and volume of the prostate pre and post treatment of 5α-reductase inhibitor and tamoxyfen in patients with BPH. Material and Methods: We collected 40 patients who had been diagnosed as BPH without urine retention. They were classified in to 4 groups, each group contained of 10 patients who were given tamoxifen, dutasteride, combination tamoxyfen with dutasteride, or placebo. We recorded IPSS, uroflow, and volume of the prostate before and after 3 months of medication. Data were analyzed by the SPSS 12 program. Results: Q max (7,75 + 3,5538 to 9,15 + 2,9448) and IPSS (z score –1,633) after treatment with tamoxyfen (p > 0,05) was not improved. We found significant decrease of the prostate volume (40,124 + 7,9129 to 36,323 + 8,2573) after treatment with tamoxifen (p < 0,05). There is significant improvement of Q max (9,55 + 3,2793 to 15,12 + 4,3522), IPSS (z score –2,887), and significant decrease of the prostate volume (30,93 + 9,0031 to 24,506 + 7,3267) after treatment with dutasteride (p < 0,05). There was also significant improvement of Q max (6,55 + 2,5435 to 8,86 + 4,4475), IPSS (z score –2,449), and decrease of prostate volume (31,403 + 9,0031 to 26,78 + 7,3267) after treatment with the combination dutasteride and tamoxifen (p < 0,05). None of those parameters were improved in placebo group. Conclusion: Q max and IPSS improve significantly in the dutasteride and the combination group. There was a significant decrease of the prostate volume in all groups except the placebo group.
Co-Authors A.A. Ketut Agung Cahyawan W Affandi, Reza Ahmad Kholis Anny Setijo Rahaju, Anny Setijo Aril Rizaldi Ariyo Sakso Bintoro, Ariyo Sakso Azmi, Yufi Aulia Bambang Soeprijanto Boyke Soebhali, Boyke Dimas Sindhu Wibisono Djoyo M Boetoro, Djoyo M Doddy M Soebadi Doddy M. Soebadi Edwin Ongkorahardjo, Edwin Endang Joewarini Faadilah, Ashifa Hasna Farezi, Reza Adrio Haditanojo, Wiyanto Hariyoto, Bangun Oktavian Harmaya, Andri Kusuma HASAN MADANI Hendromartono Hendromartono, Hendromartono HERAWATI, LILIK Herdiansyah, Akbar Dimas Hoetama, Sakti Indarjadi, Ignasius Jamhari, Muhammad Arif Hakim Jayanti Dian Eka Sari, Jayanti Dian Kenconojati, Hapsari Khoirul Kholis, Khoirul Krismaningrum, Veronika Intan Kurnia Penta Seputra Lukman Hakim Moh. Ayodhia Soebadi Mufasirin Muhammad Reza Gautama Muhammad Rozaqy Ishaq Muris, Haviv Muslimah, Bintang Nafis Audrey Febriansyah Negara, Muhammad Surya Nurdin, Ambo Tuwo Nurdin, Ambo Tuwo Nurfaizah, Diza Ulya Oktaviani, Dian Paramita Paksi Satyagraha Praja, Ratih Novita Pratama, Widya Sakti Puspikawati, Septa Indra Rachmat Budi Prasetyo, Rachmat Budi Rakhmatiar, Fadhilla Riza Mazidu Sholihin Rizaldi, Aril S.Pd. M Kes I Ketut Sudiana . Saksono, Bayu septa surya wahyudi, septa surya Sirait, Binsar Marshall Maranatha Soebadi, M Ayodhia Sukarno, Gerda Sunaryo Hardjowijoto Surya, Prima Ardiansah Susilo, Rahadian Indarto Syakri Syahrir, Syakri Tarmono Djojodimedjo wahjoe djatisoesanto Wayan Suarsana Widodo J P Widodo J Pujiraharjo Yuanda, Rameshdo Yudhana, Aditya Zamroni Zamroni Zulfian Hasibuan