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A Systematic Review and Meta-Analysis of Non-Antibiotic Agents in Comparison to Antibiotic Therapies for Prevention of Recurrent Urinary Tract Infection Munawwir, Abdul; Syuaib, Achmad
Brawijaya Journal of Urology Vol. 5 No. 02 (2025): Brawijaya Journal of Urology
Publisher : Department of Urology, Faculty of Medicine, Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.11594/bjurology.2025.005.02.3

Introduction. Prolonged antibiotic usage can lead to modifications in the normal gastrointestinal tract and vaginal microbiome, which contributes to the UTI recurrence. This study aims to assess the impact of non-antibiotic therapies compared to antibiotic interventions in the prevention of recurrent urinary tract infections (UTIs). Methods. A systematic literature search was carried out from the PubMed, Google Scholar, Cochrane, and ScienceDirect databases published from 2013–2023, adjusted for inclusion and exclusion criteria. Keywords and Medical Subject Headings (MeSH) used were urinary tract infection, UTI, recurrent UTI, antibiotics, anti-bacterial agents, antimicrobial versus non antibiotic agents, probiotics, cranberries, D-mannose, vitamins, NSAID, prevention, treatment. The RevMan 5.3 program was used to analyze the risk of recurrent UTIs. Forest plot analysis was used to present relative risk estimates from individual studies and combined meta-analysis results. Results. Six studies were deemed eligible for quantitative synthesis and were included in this meta-analysis. This meta-analysis study showed a large heterogeneity, with p= 0.006 and I²= 85%. Pooled analysis using a fixed effect model showed the development of recurrent UTI was significantly lower in women with symptomatic UTI who were given non-antibiotic interventions compared to antibiotic interventions, with a relative risk of 0.75 (95% confidence interval (CI)= 0.61–0.92). This shows that non-antibiotic interventions significantly reduce the incidence of recurrent UTI compared to antibiotic interventions. Conclusion. Non-antibiotics interventions such as cranberry extract, D-mannose, NSAIDs, and herbal medicines can prevent recurrent UTI, and the results appear to be better or the same as antibiotic interventions. Meta-analyses should consider small numbers of studies with varying study designs and quality as well as small overall sample sizes.

Adherence to the Mediterranean Diet for a Better Sperm Quality: A Comprehensive Systematic Review and Meta-Analysis Munawwir, Abdul; Adhani, Zalsabila Tiara
Jurnal Gizi dan Pangan Vol. 20 No. 1 (2025)
Publisher : The Food and Nutrition Society of Indonesia in collaboration with the Department of Community Nutrition, IPB University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.25182/jgp.2025.20.1.61-70

The aim of this study is to investigate whether a higher adherence to the Mediterranean Diet (MD) can enhance reproductive indicators in infertile men. A comprehensive review and meta-analysis were conducted to assess whether increased adherence to the MD can enhance reproductive indicators in infertile men. An extensive search was conducted for pertinent studies in PubMed, Medline, and Google Scholar. The search included relevant publications published in the last 10 years from 2015. The Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) 2020 instrument was used to evaluate the studies. The study's quality was evaluated using the Newcastle-Ottawa Scale (NOS). The data were analyzed and evaluated using RevMan version 5.4.1. The data on sperm volume were not statistically significant. The meta-analysis indicated an odds ratio of 1.06 for low semen volume (<1.5 mL) associated with low adherence to the MD (I2=12%; 95% CI:0.59–1.93, p=0.84). Furthermore, the analysis revealed a 2.86-fold increase in the probability of achieving higher sperm concentration (>15 × 106/mL) in individuals who adhered to the MD (I2=33%; 95% CI:1.58–5.18, p=0.0005). The meta-analysis further suggests that adherence to the MD is associated with a 2.54-fold increase in the likelihood of improving sperm count (>39 × 106/ejaculate) (I2=48%; OR=2.54; 95% CI:1.32–4.90, p=0.005). The meta-analysis on sperm motility demonstrated that individuals who adhere strictly to the MD are more likely to exhibit normal motility (>40%) (I2=0%; OR=4.64; 95% CI:2.41–8.95, p<0.00001). The meta-analysis further revealed a 2.66-fold increased likelihood of better sperm morphology (>4%) (I2=0%; OR=2.66; 95% CI:1.39–5.10, p=0.003) in individuals adhering to the MD. The present systematic review with meta-analysis indicates that higher adherence to the MD is associated with improved sperm quality parameters (sperm count, sperm concentration, sperm motility, and sperm morphology).

Potential of Preoperative Testosterone Stimulation Therapy to Reduce Complication in Hypospadias Repair: A Systematic Review and Meta-Analysis Munawwir, Abdul; Mustamar, Fikri Akbar; Palinrungi, Muhammad Asykar; Aristo, Aristo
Brawijaya Journal of Urology Vol. 6 No. 01 (2025): Brawijaya Journal of Urology
Publisher : Department of Urology, Faculty of Medicine, Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.11594/bjurology.2025.006.01.4

Introduction. The pre-operative hormone stimulation is recommended for hypospadias patients, especially those with small penis, to improve the results and outcomes of hypospadias repair. We conducted a systematic review and meta-analysis to evaluate the effectiveness of pre-operative testosterone stimulations before hypospadias repair. Methods. We performed a comprehensive search for relevant studies from PubMed, Medline, Cochrane, Proquest, and Embase from August 2000 until August 2023 . The phrases "hypospadias" and "testosterone treatment" were utilized. Only studies focusing on patients diagnosed with hypospadias were considered. This analysis exclusively included English-language papers, randomized control trials, cohort studies, and case-control studies. Case studies without comparable groups were excluded. Editorials, comments, and review articles were excluded from the study. We used the PRISMA guidelines for this systematic review and meta-analysis report. RevMan version 5.4.1 was used to analyze and evaluate the data. Results. A total of 832 patients undergoing urethroplasty were evaluated in 7 studies. A total of 372 patients were categorized into the intervention group, which received testosterone hormone therapy (parenteral, intramuscular, and topical). Patients who receive preoperative testosterone therapy have a 0.68 reduced risk of complications rate compared to those who did not (P = 0.03, I2 = 28%, CI: 0.68, OR: 0.48 - 0.96), reduced meatal stenosis (P = 0.04, OR: 0.66, 95% CI: 0.44 - 0.98, I2 = 28), reduced the risk of postoperative glans dehiscence (P = 0.0004, OR: 0.46, 95% CI (0.30-0.71), I2 = 57%), and reduced risk of fistula urethrocutaneous (P = 0.03, OR: 0.58, 95% CI: 0.36 - 0.94, I2 = 22%). Conclusion. Pre-operative testosterone stimulation can improve surgical outcomes. Complication rates, such as meatal stenosis, glans dehiscence, and fistula, showed a significant effect in patients who intervened with testosterone stimulation pre-hypospadias repair. Keywords: hypospadia, improve, outcome, repair, testosterone

WEBBED PENIS : A RARE CASE REPORT Munawwir, Abdul; Tiara Adhani, Zalsabila
Medika Tadulako: Jurnal Ilmiah Kedokteran Fakultas Kedokteran Vol. 10 No. 1 (2025): Maret
Publisher : Universitas Tadulako

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22487/mtj.v10i1.1702

ABSTRAK Webbed penis adalah penyakit hipoplasia penis dan skrotum, yang dapat menyebabkan penampilan yang buruk pada ukuran penis, kelengkungan penis dan kasusnya jarang terjadi. Angka kejadian webbed penis sangat kecil. Pasien anak laki-laki dengan bentuk penis yang berbeda dari anak lainnya. Bentuk penis yang dimaksud orang tua pasien adalah bengkok dan tidak bisa diluruskan. Orang tua pasien mengatakan saat pasien buang air kecil tidak sepenuhnya memancar ke depan melainkan cenderung ke bawah karna penis tak dapat diluruskan. Terdapat preputium ventral yang terhubung ke skrotum. Webbed penis merupakan bagian dari inconspicuous penis atau kelainan genital dengan ukuran penis yang terlihat kecil. Pada pasien ini secara fisik didapatkan penis terlihat kecil. Selanjutnya, menurut teori pada pemeriksaan fisik ditemukan adanya pengangkatan kulit skrotum ketika penis ditarik ke atas, perlengketan penoscrotal dapat meluas dari kulit preputial ke dinding dinding skrotum dan kulit penis hilang pada bagian ventral penis. Webbed Penis dapat ditegakkan melalui anamnesis dan pemeriksaan fisik. Penatalaksaan pada webbed penis adalah rekonstruksi penis untuk memperbaiki sudut penostrotal. Terdapat tiga metode koreksi webbed penis, yaitu teknik Heineke-Mikulicz, V-Y, dan Z plasty. ABSTRACT Webbed penis is a disease of hypoplasia of the penis and scrotum, which can lead to poor appearance in penis size, curvature of the penis and cases are rare. The incidence of webbed penis is very low. The patient was a boy with a penis shape different from other children. The penis shape mentioned by the patient's parents was curved and could not be straightened. The patient's parents said that when the patient urinated, it did not go all the way forward, but tended to go downward because the penis could not be straightened. There is a ventral prepuce attached to the scrotum. Webbed penis is part of inconspicuous penis or genital disorder with small penis size. In this patient the penis was found to be physically small. In addition, according to the theory of physical examination, there is a lifting of the scrotal skin when the penis is pulled up, penoscrotal adhesions may extend from the preputial skin to the scrotal wall, and the penile skin is missing on the ventral part of the penis. Webbed penis can be identified by history and physical examination. The treatment of webbed penis is penile reconstruction to correct the penile-strostrotral angle. There are three methods of correction of webbed penis, namely Heineke-Mikulicz, V-Y and Z-plasty techniques.

PENILE CANCER AND MULTIPLE PREPUTIAL STONE: A RARE CASE REPORT Munawwir, Abdul; Yonatha, Teddy
Indonesian Journal of Urology Vol 32 No 3 (2025)
Publisher : Indonesian Urological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32421/juri.v32i3.940

Objective: This paper aims to report a case of penile cancer with multiple prepuce stones in a 46-year-old non-circumcised male. Case Presentation: A 46-year-old male patient came to the clinic with complaints of a slowly enlarging penis since the last 2 months. Complaints are accompanied by difficulty and pain when urinating, sometimes there are stones that come out when urinating. Physical examination revealed an enlarged penis, irregular shape, tenderness, unclear borders. Multiple prepuce stones, pus accumulation, and suspicion of malignancy in the penis were observed. Histopathology showed squamous cell carcinoma (SCC) of the penis. The patient was discharged 4 days postoperatively and prepared for follow-up treatment. Discussion: Penile cancer and prepuce stones are very rare cases. Smegma accumulation, chronic inflammation, and urinary stasis are the pathophysiology of penile cancer and prepuce stones. Conclusion: Penile cancer and preputial stones are very rare. We performed a surgical procedure to divert urine by urethral catheterisation, treated the infection and took penile tissue for biopsy, after which he was referred for further treatment. Keywords: Penile cancer, multiple prepuce stone, a rare case report.

ASSOCIATION BETWEEN VITAMIN D RECEPTOR GENE POLYMORPHISM AND RENAL CALCIUM STONES : A LITERATURE REVIEW Adhani, Zalsabila Tiara; Munawwir, Abdul; Sabir, M.
Medika Tadulako: Jurnal Ilmiah Kedokteran Fakultas Kedokteran Vol. 9 No. 2 (2024): Oktober
Publisher : Universitas Tadulako

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22487/mtj.v9i2.1571

ABSTRAK Latar Belakang : Penyakit batu ginjal (nefrolitiasis) mempengaruhi hampir semua populasi di seluruh dunia dengan prevalensi yang terus meningkat. Beberapa penelitian menunjukkan reseptor vitamin D (VDR) berkorelasi dengan pembentukan batu kalsium ginjal. Tujuan penulisan artikel ini adalah untuk menemukan hubungan antara polimorfisme gen reseptor vitamin D (VDR) terhadap pembentukan batu kalsium ginjal dengan melakukan tinjauan literatur terhadap penelitian sebelumnya sesuai dengan kriteria yang ditetapkan. Metode : Pencarian literatur dilakukan melalui beberapa database jurnal internasional yaitu Pubmed dan Google Scholar. Pencarian ini bertujuan untuk menemukan literatur yang berkaitan dengan polimorfisme reseptor vitamin D (VDR) dan batu kalsium ginjal. Pencarian literatur dilakukan dengan menggunakan kata kunci “vitamin D receptor polymorphism” dan “calcium renal stone”. Kami menetapkan kriteria inklusi dan ekslusi pada penelitian ini kemudian melakukan peninjauan literatur secera komprehensif terhadap penelitian yang relevan. Hasil : Kami melakukan peninjauan terhadap 10 artikel ilmiah yang memenuhi syarat dan telah menemukan hubungan antara VDR gen polimorfisme (ApaI, BsmI, FokI, and TaqI) terhadap pembentukan batu kalsium ginjal pada manusia. Kesimpulan : Terdapat hubungan antara VDR gen polimorfisme (ApaI, BsmI, FokI, and TaqI) terhadap pembentukan batu kalsium ginjal pada manusia. ABSTRACT Background : Kidney stone disease (nephrolithiasis) affects almost all populations worldwide with an increasing prevalence. Several studies have shown that vitamin D receptor (VDR) is correlated with renal calcium stone formation. The purpose of writing this article is to find the relationship between vitamin D receptor (VDR) gene polymorphisms and renal calcium stone formation by conducting a literature review of previous studies according to established criteria. Methods : Literature search was conducted through several international journal databases, namely Pubmed and Google Scholar. This search aims to find literature related to vitamin D receptor (VDR) polymorphisms and kidney calcium stones. The literature search was conducted using the keywords “vitamin D receptor polymorphism” and “calcium renal stone”. We set inclusion and exclusion criteria for this study and then conducted a comprehensive literature review of relevant studies. Results: We reviewed 10 eligible scientific articles and found an association between VDR gene polymorphisms (ApaI, BsmI, FokI, and TaqI) and calcium renal stone formation in humans. Conclusion : There is an association between VDR gene polymorphisms (ApaI, BsmI, FokI, and TaqI) and kidney calcium stone formation in humans.

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